Assessment of biodegradable chelating agents in the phytoextraction of heavy metals from multi-metal contaminated soil

A pot incubation experiment under natural conditions was designed to investigate the effects of three biodegradable chelating agents, namely; the [S,S]-isomer of ethylenediamine disuccinate (EDDS), citric acid (CA), and tetrasodium N,N-Bis(carboxymethyl)-L-glutamate acid (GLDA), on two plant species (Brassica juncea and Brassica rapa) in terms of plant foliar growth, dry matter yield, and heavy metal (HM) accumulation. Both plant species exhibited diminished growth and symptoms of phytotoxicity under HM stress. The application of EDDS and CA affected plant foliar growth, biomass production, and led to the development of chlorotic lesions on leaves. EDDS and CA also decreased the shoot length by 38.5% and 45.2% in B. juncea, and 60.1% and 100% in B. rapa, respectively. In contrast, GLDA relieved HM stress by significantly increasing plant growth (P > 0.05) and was shown to be well tolerated (tolerance index [TI]; B. juncea = 99% and B. rapa = 123%). Among both plants, B. juncea displayed the ability to accumulate a wider range of HMs at higher concentrations. Amongst the three chelators, EDDS induced the highest bioconcentration (BCF) of Pb (2.45), Zn (2.68), and Cd (3.36) while CA achieved better results for Ni (4.01) and Cr (1.45). However, the current results showed that even with the application of chelating agents, HMs were predominantly accumulated in roots and translocation factor was generally <1. The findings of this investigation emphasize that chelate-assisted phytoextraction with Brassica spp. is highly limited in multi-metal settings, making it an unsuitable option for severely contaminated sites.

[Spontaneous triple pregnancy on bicicatricial uterus in the referral health center of commune II of Bamako, Mali]

The trimellar pregnancy on bicicatricial uterus is a rare situation. It can be associated with many maternal-fetal complications. Given these risks, some teams opt for an embryonic reduction. We report a case of spontaneous trimellar pregnancy on bicicatricial uterus. This was a 38 year-old patient, third pregnancy, second birth, 2 alive with a history of 2 caesareans. The evolution of the pregnancy was marked by a urinary tract infection at 34 weeks of gestation. The caesarean section performed at 36 weeks of gestation allowed the birth of 3 newborns, 2 of which were females in 2000 and 1900 grams, and one male weighing 2400 grams. The postpartum was marked by a rapidly resolved eclampsia crisis.

[Ct scan diagnosis of polyostotic fibrous dysplasia with maxillofacial dysmorphia: a case report]

We report a rare case of polyostotic fibrous dysplasia with maxillofacial dysmorphia diagnosed in the radiology department at Hopital Sominé Dolo of Mopti. The aim was to describe the role of medical imaging including the CT scan in its diagnosis. He was a 42-year-old man of rural origin with poor socio-economic conditions. He was sent to us for a craniofacial CT scan for assessment of a maxillofacial mass. This CT scan showed a thickening of the diploid of the vault and the cranial base with osteocondensation and osteolytic lesions at the maxillofacial level. An extension assessment showed polyostotic involvement. His diagnosis is based on medical imaging and in particular CT scan. Three types of radiological aspects are evocative: a homogeneous or heterogeneous clarity, a smoke-like appearance and a slightly condensed appearance. Complications observed were deformities, fracture of the femoral neck and aesthetic damage.

[Materno-Fetal Prognosis Of Anemia In Bougouni]

GOAL

The goal was to assess the maternal-fetal prognosis of anemia in pregnant women in the Bougouni reference health center.

METHODS

We carried out a prospective descriptive and analytical cross-sectional study from January 1 to December 31, 2013 at the Bougouni reference health center. It covered all pregnant women with a hemoglobin level below 11g/dl regardless of the outcome of the pregnancy.

RESULTS

The prevalence of anemia in pregnant women was 33.2%. They were women married to peasants in 88.6% of cases, unschooled in 93.2% of cases, having not done antenal care in 56.8% of cases. Malaria was the most common etiology in 75% of cases. Anemia was severe in 61.4% of cases. The maternal-fetal prognosis was dominated by 3.3% of maternal death, 12.5% of abortion, 7.6% of prematurity and 6.8% of fetal death in utero.

CONCLUSION

Anemia in pregnant women is the source of many maternal-fetal complications.

[Pregnancy And Delivery In The Large Multiparous In The Reference Health Center Of Commune II Of Bamako, Mali]

AIM

The aim was to compare the maternal-fetal prognosis of pregnancies in large multiparous with that of other parities.

MATERIALS AND METHODS

We conducted a case-control study from March 1st, 2014 to February 1st, 2015. It concerned all parturients admitted in our service during the study period. We have chosen 1 case for 2 witnesses. All the large multiparous were included as cases and as witnesses the primiparous, the pauciparous and the multiparous who gave birth just before and after the case. The statistical test was the Chi2 with a significance level at 5%.

RESULTS

The frequency of pregnancy in the large multiparous was 4.93%. They were housewives in 84% of cases, unschooled in 74.7% of cases. The maternal-fetal outcome was dominated by uterine rupture in 0.6% of cases, immediate postpartum hemorrhage in 9.8% of cases, vicious presentations in 5.5% of cases and cord prolapse in 6.8% of cases.

CONCLUSION

Large multiparity is common in our practice. It is a high-risk pregnancy because of its many maternal-fetal complications.

[Pregnancy and delivery for women aged 40 years and over at the reference health center of commune II of Bamako district, Mali]

GOAL

The aim of this study was to compare the maternal-fetal prognosis of pregnancies at 40 years of age and above with that of pregnancies obtained before 40 years of age in the obstetric gynecology department of the reference health center of commune II of Bamako district.

MATERIALS AND METHODS

This was a prospective cohort study that was conducted at the maternity ward of Reference Health Center of Commune II of Bamako district from 1st January to 31 December 2012. Were included in our study as patients exposed, all the pregnant women of 40 years and over and as unexposed patients, pregnant women aged 20-39 who gave birth in our service. Teenage pregnancies were not included in this study. The statistical tests used were Pearson's Khi2 and Fisher's test with a significance level of 5%.

RESULTS

The frequency of pregnancy among women aged 40 and over was 1.68%. These were large multiparas unschooled patients in 60% of cases, with hypertension in 6.7% of cases. Pregnancy in her patients was associated with a high rate of caesarean section in 16.7% of cases, term overrun in 6.7% of cases, seat presentation in 6.7% of cases, macrosomia in 6.7% of cases and fetal malformation in 1.7% of cases.

CONCLUSION

Slight account of its many maternal-fetal complications, pregnancies in women 40 years and older deserve special attention.

[Assessment of the use of partogram at the district maternity hospital of commune II in Bamako area]

OBJECTIVE

To estimate the use of the partogram at the district hospital of commune II in Bamako area; to identify the risk factors by pregnant women and her newborn babies ; to appreciate the filling quality of the partogram; to determine the sensibility, the specificity and the predictive worth of the alert line.

METHOD

Our study has been conducted at the district hospital of commune II in Bamako area because of his high examination rate. The study was retrospective, analytic and transversal, conducted during 12 months (from first January 2005 to 31 st December 2005). Were considered in this study, partograms of all pregnant women, who have been admitted to delivery in the hospital during the study period and whom labor was monitored with partogram from latence phase or active phase. Were excluded, partograms of women, who has delivered at home, the one who have suffered prophylactic cesarean and the one who have been admitted with a cervix dilatation ≥8 cm.

RESULTS

287 partograms ( 18,85%) were correctly filled; 64% of the deliveries were performed left of the alert line; 31,3% right of the alert line; 4,7% right of the action line. 83,04% of the pregnant women performed at least one prenatal examination, the age bracket of 15 to 19 years shows a little predominance with 27% of cases; 46,71% among them have delivered right of the alert line. The primigravidas represent 32% of the sample; among them, 38% got over the alert line and 7,93% the action line. Women smaller than 150 cm represent 1,05% ( 16 cases). In this bracket 68,75% ( 11 cases) suffered caesarean, 31,25% (5 cases) delivered normal. The caesarean has been performed again by 61,45% of the pregnant women, who had a previous cesarean, 29,52% have delivered normal. Concerning the newborn babies, 1,24% coming from the 84,95% deliveries whom labor time was lower than 10 hours, 51,98% those coming from the 13,27% deliveries whom labor time was between 11 and 24 hours, 100% of those coming from the 1,77% deliveries whom labor time was over 24 hours, had a low Apgar score at birth. 65,06% of the newborn babies delivered from the 5,45% women with greenish amniotic liquid have a low Apgar score against 3,32% of those from 73,32% with clear amniotic liquid.

[Neurologic disorders in pregnancy and post-partum period at the neurology service of Chu du Point-G and the referral center of the Commune V of Bamako]

The objective of the study was to describe epidemiological and clinical characteristic of acute vascular accidents, epilepsies and eclampsy, observed during the periods of pregnancy and post delivery. The study was prospective, conducted during 19 mouths from August 2005 to February 2007. Women aged from 15 to 45 years were considered, presenting neurological disorders. Among 6914 consulted patients, 37 were recruited and presenting required criteria of neurological disorders (3.02%). Most of the case (48.7%) were between the ages of 15 to 25 years. Epilepsy was detected in 51.40% of this group, acute vascular accidents 37.83% and eclampsy 13.51% of the cases. The evolution of the pregnancy was favorable eutopic delivery was frequent, only 1 caesarean has been registered.

[Assessment of the use of partogram at the district maternity hospital of commune II in Bamako area]

OBJECTIVE

To estimate the use of the partogram at the district hospital of commune II in Bamako area; to identify the risk factors by pregnant women and her newborn babies; to appreciate the filling quality of the partogram; to determine the sensibility, the specificity and the predictive worth of the alert line.

METHODOLOGY

Our study has been conducted at the district hospital of commune II in Bamako area because of his high examination rate. The study was retrospective, analytic and transversal, conducted during 12 months (from first January 2005 to 31 st December 2005). Were considered in this study, partograms of all pregnant women, who have been admitted to delivery in the hospital during the study period and whom labor was monitored with partogram from latence phase or active phase. Were excluded, partograms of women, who has delivered at home, the one who have suffered prophylactic cesarean and the one who have been admitted with a cervix dilatation ≥ 8 cm.

RESULTS

287 partograms (18.85%) were correctly filled; 64% of the deliveries were performed left of the alert line; 31.3%right of the alert line; 4.7% right of the action line. 83.04% of the pregnant women performed at least one prenatal examination, the age bracket of 15 to 19 years shows a little predominance with 27% of cases; 46.71% among them have delivered right of the alert line. The primigravidas represent 32% of the sample; among them, 38% got over the alert line and 7.93% the action line. Women smaller than 150 cm represent 1.05% ( 16 cases). In this bracket 68.75% (11 cases) suffered caesarean, 31.25% (5 cases) delivered normal. The caesarean has been performed again by 61.45% of the pregnant women,who had a previous cesarean, 29.52% have delivered normal. Concerning the newborn babies, 1.24% coming from the 84.95% deliveries whom labor time was lower than 10 hours, 51.98% those coming from the 13.27% deliveries whom labor time was between 11 and 24 hours, 100% of those coming from the 1.77% deliveries whom labor time was over 24 hours, had a low Apgar score at birth. 65.06% of the newborn babies delivered from the 5.45% women with greenish amniotic liquid have a low Apgar score again 3.32% of those from 73.32% with clear amniotic liquid.

[Dysmenorrhea in adolescents: epidemio-clinical study at the referral health center, Bamako District. Report of 300 cases]

This clinical epidemiological study has been conducted at the district hospital of Commune II in Bamako area.Dysmenorrhea has become a very common feature during out patients consultation. It affects almost one adolescent out of 3 examined during this study which represent 42, 8% of the studied population ranged from 10 to 19 years, with a men age of 16 years. Most of them were household women (50%),never pregnant (60%) and never delivery (64%). Most of them have been mainly claiming about contraction pain (33%) and discomfort (17,3%). The pain has been followed by asthenia (86,7%), and irritability (87,7%).Dysmenorrhea was a major cause of absenteism (48,3%). The factors influencing this type of dysmenorhea was the age and psychological stress.

[Induced abortion. Report of 180 cases at the Gabriel Toure Hospital]

A prospective case study on provocated abortion has been conducted at gynaecology and obstetric department of Hôpital Gabriel Touré from September 2003 to June 2004. We included in the study 180 cases and 360 controls (normal delivery pregnant women) matched by age to the cases. 5 04% of our cases undergone a provocated abortion; in 47.8%, the abortion was provoked by paramedical personal. Hemorrhagic complication was noted in 71.1%. The main reason of provocated abortion was single women, family pressure, fair of society and uncontrolled contraception.

[Socio-demographic and prognostic aspects of unfollowed pregnancies of patients admitted in the Department of Gynaecology-Obstetric of Gabriel Toure Hospital]

The prenatal followed up permit, on the one hand, to track down risk pregnancies, to appreciate the evolution of pregnancy and its repercussion on the maternal state, to finally make the prognosis of the childbirth and on the other hand to identify risk pregnancies and to assure a management outside emergency context. They contribute this fact to the meaningful reduction of the maternal mortality. The non followed up pregnancies are characterized by their important maternal and fetal mortality and morbidity. The aim of our survey was to determine the frequency of the unfollowed pregnancies, to describe the socio demographic profile of the women and to determine the prognosis of these pregnancies.

MATERIAL AND METHODS

Our survey had for setting the service of Gynecology and obstetrics of Gabriel Touré hospital. Center of cares, research and formation, this service that is 3rd level in the sanitary pyramid in Mali, receives emergencies from other motherhoods of lower level. Were include in this survey, women who delivered in the service and hadn't done any prenatal consultation. Criterias of non inclusion were next one: women having done at least a prenatal consultation, women having delivered in another sanitary structure, all cases of non assisted childbirths, women whose gestational age is lower to 28 weeks and/or fetal weight lower than 500 grams. Every case has been matched to a witness (consistent woman who has been followed and delivered in the service) according to criterias of age and parity. The statistical tests used to study associations between variables are the chi2 with a significativity doorstep of P = 0.05 and Odd ratio (OR).

RESULTS

We recorded 2173 childbirths and 286 non followed pregnancies been 13.16% of frequency. The middle age of our patient was 23 years with extremes of 16 and 44 years, nullipareses represented 25.9% of cases. The domestic helps were more numerous in the group of cases with 4.9% against 0.3% in the witness group (P = 0.0006, OR = 14.6; IC [2.01, 30.05]). The maternal prognosis is marked by 2.1% of death (P = 0.013). Fetal prognosis is bad with 10.9% of child stillborn (P = 0.0007; OR = 3.19) and 21.5% of morbid APGAR.

CONCLUSION

The absence of prenatal consultation is associated to a height maternal and fetal mortality and morbidity.

[Association of extrauterine and intrauterine pregnancy: 3 cases]

Extra uterine pregnancy (GEU) constitutes, by its frequency a problem of public health, by its gravity an obstetric emergency and a problem of fertility for the woman. It represents the chief reason of maternal death during the first quarter of pregnancy. The association of extra-uterine and intra-uterine pregnancy is a particular case of twin pregnancy said ditopic. It is rare, but non exceptional. The authors bring three cases to remind us of its existence.

VAGINAL HYSTERECTOMY IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY OF THE Point "G" HOSPITAL

Our survey consisted in evaluating the prevalence, specifying the indications and describing per and post - operation complications of vaginal hysterectomy in the Department of Gynecology and Obstetrics of the National Hospital of "Point G ". We conducted a descriptive retrospective survey on 58 cases of vaginal hysterectomies performed in that Department from 1995 to December 2000. Vaginal hysterectomies represented 27.3% of all hysterectomies done in the Department. The mean age of the patient was of 56 +/-2 years. The mean parity was 8. In 91.4% of cases this intervention was a step of the cure of a 3rd degree genital prolapsus. Ménométrorragia represented 5.2%, myomatus delivered by the cervix represented 1.7% and high rank cervical dysplasis was 1.7%. Per and post - surgery complications were dominated by perineal infections (5.2%), hemorrhage (1.7%) and urine retention (1.7%). The mean length of hospitalization was of 7+/-2 days. Vaginal hysterectomy is praticable in our context and secondary morbidity remains within acceptable limits. Because of its advantages this technique must be popularized.

Serum levels of the proinflammatory cytokines interleukin-1 beta (IL-1beta), IL-6, IL-8, IL-10, tumor necrosis factor alpha, and IL-12(p70) in Malian children with severe Plasmodium falciparum malaria and matched uncomplicated malaria or healthy controls

Inflammatory cytokines play an important role in human immune responses to malarial disease. However, the role of these mediators in disease pathogenesis, and the relationship between host protection and injury remains unclear. A total of 248 cases of severe Plasmodium falciparum malaria among children aged 3 months to 14 years residing in Bandiagara, Mali, were matched to cases of uncomplicated malaria and healthy controls. Using modified World Health Organization criteria for defining severe malaria, we identified 100 cases of cerebral malaria (coma, seizure, and obtundation), 17 cases of severe anemia (hemoglobin, <5 g/dl), 18 cases combined cerebral malaria with severe anemia, and 92 cases with hyperparasitemia (asexual trophozoites, >500,000/mm3). Significantly elevated levels (given as geometric mean concentrations in picograms/milliliter) of interleukin-6 (IL-6; 485.2 versus 54.1; P = <0.001), IL-10 (1,099.3 versus 14.1; P = <0.001), tumor necrosis factor alpha (10.1 versus 7.7; P = <0.001), and IL-12(p70) (48.9 versus 31.3; P = 0.004) in serum were found in severe cases versus healthy controls. Significantly elevated levels of IL-6 (485.2 versus 141.0; P = <0.001) and IL-10 (1,099.3 versus 133.9; P = <0.001) were seen in severe malaria cases versus uncomplicated malaria controls. Cerebral malaria was associated with significantly elevated levels of IL-6 (754.5 versus 311.4; P = <0.001) and IL-10 (1,405.6 versus 868.6; P = 0.006) compared to severe malaria cases without cerebral manifestations. Conversely, lower levels of IL-6 (199.2 versus 487.6; P = 0.03) and IL-10 (391.1 versus 1,160.9; P = 0.002) were noted in children with severe anemia compared to severe malaria cases with hemoglobin at >5 g/dl. Hyperparasitemia was associated with significantly lower levels of IL-6 (336.6 versus 602.1; P = 0.002). These results illustrate the complex relationships between inflammatory cytokines and disease in P. falciparum malaria.

[Complications of illegal induced abortions at Bamako (Mali) between December 1997 and November 1998]

We carried out a descriptive retrospective study over a period of one year, in the Gynecology and Obstetrics Referrals Department of Gabriel-Touré Hospital at Bamako. We analyzed 1,081 files of patients presenting at the department with complications of spontaneous or induced abortion. We identified and studied 189 cases of illegal induced abortions. The patients were young (mean age 21.8 years), of a low socioeconomic level and most (71.4%) had no living child. The gestational age of the fetus was less than 12 weeks for 19.5% of the women and between 13 and 16 weeks for 47.6%. The abortions were carried out by traditional practitioners (3.7%), general practitioners (9%), trainee nurses (10.5%) and state nurses and midwives (57.1%). In more than half the cases (71.4%), the abortion took place at the home of the practitioner. Several methods of abortion were used (e.g. curettage, uterine probes). In 44.4% of the cases, the woman refused to comment on the reasons for the abortion. The other women cited mostly academic reasons (20.63% of cases) and fear of their parents (13.22%). The main reasons for consultation were bleeding (51.3%), hyperthermia (35.4%), pain (9. 52%) and neurological problems (3.1%). Three types of complication were identified: bleeding (47%), infectious complication (33.3%) and drug poisoning (4.2%). The rate of maternal mortality was 10% and the management of the patients required surgical (from curettage to hysterectomy) and medical treatment, with a mean stay in hospital of 10 days.