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Biomedical subjects

M Diarra

Publications and source records attributed to M Diarra.

18 recordsLinked to original sources
PubMed2006

[Implementation of the hypertension network in Mali (RHYTM)].

In view of the rising prevalence of arterial hypertension and its complications throughout sub-Saharan Africa including in rural areas, the Association of the Rural Doctors of Mali asked its NGO partner, Sant6 Sud, for assistance in setting up a medical network dedicated to hypertension. This report describes the implementation of the Mali Hypertension Network (French acronym, RHYTM) that involved three stages, i.e., physician training, development of appropriate protocols and field trials. The physician training stage was carried out over a one-week period and covered all the aspects of hypertension. In the second stage international guidelines were used as a basis for development of appropriate protocols for the rural setting. Field trials were conducted in the villages to verify the feasibility of the protocols and functionality of the network. Treatment of hypertension depends mainly on lifestyle and dietetic measures with emphasis on reducing salt intake. Drug treatment is based primarily on first-intention use of thiazidic diuretics. Management of this chronic pathology runs up against socio-cultural, economic and logistic obstacles. These problems are discussed and possible solutions are proposed. This preliminary experience will provide epidemiologic and clinical data on a sample population including more than 80000 people and explore the possibility of extending the network to other zones in this area of Africa.

Delivery of Health Care↗
PubMed2005

[Intestinal parasitosis during AIDS diarrhoea].

The main goal of this work was to study the parasitic infections during AIDS diarrhoea. A longitudinal study was carried out from October 2000 to November 2001 in the Hepato-Gastro-Enterology department of Gabriel Toure Hospital and in the Department of Epidemiology and Parasitic infections of Faculty of Medicine, Pharmacy and Odonto-stomatology of Bamako (Mali), concerning HIV positive patients suffering from diarrhoea. Detecting microbes in stools has been done through direct microscopic examination and according to procedures of Henricksen Poblenz Baerman, Kato Katz and the PCR. Among the 70 patients involved, the sex-ratio was 53%, the average age was 35 +/- 8.4 years. Fever weight loss, skin affections and digestive mycosis were often associated. Opportunistic infections have been relatively frequent with Cryptosporidium parvum with 20%, Isospora belli with 8.5% and Microsporidium with 11.5% of cases. Other non-opportunistic microbes were found. Death within the first two weeks seems more important in case of infection by Cryptosporidium parvum. The frequency and the danger of those opportunistic infections require their efficient diagnosis and care management.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Prescription and use of benzodiazepins in Saint-Louis in Senegal: patient survey].

Prescription and use of benzodiazepins were evaluated with a patients survey. Direct interview were conducted with 150 patients in ten pharmacies in the city of Saint-Louis, Senegal from January to June 2002. Ten of the 15 retail pharmacies in this city agreed to participate in the survey. All patients gave their agreement to participate to the study; the questionnaire contained essentially closed questions. Writers of prescriptions were general practitioners (38.67%), specialists (34.67%), nurses (18%) and midwifes (8.66%). The most prescribed benzodiazepins were prazepam, dipotassic clorazepate, lorazepam and diazepam. Use of these drugs during night is most recommended. Nevertheless, 26.67% of the prescriptions indicated the drug should be use during the day. The period of use was between one and three Months for 33.99% of patients and three Months or more in 42%. Benzodiazepins were used by 66.67% for insomnia, alone or associated with another condition, for anxiety by 14.6% and for epilepsy by 10%. Prescriptions were for benzodiazepins alone in 47.37% of the patients and in combination with other psychotropic drugs for 19.33%. Somnolence and dependence were the most reported side effects.

Adult↗
PubMed2004

[Study of antigen HBs and antivirus antibodies of hepatitis C during hepatopathies in Mali].

A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed the seroprevalence of hepatitis C virus (HCV) in 91 carrier patients of chronic hepatopathy at a cirrhrosis stage (53) or of hepato-cellular carcinoma (38) and to compare with in 92 blood donors as a control population. Only seroprevalence confirmed by a complementary test has been taken into account (RIBA). HCV seroprevalence reached 25% including all hepatopathies, 24% in cirrhrosis and 26% in hepato-cellular carcinomae (HCC) versus 4% in blood donors. Antigen HBs of hepatitis B virus has been found in 55% of patients, versus 25% of the control cases (p = 0.0006). On the whole, the two markers have been notified a little more often in HCC than in cirrhosis and the combination of the two markers has been more frequent during cirrhosis as well. The role of HCV played in cirrhosis and HCC onset in Mali appears to be important.

Adult↗
PubMed2004

[Sodium fluoride controlled release system for intra buccal use].

Hydroxyapatite which has the same elemental chemical composition as natural bone and teeth is one of the promising raw material for the design of drug controlled release system in intrabuccal use. It is stable and biocompatible and widely used in orthopedics and odontology. So, in order to improve the administration of drugs for intrabuccal use, we have developped a fluoride controlled release delivering system. We have formulated tablets of 160 to 200 mg to be fixed on the vestibular face of a molar or a premolar and permitting to reach high enough local concentrations for desirable therapeutic effect. The tablets have a granular matrix composed of hydroxyapatite and fillers, ethylcellulose and/or Eudragit. For all tablets, the pharmacotechnical values support the pharmacopoeia norms. On fragments of tissue maintained in culture, the sodium fluoride is released at constant rate. The release profiles observed are predictable. No disintegration of tablets have been observed during release studies and after. Histological analyses performed after release studies showed the biocompatibility qualities of the tablets.

Administration, Topical↗
PubMed2003

Fluoride controlled release tablets for intrabuccal use.

We have developed a fluoride controlled release delivering system for intrabuccal use, permitting to reach high enough local concentrations for desirable therapeutic effect with minimal side effects. We have formulated tablets of 160-200mg intended to be fixed on a tooth. The tablets have a granular matrix composed of pure hydroxyapatite, Eudragit((R)) and/or ethylcellulose. NaF is added either by a mechanical mixing or an impregnation method. Profiles of continuous in vitro drug release in saline phosphate buffered solution were recorded by means of a fluoride selective electrode. Linear profiles are observed when ethylcellulose is used. The most reproducible results are obtained when the impregnation method is used. Eudragit((R)) increases the dissolution efficiencies while ethylcellulose decreases it.

Administration, Buccal↗
PubMed2003

[Sickle cell disease neonatal screening. First evaluation].

A neonatal screening allows a preclinical diagnosis of major sickle cell syndromes and an early management of the affected children. That would improve their life quality and expectancy. The preliminary program was set up on 518 senegalese newborn aged from 1 to 4 days, and coming from all the country ethnic groups. Isoelectrofocalisation is the test used on dried blood eluate and the positive control on citrate agar gel. 478 samples out of 518 (92.5%) have been analysed. Haemoglobinopathy have been found in 11.1% of cases, distributed as follow: heterozygoty FAS and FAC: 9%, double heterozygoty FSC: 0.2% and homozygoty FSS: 1.9%. Sickle cell neonatal screening should be imperatively implemented, with regards in economical considerations. It would be relevant to integrate it in a larger program including information, training and genetic counselling in order to avoid homozygotes birth and to lower the spread of this disease.

Anemia, Sickle Cell↗
PubMed2002

[Femoral implants of coral and ceramics: histological results after 120 days].

The authors have made an histological study of the evolution, after 120 days, of coral implant and tricalcic phosphate ceramic implant in each femur of 12 rabbits. The results have shown on the one hand that ceramic is resorbed faster than coral, on the other hand that for both types of biomaterials the resorption was much faster for the implants in contact with the bone-marrow than for those which were not.

Animals↗
PubMed1998

Elaboration and evaluation of an intraoral controlled release delivering system.

In order to improve the administration of drugs for all pathology of the oral cavity, we have developed an intraoral controlled release delivering system, permitting to reach high enough local concentrations for desirable therapeutic effect with minimal side effects. We have formulated tablets of 200 mg intended to be fixed on a tooth. These tablets resist food and drink attacks. The tablets we elaborated have a granular matrix composed of hydroxyapatite, ethyl cellulose and Eudragit. Zinc sulfate is used as the first model of an active drug, it has a therapeutic effect on buccal mucous. Profiles of continuous in-vitro drug release in distilled water at 37 degrees C show that zinc sulfate release by the matrix structure for the different tablet formulations is regulated by the proportions of the different components.

Acrylic Resins↗
PubMed1998

[Development and evaluation of an active substance controlled-release device for use in the oral cavity].

In order to improve drug administration for diseases of the oral cavity, we have developed an intraoral controlled release delivery system enabling local concentrations high enough for desirable therapeutic effect with minimal side effects. We have formulated 200 mg tablets to be fixed on a tooth. These tablets resist attacks by food and beverages. The tablets have a granular matrix composed of hydroxyapatite, ethyl cellulose and Eudragit. Zinc sulfate, which has a therapeutic effect on the buccal mucosa was used as the first model of an active drug. Profiles of continuous in vitro drug release in distilled water at 37 degrees C show that zinc sulfate release by the matrix structure for the different tablet formulations is regulated by the proportions of the different components.

Acrylic Resins↗
PubMed1994

Problems and pitfalls in the use of estimated age in anthropometric measurements of children from 6 to 60 months of age: a case from Mali.

Estimates of the age of children are often used uncritically in anthropometric measures. This study shows that even with construction of calendars for use of determination of age, substantial training, a careful follow-up in the field by research assistants, and control of all questionnaires immediately after the interviews of the caretakers and weighing of the children, errors remain in estimating the age of children. Such errors may affect the results substantially, leading to errors in the estimation of age-based measures of nutritional status. In the case of Northern Mali, the effect was most likely an underestimation of malnutrition by perhaps as much as 10 to 30 percentage points. The biases in age estimation in many cases are not constant across subgroups of a population. Therefore age estimation problems may lead to wrong decisions regarding policy formulation, planning of development programs and activities, identification of target groups, and, in particular, evaluation of programs and activities. In situations where age has to be estimated, anthropometric measurements that are less influenced by errors in age estimation are recommended.

Age Factors↗
PubMed1994

Dual core and shell temperature regulation during sea acclimatization in Gentoo penguins (Pygoscelis papua).

Penguins are able to maintain a high and constant body temperature despite a thermally constraining environment. Evidence for progressive adaptation to cold and marine life was sought by comparing body and peripheral skin temperatures, metabolic rate, and thermal insulation in juvenile and adult Gentoo penguins exposed to various ambient temperatures in air (from -30 to +30 degrees C) and water (3-35 degrees C). Juvenile penguins in air showed metabolic and insulative capacities comparable with those displayed by adults. Both had a lower critical temperature (LCT) close to 0 degree C. In both adults and juveniles, the intercept of the metabolic curve with the abscissa at zero metabolic rate was far below body temperature. This was accompanied by a decrease in thermal insulation below LCT, allowing the preservation of a threshold temperature in the shell. However, this shell temperature maintenance was progressively abandoned in immersed penguins as adaptation to marine life developed, probably because of its prohibitive energy cost in water. Thus adaptation to cold air and to cold water does not rely on the same kind of reactions. Both of these strategies fail to follow the classical sequence linking metabolic and insulative reactions in the cold.

Acclimatization↗
PubMed1994

[Anatomo-clinical study of chronic gastritis in Mali].

The aim of our study was to evaluate the frequency of chronic gastritis and its anatomoclinical aspects in Mali. Within thirteen months of prospective study, we have recorded seventy four chronic gastritis histologically confirmed which represented 3.28% of the total oesogastroduodenal pathologies registered during the same period (2256 cases). Chronic gastritis has been most observed between 31 to 40 years (24.3%) and women were affected (sex ratio = 0.6). Households and civil servants were predominant. The precocious burning epigastralgy just after the meal was the main motive of the examination and chronic gastritis has been a fortuitous discovery. The basic alimentation included smoked or dried fish, peanuts, "tô" and salt. The most frequent endoscopic aspect was the congestive one. The duodenogastric reflux was not negligible. The diffuse form and antral localisation were more frequent. Five displasiae and four intestinal metaplasiae have been found.

Adolescent↗
PubMed1992

[Prevention of iodine deficiency disorders in children in the rural African zone].

The effectiveness of iodinated silicone polymers placed in bore wells for combating goiter in children under 15 years of age was evaluated in two villages in Mali. Of the 581 included children, 367 did and 214 did not receive supplemental iodine. Overall, follow-up data at one year were available for 86% of study subjects. At baseline, Goiter was present in 43.3% of the children in the supplemental iodine group and in 69.2% of controls. Stage G1B predominated in both sexes. After one year, 36% of the goiters had resolved in the supplement group. Effectiveness of iodine supplementation was greater in young children with small goiters. Urinary iodine levels returned to normal by the third month. Iodine levels in the supplemented water remained above 50 micrograms/l throughout the year; daily intake of iodine was 50 to 100 micrograms. In the unsupplemented village, 21 new cases of goiter occurred, for an annual incidence of 40%.

Adolescent↗
PubMed1983

Interaction of methotrexate metabolites with beef liver dihydrofolate reductase-I. Binary complex study.

In order to explain the difference of inhibition of dihydrofolate reductase (DHFR) by methotrexate (MTX) and its metabolites 7-hydroxymethotrexate [7OH (MTX)] and polyglutamate derivatives [MTX (G1) and MTX (G2)], direct determinations of binding parameters to beef liver DHFR were performed. Association constants are calculated by fluorescence titrations and thermodynamic parameters by microcalorimetric measurements. The parameters of interaction are nearly identical for MTX and polyglutamate derivatives but are different for MTX and 7OH (MTX). For this last derivative electrostatic forces are less predominant and a larger modification of its conformation appears in the enzyme during the complex formation.

Animals↗
PubMedDate not supplied

[Transferrine soluble receptors' contribution to the assessment of iron status in homozygous drepanocytic anemia].

Sickle cell anemia does not cause martial deprivation per se, but may worsen when iron deficiency exists, notably in tropical zone where infectious diseases and malnutrition are endemic mainly during childhood. This study was aimed to assess iron deficiency prevalence among children with sickle cell disease (SCD) and to determine the best parameters for its diagnosis. In addition to classical parameters, we measured transferrine's soluble receptors which can reveal an iron deficiency, either isolated or associated to another condition since its level is not influenced by chronic anemia. Assays were carried out in 40 homozygous SCD patients, aged 3 to 18 years, having an hemoglobin level < 11 g/dL and in 30 age-paired controls assumed to be healthy and having a negative Emmel test and an hemoglobin level < 11 g/dL. The results showed hyposideremia (serum iron < 60 microg/dL) in 17.5% of the patients. Ferritinemia, transferrinemia as well as total iron fixation capacity were in the normal range for the majority of SCD patients in spite of the frequency of hyposideremia and microcytic anemia (20%). Transferrine's saturation coefficient was low in 22.5% of patients, which can be due to martial deprivation or to inflammatory status. These results confirm the limitations of usual biochemical parameters in the diagnosis of iron deficiency in homozygous drepanocytosis. Soluble receptors' levels were increased in 60% of controls; that proves that iron deficiency prevalence is high in our countries. Higher levels were found in 97.5% of patients. However, receptors' levels are increased during haemolysis, thus it is difficult to ascertain the origin of the increase, but taking into account its index value can reduces misinterpretation. In addition, considering simultaneously microcytosis, hypochromia, transferrine's soluble receptor level and its index, we can speculate that martial deficiency occurs in 20% of SCD patients, a percentage close to the 17.1% obtained by other authors using only the combination of microcytosis and hypochromia. It results from this study that associating microcytosis and hypochromia could validly assess iron deficiency during drepanocytosis.

Adolescent↗
PubMedDate not supplied

[Vitamin A deficiency and food consumption of children aged 6 to 84 months in a Mali rural area].

A cross-sectional study was carried out during the dry season, within the framework of an extension of an existing sanitary program. In December 1991, a cluster sample of 2,631 children was selected in a rural district of Mali, in the district of Koutiala, with good agricultural conditions. A sub-sample of 262 mothers was selected for interviews concerning their knowledge and attitudes about vitamin A deficiency symptoms. Prevalence of clinical symptoms was 2% for night blindness, 0.3% for Bitot's spots and 0.2% for corneal scars. Night blindness was more common after 3 years. The study of weekly consumption of vitamin A rich foods, made on a sample of 519 children, revealed that only 3.3% ate vitamin A rich foods less than seven times a week and 2.7% never ate any. According to the recommended dietary allowances, vitamin A deficiency was not a public health problem in this region. However, these results do not agree with those of the clinical study. It should be noted also that protein energy malnutrition is scarce among the children. These results allowed an estimate of the prevalence of vitamin A deficiency, but were insufficient for the design of strategies to reduce this prevalence. Simple and relatively cheap epidemiological methods like case-control studies are not commonly used in developing countries. These methods could be used to obtain a better estimate of social, cultural and biological risk factors, and therefore, better targeting interventions.

Child↗