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Introduction: Peripartum cardiomyopathy (PPCM) is a heart failure whose etiology is still unknown. The aim of work was to study peripartum cardiomyopathy in its epidemiological, clinical, paraclinical and therapeutic aspects at the Tombouctou hospital. Methods: This is a descriptive cross-sectional study carried out in the Medicine Department of the Timbuktu hospital from January 1 to December 31, 2019. It concerned patients who presented heart failure between the 8th month of pregnancy and the first 5 months postpartum. Results: During the study,23 patients were collected. Average age of the patients was 23.50 ± 3.50 years with extremes of 16 and 34 years. Incidence of Peripartum cardiomyopathy (PPCM) was 1/345 pregnancies. Average parity was 3.20 with extremes of 1 and 8. Symptoms appeared at postpartum with 87% of cases. A significant delay in diagnosis was observed. Global heart failure was the mode of decompensation with 70%. Electrocardiographic signs were mainly sinus tachycardia (87%) and left ventricular hypertrophy (83%). Cardiac ultrasound showed in all cases dilated cardiomyopathy and it was associated with thrombus in left ventricle cavity for three cases. Left ventricular ejection fraction was severely impaired in 70% of cases. Pulmonary hypertension was significant in 52%. Most commonly drugs we used in our series at acute stage were duretics: furosemide 100% and spironolactone 70% (100% and 70%) and ACE inhibitors (90%). Beta-blockers (bisoprolol and carvedilol) were used in 15 patients. Bromocriptine (prolactin inhibitor) was used for 2 patients. Conclusion: Peripartum cardiomyopathy is a serious cardiac complication of pregnancy of unknown cause, common in the African population.

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

Congenital heart diseases are abnormalities of heart that occur during intrauterine life. Our work aimed to study the epidemiological and echocardiographic aspects of congenital heart disease with Cardiology Department of the Tombouctou hospital. This was a descriptive cross-sectional study from November 2018 to December 31, 2019 on Doppler echocardiography reports from patients admitted to the Cardiology department. The probes used were 3.5 and 5 MHz on an Esaote Mylab40 device. The inclusion criteria concerned patients of both sexes under the age of 16, hospitalized or followed in the cardiology department for cardiac symptoms and having benefited from a cardiac Doppler ultrasound. Results: During the study period, 370 echocardiographic examinations were performed and revealed 20 cases of congenital heart disease with a prevalence of 5.45%. The female sex was the majority 13/7 cases which makes a sex ratio of 0.54. Heart murmurs were the main reason for requesting cardiac Doppler ultrasound with the 13 out of 20 cases of congenital heart disease (65%). Interventricular communication was represented by 15 cases (75%). Congenital heart disease is a reality in Africa. Its frequency and reported series are underestimated due to the inaccessibility of Doppler echocardiography.

Introduction: The partial ventricular atrioventricular canal is a congenital heart malformation of the ostium primum type of variable surface that can reach the single atrium where the interatrial septum is no more than a cephalic muscular vestige attached to the roof of the atrium. His diagnosis at the age of 73 is not a common situation. The interest of this clinical case that we report lies in the peculiarity of its mode of discovery and its evolution under medical treatment. Observation. He was a 73-year-old patient with no known cardiovascular risk factor and has since been at about 18 years of age with heart failure syndrome with progressive dyspnea, cough and edema of the lower limbs, but never explored for lack of financial means, and the evolution was enamelled by episodes of cardiac decompensation, the last of which dated back to 03/07/2018 justifying a hospitalization in our service. Cardiac ultrasound shows a partial atrioventricular canal. The care was medical. Conclusion: The atrioventricular canal is a congenital heart disease complex of poor prognosis.

Background Faecal calprotectin (FC) and faecal immunochemical tests (FIT) have the disadvantage of requiring faecal samples. It has been reported that prostaglandin E–major urinary metabolite (PGE-MUM) values correlate with Mayo endoscopic scores (MESs) for ulcerative colitis (UC). However, there has been no report that PGE-MUM can determine endoscopic remission under remission phase UC, nor comparative study of PGE-MUM with FC and FIT. Thus, we aimed to examine the association between PGE-MUM values and the colonoscopy (CS) results of patients in the remission phase of UC, and to compare the accuracy of using PGE-MUM vs. that of using FC or FIT values for determining endoscopic remission. Methods Patients diagnosed with UC who were under clinical remission and had planned to undergo CS from August 2017 to March 2019 were enrolled. FC levels were measured and FITs were performed on the day of CS; PGE-MUM was measured either the day before or after CS. Three physicians independently scored the CS findings (MES, Modified Mayo Endoscopic Score [MMES], and UC endoscopic index of severity [UCEIS]) while blinded from clinical information. We analysed the differences in PGE-MUM values between two groups, which were divided between those that did achieve and those that did not achieve the following scores: (1) MES 0 point, (2) MES 1 point, (3) modified MES 0 point, (4) modified MES ≤1 point, (5) UCEIS 0 point, (6) UCEIS ≤2 points. In addition, the accuracy of PGE-MUM, FC, and FIT with respect to determining the achievement of (1) through (6) were compared by using areas under the receiver operating characteristics curves. Patients with altered UC activity between the day of PGE-MUM measurement and CS, and those who received NSAIDs on the day of PGE-MUM measurement, were excluded from the analysis. Results Of the 125 enrolled subjects, 30 patients were excluded (urine specimens not submitted, 11; poor stool specimens, 6; NSAIDs users, 10; clearly altered UC activity, 3). The remaining 95 patients (average age 48.2 years, 57 males, and 54 patients with total colitis type), were eligible for analysis. The median PGE-MUM values (in µg/g·Cr) for groups that did or did not achieve (1) through (6) were as follows: (1) 14.6/17.2, p = 0.106; (2) 14.9/20.5, p = 0.039; (3) 14.5/17.4, p = 0.059; (4) 14.1/21.8, p < 0.001; 5) 14.5/17.4, p = 0.059; (6) 14.7/22.2, p = 0.003. The areas under the receiver operating characteristics curves for PGE-MUM/FC/FIT used for determining the achievement of 1) through 6) were as follows: (1) 0.597/0.664/0.682, (2) 0.692/0.74/0.825, (3) 0.613/0.686/0.692, (4) 0.794/0.82/0.786, (5) 0.613/0.686/0.692 and (6) 0.778/0.824/0.825. Conclusion PGE-MUM is equally as effective as FC and FIT for determining the achievement of endoscopic remission.