Introduction: Sexual assault violates fundamental rights, including physical and psychological integrity and security of the person. The purpose of this work was to take stock of the holistic management of sexual assaults received in the service. Patients and method: We conducted a cross-sectional and descriptive study covering the period from June 2017 to May 2020, i.e. three years. It focused on all survivors of sexual assault received in the unit of <On Stop Center> which houses the Obstetric Gynecology Department of the CSRéf CV of the district of Bamako in Mali. Results: The prevalence of sexual assault was 1.79%. The average age of survivors was 24 years. Sexual assaults mainly concerned adolescent girls (92.20%). The majority of survivors had been admitted (88.84%). They were single (89.80%). The average gesture was 4. The alleged perpetrator was unknown to the survivor in 79.14%. Genitogenital penetration with ejaculation was reported in 70.14% of cases, including 52.40% in a climate of violence. The initial clinical evaluation found recent hymenal lesions found in 13.58% of cases and an intact hymen in 9.42% of survivors. Holistic management included a paraclinical assessment component and a care administration and support component. The drafting of a medical certificate in three copies was systematic. Conclusion: Sexual assaults are relatively common in our department. They are probably underestimated. Keywords: Violence, gender, survivors, bamako.

Background: Cardiotocography (CTG) records changes in fetal heart rate and their temporal relation with uterine contractions. Its aim is to diagnose the hypoxia and prioritize the babies who need urgent delivery. Objective: The aim of the study is to assess the role and effectiveness of admission CTG and compare the abnormal and normal CTG regarding fetal outcomes. Methods: It is a prospective observational study held in Z.H. Sikder Women’s Medical College & Hospital for the period of 1 year (July 2020 to June 2021). 500 pregnant women were studied in this period. Admission and intermittent CTG was done according to need. Statistical level of significance was set at p <0.05. Result: Total 500 cases were taken as study population according to inclusion criteria and divided into two groups, normal and abnormal CTG. Abnormal CTG includes both suspicious and pathological varieties. Difference in Apgar score, NICU admission and perinatal asphyxia was statistically significant (p<0.05). Conclusion: A CTG is a non-invasive, reliable and cost-effective screening method to evaluate the fetal condition and to predict perinatal outcome in high risk and also in low-risk pregnancies. Caesarean section rates may be dramatically reduced by appropriate use of CTG.

Background: Hypertensive disorders of pregnancy have been a challenge to the obstetricians and researchers since many centuries. Prediction of preeclampsia (PE) in the early pregnancy is of utmost help in preventing the disorder and minimizing its severity. Objective: To evaluate the predictive accuracy of microalbuminuria in early pregnancy for the development of preeclampsia. Methods: A prospective cohort study was carried out in the Obstetrics and Gynaecology Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, over a period of one year. 133 pregnant women at 10 – 14 weeks of gestation were included in the study. The group of women with microalbumin excretion 20 – 300 mg/L in a spot sample of urine was designated as ‘exposed’ group and those with albumin excretion < 20 mg/L as ‘unexposed’ group. The outcome variable was development of either Preeclampsia or Eclampsia or Gestational Hypertension. Result: Among 133 study subjects, 13 developed adverse outcomes (PE/GHTN). The pregnant women were predominantly in their 2nd decades of life (20 – 30 years old) with mean ages of the adverse and normal outcome groups being 25.6 and 24.9 years respectively (p = 0.614). No significant association was found between adverse outcome and parity (p = 0.729). The past history of preeclampsia tends to be significantly associated with PE or GHTN (p = 0.048). Nearly half (46.2%) of those who developed preeclampsia/GHTN had microalbuminuria in early pregnancy compared to 23.3% of those who did not have microalbuminuria. The risk having preeclampsia/GHTN in the ‘exposed’ group is 2.5 (95% CI = 1.0 – 6.9) times higher than that in the ‘unexposed’ group (p = 0.037). The sensitivity of microalbuminuria was inappreciably low (46.2%). However, its specificity is optimum (76.7%). The positive and negative predictive values of the test were 17.6% and 92.9% respectively with high yield of false positive and low yield of false negative results. The overall predictive accuracy of the test was found to be 73.7%. Conclusion: The study concluded that presence of microalbuminuria in pregnant women in their 1st trimester significantly predicts PE/GHTN.

One of the important and underappreciated reproductive health problems in developing countries is the high rate of infertility and childlessness. A cross-sectional type of descriptive study was conducted to evaluate the male fertility status by the conventional semen analysis. This study was conducted in which 100 men with age ranged from 20 to 45 years of a primary and secondary infertile couple of more than one year, in the Infertility OPD of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka during October 2012 to March 2013. They were divided into two groups depending on the results of their semen analysis: 35 with abnormal semen and 65 with normal semen profile. The mean (±SD) age was 34.0±4.7 years in patients with abnormal semen and 33.9±5.6 years in patients with normal semen. Nearly one-third (31.42%) of the patients was a farmer in abnormal semen and 7.7% in normal semen. The majority (62.85%) of the abnormal semen patients worked in hot environments, STD was found 20.0% in patients with abnormal semen and 3.1% in patients with normal semen, mumps observed 8.6% in abnormal semen and 3.1% in normal semen patients. Surgical history was found 11.4% in abnormal semen and 1.5% in normal semen patients. Positive family history of infertility was found in 8.6% of abnormal semen patients but no positive family history of infertility was found in normal semen patients. Varicocele was found 25.7% in patients with abnormal semen and 21.5% in patients with normal semen. Primary subfertility was 91.4% in abnormal semen patients and 58.5% in normal semen patients. Farmer, hot working environment, STD, surgical history, positive family history, primary subfertility were significantly (p<0.05) higher in patients with abnormal semen. The highest number of patients were oligospermic (51.4) followed by azoospermia 22.9%, asthenozoospermia 17.1%, teratozoospermia 5.7% and aspermia 2.9%. Occupational exposure, STD, hot environment, past surgical history has a significant negative impact on male infertility.

Introduction: Hysterectomy is a surgical procedure commonly performed in obstetrics gynecology at the Sominé Dolo hospital in Mopti, but no study had been conducted. The aim of this study was to determine the prevalence of hysterectomy and to review gynecological and peripartum hysterectomies. Methods: This was a descriptive cross-sectional study conducted over a period of 12 months from January 1, 2017 to December 31, 2017 in the obstetrics gynecology department of the Sominé Dolo hospital in Mopti Mali. Eligible patients were represented by all those who had undergone a peripartum or gynecological hysterectomy during the study period in our service. Our supports consisted of patient files, patient interviews, the operating report register, the delivery register and the hospitalization register. Data were entered and analyzed using Epi info3.5.3 software and word processing was performed using Word 2007 software. Results: During the study period, all the surgical interventions represented 522 cases, i.e. an overall prevalence of 9.2% (57/522) among which hysterectomies during the gynecological period represented 70% (38/57) against 30% (19/57) peripartum hysterectomies. The average age of the patients was 46.5 years with the extremes of 18 and 75 years. The types of hysterectomies were represented in the vast majority by total interadnexal hysterectomy 77.2% (44/57) followed by subtotal hysterectomy 15.8% (9/57) and hysterectomy plus bilateral adnexectomy 7% (4 /57). Conclusion: Hysterectomy is one of the most practiced surgical activities at the Sominé Dolo hospital in Mopti. It constitutes an alternative solution for the practitioner to save the life of the patient, particularly in the event of emergency hysterectomies which represented a significant proportion in our study.

Background: Carbon monoxide is produced in abundance in the Niger Delta, a fact that was acknowledged in the World Bank study of the region in 1995 and the Environmental assessment of Ogoni land by UNEP in 2011. Objectives: To ascertain the extent of CO pollution in the Niger Delta, its impact on foeto-maternal health and to review the pathophysiology and the treatment of the poisoning. Methods: A mixed method study (observational-descriptive and systemic review). A literature review on the above objectives was carried out. The known foeto-maternal impact of CO exposure was extrapolated to the prevailing state of CO pollution in the Niger Delta. Questionnaires distributed to Doctors working in the tertiary Centres in the core Niger Delta focused on the prevalence, clinical presentations and foeto-maternal findings in patients who presented with CO poisoning. Results: There was no data on the prevalence and clinical presentations of CO pollution in the Niger Delta. The ambient and indoors air concentration of CO in the Delta range from 0 ppm to 191μg/m3 but in places within 60-200 metres from crude oil flow stations, the concentrations range from 100 to 5320 μg/m3. Maternal impact of CO pollution ranges from headaches at carboxyhaemoglobin (COHb) levels of 5-20% to maternal death at COHb levels of >66% while in the foetus, it causes birth defects, growth restriction, prematurity and sudden intrauterine and early neonatal death. Conclusion: The core Niger Delta is under perpetual siege of CO pollution and the ambient and indoors air concentration of it in the Delta range from 0 ppm to 191μg/m3.