Introduction: Congenital limb gangrene is a rare pathology. In the majority of cases, no cause is identified and its treatment is not codified. Observation: 29-week premature newborn, female from poorly followed twin pregnancy. Clinical examination at admission found an unstable neonate, the presence of necrosis of the left hand and forearm well limited, with absent humeral pulse and absence of hand movement. Surgical treatment was scheduled for amputation of the limb after the agreement of the parents whose postoperative follow-ups were simple. Conclusion: Congenital gangrene remains a rare entity in neonatology.

Introduction: Bart's syndrome is a rare neonatal pathology combining congenital skin aplasia affecting the extremities and congenital epidermolysis bullosa, exceptionally described on black skin. Observation: A 2-day-old male newborn was referred for multiple ulcerations of the limbs observed at birth. The clinical examination found an absence of bilateral and symmetrical skin occupying almost all of the two lower limbs with some flaccid bubbles. The vascular network was clearly visible. The rest of the skin coating was normal. The diagnosis of Bart syndrome in connection with epidermolysis bullosa was evoked clinically and despite pediatric and dermatological management, the evolution was rapidly fatal by severe sepsis. Discussion: Bart syndrome corresponds to a clinical picture of congenital skin aplasia associated with congenital epidermolysis bullosa suspected by areas of fragility and sometimes bubbles. All types of congenital epidermolysis bullosa may be associated with this syndrome. The clinical diagnosis is generally easy but the therapeutic management is difficult and the prognosis reserved. Conclusion: Bart syndrome is a curious congenital association of well-defined skin symptoms, the etiopathogeny of which still remains poorly elucidated, hence the difficulty of establishing an antenatal diagnostic strategy or giving appropriate genetic advice.

Introduction: Influenza is an acute respiratory infectious disease, highly contagious due to influenza viruses. The objective of this work was to identify, understand the epidemiology of circulating strains and estimate disease transmission. Patients and Methods: The study was carried out in the pediatric department of the Sikasso Hospital. This was a prospective, longitudinal descriptive study over a five-year period (January 1, 2015 to December 31, 2019). She was interested in severe acute respiratory infections (SARI) for hospitalized patients in the pediatric department. Results: During the study period the prevalence of severe acute respiratory infections among hospitalized children was 21.85‰. The majority of cases were observed in 2019 with 58 cases, the sex ratio was 1.8. The age group from 0 to 1 was the most represented with 100 cases (48.30%) followed by 2 to 4 years 73 cases (35.24%) and 5 to 15 years 34 cases (16.46%). More than half of the patients lived in rural areas 129 (62.31%). Fever and cough were present in the majority of patients. No children had received influenza vaccination. In study 36 (17.39%) cases were positive for influenza A and B.

Objective: Study the impact of breast feeding on the fate of preterm infants with a birth weight of less than 1500g. Patients and Methods: This was a retrospective, analytical descriptive study carried out over a period of one year (2019) at the neonatal unit of the pediatric department of the Sikasso Hospital. All premature newborns weighing less than 1500g were included. Premature infants over 1500g and term infants were excluded from the study. Chi2 test and odds ratios were used to highlight risk factors for death. The significance threshold adopted was p < 0.05. Results: A total of 50 premature newborns out of 130 admitted. 53.4% female and 45.6% male. 13% of mothers were between 17 and 20 years old with a poor pregnancy in 25.1%; 56.5% were housewives; 11.8% lived in urban areas; 53.4% of premature infants had an entry weight of less than 1200g. The majority of premature babies were fed breast milk through an orogastric tube and / or a teaspoon. Fifty-four (54%) of premature infants acquired food independence between 36 and 38 weeks corrected age. At discharge, 78.8% of premature babies are kept eutrophic; 21.2% acquired ectopic growth retardation. 70% benefited from catching up the weight.

Introduction: Perinatal asphyxia is one of the leading causes of perinatal death. According to the WHO, two thirds of these deaths can be prevented with simple and effective interventions. The HBB (Helping Babies Breathe) program provides effective care for asphyxiant newborns regardless of the level of care. Objective: The objective of our work was to assess the knowledge of neonatal resuscitation equipment and procedures according to the HBB program by qualified nursing staff at the level of referral health structures in the Sikasso region of Mali. Methodology: This is a multicenter cross-sectional survey over a period of 4 months. It was carried out in two maternities and two referral neonatal units in Sikasso. The target population studied was made up of the nursing staff involved in the reception and care of newborns in the delivery room, in postpartum suites and in neonatal departments. Results: Eighty percent (112/141) of targeted caregivers were interviewed. More than half (44%) had more than 6 years of experience in neonatal care. Only 27% had received training in neonatal resuscitation including HBB. The most cited materials used for resuscitation were the mucus aspirator (82%), the ventilation bag (67%) and the heated table (60%). The bestknown resuscitation procedures were airway aspiration (82%), mask ventilation (60%), and hypothermia control (48%). Conclusion: Knowledge of newborn resuscitation remains very insufficient in the reference structures in Sikasso. It is necessary to implement a strategic plan for continuous training of staff with periodic monitoring in health structures.