Introduction Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. Methods This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. Results We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. Conclusion The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.

Introduction: Anaemia is a condition that is often underestimated and insufficiently treated in the elderly. It is the most common haematological problem in this age group, with 30% of aetiologies remaining unexplained. In our context, few patients benefit from investigation, hence this study to assess the state of anaemia. Methods: We conducted a retrospective study from January 2011 to December 2012 in the internal medicine department of the Point "G" University Hospital. All hospitalised patients aged 65 and over with anaemia according to the WHO definition were included. Results: Among 199 elderly subjects hospitalised during our study period, 95 (47.73%) presented with anemia. The sex ratio was 1.71. The mean age of the patients was 73.39 ± 6.65 years. Weight loss (82.1%), polypnea (56.5%) and dyspnea (21.1%) were the predominant clinical manifestations. The mean haemoglobin level was 8.93 g/dl, with extremes of 3.1 and 12.5 g/dl. Aregenerative normochromic anemia (37.9%) was the most common. Inflammatory anemia was the main cause of anemia in the elderly (58.6%), followed by multifactorial anemia (20.7%), renal failure (6.9%) and unknown causes (6.9%). Conclusion: Anemia is a frequent condition in elderly patients in internal medicine, dominated by inflammatory causes.

The authors report a case of systemic lupus associated with a composite heterozygosis SC with thalassemic component in a 19-year-old patient hospitalized for anemia and polyarthralgia who has a staturoponderal delay, macular erythematous lesions in butterfly wings on the face and ears, photosensitivity, puffy face, alopecia, pubic and axillary hair loss, scalp dermatophytosis, painful swelling of the interphalangeal joints, wrists and knees. The hemoglobin electrophoresis showed a compound heterozygote SC associated with β thalassemia. Antinuclear antibodies were positive with an anti-Sm positive antibody. Conclusion: The diagnosis of both diseases can be difficult when symptoms are concomitant and look alike.

Introduction: Clinical and biological manifestations after total thyroidectomy constitute one of the frequent reasons for consultation in our medical services. Several studies on thyroid pathology have been carried out in Mali, but none to our knowledge has been devoted to the postoperative clinical and biological follow-up of hyperthyroid goitres after total thyroidectomy, hence the interest of this study which aimed to evaluate the clinico-biological manifestations after total thyroidectomy of hyperthyroid goitres in the department of Endocrinology-Internal Medicine, Surgery of the Hospital of Mali. Materials and methods: This was a descriptive, retrospective study from January 2010 to December 2014. All patients who had undergone total thyroidectomy for hyperthyroid goiter, who were treated before discharge with levothyrox (50 to 150 µg/day) to prevent hypothyroidism, who had a complete file and who were followed up in the Endocrinology-Internal Medicine and Thoracic Surgery Departments of the Mali Hospital were included. Results: We collected 550 cases, of which 54 met our inclusion criteria, i.e. a prevalence of 9.8%. The series was composed of 51 (94.4%) women and 3 (5.6%) men, i.e. a sex ratio of 0.06. The most common age range was 41-60 years with extremes of 22 and 75 years. Anterocervical swelling was the reason for consultation in 98.1% of cases. At D7 post-op, we noted dysphonia in 10 (18.5%) patients, 5 (9.25%) cases of hypocalcemia and 33 (61.1%) cases of hypothyroidism on 38 samples. The other manifestations were: at 1 month follow-up, asthenia (5.6%), biological hypothyroidism (9.3%), at 3 months follow-up: transient hypoparathyroidism (3.7%), a loss of sight rate (7.4%), at 6 months follow-up: signs recorded were asthenia, fragility of the phaneras, lethargy, a loss rate of 11.1%. At one year follow-up, the most frequent signs were: skin infiltration (3.7%), definitive hypoparathyroidism (3.7%), a loss rate of 16.7%. Conclusion: Total .............

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