Introduction : Chaque année l'OMS dénombre près d'un million de nouveaux cas de méningites bactériennes avec une létalité de 10%. Depuis l'introduction du vaccin contre l'Haemophilus influenzae b (Hib) en 2005, du vaccin contre le Streptococcus pneumoniæ en 2011 et les campagnes de vaccinations de masse contre le Neisseriameningitidis A, aucune étude n'a porté sur les méningites bactériennes dans le service de pédiatrie de l'hôpital du Mali d'où l'initiation de ce travail.Matériels et méthodes : Il s'agissait d'une étude descriptive rétrospective couvrant la période de 01Janvier 2012 au 31 Décembre 2017 et prospective allant du 01 Janvier au 31 Décembre 2018 chez les enfants d'un mois à 15 ans hospitalisés pour méningite bactérienne dans le service de pédiatrie de l'Hôpital du Mali.Résultats : Durant la période de notre étude nous sur les 6429 enfants hospitalisés nous avons enregistré 88 cas de méningites bactériennes soit, une fréquence hospitalière de 1,4%. Le sex ratio était de 1,5. Les enfants de moins de 5 ans étaient les plus touchés (71,6%). Les enfants étaient immunisés contre Hib (72,7%) et pneumocoque (71,6%) . La fièvre était présente chez 80,6% de nos enfants associées ou non au coma (68.2%%, à la convulsion (56,8%) et à l'agitation (13,6%). Les principaux germes isolés étaient : le Streptococcus pneumoniæ (36,4 %), le NeisseriameningitidisW135, X, C (12,5%) et l'Haemophilus influenzae (9,1%). L'association du Ceftriaxone et de la gentamycine a été utilisée avec succès chez 77.3% de nos enfants. Le taux de guérison était de 64,8%, le taux des séquelles (12, 5%) et le taux de létalité (18, 2%).Conclusion : Le pneumocoqueest le germe majoritairement responsable des méningites bactériennes malgré l'introduction du vaccin antipneumococcique conjugué treize valent. Les sérogroupes W135, X, et C de méningocoque qui sont aussiresponsables des méningites dans notre service

Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.

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Introduction: Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the patient or at the time of delivering the care or which does not manifest itself only after the patient has been discharged or an infection contracted by the professional in the course of his duties. Objectives: To identify mean causative germs and to determine their sensitivity to antibiotics and to identify the risk factors of health care-associated infection. Material and methods: It was about a prospective longitudinal study conducted from November 1, 2017 to April 1, 2018 (6 months) in all children admitted to the pediatric surgery service. Non-consenting parents and outpatient necrosectomy case have not been included in this study. Results: This study included 200 patients, of whom 30 experienced the hospital acquired infections with an infection rate of 15%. The surgical site infection was the most common type, with 16 cases (53.3%), followed by burns in 13 cases (43.3%) and urinary tract infection in 1 case (3.3%). The average age of patients with infection was 56.33 ± 48.66 months with extremes of 1 and 180 months. The sex ratio was 1.30 for infected patients and was 1.83 for uninfected patients. The main bacteria responsible for surgical site infection were: Escherichia coli (4 cases), Acinetobacter baumanii (3 cases), Klebsiella pneumoniae (2 cases), Staphylococcus aureus (2 cases), Enterobacter cloacae (1 case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis (1 case). Among burn patients, the most frequent germs were: Acinetobacter baumanii (7 cases), Klebsiella pneumoniae (6 cases), Staphylococcus aureus (6 cases), Escherichia coli (4 cases

The simultaneous double volvulus of the transverse colon and sigmoid in the same patient is a rare cause of intestinal occlusion. Two cases were observed in general surgery in Kati. Its clinical symptomatology does not differ from other occlusions as well as simple radiological images. It is an extreme surgical emergency, the diagnosis is generally intraoperative. Extensive left hemicolectomy with terminoterminal rectal anastomosis was performed. The surgical follow-up was simple.