Migraine is a debilitating but benign disease that can affect the quality of life of patients, disrupt the emotional relationships and impact on educational and vocational activities. The aim of our work was to study the epidemiology and impact of migraine in schools in the urban district of GAO in Mali.This is a cross-sectional study among students in the city of Gao. The survey was conducted in 11 schools, each of which represented a cluster. The study involved 733 students and diagnosis of migraine was made according to the 2004 IHS criteria except the criterion for the number of crises.The overall prevalence of migraine in school was 17.3% (95% CI [14.6% to 20%]). The headache prevalence among students was 20% (95% CI [16.91% to 23.09]), it was significantly higher 23.0% in girls than in boys 14.8% (p < 0.01). About its impact on school life, 63.8% of students had experienced absenteeism due to migraine from 1 to 14 days in the last quarter preceding the survey with a limiting concentration in 19.2% of students with migraine.In conclusion, migraine is common among students of Gao, it is more important in female. It has a negative impact on academic performance. It is therefore necessary to control its management to reduce the extent of the disease in this environment.

The migraine is a chronic neurological disease that affects 10 to 12% of the population, with a clear preponderance females and this from puberty. The women report a longer attack duration. Presence and severity of associated symptoms, such as photophobia, phonophobia, nausea, vomiting, and cutaneous allodynia are more prevalent in women. Some clinical forms are well described as catamenial migraine. Several comorbidities have been described in migraine women. Among these diseases associated with migraine: vascular diseases, asthma, allergies, epilepsy, restless legs syndrome, and various chronic pain syndromes and psychiatric disorders. Treatment of migraine in women raises the difficulty of managing seizures and during pregnancy and the period of menstruation. The therapeutic difference mainly concerns menstrual migraine. In women with migraine, it is therefore recommended to be particularly attentive to comorbidities, the presence of which significantly increases the risk of arterial vascular events. Migraine is very common with a particular impact on the quality of life of women. These various specificities and their evolution over time must lead to continuous training of general practitioners, other specialists in women's health including gynecologists in order to reduce the morbidity of the disease by better prevention of crises through the harmonization of research by scientific societies from different continents.

Abstract:In Niger, palliative care is a necessity in everyday medical practice. However, the setting up of structures and / or mobile teams specifically dedicated to palliative medicine still faces enormous challenges. Most patients who consult for noncommunicable disease or specifically for tumors or other incurable illnesses as some neurological diseases come advanced stages, requiring palliative care whereas there is as yet no national structure specifically dedicated to palliative care. No domain of research in palliative care is developed in Niger. No specific scientific work on palliative care have been conducted and published in Niger. This testifies to the lack of promotion of this specialty in Niger. So the ignorance of palliative care, access to morphine and ordinary molecules fight against pain are a real obstacle to the practice of palliative medicine in Sakoira Integrated Health Center (Tillabéri) in republic of Niger.

The occurrence of cerebellar infarction associated with a patent foramen ovale during a migraine attack is rare and ambiguous etiopathogenic explanation. We report the case of a young patient. It was about a 25-years-old, migraine known since age of 8 years, with no particular medical history, admitted to the neurology department of Fann National Teaching Hospital of Dakar for headaches, acute onset of balance and walking disorders in a context of big rotatory dizziness. Neurological examination have objectified a Wallenberg syndrome. The rest of the physical examination was normal. The diagnosis of cerebellar infarction was retained on basis of brain CT and brain MRI. The etiologic test showed patent foramen oval at transoesophageal echocardiography. The diagnosis of migrainous infarction was retained on basis of the young age of the patient, migraine with aura, presence of patent foramen ovale (vascular risk factor etiology?) and lack of any other cause. Patient received anticoagulants and analgesics combined with physical rehabilitation. Outcome was favorable marked by motor recovery. A migrainous infarction, especially cerebellar infarction should be discussed in front of any attack in known migraine with focal neurological signs.

Background: Noncommunicable diseases are the leading cause of death in the world and low and middle-income countries suffer from preventable premature death. The aim of this study was to assess the risk factors for noncommunicable disease (NCDs) in general and particular cardiovascular diseases (CVDs) among the outpatients of our department of medicine. Methods: We performed a cross-sectional study from April to December 2017 by the consecutive enrollment of outpatients who attended in our department of medicine of Hôpital Sominé DOLO de Mopti, Mali. Clinical and laboratory data were measured for cardiovascular risk assessment. Framingham Risk Score (FRS) and Systemic Coronary Risk Estimation (SCORES) were computed by using Framingham and SCORE equations. Metabolic syndrome was defined using the harmonized criteria from the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Data were captured in excel and analyzed with R version 4.0.3. The statistical significance was set at p = 0.05. Results: A total of 292 patients were enrolled in this study. The prevalence of traditional cardiovascular risk factors was 36.64%, 21.57%, 14.04%, and 13.01% for high blood pressure, hyperglycemia, smoking, and alcohol consumption, respectively. The metabolic syndrome accounted for 23.63%.