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Open Journal of Internal Medicine 2020年第1期10卷 96-101页

作者： Abago Balaka Toyi Tchamdja kodjo Agbeko Djagadou Akila Bassowa Komi Dzidzonu Némi Lihanimpo Djalogue Komi Edem Mossi Abou-Bakari Tchala Mohaman Awalou Djibril Internal Medicine Unit Lomé Togo Health Science Faculty University of Lomé Lomé Togo Health Science Faculty University of Kara Kara Togo Gynecology and Obstetrics Unit Lomé Togo

Objectives: Study the prognostic, clinical and epidemiological profile of high blood pressure and pregnancy association at the Sylvanus Olympio Teaching Hospital (CHU Sylvanus Olympio) of Lomé. Patients and Method: It is about a retrospective study that is carried out at the gynecology-obstetrics unit from January to December 2016. Pregnant women with High Blood Pressure after delivery were concerned. Results: In total, 767 pregnant women with High Blood Pressure out of 12107 were taken. The frequency of HBP-pregnancy association was 6.33%. The 21 to 30 bracket age was the most represented (53.71%). The most common risk factor was the overweight or over-obseness (41.98%). Other risk factors were the first delivery and maternal age superior to 30 years old. Common clinical cases described in the study are the same as a predominance of preeclampsia. Caesarean has been the common method of delivering with foetal complications of prematurity type, neonatal suffering and hypotrophy. Conclusion: HBP-pregnancy association is a public health concern with serious foetal maternal complications. The prevention of this association is of great importance.

关键词： HTA-Pregnancy Complication Prognostic Lomé (Togo)

Prostate Biopsy: Which Technique for Which Results at LoméUniversity Hospital in 2017?

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Open Journal of Urology 2018年第4期8卷 125-133页

作者： Tchilabalo Matchonna Kpatcha Tchin Darré Essodina Padja Adolphe Essomindedou Leloua Gnimdou Botcho Edoé Viyomé Sewa kodjo Tengue Komi Hola Sikpa Ekoué David Dosseh Department of Urology University Teaching Hospital of Lomé Lomé Togo Department of Pathology University Teaching Hospital of Lomé Lomé Togo Department of Surgery University Teaching Hospital of Kara Kara Togo Department of Surgery University Teaching Hospital of Lomé Lomé Togo

Background: Diagnosis of prostate cancer is certified by histology true prostate biopsies. The aim of our study was to evaluate our prostate biopsy method. Material and Methods: It was a prospective study including patients underwent prostate biopsy. Inclusion criteria were prostate specific antigen (PSA) level up to 4ng/ml and/or abnormal prostate at digital rectal examination. Patients who had risk factors of bleeding have been excluded of the study. The preparation before biopsy included antibioprophylaxy (Ciprofloxacine-Tinidazole) and rectal hypertonic cleaning (Normacol*). Twelve cores have been taken in each prostate by transrectal digital-guided way, using Biopty Gun 18 Gauge. Local anesthesia has been done previously by intrarectal application of 20 ml of gel of Lidoca?ne. Two other cores were taken into each abnormal area at rectal examination. The follow-up have been done during twelve weeks. Results: Eighty patients of 65 years of age were included. Nine patients had familial history of prostate cancer. PSA levels ranged from 5 to 6400 ng/ml with a median of 26.77 ng/ml ± 11.2. Complications occurred in 11.25% of patients, principally infectious complications which caused death of one patient by septicemia. The rate of cancer detection was 20%. Prostate abnormality at digital rectal examination and the presence of familial history of prostate cancer were not predictive factors of the presence of cancer on cores. Conclusion: Our prostate biopsy method is limited by the lack of ultrasonographic guidance and is at important risk of infectious complications.

关键词： Biopsy Prostate Cancer Digital Guidance Infectious Complications

以幽门梗阻为表现的嗜酸性粒细胞胃肠炎2例报道及文献复习

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新医学 2016年第7期47卷 462-467页

作者： kodjo-KunaleAbassa 魏波尉秀清郭云蔚中山大学附属第三医院消化内科 510630

目的提高对以幽门梗阻为主要表现的嗜酸性粒细胞胃肠炎(EGE)的临床表现和诊治要点的认识。方法报道2例以幽门梗阻为主要表现的EGE,并以"eosinophilic gastroenteritis"等为检索词在Pub Med数据库检索相关文献;结合检索结果分析该病的临... 详细信息

目的提高对以幽门梗阻为主要表现的嗜酸性粒细胞胃肠炎(EGE)的临床表现和诊治要点的认识。方法报道2例以幽门梗阻为主要表现的EGE,并以"eosinophilic gastroenteritis"等为检索词在Pub Med数据库检索相关文献;结合检索结果分析该病的临床表现、诊断方法、治疗原则。结果病例1为27岁女性,因上腹痛、恶心、呕吐2周,呕血半小时入院,查血红蛋白63 g/L,嗜酸性粒细胞(EO)正常,胃镜检查发现贲门黏膜撕裂并出血(金属夹钳夹止血),十二指肠球部溃疡(A1)并狭窄,予质子泵抑制剂治疗,复查胃镜十二指肠球部病变愈合欠佳,活检病理发现大量EO浸润,加激素治疗后复查胃镜病变愈合。病例2为24岁男性,因腹胀、腹痛、呕吐2年,再发伴发现腹部包块20余日入院。查白细胞7.83×109/L,EO 1.74×109/L。胃镜检查示贲门黏膜隆起灶,十二指肠球降交界部隆起肿物,外科剖腹探查+远端胃切除+毕Ⅱ式术,术后病理示大量EO浸润,予激素、护胃、抑酸等内科治疗后症状消失。Pub Med数据库中共收集59例确诊梗阻型EGE,其中35例(59.3%)以幽门梗阻为主要表现,病变分别位于幽门、十二指肠球部或降段,其余24例(40.7%)为大肠和或小肠病变引起的下消化道梗阻(其中以回肠梗阻最多见)。结论以幽门梗阻为表现的EGE极其罕见,临床表现无特异性,容易被临床医生误诊或漏诊。活检病理结果在该病的诊断中起较关键的作用。多了解该病可提高该病的诊断率。

关键词：嗜酸性粒细胞胃肠炎,梗阻型诊断

Male Urethral Stricture: Epidemiological, Clinical, and Therapeutic Aspects in Kara

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Open Journal of Urology 2023年第4期13卷 101-107页

作者： Komi Hola Sikpa Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Essomindedou Leloua Messan Semefa Agbedey Essodina Padja Kossiwa Rose Assou kodjo Tengue Tchilabalo Matchonna Kpatcha Kara Teaching Hospital Kara Togo Sokode Regional Hospital Center Sokode Togo Sylvanus Olympio Teaching Hospital Lomé Togo

Background: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in Kara, a semi-urban city? Objective: Assess the management of male urethral stricture in Kara. Patients and Methods: This was a descriptive study with retrospective data collection. The study took place in the urology department of the teaching hospital of Kara, from December 2020 to December 2022. All cases of male urethral stricture, surgically treated at the teaching hospital of Kara, were listed. The inclusion criteria were as follows: any patient who had been treated surgically for male urethral stricture in the urology department of the teaching Hospital of Kara. The operating theater register and hospital records were used to collect the data. The diagnosis of urethral stricture had been made with retrograde urethrogram. A total of 24 patients were treated for male urethral stricture during the study period. The following variables were studied: age, reason for consultation, location, length, and etiology of the stricture;the type of treatment received: optical internal urethrotomy, or anastomotic urethroplasty, and the results. The result was considered good if, after removal of the urethral catheter, the patient regained his micturition without the need for dilatation;the result was considered average if, after removal of the urethral catheter, the patient needed one or more dilatation sessions to regain urination;the result was considered poor if, after removal of the catheter, the patient did not regain good micturition despite the urethral dilatation sessions. Microsoft excel and epi info 7 software were used for data processing. Results: The average age of our patients was 43.7 years ± 10.18 with extremes ranging from 27 to 70 years. The most represented age groups were that of 40 to 50 years, with 37.5% of cases;and that of 30 to 40 years with 33.3% of cases. The patients had c

关键词： Male Urethral Stricture Optical Internal Urethrotomy Anastomotic Urethroplasty Kara Togo

Experience with Open Prostatectomy in Lomé, Togo

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Open Journal of Urology 2016年第5期6卷 73-79页

作者： Tchilabalo M. Kpatcha Boyodi Tchangai kodjo Tengue Fousséni Alassani Gnimdou Botcho Tchin Darre Essomindedou Leloua Komi H. Sikpa Edoe V. Sewa Tsipa Anoukoum Komlan Gnassingbe Department of Urology the University Teaching Hospital of Lomé Togo Departement of Surgery the University Teaching Hospital of Lomé Togo Department of Pathology the University Teaching Hospital of Lomé Togo Department of Pediatric Surgery the University Teaching Hospital of Lomé Togo

Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. Objective: The objective is to determine the pattern and outcomes of open prostatectomy in Lomé. Patients & Methods: From December 2011 to November 2012, we conducted a descriptive cross-sectional study on a series of patients treated for prostate adenoma. Dysuria was assessed using the International Prostate Symptom Score (IPSS). The history of each patient was recorded, as well as paraclinical data. All patients were surgically treated via abdominal incision procedure. The data obtained included the patients’ demographics, clinical features, the IPSS scores, investigations, type of open prostatectomy, outcome and follow-up. The data were analyzed for means and frequencies using Epi Info version 3.5.3. Results: Fifty-four consecutive patients underwent surgery consecutively, their ages ranging from 40 to 92 years, with an average of 67.27 ± 12.50 years. In all, 46 (85.2%) patients presented with obstructive symptoms and 26 (48.1%) presented with urinary retention. The average prostate volume was 114.31 ± 20.11 cm3 with a range of 31 - 485 cm3. The average blood loss at surgery was 425.92 ± 38.2 ml with an average operating time of 66.05 ± 15.75 mins and the main complications were hemorrhaging and clot retention in 7 (13%), epididymo-orchitis in 9 (16.7%), and urinary incontinence in 6 (11.1%) patients. IPSS scores were under 7 in 92% of patients three months after surgery and the mortality rate was 3.7%. Conclusion: This study has shown that open prostatectomy in our environment is still the commonest surgical option for benign prostatic hyperplasia with good outcomes though with manageable complications.

关键词： Open Prostatectomy Benign Prostate Hyperplasia Good Outcome Complications Lomé Togo

Direct Cost of Primary Open Angle Glaucoma Management

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Open Journal of Ophthalmology 2022年第4期12卷 352-361页

作者： Kokou Vonor kodjo Wotogbé Gamélé Keke Yawa Nagbé Yaovi Tété Roger Ahlonko Kuaovi-Koko Koffi Didier Ayéna Méba Banla Komi Parice Balo Service d’Ophtalmologie CHR Kara Tomdè Togo Département d’Ophtalmologie Faculté des Sciences de la Santé Université de Lomé Lomé Togo Cabinet AFIA Lomé Togo

Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic an

关键词： Glaucoma Direct Cost Management Lomé Togo

Human Immunodeficiency Virus Can Affect the Semiology of Osteoarticular Infections?

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Open Journal of Rheumatology and Autoimmune Diseases 2014年第4期4卷 235-239页

作者： Owonayo Oniankitan Komi C. Tagbor kodjo Kakpovi Eyram Fianyo Prénam Houzou Viwalé E. S. Koffi-Tessio Moustafa Mijiyawa Rheumatology Department CHU Sylvanus Olympio Lomé Togo

Objective: To compare the epidemiological, the clinical and the paraclinical profile of osteoarticular infections in HIV-positive patients and in HIV-negative patients. Patients and Methods: patients with Osteoarticular infections recognized on the basis of radioclinical and epidemiological arguments were included in this study. The comparison that was based on the existence or was not of HIV infection focused on various clinical and biological components. Of these 15,800 rheumatic patients admitted in 18 years, 461 have suffered from Osteoarticular infection (2.9%). The 461 patient objects of this study were divided into 235 cases of infectious arthritis including 38 cases of co-infection with HIV and 225 cases of infectious spondylodiscitis including 21 cases of HIV co-infection. Results: There were 246 women (53.4%) and 215 men (46.4%) with a sex ratio of 1.1. The mean age was 37.7 ± 13.6 years. The data comparison of HIV-negative patients and HIV-positive patients had not shown statistically significant difference in the infectious spondylodiscitis group and in the group of infectious arthritis patients. Only fever was statistically significant in both groups and weight loss in the group of infectious arthritis (p < 0.001). Conclusion: HIV seems not to particularly influence the semiological profile of Osteoarticular infections in Lomé.

关键词： Black Africa Spondylodiscitis Arthritis HIV

Lumbar Spondylolisthesis in Rheumatological Practice in Lome (Togo): Frequency and Semiological Profile

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第1期12卷 21-28页

作者： Cyrille Komi Tagbor Viwale Etonam Sika Koffi-Tessio Prenam Houzou Eyram Fianyo kodjo Kakpovi Kokou Hefoume Amegan-Aho Sadat Oniankitan Awaki-Esso Atake Victor Adjenou Owonayo Oniankitan Moustafa Mijiyawa Rheumatology Department Be Hospital Lome Togo Rheumatology Department Sylvanus Olympio Teaching Hospital Lome Togo Rheumatology Department Kara Teaching Hospital Kara Togo Rheumatology Department Tomde Regional Hospital Kara Togo Paediatric Department Ho Teaching Hospital Ho Ghana Clinic Autel d’Elie Lome Togo

Objectives: To determine the frequency, the clinical and radiological features of lumbar spondylolisthesis in a rheumatological practice in Lomé. Patients and methods: This was a cross-sectional study conducted in the rheumatology department of the Sylvanus Olympio Teaching Hospital in Lomé between January 1997 and December 2019. Medical records of patients with symptomatic spondylolisthesis with radiographic confirmation were reviewed. The Meyerding classification system was used for grading. Results: Of the 350 patients contacted, 118 consented to participate in the study, making a response rate of 33.71%. Of the 118, 104 (88.1%) were females. 109 (92.4%) presented with radicular pain and 9 (7.6%) presented low back pain. The mean age of the patients was 54.24 ± 11.19 years. The average duration of the pain was 4.56 ± 1.32 years. The spondylolisthesis level most involved was the L4 - L5 (92/118), followed by L5 - S1 (23/118). 106 (89.8%) patients had anterolisthesis only, seven (5.9%) combination anterolisthesis and retrolisthesis. The spondylolisthesis was associated with spondylosis in 110 (93.2%) patients. Spondylosis was found at level L4 - L5 in 38.98% patients, followed by L5 - S1 (24.58%), L3 - L4 (18.64%). Grade I slip was found in 108 (91.53%) patients and Grade II slips 10 (8.47%). Isthmic lysis was found in 40 (33.9%) patients and it was located at L4 in 30 (75.0%). Conclusion: Lumbar spondylolisthesis appears to be expected in Lomé patients with nonspecific back pain and mainly affects females.

关键词： Low Back Pain Spondylolisthesis Sub-Sahara Africa Togo

Urological Endoscopy: Results of the First 15 Months, in Kara (Togo)

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Open Journal of Urology 2022年第9期12卷 492-498页

作者： Komi Hola Sikpa Gnimdou Botcho Messan Semefa Agbedey Essodina Padja Essomindelou Leloua Kossi Edem Gueouguede Pwerew Rodolphe Plante Edoe Viyome Sewa kodjo Kevin Tengue Matchonna Tchilabalo Kpatcha Centre Hospitalier Universitaire Kara Kara Togo Centre Hospitalier Regional Sokodé Sokodé Togo Centre Hospitalier Universitaire Sylvanus Olympia Lomé Togo

Background: The urology department of the Teaching Hospital of Kara is the 2nd urology department in Togo, Kara being a semi-urban town located 400 km from Lomé the capital. While for a long time only open surgery was used, the acquisition of urological endoscopic equipment in February 2021, has revolutionized the urological management of patients. Objective: Report the results of the first 15 months of urological endoscopy practice at the Kara Teaching Hospital, identify the particularities, announce the prospects. Patients and Methods. This was a retrospective and descriptive study, which took place in the urology department of the Kara Teaching Hospital, from February 2021 to April 2022, i.e. a period of 15 months. The register of operative reports and patient records were used for data collection. The following parameters were studied: age, sex, diagnosis, indication, diagnostic or therapeutic nature of the procedure, and results. EPI INFO 7.***.4.0 software was used for data analysis. Results: A total of 102 urological procedures (endoscopic and non-endoscopic) were performed during the study period;of the 102 interventions, 62 were endoscopic urological interventions, i.e., 60.7% of the interventions. The average age of patients treated was 55.5 years (±16.4) with extremes ranging from 28 to 87 years. Men accounted for 84% of patients treated. Prostatic hypertrophy was the most common urological pathology in our study, requiring endoscopic intervention in 40% of cases. Transurethral resection of the prostate was the most performed endoscopic procedure in our study with 43.5% of cases. The various endoscopic interventions resulted in success in 96.7% of cases. Conclusion: Urology nowadays cannot be done without endoscopy. At the Kara Teaching Hospital, the results are already promising after less than 24 months of endoscopic practice in urology. Advocacy must be made to political decision-makers, so that the situation is even better, for the good of both urologis

关键词： Urological Endoscopy Results Kara Togo

Septic Arthritis of the Hip in Lome (Togo)

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第3期11卷 97-105页

作者： Komi Cyrille Tagbor Viwale Etonam Sika Koffi-Tessio kodjo Kakpovi Prenam Houzou Eyram Fianyo Sadat Oniankitan Awaki-Esso Atake Parou Kamkote Kokou Hefoume Amegan-Aho Owonayo Oniankitan Moustafa Mijiyawa Rheumatology Department Be Hospital Lome Togo Rheumatology Department Sylvanus Olympio Teaching Hospital Lome Togo Rheumatology Department Tomde Regional Hospital Kara Togo Rheumatology Department Kara Teaching Hospital Kara Togo Paediatric Department Ho Teaching Hospital Ho Ghana

Objectives: To determine the epidemiological, clinical, and bacteriological characteristics of septic arthritis of the hip (SAH) among patients hospitalized in the departments of Rheumatology in Lomé. Patients and Methods: This was a multicentre, descriptive study, conducted over a 16-year period, from January 2004 to December 2020 on patients’ records at the three departments of Rheumatology in Lomé. We included in this study only patients with complete laboratory and radiological data. Patients who underwent hip replacement surgery and those with arthritis of the hip due to all inflammatory arthropathies were excluded. The diagnosis of SAH was based on clinical, radiological and bacteriological features. In the absence of bacteriological confirmation, the presumptive etiological diagnosis was based on epidemiological data, contacting with a person with tuberculosis, the presence of high-grade fever, the mode of presentation of the symptoms, the patient’s general appearance, and the result of the tuberculin skin test. The data was collected using Epi info 7.0 and statistical analysis was performed using STATA/IC 11.0. Results: Out of 3776 patients hospitalized in the three departments over the study period, 705 (18.67%) were diagnosed with septic arthritis of which 70 (9.92%) patients with SAH. The 70 patients with SAH were 44 (62.86%) females, and 26 (37.14%) males, with a sex ratio of 1.7 F/M. The mean age of the patients was 42.43 ± 19.37 years (range: 5 years and 80 years) and the mean duration of symptoms was 6.57 ± 8.85 months (range: 2 days and 48 months). The pain was inflammatory in nature in 46 (65.71%) and mechanical in nature in 24 (34.29%) patients. The onset of the disease was progressive in 50 (71.43%) patients and sudden in 20 (28.57%) patients. The locations of the pain were: groin only 25 (35.71%), greater trochanter only 15 (21.43%), groin and lower back 14 (20%

关键词： Septic Arthritis Hip Togo Africa