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Urological Emergencies at Kara Teaching Hospital (Togo): Epidemiological, Clinical and Therapeutic Profile

Open Journal of Urology 2023年第1期13卷 1-8页

作者： Komi Hola Sikpa Tchilabalo Matchonna Kpatcha Kodjo Tengue Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Messan Semefa Agbedey Pwerew Rodolphe Plante kossi edem gueouguede Kara Teaching Hospital Kara Togo

Background: The urology department of the teaching hospital of Kara is the second urology department in Togo, after that of the teaching hospital Sylvanus Olympio, in Lomé the capital. It is a very young service, created less than 5 years ago. Urological emergencies were previously managed by general surgeons, for lack of urologists. The influx of patients with urological pathologies has increased with the arrival of urologists. The update on urological emergencies having been made in Lomé, we therefore wanted to take stock of urological emergencies at the teaching hospital of Kara. Objective: To describe the epidemiological, clinical, and therapeutic aspects of urological emergencies received at the teaching hospital of Kara. Patients and Methods: This was a descriptive study with retrospective data collection. The study took place in the urology department, and in the surgical emergency department of the teaching hospital of Kara, over a period of 18 months, from January 2021 to June 2022. The on-call medical team consisted of the intern in on-call medicine, and an on-call urologist, whom the intern called upon when he received a urological emergency. Pediatric urological emergencies were managed by the pediatric surgeon and were not considered in our study. The operating room register, the surgical emergency consultation register, the urology department consultation register, and the records of patients hospitalized in the urology department were used for data collection. The following parameters were studied: age, sex, type of urological emergency, and therapeutic management;epi info 7 software was used for data processing. Results: The average age of the patients was 52.5 ± 19.6 years with extremes ranging from 16 years to 102 years. Note that 57.7% of the patients were over 50 years old. The sex ratio was 8.9. Urinary retention was the most common urological emergency in 47.7% (52) of cases;follow-up of infectious pathologies in 30.2% (33) of cases. Among the

关键词： Urological Emergencies Profile Kara Togo

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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

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Brain Amyloidoma: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2020年第4期10卷 403-421页

作者： Abd El Kader Moumouni Daniel Memia Zolo Essossinam Kpelao Pascal Compaore Dabou Abiba Tamou Tabe Latevi Lawson Pwerew Rodolphe Plante edem kossi gueouguede Benedicte Souho Abderrahmane Hamlat Department of Neurosurgery CHU Martinique Martinique France Department of Neurosurgery CHU Kara Kara Togo Department of Neurosurgery CHU Sylvanus Olympio Lomé Togo Departments of Radiology CHR Kara Kara Togo

Introduction: Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. Case Report: A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m2). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. Conclusion: No guidelines can be suggested for brain amyloidoma treatment;the “wait and see” was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.

关键词： Amyloidoma Brain Literature Review

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Urological Emergencies at Kara Teaching Hospital (Togo): Epidemiological, Clinical and Therapeutic Profile

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Open Journal of Urology 2023年第1期

作者： Komi Hola Sikpa Tchilabalo Matchonna Kpatcha Kodjo Tengue Gnimdou Botcho Edoe Viyome Sewa Sabi Rachid Sade Messan Semefa Agbedey Pwerew Rodolphe Plante kossi edem gueouguede

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

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Open Journal of Urology 2022年第9期

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

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Mortality in Cardiology in Sub-Saharan Africa: Case of the Cardiology Department of the Teaching Hospital Sylvanus Olympio of Lome

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World Journal of Cardiovascular Diseases 2023年第8期13卷 477-492页

作者： Afassinou Yaovi Mignazonzon Dola kossi edem Pessinaba Soulemane Atta Borgatia Pio Machihude Baragou Soodougoua Damorou Findibe Cardiology Department Sylvanus Olympio Teaching Hospital of Lome Lome Togo Cardiology Department Teaching Hospital Campus of Lome Lome Togo Medical Department Sokode Regional Hospital Center Sokode Togo Cardiology Department Kara Teaching Hospital Kara Togo

Background: Cardiovascular disease is the leading cause of death worldwide. The specificities of cardiology mortality in Togo are not well known. The objective of this study was to determine the profile of deaths in the cardiology department of the Sylvanus Olympio Teaching Hospital (CHU SO) in Lome. Materials and Methods: This was a cross-sectional study conducted over a period of 06 years, from January 1, 2015 to December 31, 2021, in the cardiology department of the Sylvanus Olympio Teaching Hospital in Lome. In this study, we included all medical records of patients who died in hospital in the cardiology department during the study period. Results: During the study period, 2762 patients were hospitalized in the cardiology unit at CHU SO. We recorded 112 deaths meeting our criteria, for an intrahospital mortality rate of 4.19%. The average age of patients was 53.79 ± 18.27 years. Hypertension was present in 47.3%. Sickness insurance coverage was not available for 94.64% of those who died. The major cardiovascular diseases observed were myocardium in 43.75% whose dilated cardiomyopathy accounted for 71.42%;and rhythmic lesions in 34.82%. Biological infectious syndrome (56.25%), renal failure (48.21%), anemia (47.27%), lung infection (32.14%), hyponatremia (33.04%) were the main comorbidities observed. Among the circumstances of death, sudden death was found in 32.14%, cardiogenic shock in 20.54% and septic shock in 13.39%. Conclusion: The profile of deaths in the cardiology department of the CHU SO reveals that myocardial injuries are more present with circumstances of death dominated by sudden death.

关键词： Mortality Rate Cardiology CHU Sylvanus Olympio

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Compliance with Oral Anti-Diabetic Treatment in Lome

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Open Journal of Internal Medicine 2024年第1期14卷 53-63页

作者： Tchamdja Toyi Djalogue Lihanimpo Kodjo kossi Kaaga Laconi Yéba Mossi Komi edem M’bortché B. Kodjo Ehon Ata edem Djibril Mohaman Awalou Balaka Abago Internal Medicine Departement Université de Kara Kara Togo Internal Medicine Departement Université de Lomé Lomé Togo

Objective: The objective of this study was to assess adherence to antidiabetic therapy in type II diabetic patients and factors associated with Lomé. Method: This was a descriptive observational study conducted among diabetics in diabetes care centers from May 1, 2020 to October 1, 2020, for a period of 6 months. Results: A total of 300 patients were questioned. The mean age was 56.61 years (standard deviation = 11.7). The sex ratio was 0.6. All the patients were on drug treatment, 83.4% of whom were on metformin and 37.5% on Glibenclamide. In 58.3% of the cases, the patients were on dual therapy and 96.2% had an abovenormal glycated hemoglobin value. There was a medication adherence problem with poor adherence in 30.7%. Being aged 50 and over (ORC = 1.78, p = 0.048), playing sports (ORR = 1.87, p = 0.046), have reaching a higher level of education (ORR = 5.78, p = 0.005) significantly increased the chances of patients having a good/minimal problem of adherence. Conclusion: Diabetes affects in Togo, more women than men with a predominance of those aged 50 and over. Adherence to therapy remains a challenge.

关键词： Type II Diabetes Metformin Compliance Associated Factors

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Cervical Cancer Screening by Midwives in the Kara Region of Northern Togo: Knowledge, Attitudes and Practices

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 140-146页

作者： kossi edem Logbo-Akey Dede Regina Ajavon Kignomon Bingo M’bortche Pierre Yendoubé Kambote Kbando Noé Patidi Abdoul Samadou Aboubakari Department of Gynecology and Obstetrics CHU Kara University of Kara Kara Togo Gynecology and Obstetrics Department of CHR Tomdé University of Kara Kara Togo Clinic of the Togolese Association for Family Welfare (ATBEF) University of Lome Lome Togo University of Lome Lome Togo

Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. Methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: Midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.

关键词： Cancer of the Cervix Knowledge Screening Midwives Kara

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Delivery Outcome in Women with Major Sickle Cell Syndrome: A Comparative Study of the Homozygous Forms “SS” versus the Heterozygous “SC”

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 713-722页

作者： Amah Biova Adama-Hondégla Abdoul-Samadou Aboubakari kossi edem Logbo-Akey Kodjo Fiagnon Akila Bassowa Koffi Akpadza Department of Gynecology and Obstetrics of the Sylvanus Olympio University Hospital of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital of Kara Kara Togo

Objectives: To determine the prevalence of women who delivered in the two major sickle cell syndromes, “SS” and “SC”, and to identify maternal and early neonatal prognosis inherent to each form. Material and Methods: This is a comparative, descriptive and retrospective cross-sectional study of 226 files of women carrying major sickle cell syndrome (66 cases of “SS” form versus 160 cases of “SC” form), collected from May 2008 to May 2013 at the Gynecology and Obstetrics Clinic of the Sylvanus Olympio’s University Hospital of Lomé. Data were processed by Epi Info 6 software. For comparison of variables, the Chi-2 test of Fisher with significance as p < 0.05 has been used, so is the calculation of Odds Ratio with its confidence interval at 95%. Results: Carriers of the two major sickle cell syndromes represent 0.8% of all the deliveries during the study period. Caesarean section, especially prophylactic one, was the dominant mode of delivery. The SS forms have been exposed to have more vaso-occlusive crises (22.7% vs. 13.1%;p = 0.04, OR = 0.31), more blood transfusion (57.6% vs. 29.4%;p = 7 × 10-5, OR = 3.2) and more puerperal infections (p < 0.05). Acute chest syndrome was not related to any of the two forms of sickle cell disease (13.6% vs. 8.1%;p = 0.15). The maternal mortality rate and the perinatal mortality among SS form against SC form were not significant (respectively 15.1% vs. 8.7%;20.9% vs. 17.1%). Conclusion: Maternal and fetal complications were present in both forms of major sickle cell syndrome but the "SS" form gave exposure to greater maternal morbidity. Resuscitative measures in adults and newborns should be reinforced at the delivery time of these “at-risk-pregnancies”.

关键词： Sickle Cell Disease Childbirth Prognosis Homozygous SS Heterozygous SC Togo Africa

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Outcome of Pregnancies under Cupper Intrauterine Device: Experience of 10 Cases Collected at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 616-623页

作者： Bingo Kignomon M’bortche kossi edem Logbo-Akey Tina Ayoko Ketevi Baguilane Douaguibe Francis Baramna-Bagou Abdoul-Samadou Aboubakari Koffi Akpadza Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynaecology-Obstetrics The University Hospital Kara Kara Togo Department of Gynaecology-Obstetrics The University Hospital Sylvanus Olympio Lomé Togo

Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. Methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF Main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.

关键词： Contraception Pregnancy Etiologies Outcome Lomé

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