Sylvanus Olympio Teaching Hospital Research Articles

OTHR-10 CENTRAL NERVOUS SYSTEM TUMORS IN LOME, TOGO

Abstract INTRODUCTION Central nervous system (CNS) is a public health issue in Togo. This study aimed to describe the characteristics and the management of CNS tumors in Togo. METHOD We carried out a retrospective analysis of patients seen at Sylvanus Olympio Teaching Hospital, in Lomé, with histologically proven CNS tumors, between 2027 and 2022. The following parameters were analyzed: sex, age, symptoms, neurologic status, surgical procedure, and histopathological diagnosis. RESULTS There were 154 (130 intracranial tumors and 24 spinal tumors) patients operated. The mean age was 39.6 ± 28.2. for intracranial tumors, patients presented with headaches (46 %) and seizures (40 %). For spinal tumors, patients were admitted with paraparesis in 48 % of cases. Meningiomas (47 %) were the most frequent intracranial tumors. CONCLUSION Intracranial tumors are the most frequently managed of CNS tumors in Togo.

Auricular and periauricular pathologies in the ENT department of Sylvanus Olympio Teaching Hospital in Lome (Togo)

The aim of this study is to describe the epidemiological aspects, clinical features and principles of management of different types of auricular and peri-auricular pathologies. This is a 5-year retrospective descriptive study (from May 1, 2018 to April 30, 2023) of the records of patients who consulted for a functional or cosmetic complaint relating to the auricle or periauricular region in the ENT and cervico-facial surgery department of the Centre hospitalier universitaire Sylvanus Olympio. A total of 159 cases over 5 years, i.e. an annual frequency of 31 cases, met the study criteria. The mean age of the patients was 22.2 years. Children and students accounted for 24.5% and 23.9% of cases respectively. Auricular pathologies accounted for 64.8% of cases and peri-auricular pathologies for 36.2%.Tumors and trauma accounted for 33.3% and 29.6% of cases respectively, and congenital pathologies were found in 29.9% of cases. Among traumatic lesions, intentional assault and battery was the cause in 21.3%, followed by road accidents in 17.2%. The right ear was affected in 48% and the lobule in 40.4%. Keloids accounted for 17.6% of all cases, and 53% of tumors and pseudotumors. The left ear was involved in 50% of cases. Piercing was the cause of keloids in 10.7% of cases. Auricular and peri-auricular pathologies were dominated by benign tumors, trauma and congenital pathologies, and involved young subjects. Management is based on the type of lesion, with functional and aesthetic considerations in mind.

Factors associated with the satisfaction of parents of children hospitalized in the pediatric ward in Togo.

Introduction : Patient satisfaction is a central element in the evaluation of the quality of care. The objective of the study was to describe the factors associated with the satisfaction of parents of children hospitalized in the pediatric ward at the Sylvanus Olympio Teaching Hospital. Patient and method: A cross-sectional study with an analytical aim was carried out between June and August 2022 in the pediatric ward at the the Sylvanus Olympio Teaching Hospital. Results: A total of 165 parents agreed to participate in our study. The mean age (+/- standard deviation) of the parents was 33.5 years (+/- 8.8). The main elements associated with good satisfaction were: reception (p= 0.009), execution of care (p<0.001) and reaction of caregivers when called (p<0.001). The cost of hospitalization was high according to 69.7% (115) parents and the quality of equipment was poor according to 41.2% (68) others. Conclusion : Satisfaction was statistically significant between the reception, the care received and the reaction of the caregivers to the children's complaints and not the socio-demographic characteristic.

Epidemiological, clinical, therapeutic and evolutionary specificities of the association between venous thromboembolic event and cancer in sub-Saharan Africa: Case of Togo

Our study aimed to describe the clinical, paraclinical, therapeutic and outcomes of patients with venous thromboembolic event (VTE) associated with cancer in the context of limited resources. This was a descriptive cross-sectional study over a period of six years from March 1, 2016 to March 31, 2022, in the cardiology department and the oncology unit of the Sylvanus Olympio Teaching Hospital of Lome. Our study examined medical records of patients who were at least 18 years old and had venous thromboembolic disease and cancer that was histologically confirmed. This study did not include records that were incomplete or records from patients with coronavirus disease. Our study included 87 patients with average age of 56.36±15.26 years. The discovery of VTE occurred incidentally in 28.74%. Venous thrombosis was isolated in 68.96% and proximal in 95%. Pulmonary embolism was bilateral in 77.77%. Gynaecological and urological cancers were found in 33.33% and 32.19% respectively. Adenocarcinoma was the histological type of cancer found in 47.13%. Cancers were at a very advanced stage in 74.71%. Treatment with antivitamin K was prescribed in 12.65%. In our study, there were 58 patients who passed away with a mortality rate of 66.66%. The cause of death was a complication of VTE in 22.42% and related to the course of cancer in 63.79% of cases. VTE during cancer is particular with a fatal evolution due to the severity of VTE and the very advanced stage of cancer.

Lower extremity amputations (LEAs) in a tertiary hospital in Togo: a retrospective analysis of clinical, biological, radiological, and therapeutic aspects

BackgroundWe analysed the clinical, biological, radiological profiles, and therapeutic patterns of the patients who underwent a surgical lower extremity amputation (LEA) in Togo from 2010 to 2020.MethodsRetrospective analysis of clinical files of adult patients who underwent an LEA at a single centre (Sylvanus Olympio Teaching Hospital) from 1st January 2010 to 31st December 2020. Data were analysed by CDC Epi Info Version 7 and Microsoft Office Excel 2013 software.ResultsWe included 245 cases. The mean age was 59.62 years (15.22 SD) (range: 15–90 years). The sex ratio was 1.99. The medical history of diabetes mellitus (DM) was found in 143/222 (64.41%) files. The amputation level found in 241/245 (98.37%) files was the leg in 133/241 (55.19%) patients, the knee in 14/241 (5.81%), the thigh in 83/241 (34.44%), and the foot in 11/241 (4.56%). The 143 patients with DM who underwent LEA had infectious and vascular diseases. Patients with previous LEAs were more likely to have the same limb affected than the contralateral one. The odds of trauma as an indication for LEA were twice as high in patients younger than 65 years compared to the older (OR = 2.095, 95% CI = 1.050–4.183). The mortality rate after LEA was 17/238 (7.14%). There was no significant difference between age, sex, presence or absence of DM, and early postoperative complications (P = 0.77; 0.96; 0.97). The mean duration of hospitalization marked in 241/245 (98.37%) files was 36.30 (1–278) days (36.20 SD). Patients with LEAs due to trauma had a significantly longer hospital admission than those with non-traumatic indications, F (3,237) = 5.505, P = 0.001.ConclusionsCompared to previous decades, from 2010 to 2020, the average incidence of LEAs for all causes at Sylvanus Olympio Teaching Hospital (Lomé, Togo) decreased while the percentage of patients with DM who underwent LEAs increased. This setting imposes a multidisciplinary approach and information campaigns to prevent DM, cardiovascular diseases, and relative complications.

Sténose hypertrophique du pylore en chirurgie pédiatrique du Centre Hospitalier Universitaire Sylvanus Olympio LoméTogo

Objective-the aim of this study was to determine the hospital frequency of hypertrophic pyloric stenosis and the socio-demographic characteristics of patients with HPS, to describe the clinical and therapeutic aspects and to evaluate the operative follow-up. Methods-This was a retrospective descriptive study conducted over aperiod of 06 years and 06 months (January 2014 to June 2020) in the pediatric surgery department of the Sylvanus Olympio Teaching Hospital in Lomé. Complete records of patients from 0 days to 30 months of age hospitalized and managed for HPS during the study period were included. Epidemiological, anamnestic, clinical, paraclinical, therapeutic and evolutionary data were studied. Results-a total of 17 patients were collected in the department. The hospital incidence of HPS was approximately 3 cases per year. The predominance was male. The mean age of the patients was 40.4 ± 15.1. Vomiting of curdled milk was the main reason for consultation. Ultrasound was performed in all patients and was diagnostic in the majority of patients (15 patients). The ionogram was disturbed in 14 patients, hypochloremia being the mostcommon ion disorder. Management consisted on open Fredet and Ramstedt extramucosal pylormyotomy in all patients. The supra-umbilical approach was the most commonly used. All patients had a favourable outcome. Conclusion-hypertrophic pyloric stenosis was characterised by a delay in consultation with a clinical picture dominated by vomiting causing ionic disorders. However, the encouraging therapeutic results noted could be improved.

High faecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) among hospitalized patients at Sylvanus Olympio Teaching Hospital, Lomé, Togo in 2019

Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are a global health concern, associated with increased morbidity and mortality. Even in the absence of infections, colonization by these pathogens is still a great threat because of the risk of cross transfer among hospitalized patients. Faecal carriage of ESBL-PE remained poorly documented in Africa. This study aimed to determine faecal carriage rate of ESBL-PE, factors associated with carriage, and antimicrobial susceptibility of the strains among hospitalized patients at Sylvanus Olympio Teaching Hospitals (CHU SO) in Lomé, Togo.
 Methodology: This was a cross-sectional study of 105 randomly selected hospitalized patients between September and November 2019. Socio-demographic and clinical data as well as rectal swabs were collected after obtaining the consent of the selected participants. Rectal swabs were cultured on selective bromocresol purple (BCP) lactose agar containing 6µg/l ceftazidime, for isolation of Enterobacteriaceae. Identification of each isolate was performed using Uriselect 4 medium and API 20E. Antibiotic susceptibility of the bacterial isolates was performed by the Bauer-Kirby agar disc diffusion test and interpreted according to CASFM-EUCAST recommendations.
 Results: The faecal carriage rate of ESBL-PE among selected hospitalized patients was 80.9% (85/105). Escherichia coli was the most frequent bacteria 69.5% (73/105), followed by Klebsiella pneumoniae 22.8% (24/105). The antibiotic profile of ESBL producing Escherichia coli showed resistance to amoxycillin+clavulanic acid (72.6%), ticarcillin+clavulanic acid (82.2%), piperacillin+tazobactam (30.1%), cefoxitin (30.1%) ciprofloxacin (84.9%), levofloxacin (76.7%), nalidixic acid (83.6%), chloramphenicol (26.0%), gentamicin (49.3%), sulfamethoxazole-trimethoprim (86.3%), imipenem (5.5%), and ertapenem (21.9%). All (100%) isolates were sensitive to amikacin and fosfomycin. None of the characteristics or risk factors assessed was significantly associated with faecal carriage of ESBL-PE.
 Conclusion: Faecal carriage rate of ESBL-PE in these hospitalized patients was very high, but no factor was associated with carriage of ESBL-PE among the study population. Implementation of infection control measures, and surveillance are needed to limit the spread of these resistant pathogens within CHU SO healthcare facilities.

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

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.

Hypertrophic Cardiomyopathies at the Sylvanus Olympio Teaching Hospital of Lome: Epidemiological, Diagnostic, Therapeutic and Evolutive Aspects

Background: Hypertrophic cardiomyopathy (HCM) is a form of cardiomyopathy that may involve several aspects.The aim of our study is to describe the epidemiological, diagnostic, therapeutic and short-term prognostic aspects of this form of cardiomyopathy at the Sylvanus Olympio Teaching Hospital of Lome. Materials and Methods: This was a cross-sectional study that was carried out over a four-year period from January 1, 2016 to December 31, 2019. We included in this study, patients admitted to the Cardiology Department of the Sylvanus Olympio Teaching Hospital of Lome, in whom the diagnosis of hypertrophic cardiomyopathy was retained at echocardiography in the absence of any other cause that could explain the significant hypertrophy of the walls. Results: The prevalence of hypertrophic cardiomyopathies in our study was 0.31%. The mean age of patients was 51.35 ± 15.28 years with a male predominance (sex ratio M/F of 1.22). The majority of patients (60%) were between 45 and 74 years old. The clinical presentation was dominated by congestive heart failure in 15 patients (75%). Half of the patients (50%) had type III hypertrophic cardiomyopathy according to Maron’s classification. Seven patients (35%) had obstructive HCM and the mean thickness of the interventricular septum in diastole was 15.88. Left ventricular systolic function was impaired in 40% of patients. No patient was able to do a genetic test. The combination of beta-blocker (95%), an inhibitor of the renin- angiotensin-aldosterone system (90%) and furosemide (85%) constituted the essential part of the treatment combined with Lifestyle changes. No patients have benefited from implantable cardioverter defibrillators. The yearly mortality rate at the end of our study was 70%. Conclusion: Hypertrophic cardiomyopathy remains a relatively rare pathology. It is often a late diagnosis in the context of heart failure with limited therapeutic means, explaining its heavy morbidity and mortality.

Epidemiology of intussusception among infants in Togo, 2015-2018.

Introductionintussusception is the leading cause of bowel obstruction in infants and young children. We describe the epidemiology and diagnostic and treatment characteristics of intussusception among Togolese infants over a 4-year period.Methodswe implemented active surveillance among infants younger than 1 year of age admitted with intussusception from 2015 to 2018 at Sylvanus Olympio Teaching Hospital and in 2018 at Campus Teaching Hospital. Brighton Collaboration Level 1 case definition criteria were used to confirm the diagnosis of intussusception.Resultsduring four years, 41 cases of intussusception, with an annual range of 8 to 14 cases (median: 10) were reported; and the highest number of cases (89%) was enrolled at Sylvanus Olympio teaching hospital. Intussusception was uncommon in the first 2 months of life, peaked from 5 to 7 months old (63%), with male predominance (63%), and showed no significant seasonality. One third of cases (34%) were transferred to the sentinel surveillance site from another health facility; and the median delay in seeking care was 4 days (range: 0-11) with ≥ 48-hour delay in 59% of cases. Clinical symptoms, ultrasound and surgery were combined to diagnose intussusception in all the cases (100%). The treatment was exclusively surgical, and intestinal resection was common (28/41, 68%). A high case fatality rate (23%) was observed and the average length of hospital stay was 10 days (range: 1-23).Conclusionactive surveillance for intussusception in Togo has highlighted exclusive use of surgical therapy; often associated to an intestinal resection with a very high case fatality rate.

Trauma of the Male Genitals in the Teaching Hospital Sylvanus Olympio of Lome: Lesional and Therapeutic Aspects

Introduction: Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work was to provide an overview of these lesions by describing the epidemiology, the diagnostic approach, their therapeutic and prognostic aspects. Materials and Methods: It was a retrospective study carried out over a ten-year period, from January 1, 2009 to December 31, 2018. It included male patients, admitted and treated in surgical emergencies and in the urology department of the Sylvanus Olympio Teaching Hospital in Lomé for trauma of male external genital organs. Results: Thirty-five cases had been collected. They had represented 1.5% of urological emergencies. The subjects were young with a mean age of 29.6 ± 3.1 years, with extremes of 18 and 60 years. Trauma to the penis was more frequent and found in 60% of cases, with the mechanism of coitus misstep in 54.3%, leading to a fracture of the penis. Testicular contusions were found in 22.9% of the cases. The ultrasound was performed in 6 patients. Four orchidectomies were performed for an unsustainable testicle found at scrototomy. The postoperative had been simple in all cases. Fifteen patients (42.8%) had been regularly followed on 18 months. Residual testicular pain and mode-rate erectile dysfunction was noted respectively in 3 and 2 patients. Conclusion: TEMGO, although rare, require perfect knowledge for adequate therapeutic decisions, as they can compromise the functional prognosis of concerned organs.

Breast Cancer and Pregnancy at Sylvanus Olympio Teaching Hospital of Lome -Togo

Breast Cancer and Pregnancy at Sylvanus Olympio Teaching Hospital of Lome -Togo

Management of Incomplete Abortions by the Manual Intra Uterine Suction Technique at Sylvanus Olympio Teaching Hospital of Lome-Togo

Management of Incomplete Abortions by the Manual Intra Uterine Suction Technique at Sylvanus Olympio Teaching Hospital of Lome-Togo

Laryngo-tracheo-bronchial foreign bodies: epidemiological, diagnostic and therapeutic aspects

<p class="abstract"><strong>Background:</strong> The objective of the study was to describe the epidemiological, diagnostic and therapeutic aspects of laryngo-tracheo-bronchial (LTB) foreign bodies (FB).</p><p class="abstract"><strong>Methods:</strong> A 20-year retrospective study, performed in the ENT, head and neck surgery department of Sylvanus Olympio Teaching Hospital in Lomé, dealing with patients treated for this LTB. </p><p class="abstract"><strong>Results:</strong> Sixty-one cases of LTB FB were collected. The LTB FB represented 3.05 cases per year, 11.71% of the FB airways and 4.08% of ENT FB. Thirty-two patients (52.46%) were male, a sex ratio of 1.10. The average age of patients was 5.08 years, with extremes of 4 months and 43 years. In 31 cases (50.82%), the accident occurred during the meal and in 30 cases (49.18%) during a game. The penetration syndrome was found in 54 cases (88.52%). FB was extracted by rigid tube bronchoscopy in 50 patients (81.97%). The most common site of endoscopy was right bronchus in 30 cases (49.18%) and in 11 cases (18.03%) FB was laryngeal. Organic FB accounted for 31 cases (50.82%) and was dominated by peanuts (29.5%), for non-organic FB they were dominated by pebbles (8.2%). The evolution was favorable in 58 cases (95.08%).</p><p class="abstract"><strong>Conclusions:</strong> Severe accidental pathology, the prognosis depends on the nature of the body, its seat and the time of care.</p>

Intracranial Meningiomas among Intracranial Tumors in the Neurosurgical Unit of Sylvanus Olympio Teaching Hospital

Objective: To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). Method: We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. Results: 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). Conclusion: Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.

High Blood Pressure and Pregnancy in a Hospital Environment in Lomé: Prognostic and Clinical Epidemiological Aspects

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 Lome. 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.

Etiology of Pediatric Bacterial Meningitis Pre- and Post-PCV13 Introduction Among Children Under 5 Years Old in Lomé, Togo

BackgroundPediatric bacterial meningitis (PBM) causes severe morbidity and mortality within Togo. Thus, as a member of the World Health Organization coordinated Invasive Bacterial Vaccine Preventable Diseases network, Togo conducts surveillance targeting Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae, at a sentinel hospital within the capital city, Lomé, in the southernmost Maritime region.MethodsCerebrospinal fluid was collected from children <5 years with suspected PBM admitted to the Sylvanus Olympio Teaching Hospital. Phenotypic detection of pneumococcus, meningococcus, and H. influenzae was confirmed through microbiological techniques. Samples were shipped to the Regional Reference Laboratory to corroborate results by species-specific polymerase chain reaction.ResultsOverall, 3644 suspected PBM cases were reported, and 98 cases (2.7%: 98/3644) were confirmed bacterial meningitis. Pneumococcus was responsible for most infections (67.3%: 66/98), followed by H. influenzae (23.5%: 23/98) and meningococcus (9.2%: 9/98). The number of pneumococcal meningitis cases decreased by 88.1% (52/59) postvaccine introduction with 59 cases from July 2010 to June 2014 and 7 cases from July 2014 to June 2016. However, 5 cases caused by nonvaccine serotypes were observed. Fewer PBM cases caused by vaccine serotypes were observed in infants <1 year compared to children 2–5 years.ConclusionsRoutine surveillance showed that PCV13 vaccination is effective in preventing pneumococcal meningitis among children <5 years of age in the Maritime region. This complements the MenAfriVac vaccination against meningococcal serogroup A to prevent meningitis outbreaks in the northern region of Togo. Continued surveillance is vital for estimating the prevalence of PBM, determining vaccine impact, and anticipating epidemics in Togo.

Epidemiology and outcomes of in-hospital acute burn-patients in Togo: A retrospective analysis

BackgroundBurn epidemiologic data are limited in sub-Saharan Africa. This study was aimed at filling the gap in the real-time data about burns in Togo by assessing sociodemographic, clinical and outcome characteristics, causes and severity of burns of hospitalized patients for prevention programs. MethodologyThis retrospective study analysed the medical folders of patients admitted to the ICU department of Sylvanus Olympio Teaching Hospital (SOTH) in Lomé for an acute burn injury during 7 years (January 2007–December 2013). We collected sociodemographic parameters, causes, and mechanisms of burns; the time between burns injury and admission to the Surgical Emergency Department (SED), pre-hospital care, pre-existing medical conditions, and treatments. Burned total body surface area (TBSA), anatomical sites and depth of burns, treatment and outcomes were assessed by EPI INFO 3.5.3 (ATLANTA CDC 2003). ResultsBurns represented 2.1% of all admissions to the SED. Of the 1,843 burn patients, 497 (26.9%) were admitted to the ICU department, and 1,346 (73%) were treated as outpatients. The analysis included the complete folders of 211 patients. The patients’ mean age was 14.9 years (4 months-94 years). The male to female ratio was 1.67. Children numbered 129 (61.1%) and adults 82 (38.9%).Burns were caused by hot liquids in 74.4% of children and in 13.4% of adults (p = 0.003), and by flames in 73.2% of adults and 19.4% of children (p = 0.001). The mean burned TBSA was 26.5% (range 3%–95%). Mean Abbreviated Burn Severity Score was 4 (range 2–11) for children and 6 (range 3–13) for adults.Medical treatments were fluid resuscitation, close or open wound dressing. Surgical treatments included escharotomy in 28 (13.3%) patients, skin grafts in 23 (11%), local flaps in 3 (1.4%), and fingers or limbs amputations in 9 (4%). Mean hospital stay was 21 (range 1–99) days. The overall burn-related mortality rate was 24.6%. ConclusionsIn Togo, over the 2007–2013 period, children were most affected in house-related accidents, whereas adults had most fire burns with extended burned TBSA and associated injuries. Only few patients had surgery and in delayed planning.This study has identified the essential requirements to enhance burn care management and provided an outline for further epidemiologic studies.

Complicated High Blood Pressure in Hospital Area in Lom&amp;amp;#233;

The target of the study was to identify patients living with Compound high blood pressure and describe the epidemiological, treatment and progressive aspects. We had realized retrospective and descriptive study completed throughout twelve months from 1st January to December 31, 2011. The study took into account 250 hypertensives known or not admitted in the cardiology and medical intensive care units at the Sylvanus Olympio Teaching Hospital in Lomé. In total, the frequency of complications of the High Blood Pressure was 33.3% with a male predominance. Patients’ average age was 52.4 years. The most frequent reasons of admission were coma (32%) and hypertensive eruption (28%). The excessive consumption of salt and alcohol were other dominant modifiable risks factors with respectively 36.8% and 22.8%. Neurologic complications were the most frequent of cerebrovascular accidents (CVA) (66%) among which strokes represented 69.7%. Cardiac complications came in second position (31.2%). Double treatment was optional in 62.2% cases with IEC+ Ica++ associated. In 56.6% cases patients with renal disease in terminal stage had been dialysed. The level of total lethality was 34%. The main cause of death was CVA (cerebrovascular accidents) (85.9%). High Blood Pressure is then a very plague with regard to its complications. Its effective caretaking is nothing but through primary prevention based on sensitization, education of the entire grass-roots and it requires the mobilization of all social components.

F&amp;amp;#339;tal Death in Utero: Maternal Epidemiological and Prognostic Aspects at Sylvanus Olympio Teaching Hospital in Lom&amp;#233;

The fetal death In Uterus is relatively a common problem in developing countries. In Africa, the rate of deaths varies from one hospital to another. We wanted to evaluate the prevalence, to describe the epidemiological aspects, etiologies and maternal prognosis associated with fetal deaths in Uterus in 2017 at Sylvanus Olympio Teaching Hospital in Lome. Patients and methods: This was a retrospective descriptive study conducted from January 1st to December 31st, 2017. We have included all pregnant cases received and treated on the spot for in uterus deaths as defined by the World Health Organization. Medical termination of pregnancy records, intrapartum deaths, less than 22 amenorrhea weeks’ pregnancies and complications of abortion were not included. Results: The fetal death rate in uterus was 3.64%. The multigravida and multiparous were respectively 49% and 41%; the referees were 51%, 28% evacuated; 21% came on their own. The gestational age of 28 - 37 weeks was 39% and 17% had no prenatal consultation. The analysis has revealed that high blood pressure, preeclampsia, and retroplacental hematomas were the main etiologies associated with fetal deaths in uterus. Conclusion: In uterus fetal deaths remain common in our country. The main causes were hypertension disorders of pregnancy. There were also some unknown causes which could be related to economic or cultural reasons. For instance, autopsies of in uterus deaths and placental anatomopathology examination are not performed because of culture.