[Ten years of destructive eyeball surgery in Lomé]. / Bilan de dix ans de chirurgies mutilantes oculaires à Lomé.

INTRODUCTION: Destructive surgery of the eyeball comprises radical procedures - evisceration, enucleation, and exenteration - with various indications. The purpose of this study was to determine the features of these procedures in Lomé. PATIENTS AND METHODS: We conducted a retrospective study reviewing records for all patients undergoing these procedures in 3 ophthalmic centers in Lomé in the decade from 2002 through 2011. RESULTS: Of 6240 eye operations, 76 involved one of these three procedures, for a frequency of 1.2%. Patients' mean age was 40.1 ± 26.9 years (range: 1 day to 91 years). The sex ratio (of men to women) was 1.2. The principal indications were staphyloma (38%), ocular and orbital tumors (30%), and phthisis bulbi (24%). Retinoblastoma was the leading type of ocular/orbital tumor (52%). Local anesthesia was performed in 64% of cases, and general anesthesia in 36%. Evisceration was practiced in 67% of cases, enucleation in 24%, and exenteration in 9%. An ocular prosthesis was placed in 46%. CONCLUSION: Staphyloma was the leading indication for destructive surgery. Given the damage of this type of procedure, primary prevention is important, including early and adequate management of ocular conditions.

[Compliance to treatment in heart failure patients in Lomé]. / Observance thérapeutique de l'insuffisant cardiaque à Lomé

BACKGROUND: The incidence and prevalence rates of the heart failure in the world approach epidemic proportions. The evaluation of the follow-up of the treatment of heart failure can allow the setting up of strategies to reduce the frequency of decompensations and improve the quality of life of these patients. OBJECTIVES: To estimate the compliance to treatment and factors liable to influence it in Togolese patients suffering from heart failure. PATIENTS AND METHODS: This study was carried out from January 1st, 2008 to June 30th, 2009 in the department of cardiology of the university teaching hospital Campus in Lomé and included prospectively, patients with chronic heart failure hospitalized for acute decompensation and of which the heart failure was diagnosed and treated for at least 3 months. Questionnaires were filled to estimate the compliance to medication, to diet, as well as knowledge of the patients on their disease and their relationship with their doctor and their family. RESULTS: In the 103 patients included, we noticed no good compliance to medication; there were 74.7% of bad compliance to medication, 47.3% of good compliance to diet; 62.1% of patients had enough knowledge on their disease, 29.1% considered that their doctor did not grant them enough time; 57.3% estimated to have no necessary support of their family. Bad compliance to treatment was correlated to the existence or not of a health care insurance (OR=115.5; 95% CI=21.51-620.08; P<0.0001); this difference persisted after adjusting for age, sex and monthly income (OR=99.65; 95% CI=18.87-587.21; P=0.001). Bad compliance was not associated with monthly income (OR=0.93; 95% CI=0.37-2.28; P=0.944); it was neither influenced by traditional therapy (OR=1.58 95% CI=0.64-3.91; P=0.43), nor recovery prayers (OR=1.6; 95% CI=0.62-4.13; P=0.45), nor frequency of tablets intake (≥3 intake day), OR=0.169; 95% CI=0.05-0.49; P=0.43. CONCLUSION: The compliance to medication in Togolese heart failure patients was very low and essentially correlated to the absence of health care insurance.

[Evolution of cardiovascular diseases' admissions in cardiology departments of Lomé hospitals: a cross-sectional study on 7959 patients from June 2004 to May 2009]. / Évolution des admissions pour maladies cardiovasculaires en milieu cardiologique à Lomé : étude transversale de 7959 patients de juin 2004 à mai 2009.

BACKGROUND: To determine the frequency of cardiovascular diseases, their risk factors as well as their evolution in two cardiology departments of Lomé. METHODS: This cross-sectional study was carried out among patients attending two cardiology departments of Lomé, from June 2004 to May 2009, who had a diagnosis of cardiovascular disease. RESULTS: A total of 7959 patients were included. Female gender predominated. The mean age was of 49.5 ± 17.2 years. The number of admissions increased from 958 in 2004 to 2399 in 2009. Arterial hypertension (62.7%) and ischemic heart diseases (10.6%) were the most frequent diagnoses. Among patients with a diagnosis of heart failure, the etiology was not recorded for 12.2%. Overweight and dyslipidemia were significantly more frequent in women (P<0.001), while smoking and physical inactivity were significantly more frequent in men (P<0.001). During the period, there was a moderate rise of the prevalence of overweight, dyslipidemia, and physical inactivity, whereas the prevalence of diabetes and smoking remained almost unchanged. CONCLUSION: Admissions for cardiovascular diseases increased from 2004 to 2009. This epidemiological transition may be related to poor awareness of cardiovascular disease among the low-income population and the financial burden of health care.

[Management of high-grade atrioventricular block in Lomé, Togo]. / Prise en charge des blocs auriculoventriculaires de haut degré à Lomé (Togo).

The purpose of this cross-sectional study was to describe epidemiological, clinical and therapeutic aspects of high-grade atrioventricular block in Lomé. Out of 2245 patients hospitalized between June 2004 and May 2009, a total of 22 cases of high-grade atrioventricular block were detected thus a prevalence of 1%. The main symptoms were syncope and presyncope (73%) and dyspnea (50%). There was 77.2% of chronic grade III atrioventricular block and 22.8% of grade II atrioventricular block. A pacemaker has been established in 8 patients (40% of the patients presenting a class I indication) in VVI (R) mode. We noted 59% of deaths among patients who did not benefited from any cardiac pacing.