Profil des édentements partiels selon la classification de Kennedy-Applegate dans une structure de soins dentaires de Lomé (Togo) / Profile of partial edentulism according to the Kennedy-Applegate classification in a dental care structure in Lome (Togo)

Introduction. La documentation des édentements partiels est un indicateur de l'état buccodentaire et permet d'évaluer les besoins en soins prothétiques. L'objectif de ce travail était de décrire le profil des édentements partiels selon la classification de Kennedy-Applegate dans une structure de soins dentaires. Matériels et méthodes. Il Une étude transversale descriptive a été réalisée durant 3 mois dans le service d'odonto-stomatologie et de chirurgie maxillo-faciale du Centre Hospitalier Universitaire Sylvanus Olympio (CHU-SO) de Lomé (Togo). Les données sociodémographiques et cliniques des patients inclus ont été recueillies et analysées grâce au logiciel Jamovi® version 2.2.5. Résultats. L'échantillon comportait 82 sujets dont 50% de femmes. L'âge moyen était de 47,4 ± 15,1ans. Les édentements de classe III de Kennedy prédominaient avec 75,2% des arcades édentées. Les édentements de classe III étaient retrouvés à 82,1% dans la tranche d'âge 19-40 ans, les 61 ans et plus comptaient 20% des classes I et 24% des classes II. L'édentement était significativement associé à l'âge (p=0,046). Conclusion. Il apparait que la classe III de Kennedy est globalement la plus fréquente des édentements partiels et que l'étendue édentement augmenterait avec l'âge

Introduction. Documentation of partial edentulism is an indicator of oral health status and enables prosthetic care needs to be assessed. The aim of this study was to describe the pattern of partial edentulism according to the Kennedy-Applegate classification in a dental care facility. Materials and methods. This A descriptive cross-sectional study was conducted over a 3-month period in the Odonto-stomatology and maxillofacial surgery department of the Centre Hospitalier Universitaire Sylvanus Olympio (CHU-SO) in Lomé (Togo). The sociodemographic and clinical data of the included patients were collected and analysed using Jamovi® version 2.2.5 software. Results. The sample included 82 subjects, 50% of whom were women. The average age was 47.4 ± 15.1 years. Kennedy class III edentulism predominated with 75.2% of edentulousness arches. Class III edentulous was found at 82.1% in the 19-40 years age group, those aged 61 years and over had 20% of class I and 24% of class II. Edentulism was significantly associated with age (p=0.046). Conclusion. It appears that Kennedy class III is globally the most frequent of partial edentulism and that the extent of edentulism would increase with age.

Late Diagnosis of Bilateral Choanal Atresia: A Case Report of a Nine-Year-Old Girl.

Bilateral choanal atresia is a surgical emergency because of the risk of neonate death from acute asphyxia if treatment is delayed. Its diagnostic confirmation is often endoscopic or CT scan and requires a search for associated malformations. We present the case of a nine-year-old girl who was referred to the ENT department with suspected adenoid pathology. Her medical history showed respiratory distress at birth treated as a neonatal infection. We suspected bilateral choanal atresia due to the absence of fogging on mirror test and failure to pass a 6Fr or 8Fr suction catheter through the nasal cavity into the nasopharynx. Facial CT confirmed the presence of bilateral mixed osteo-membranous choanal atresia. Transpalatal choanoplasty was successfully performed with pre and postoperative endoscopic examination. This clinical case adds to the limited literature on bilateral choanal atresia diagnosed long after birth, raising once again the lack of knowledge of choanal atresia by some health workers, emergency neonatal care, the mechanism of breathing in the newborn, and the management of this malformation. Transpalatal choanoplasty is a good alternative when technical conditions do not allow an endoscopic endonasal approach.

Skin cancers in people with albinism in Togo in 2019: results of two rounds of national mobile skin care clinics.

BACKGROUND: In people with albinism (PWA), the deficiency of melanin increase the risk of skin cancers. The aim of this study was to determine the prevalence of skin cancers and characteristics of these detected skin cancers (histological types, localization) in PWA in 10 cities in Togo in 2019. METHODS: This is a cross-sectional study of medical records of PWA systematically examined during two mobile skin care clinics in 2019, as part of a programme for the prevention and management of skin cancers in these subjects. RESULTS: During the study period, 280 (95.2%) of the 294 PWA consulted, had developed skin lesions. Of the 280 PWA, the pathological reports from the medical records of 33 patients (11.8%; (95%CI = [8.2-16.2]) had concluded to non-melanoma skin cancers. The mean age of these 33 patients was 38.6 ± 15.2 years and the sex-ratio was 1. Their occupations were mainly resellers (21.2%), traders (15.2%) and farmers (12.2%). In the 33 patients, 54 cases of non-melanoma skin cancers were identified, with some patients having more than one tumor, and some of them having more than one (histologically confirmed) diagnosis. These 54 non-melanoma skin cancers were divided into 21 cases of invasive squamous cell carcinomas, 2 cases of Bowen's disease and 31 cases of basal cell carcinomas. These non-melanoma skin cancers mainly occurred in the head and neck (33 cases; 61.1%), the upper limbs (15 cases; 27, 8%) and the trunk (4 cases; 7.4%). CONCLUSION: The results of this study show a high prevalence of skin cancers among PWAs in Togo in 2019, only non-melanoma skin cancers. In addition, they illustrate the role of ultraviolet rays with regard to the localization of skin cancers and the occupations of patients. Popularization and compliance with photo protection measures, systematic and regular examination of the skin of these PWAs will allow early detection and treatment of these skin cancers.

Factors Associated with Skin Cancers in People with Albinism in Togo.

OBJECTIVE: The aim of this study was to identify the factors associated with skin cancers in people with albinism (PWA) in Togo. METHOD: This is a retrospective analytical study of the records of PWA examined during five dermatological consultation campaigns from 2019 to 2021. RESULTS: During the study period, 517 PWA were seen. Sixty-four (12.3%) of these PWA had presented with 137 cases of skin cancer. The sex ratio (M/F) was 0.9. The average age of PWA with skin cancer was 39.69 ± 15.61 years and that of PWA without skin cancer was 19.17 ± 15.24 years (p ≤ 0.001). The 137 cases of skin cancers were dominated by basal cell carcinomas (45.9%). These skin cancers were located preferentially in the cephalic region (77 cases; 56.2%), followed by the upper limbs (33 cases; 24.1%). In multivariate analysis, the risk factors for skin cancers in PWA were age over 39 years (p ≤ 0.001) and the presence of actinic keratoses (p ≤ 0.001). In contrast, the presence of ephelides (p=0.018) was a protective factor. CONCLUSION: This study confirms that advanced age and actinic keratoses are risk factors for skin cancer in PWA, in connection with the cumulative role of solar radiation. Its originality lies in the identification of ephelides as a protective factor. The knowledge and consideration of these risk factors will make it possible to optimise strategies for the prevention of skin cancers in PWA.

A Histopathological Study of Skin Lesions in Individuals with Oculocutaneous Albinism in Togo in 2019.

OBJECTIVE: The aim of this study was to study the histopathological patterns of skin lesions in persons with albinism (PWA) in Togo in 2019. METHOD: During two mobile skin care clinics in 2019, biopsies/excisional biopsies were performed in PWA in case of clinical doubt or in front of lesions suspected to be cancerous for histological examination. Anatomopathological reports were thus analysed. RESULTS: During the two mobile skin care clinics, 115 biopsies/excisional biopsies were carried out in 79 PWA, with a mean age of 24 ± 16.1 years. Histological examination led to a diagnosis in 110 cases (95.6%) and was inconclusive in 5 cases (4 cases of uncertain histological diagnosis and one case of nonspecific histological lesions). Fourteen different histological diagnoses were made, with a frequency ranging from 0.9% (one case) to 26.9% (31 cases). The four most frequent diagnoses in descending order were basal cell carcinomas (BCCs) (31 cases; 26.9%), invasive squamous cell carcinomas (SCCs) or Bowen's disease (23 cases; 20%), keratosis (20 cases; 17.3%), and cysts (seven cases; 6.1%). The 54 skin carcinomas were diagnosed in 33 (41.8%) of the 79 patients who underwent skin biopsies/excisional biopsies. The BCC/SCC ratio was 1.3. No cases of cutaneous melanoma had been diagnosed. CONCLUSION: Skin cancers represent the main histological diagnosis in PWA (46.9%) in Togo in 2019. The pattern of cutaneous malignancies in PWA shows the same trend as that seen in Caucasians with a predominance of basal cell carcinomas.

Dermatological and epidemiological profile of patients with albinism in Togo in 2019: results of two consultation campaigns.

BACKGROUND: People with albinism (PWA) are targets of prejudice and social exclusion and have limited access to specialized medical care and resources. Our study aimed to describe the epidemiological and dermatological profile of PWA in Togo. METHOD: We carried out a cross-sectional study of 294 medical records of PWA systematically examined during two mobile skin care clinics in 2019. RESULTS: The mean age of the patients was 22 ± 16.5 years, and the gender ratio (M/F) was 1. A family history of albinism was reported in 27.9% of cases, and consanguinity between the parents was found in 24.1% of PWA. Dermatological lesions on physical examination were present in 95.2% of PWA. These lesions were elastosis/wrinkles (82.9%), ephelides (79.6%), actinic keratoses (60.0%), actinic cheilitis (50.0%), and cutaneous carcinomas (11.8%). The mean age of PWA with skin carcinomas was 38.6 years. Fifty-four cases of cutaneous carcinomas had been diagnosed (31 cases of basal cell carcinoma, 21 cases of squamous cell carcinoma, and 2 cases of Bowen's disease) and were located mainly in the cephalic region (61.1%) and upper limbs (27.8%). Cryotherapy and/or excisional biopsies were the treatments for premalignant and malignant lesions. All PWA were sensitized on sun protection. CONCLUSIONS: This study shows the basic picture of dermatological characteristics of PWA with a high frequency of photo-induced lesions and skin cancers. The popularization and respect of photoprotection measures and regular skin examination of these PWA for early detection and management of lesions will reduce their morbidity and mortality.

[Primitive oto-rhino-laryngology and cervico-maxillofacial tumors: epidemiological and histological aspects]. / Cancers primitifs oto-rhino-laryngologiques et cervico-maxillo-faciaux: aspects épidémiologiques et histopathologiques.

INTRODUCTION: Establish the panorama of primitive oto-rhino-laryngology and cervico-maxillofacial tumors diagnosed at a reference center in Togo. METHODS: We conducted a retrospective, descriptive study of cancers diagnosed at the ORL and cervico-maxillofacial surgery department of the CHU Sylvanus Olympio of Lomé. It was conducted over a period of 10 years (1 January 2005 - 31 December 2014). RESULTS: ORL and cervico-maxillofacial tumors account for 0.48% of consultations and 15.3% of all ORL tumors. The average age of patients was 47 years, ranging from 3 months to 86 years. We noted a male predominance; the sex ratio was 1.45. Drinking alcohol and smoking tobacco prevailed in the cancer of the larynx. Upper aerodigestive tract (UAT) tumors accounted for 64,8%, with a prevalence of cancers of the oral cavity (36,2% of UAT), followed by cancers of the oropharynx (18,5% of UAT) and finally by cancers of the larynx (18,1% of UAT). Primary malignant cervical adenopathies accounted for 18%. The rarest lesions were cancers of the ear and of maxillomandibular bone tissue (2.24% each). Histology was dominated by squamous cell carcinoma (61.4%) followed by non-Hodgkin lymphoma (23.2%). CONCLUSION: ORL and cervico-maxillofacial tumors are frequent in Togo and can be diagnosed at any age. The predominant tumor types reported are those of the oral cavity, pharynx and primary malignant cervical adenopathies.

Extremity injuries in soldiers during the conflict in Mali: experience of Togo Level two Hospital.

PURPOSE: The aim of this study was to analyse war-related and non-war-related extremity injuries in soldiers in the Mali conflict. MATERIALS AND METHODS: This prospective study was performed from 1 May 1 to 31 December 2014. It concerned extremity injuries in soldiers treated at Togo Level 2 Hospital. RESULTS: Seventy-nine patients with an average age of 31.19 years were assessed. Among them, 50 were admitted after war injury and 29 from nonwar injury. Most war-related injuries were due to improvised explosive devices (IEDs) (36 %); road traffic accidents (51.72 %) were the main mechanism of non-war injury. A total of 125 injuries were analysed. Limb fractures were identified in 37 patients (29.6 %), and 22 cases (59.46 %) were open fractures. Twenty-six (20.8 %) patients had soft tissue wounds. The other injuries were sprains (18.4 %), muscle contusions (15.2 %), dislocations (8.8 %), traumatic amputations (4 %) and burns (3.2 %). Surgical debridement and external fixator application were the most frequently performed surgical procedures. Thirty-nine per cent of patients were evacuated to a level 3 hospital for better care. CONCLUSION: The severity of injuries and their rapid treatment require orthopaedic surgeons to have high levels of surgical experience and knowledge pertaining to military or disaster surgical doctrine.