Introduction:High blood pressure is a major cardiovascular risk factor. In hypertension, noncompliance is frequent. The objective of this work is to evaluate the therapeutic observances and to identify the predictive factors of poor compliances in Chadian hypertensive patients. Patients and Methods:It was a prospective cross-sectional study over a six-month period from January 15 to July 15, 2019. This was performed in the outpatient Cardiology and Nephrology units at the Renaissance Hospital of N'Djamena. We included all follow-up patients who had hypertension who consulted during the study period. However, dialysis patients and children were excluded from this study. The parameters studied were demographic characteristics, economic and therapeutic data and the rate of therapeutic compliance.Results: Eighty-seven patients were included. The average age was 50 years old. The sex ratio was 2.5. Sixty-seven percent (n = 58) of the patients were from urban areas. The predominant cardiovascular risk factors were smoking in 25% (n = 22) and diabetes in 23% (n = 20). Hypertension was uncontrolled in 76% (n = 66) patients. Adherence was poor in 66% (n = 57) of patients. The monthly cost of treatment was respectively 10,000 and 20,000 FCFA in 52% (n = 45) of cases. Combination therapy was observed in 70% of cases (n = 61) and 56% (n = 49) of patients had more than one drug intake. The adherence rate was 93% (n = 28) in the urban population (p < 0.001). All patients (n = 30) who were observing their treatment were educated (p < 0.001). The adherence rate was 20% (n = 6) in patients who had a monthly income less than 100,000 FCFA (p = 0.004). The adherence rate was 60% (n = 18) when the monthly cost was less than FCFA 10,000 (p = 0.003). The adherence rate was 77% (n = 23) in patients receiving monotherapy (p < 0.001). Conclusion:This study showed a low level of adherence in Chadian hypertensive patients. The complexity and cost of antihypertensive therapy, poor knowledge of hypertension, and ignorance of its severity have been the main factors of poor compliance.Compliance of hypertensive patients with antihypertensive drug therapy at the Renaissance Hospital of N'
Liposuction is a procedure commonly performed in the UK usually with a low incidence of serious sequelae; however with larger patients and increased volumes of lipoaspirate, complications have been reported more frequently. One of the rare but very serious complications postliposuction is fat embolism syndrome (FES), a life-threatening condition difficult to diagnose and limited in treatment.The authors present the case of a 45-year-old woman who was admitted to the intensive care unit postelective liposuction for bilateral leg lipoedema. She presented with the triad of respiratory failure, cerebral dysfunction and petechial rash requiring a brief period of organ support. This case highlights that with the recent increase in liposuction procedures worldwide, FES is a differential to always consider. Although still a rare condition this article emphasises the importance of thinking outside the box and how to identify and manage such a life-threatening complication.
Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N'Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N'Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.
Introduction: Arterial hypertension is a frequent pathology in cardiology consultations in Chad. We report these observations with the aim of determining the prevalence of arterial hypertension in cardiological consultation at the National Reference University Hospital in N'Djamena. Methodology: We conducted an 8-month retrospective study from September 12, 2019 to April 16 th , 2020, in the Cardiology Department of the National Reference Teaching Hospital. The variables studied were socio-demographic and clinical. Results: out of 352 patients seen, 121 met the selection criteria, ie a hospital prevalence of 34.34% with a female predominance. The average age was 64.5 years old with extremes ranging from 17 to 94 years old. Household were the most represented with 47.93% of cases. The most common antecedents were multiparity, arterial hypertension during pregnancy, hyperuricemia with respectively 21, 48% then 4.95% for each of the last two. The most common associated cardiovascular risk factors (FDRCV) were obesity and diabetes with 13.22% and 6.61%. Grade III systolic hypertension was the most represented with 33.05% as well as grade III diastolic hypertension with 32.23% of cases. Conclusion: Hypertension is a public health problem in Chad. Hospital prevalence has almost tripled in 26 years in the same department.
Introduction: venous thrombosis is a public health problem in developing countries. Materials and Methods: This is a prospective study carried out in the cardiology department of the National Reference Teaching Hospital of N’Djamena. It spans a period of 02 years, from January 2019 to December 2020 with a 4-month follow-up for the last patients. Results: we counted a total of 49 cases of deep vein thrombosis out of 1983 patients hospitalized in the department, either a hospital prevalence of 2.47%. Our study population was dominated by the female sex (59.2%) with a sex ratio (M /W) of 0.69. The most representative age groups are those of 55-65 years old (37.0 %); 35-45 years old (26.5%) and 45-55 years old (16.0%) with an average age of 49.7 years ± 13.94 on extremes ranging from 25 to 86 years old.
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