IntroductionLe pied diabétique est une complication fréquente et grave du diabète. Le but de cette étude est de déterminer le profil épidémiologique, diagnostique, thérapeutique et évolutif du pied diabétique en milieu hospitalier à Lomé (Togo)MéthodesEtude rétrospective descriptive réalisée du 1er janvier 2011 au 31 décembre 2015 (5 ans) à la clinique médico-chirurgicale du CHU Sylvanus Olympio de Lomé. Etaient inclus dans l'étude, toute patiente hospitalisée pendant la période d'étude pour pied diabétique.RésultatsLa prévalence du pied diabétique était de 12,90%. L'âge moyen était de 60,74 ans (extrêmes: 39 ans et 86 ans). Le sexe masculin prédominait avec un sexe ratio de 1,38. Le diabète de type 2 était retrouvé chez 88,70% des patients. La durée moyenne d'évolution du diabète était de 11,67 ans (extrême: 1 an et 24 ans). Le point de départ des lésions du pied était un traumatisme générant une plaie surinfectée dans 70,97 % des cas. La gangrène (61,29%) et la nécrose ischémique (12,90%) étaient les principales lésions retrouvées. Le principal facteur étiopathogénique retrouvé était la neuropathie (61,29). La majorité des lésions (61,29%) était classée grade 4 et 5 de Wagner et 51,62% des patients avait bénéficié d'une amputation du membre pelvien.ConclusionLes lésions du pied sont fréquentes chez les patients diabétiques à Lomé. La lutte contre ce fléau passe par l'éducation des patients et du personnel soignant et par une prise en charge multidisciplinaire et concertée.
Introduction: Noma is defined as a gangrenous ulcerative stomatitis whose starting point is endobuccal. Its exact etiology remains unknown, but many risk factors have been described (malnutrition, poor hygiene, etc.). Chronic lymphoid leukemia (LLC) is a lymphoproliferative syndrome characterized by medullary proliferation of a B lymphocyte clone. It is not considered as a risk factor for noma disease. Observation: A 43-year-old patient is admitted in the odontostomatology unit of the Dapaong Regional Hospital Centre (Togo) for a deep lesion of the left cheek. The clinical examination allows to conclude the presence of a noma. Biological examinations also show a LLC at Binet stage C. In our patient, the LLC is associated with an immunosuppression and the development of infections due to the late diagnosis of the LLC. Comment: The immunosuppression and the development of infections are described in the literature as risk factors for noma disease. An association between LLC and noma could therefore exist. However, such association has been reported to date only once in the literature in 1976. Conclusion: Our observation suggests that the LLC could be a risk factor for noma disease. However, further studies based on large samples are necessary to conclude a causal association between LLC and noma.
Introduction: Dyslipidemia is a significant cardiovascular risk factor in patients living with HIV (PLWHIV). Few data are available in Togo. Objective: The purpose of this study is to assess the prevalence of dyslipidemia and associated factors in PLWHIV on Highly Active Antiretroviral Therapy (HAART). Methods: This is a descriptive and analytical cross-sectional study of patients followed at the Sylvanus Olympio University Hospital's infectious diseases department for six months. The study population consisted of any PLWHIV patient on HAART over 18 years of age who had been regularly monitored and had a serum lipid fraction assay. Results: Two hundred and eighty-four patients were included. 75.4% were women. The median age was 46 years (IQR: 39 -52) and the median CD4 count was 461 cel/U1 (IQR: 330 -607). Eighty-three percent of the patients had suppressed viral load. The median duration of follow-up under antiretroviral treatment antiretroviral treatment was 4.18 years (IQR: 2 -7). The prevalence of dyslipidemia was 72.5%. HDL hypocholesterolemia (HDL-c < 40 mg/dl) was the most represented dyslipidemia in 49.6%. Body mass index, past treated tuberculosis, HAART regimen substitution, abdominal obesity, past smoking and being exposed to Nucleoside reverse transcriptase inhibitors (NRITs) were found to be factors associated to dyslipidemia. Conclusion: Our study revealed a high prevalence of How to cite this paper: Moukaila, A.
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