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Complicated High Blood Pressure in Hospital Area in Lomé  [PDF]
Abago Balaka, Kodjo Agbéko Djagadou, Toyi Tchamdja, Mohaman Awalou Djibril, Findibe Damorou
Open Journal of Internal Medicine (OJIM) , 2019, DOI: 10.4236/ojim.2019.92002
Abstract: 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.
Self-Care Capacities of Diabetic Patients Monitored in the Internal Medicine Unit at the Kara Teaching Hospital (CHU Kara)  [PDF]
Toyi Tchamdja, Abago Balaka, Kodjo Agbéko Djagadou, Djalogue Lihanimpo, Mohaman Awalou Djibril
Open Journal of Internal Medicine (OJIM) , 2020, DOI: 10.4236/ojim.2020.102011
Abstract: Objectives: To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. Method: We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. Results: Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). Conclusion: The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.
Medical Direct Cost of Hospital Admission for Cerebrovascular Accident on Medical Recovery at the Sylvanus Olympio Teaching Hospital of Lomé  [PDF]
Abago Balaka, Toyi Tchamdja, Kodjo Agbéko Djagadou, Hamadi Assane, Komi Dzidzonu Némi, Mohaman Awalou Djibril
Open Journal of Internal Medicine (OJIM) , 2017, DOI: 10.4236/ojim.2017.74018
Abstract: Objectives: Appreciate the Medical direct cost for cerebrovascular accident on medical recovery at the Sylvanus Olympio Teaching Hospital of Lomé. Patients and method: This was a prospective and cross study that took place from 01st October 2015 to 31st July 2016 in the medical recovery Unit of Sylvanus Olympio Teaching Hospital of Lomé. Results: Of the 91 stroke patients surveyed, the average age was 55.1 years; the sex-ratio (Men/women) was 1.3 and only 8.8% of patients had benefited from INAM (National Institute of Health Insurance) granting of benefits. The proportion of ICVA was 73.6% compared to 26.4% for the MCVA. The average overall cost of granting benefits of a CVA patient was 312,245 FCFA for an average stay of 18.6 days. This cost was 399.115 FCFA in MCVA for an average stay of 19.0 days against 281.130 FCFA in ICVA for an average stay of 16.1 days. Conclusion: CVAs on the one hand inflict losses of national productivity by its handicap, and a heavy economic burden for both patients and their families on the other hand, by its high cost of granting of benefits; Hence there is the need for assistance of all kinds by national and international health actors.
Factors Associated to the Acute Metabolic Decompensation of Diabetes in Lome  [PDF]
Abago Balaka, Toyi Tchamdja, Kodjo Agbéko Djagadou, Komi Dzidzonu Némi, Mohaman Awalou Djibril, Datouda Redah
Open Journal of Internal Medicine (OJIM) , 2019, DOI: 10.4236/ojim.2019.92003
Abstract: The purpose of the study was to define basic factors of the acute metabolic decompensations of diabetes mellitus at the medical emergency units at the CHU-SO of Lomé. The question is about a prospective study carried on along 12 months from 1st January, to December 31, 2013. It implicated 83 diabetes patients known or unknown admitted at the casualty department for an acute metabolic complication. In total the frequency of acute metabolic complications of diabetes mellitus that have been essentially done through the ketoacidosis model (73.49%) and hypoglycaemic (26.5%) is of 23.38%. Majority of diabetes patients were of type 2 (68.66%) and aged 50 and over with a sex-ratio of 0.76. The ketoacidosis revealed the disease in 43.37% cases. The main factors of ketoacidosis decompensations were infections, treatment termination and myocarditis ischaemia. Hypoglycemia decompensation factors were due to the absence or deficiency of food, the overdosage. Metabolic complications of diabetes then remain frequent. Infection and treatment termination are the major factors of ketoacidosis decompensation whereas those of the absence or deficiency of food are that of hypoglycemia. The prevention is compulsory through early screening of the disease and high treatment awareness of diabetes patients.
Chronic Nephropathies in the Internal Medicine Department of the Sylvanus Olympio University Hospital  [PDF]
Agbeko Kodjo Djagadou, Toyi Tchamdja, Abdou-Bakari Tchala, Yawovi Mawufemo Tsevi, Abago Balaka, Awalou Mohaman Djibril
Open Journal of Internal Medicine (OJIM) , 2021, DOI: 10.4236/ojim.2021.113011
Abstract: Introduction: The chronic nephropathies constitute a real global public health concern due to the constant increase in the prevalence estimated between 10% and 15%. In Sub-Saharan Africa, this prevalence has been estimated at 13.9%. This study will allow knowing the epidemiological, clinical, paraclinical and etiological aspects of chronic kidney disease in the internal medicine department of CHU-SO Lomé. Method: This was a cross-sectional, retrospective and descriptive study. It concerned all the patients suffering from a chronic kidney disease, hospitalized between the 1st of January 2014 and the 31st of December 2018, for a duration of 5 years. Results: During our study, 330 cases of chronic nephropathy were identified. The prevalence of chronic kidney disease was 8.3% of admissions. The mean age of the patients was 46.3 years with extremes of 19 and 86 years and a sex ratio of 1.32. A low socio-economic level of patients was observed in 63.9% with an urban origin in 69.7%. The main risk factors for renal impairment were hypertension (55.2%), diabetes mellitus (29.1%), obesity (20.6%), use of nephrotoxic products (19.4%), HIV infection (17%) and smoking (16.1%). The causes were dominated by nephroangiosclerosis (33.3%), followed by diabetic nephropathy (25.5%) and HIV-associated nephropathy (17%). Chronic renal failure was present in 95.8% of cases and was end stage in 69.7% of cases. Anemia was the main complication during the evolution of chronic kidney disease (98.2%). Mortality was 57.3% during hospitalization. Conclusion: Chronic kidney disease is a fairly common reason for hospitalization in the internal medicine department. Emphasis should therefore be placed on preventive measures for hypertension, diabetes and HIV.
High Blood Pressure and Pregnancy in a Hospital Environment in Lomé: Prognostic and Clinical Epidemiological Aspects  [PDF]
Abago Balaka, Toyi Tchamdja, Kodjo Agbeko Djagadou, Akila Bassowa, Komi Dzidzonu Némi, Lihanimpo Djalogue, Komi Edem Mossi, Abou-Bakari Tchala, Mohaman Awalou Djibril
Open Journal of Internal Medicine (OJIM) , 2020, DOI: 10.4236/ojim.2020.101010
Abstract: 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 Lomé. 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.
Indications for Renal Needle Biopsy and Histological Spectrum of Kidney Disease in Togo  [PDF]
Eyram Makafui Yoan Yawo Amekoudi, Badomta Dolaama, Kossi Akomola Sabi, Komlan Georges Tona, Toyi Tchamdja
Open Journal of Pathology (OJPathology) , 2024, DOI: 10.4236/ojpathology.2024.142006
Abstract: Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.
Pituitary Adenoma Complicated by Acute Bacterial Meningitis in a Patient in Kara (Togo)  [PDF]
Lihanimpo Djalogue, Leleng Agba, Komi Edem Mossi, Toyi Tchamdja, Kodjo Agbeko Djagadou, Abago Balaka, Mohaman Awalou Djibril
Open Journal of Internal Medicine (OJIM) , 2023, DOI: 10.4236/ojim.2023.134032
Abstract: Introduction: In the context of pituitary adenoma, bacterial meningitis is a possible complication of surgical or medical treatment. The occurrence of meningitis before any treatment is exceptional, explained by the existence of an osteomeningeal breach caused by the adenoma whose main symptom is rhinorrhea. Case Report: We report a case of bacterial meningitis complicating a prolactin pituitary macroadenoma. The patient had been referred for jet vomiting in a febrile context preceded by headaches and visual blurring. There was no rhinorrhea. The examination revealed a meningeal syndrome and the diagnosis of acute bacterial meningitis was made. The isolated germ was the pneumococcus. Faced with headaches and visual blurring, a cerebral scan revealed a pituitary macroadenoma and pituitary hormone dosage had shown hyperprolactinemia. The meningitis was sterilized and the prolactinoma was treated with dopaminergic agonists. This allowed the normalization of prolactinemia and the disappearance of symptoms. Conclusion: The pituitary adenoma was complicated by bacterial meningitis without treatment and the presence of a meningeal breach. Hormonal and bacterial treatments have been successful.
Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo  [PDF]
Lihanimpo Djalogue, Mossi Komi Edem, El Hadj Yacoubou, Tchamdja Toyi, Djagadou Kodjo Agbeko, Balaka Abago, Djibril Mohaman Awalou
Open Journal of Internal Medicine (OJIM) , 2024, DOI: 10.4236/ojim.2024.141012
Abstract: Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases; those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.
Measurement of the Effects of Nutritional Education for Reducing Sodium Intakes and Increasing Potassium Intakes  [PDF]
Tchasso Serge Kénao, Jer？me Charles Sossa, Moussiliou Noel Paraiso, Smaila Alidou, Ghislain Sopoh, Toyi Tchamdja, Dadja Essoya Landoh, Mofou Bélo, Tchaa Abalo Baka？
Food and Nutrition Sciences (FNS) , 2023, DOI: 10.4236/fns.2023.145029
Abstract: Background: The Togolese population, like those around the world, frequently consumes foods high in salt/sodium and low in potassium, thus exposing them to cardiovascular disease (CVD). Nutritional intervention can help reverse this consumption pattern and reduce related CVD morbidity and mortality. The objective of this study was to measure the effects of a nutrition education intervention on the consumption frequencies of foods rich in sodium and potassium. Methods: The study was a quasi-experimental before- and-after study, conducted from 08 January to 16 April 2023. It involved 200 adults aged 25 - 64 years, randomly selected from two areas: an intervention area and a non-intervention area. Data were collected in two phases at 3-month intervals in both groups. The intervention consisted of nutrition education (awareness raising and cooking demonstrations) on reducing salt/sodium intake and increasing potassium-rich food intake. The kobocollect electronic questionnaire was administered to the respondents to collect data on the frequency of consumption of foods rich in sodium and potassium. Results: The median age of the respondents was 33 years old (30; 38) and 56% of the participants were women, 44% and 69% respectively in the control and intervention groups. Most participants lived in rural areas (51%), 52.4% and 49.5% in the control and intervention groups respectively. Overall, 4% (p < 0.0089) of individuals reduced their frequency of adding salt at mealtime from more than 3 times a week to less than 3 times, i.e., 5.6% in the intervention group and 1.7% in the control group. The proportion of individuals who consumed meals with green leafy vegetable sauces was reduced from more than 3 times a week to less than 3 times, i.e., 7.5% (p < 0.022), or 1% in the intervention group and 4% in the control group. Education level (0.23 [0.10 - 0.50]; p
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