Pattern of vascular diseases at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BACKGROUND: Vascular diseases are evolving fast in sub-Saharan Africa, but its management is challenged by lack of expertise and infrastructure. In the light of the prevailing challenge, this study was done to see the pattern of vascular disease and its treatment in a tertiary referral hospital. METHODS: A prospective cross-sectional study was done over a period of one year (February 9, 2016 to February 8, 2017) at Tikur Anbessa specialized hospital (TASH) at Addis Ababa, Ethiopia. RESULTS: A total of 386 patients were seen at the surgical OPD. Of these, 78(20.2%) were admitted and operate on. The male to female ratio was 1.3:1. The mean age affected was 39 +/- 10 (Range 12-91 years). On the other hand, 132 (34.2%) patients came with PAD. Of them, 46(34.8%) presented with either frank Gangrene or pre-gangrene stage. The rest 86(65.1%) had claudication pain. The other diseases seen are Varicose Vein, 100(25.9%), Carotid body tumors, 60(15.4%), Aneurysmal diseases, 36(9.1%), Vascular malformations, 34(8.7%), and Vascular injuries, 22(5.6%). During the study period, 28(35.9%) PAD, 22(28.2%) trauma patients, 8(10.2%) Chemodectomas, 8(10.2%) aneurysms, 6(7.7%) hemangiomas, 4(5.1%) varicose vein and 2(2.6%) AV fistula patients were operated. CONCLUSION: The pattern of vascular disease in Ethiopia is becoming a challenge. The gap created due to limited vascular surgeons, poor infrastructure and absent supply chain system has significantly compromised the number and type of operated-on patients. These challenges result in preventable morbidity and mortality

Le diabete du sujet age : a propos de 52 cas consecutifs

Les auteurs etudient a partir d'une population de diabetiques ages de 60 ans et plus (52 patients) les aspects vasculaires de la maladie. L'age avance etant un facteur de moindre tolerance glucosee avec hyperinsulinisme responsable des lesions vasculaires; le diabete du sujet age devrait etre marque par cette pathologie. De fait les complications vasculaires sont importantes et plus nombreuses que chez les sujets de moins de 60 ans. Observees apres cet age et donc bien apres l'emergence des complications de l'atherosclerose elles pourraient etre sous la dependance dominante du diabete. La microangiopathie diabetique est beaucoup plus frequente chez le sujet age (61 pour cent versus 33;3 pour cent). La retinopathie diabetique (29 pour cent versus 19;9 pour cent); reste classique. La macroangiopathie (maladie coronariennie; arterite des membres inferieurs) et la microangiopathie (nephropathie avec insuffisance renale) sont la marque essentielle du diabete du sujet age sous le couvert d'une hypertension arterille