[Cervical spondylodiscitis in hospital environment in Lomé [Togo]]

The spine is a frequent site of infection but cervical spine localization seems to be rare. To determine the frequency and features of cervical spondylodiscitis in patients attending the Sylvanus Olympio University Hospital Center in Togo. A retrospective study of patients hospitalized in the Department of Rheumatology over a 20-year period was conducted. The positive diagnosis of infectious spondylodiscitis has been clinical and radiological. The etiological presumption was founded on clinical and epidemiological arguments. Of the 2881 patients hospitalized, 356 had infectious spondylodiscitis of which 15 cases of cervical spondylodiscitis [eight men and seven women]. The average age of these 15 patients was 37 years at the onset of the disease of which the mean disease duration was six months. The disease was essentially located at the levels of C3C4 [seven patients] and C5C6 [four patients]. Spondylodiscitis was related to presumptive tuberculosis in 10 patients and banal germ in the remaining five others. There were three HIV infected patients. The onset of the symptomatology was progressive in all the 10 patients suffering from tuberculosis spondylodiscitis. The symptomatology has been characterized by inflammatory pains [10 patients], mechanic pains [five patients], and a gibbosity [four patients]. This study attests of the scarcity of the cervical spondylodiscitis

Rheumatic diseases profile of 13517 west african patients

To determine the patterns of rheumatic diseases in patients attending the rheumatology unit of the Lom‚ Tokoin teaching hospital. Medical records of patients seen over 16 years period were studied transversally. All the patients suffering of rheumatic disease were including in the study. 13517 patients [7755 women, 5762 men] had suffered of rheumatic disease. Degenerative spinal involvement, n= 6319 [46.47%]; tendinitis, n= 1625 [12.02 %]; knee osteoarthritis, n= 1084 [8.02 %]; chronic inflammatory rheumatism and connective tissue disorders, n= 626 [4.64 %]; infectious pathology, n= 376 [2.78 %] and hip involvement, n= 322 [2.39 %] were the diseases more observed. The features of degenerative spinal disease included low back pain [n= 2325], lumbar and radicular pain suggestive of disc herniation [n= 2035] and lumbar spinal stenosis [n= 709]. More women [n= 874] than men [n= 210] had suffered of knee osteoarthritis. Spondylarthropathies [n=93], rheumatoid arthritis [n= 62], dermatomyositis and polymyositis [n= 13] were the main forms of chronic inflammatory rheumatism and connective tissue disorders. The infection was localized in spine for 191 patients and in other bone and joints for the 185 others. The cause of infection was likely Koch bacillus for 178 patients and trivial germs for the 198 others. Necrosis of the femoral head [n= 89] had been the main form of hip involvement.This study shows the high variety of rheumatism diseases in Black Africa

[Lived and perceived of their profession by Togolese doctors]

A study has been carried out by Togolese medical doctors in order to determine the perceived and the real life of their profession. The study, which was transversal, has taken in account a sample of 52 medical doctors made on the basis of a cautious choice. Most of these medical doctors [15 general practitioners, 23 specialists and 14 hospitalo-universitaires] work in the medical cares centres of Lome. A sheet of survey has permitted the collection of demographic datas and datas relating to the medical studies and carreer. The 52 medical doctors included in the study [7 women, 45 men] were between 25 and 59 years old; their age of getting their A-level was between 16 and 23 years old, and that of getting the doctorate diploma between 24 and 37. The length of professional experience stands between 8 months and 27 years. The marital status was specified by 47 of the 52 medical doctors: 13 single, one divorced, and 33 married; 5 of the 7 women who took part in the survey were single and without any child. The love of the profession [65%], the social status it confers [37%] and the honour tied to the profession [27%] were the main motives of choosing the profession. The decision of doing medical studies was taken during secondary studies by 45 of the 52 persons. The faculty of medicine of Lome has been the study frame to general medicine studies of 35 persons [67%]. The low payment [83%], the poverty of the patients [83%], the narrowness of the technical platform [79%], the insufficiency of cares structures in paramedical personnel [67%], the insufficiency of continuing education [60%], and the lack or insufficiency of drugs [58%] were the main problems encountered during their professional experience by the people questioned. 22 medical doctors [43%] have estimated that their profession has given them a particular social status. Only 8 medical doctors have found that the real things they have gone through in the profession matches with the idea they had, while 32 [62%] are ready to choose again the profession if they have to start everything. The title time spent with the family has been stated out by 36 medical doctors [69%], the social and family prestige that came out of it by 32 [62%], and the ability to control the health of one's family by 34 [65%]. The psychological impact of the profession on the medical doctors questioned was dominated by the adoption of a philosophical attitude towards life. A better productivity of the Togolese medical doctors needs the improvement of their life conditions [adjustment of texts in force, revision of the salary scale], the renovation of the facilities, the modernization of the technical platform, the continuing education of the medical doctors and the reinforcement of the practical management of the patient on bed

[Semiological profile of gout in patients with AA, AS and AC hemoglobins]

To search a possible difference in gout and in the risk factors for gout expression according to the hemoglobin in patients seen at the lome teaching hospital rheumatology clinic [Togo]. Medical records of patients seen during 17 years were studied. The patients affected by the gout and answering New York criteria have been included. All patients object of the comparison, benefitted from a hemoglobin electrophoresis and the search of possible risk factors for gout. Among the 14902 patients seen over a 17 year period, 214 had gout [210 males, 4 famales]. These 214 patients were carriers of an A A hemoglobin [147 cases], of an AS hemoglobin [41 cases], or of an AC [hemoglobin [26 cases]. The alcoholism, the obesity, and the arterial hypertension were the main risk factors associated with gout in 207 patients [97%]. Semiological and risk factors comparison according to the type of hemoglobin didn't show statistically significant difference. it results from this study that the AS hemoglobin and AC hemoglobin don't exercise any influence on the gout Semiological expression. Thus, the presence of one of these hemoglobins in gout patient must exercise no influence in the diagnostic gait and in the etiological investigation

[Semiological profile of avascular necrosis of the femoral head in patients with AA and AS hemoglobins]

To search a possible difference in the avascular necrosis of femoral head expression in patients with AA and AS hemoglobins seen at the lome teaching hospital rheumatology clinic [Togo L medical records of patients seen at the Lome T Hospital rheumatology clinic [Togo] during 17 years were s Have been included in the present study the patients affected avascular necrosis of the femoral head and having been the objx.2 hemoglobi electroophoresis [79 patients: AS hemoglobii patients] AA hemoglobin [50 patients]. The comparison o parameters rested on the analysis of variance. epidemiological and semiological comparison of avascular necrosis of the femoral bead between the patients with hemoglobin and those having a normal hemoglobin didn't she statistically significant difference. Conclusion: the presence of AS hemoglobin in avascular necrosis the femoral head patients must not influence the gait aiming search of an etiology or risk factor

[Topographic patterna of osteoarthritis of appendicular joints in patients attending a teaching hospital clinic]

Determine the prevalence and topographic patterns of osteoarthritis. Medical records of patients seen at the Lome Teaching Hospital rheumatology clinic [logo] were studied retrospectively. Among the 12251 patients seen over a 15 year period, 1085 had appendicular osteoarthritis. Mean age at onset was 50, 3 years [extremes: 7 and 85 years], and mean duration of osteoarthritis was 4, 4 years. Principal distribution of affected joints was as follows: knee, 993 patients [844 females, 85%; 149 males]; hip, 77 patients [primary osteoarthritis: 36 patients, secondary osteoarthritis: 41 patients]; scapulohumeral joint, 5 patients; and fingers, 5 patients. At the knee, the lesions involved the medial femorotibial compartment in 493 patients [unilateral: 117 patients, bilateral: 376 patients], the lateral femorotibial compartment in 223 patients [unilateral: 74 patients, bilateral: 149 patients] and the patellofemoral compartment in 42 patients [unilateral: 17 patients, bilateral: 25 patients]. Mean age at onset of knee osteoarthritis was 50, 3 years. Among females with knee osteoarthritis, 83%were obese and 63, 5%had varus or valgus deformities. This study confirms that in black Africa the high prevalence of knee osteoarthritis contrasts with the low prevalence of primary osteoarthritis of the hip and of osteoarthritis of the fingers. Female sex, obesity, and varus or valgus deformities are the main risk factors for femorotibial osteoarthritis in black Africa