ABSTRACT
AIM: Analyze the management of gynecomastia and adipomastia; and identify the peculiarities in black people in a general surgery department of the CHU Sylvanus Olympio in Lomé (Togo). PATIENT AND METHOD: Descriptive retrospective study included 43 cases of gynecomastia and 5 cases of adipomastia (January 2014 to December 2020). The data taken into account were: epidemiological, clinical, paraclinical and the treatment (surgery and medical). The administration of hydrocortisone (solumedrol 120mg/day) for 3days immediately after surgery and the application of shea butter on the scar were performed. RESULT: Patients consult for aesthetic discomfort, especially with bilateral lesions and fear of breast cancer for unilateral lesions. Morpho-types 3 and 4 are therefore the most frequent in 75% of cases. Age was over 30years in 87% of patients. We noted retro-areolar fibrosis. The etiology was dominated by idiopathic causes. The surgery was performed in 85% of the cases. The morbidities were 5 cases of hypertrophic scars without keloid. CONCLUSION: Surgical difficulties on black skin are not only technical, but also scarring: hypertrophy and keloids. A delay in surgical management after 30years, and the prevention of unsightly scars would be a track for improving the aesthetic result.
Subject(s)
Cicatrix, Hypertrophic , Gynecomastia , Keloid , Adult , Cicatrix, Hypertrophic/etiology , Cicatrix, Hypertrophic/pathology , Gynecomastia/complications , Gynecomastia/pathology , Gynecomastia/surgery , Humans , Keloid/etiology , Keloid/pathology , Keloid/surgery , Male , Retrospective Studies , Skin/pathologyABSTRACT
PURPOSE: The aim of this study was to describe the epidemiologic, clinical, diagnostic and therapeutic aspects of spinal cord compression at the Lomé-Campus teaching hospital. MATERIAL AND METHOD: We retrospectively analyzed the files of all patients hospitalized for spinal cord compression at Lome-Campus teaching hospital from January 1, 1998, through December 31, 2007. RESULTS: 39 files were selected, mostly of men (77%). The mean age was 53 years (range: 22 to 79). Median time from the start of symptoms to hospital admission was 14.9 ± 24.5 weeks. The spinal cord compression was confirmed by myeloscan in 35 cases (90%), myelography in 2 (5%) and magnetic resonance imaging in 2 cases (5%). The thoracic spine was the most common site of involvement. The principal cause was malignant neoplasm (17 cases: 44%), followed by cervical spondylotic myelopathy (9 cases: 23%) and Pott's disease (7 cases: 18%). Only one patient underwent surgery. CONCLUSION: Spinal cord compression appears to be a rare condition in Togo. It is a true medical emergency and immediate intervention is required. Its management remains precarious and its prognosis poor.
Subject(s)
Spinal Cord Compression/diagnosis , Spinal Cord Compression/therapy , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Togo , Young AdultABSTRACT
PURPOSE: To evaluate the means for diagnosis and treatment of secondary hyperparathyroidism in patients with end-stage renal disease undergoing regular hemodialysis. METHODS: This prospective investigation studied patients with chronic renal kidney disease requiring and receiving hemodialysis at the Tokoin University Hospital in Lomé, from January 21, 2008, through December 31, 2008. RESULTS: The study population comprised 42 patients: 24 men and 18 women ranging in age from 20-82 years (mean: 42.62 years). Hyperparathormonemia was found in 20 of 24 patients for whom parathormonemia was assayed. Two patients with hyperthyroidism received a phosphorus chelator, and another went to Egypt for renal transplantation. The various other treatments we applied were not efficacious. We noted three cases of pathological fractures and one case of sudden death. CONCLUSION: The risk of parathyroidism in patients receiving hemodialysis is unavoidable. Its course is marked by a risk of sudden death due to the cardiovascular damage it causes. Numerous factors impede its effective management in Togo.
Subject(s)
Hyperparathyroidism, Secondary/diagnosis , Hyperparathyroidism, Secondary/therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Hyperparathyroidism, Secondary/etiology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Middle Aged , Prospective Studies , Renal Dialysis , Togo , Young AdultABSTRACT
AIMS: To evaluate the frequency, to identify the aetiologies of the acute scrotum and to describe their treatment in children. MATERIAL AND METHOD: Fifty seven children treated for acute scrotum in the paediatric surgery department of the Tokoin teaching hospital (Lomé) between January 2003 to December 2007 were studied. RESULTS: The frequency of acute scrotum was 5.80%. The average age was of 4.75 years (range: 7 days to 15 years). The aetiologies were: incarcerated inguino scrotal hernia (49.12%); spermatic cord torsion (29.83%); epididymo-orchitis (17.54%) and testicular trauma (3.51%). The delay of treatment was superior of 72 hours in 49.12%. The pain and the increase of the volume of the scrotum were present in all the patients. The emergency operation was performed in the spermatic cord torsion and the testicular trauma. The medical treatment was performed in the epididymo-orchitis cases. The patients presenting an incarcerated inguino-scrotal hernia benefited from a surgical cure in a delay of eight days after the acute episode. The operative continuations were in any cases simple. CONCLUSION: The diagnosis and the treatment must be precocious in the acute scrotum in order to avoid possible complications.
Subject(s)
Genital Diseases, Male , Scrotum , Acute Disease , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Genital Diseases, Male/etiology , Genital Diseases, Male/therapy , Humans , Infant , Infant, Newborn , MaleABSTRACT
But : Evaluer la frequence; identifier les causes et decrire la prise en charge des grosses bourses douloureuses de l'enfant. Materiel et methode: Il s'agit d'une etude transversale portant sur 57 dossiers d'enfants ages de 0 a 15 ans recus et traites pour grosses bourses douloureuses. Ces enfants ont ete admis dans le service de la chirurgie pediatrique du CHU-Tokoin entre janvier 2003 et decembre 2007. Resultats : Les grosses bourses douloureuses ont represente 5;80des cas de grosse bourse. L'age moyen etait de 4;75 ans (extremes : 7 jours et 15 ans). Les principales etiologies etaient : la hernie inguino-scrotale etranglee (49;12) ; la torsion du cordon spermatique (29;83) ; l'orchi-epididymite (17;54) et le traumatisme testiculaire (3;51). Le delai de prise en charge etait superieur 72 heures dans 49;12des cas. La douleur et l'augmentation du volume de la bourse etaient presentes dans tous les cas. Le traitement avait ete chirurgical d'emblee (torsion du cordon spermatique et traumatisme testiculaire) ou en differe huit jours apres l'episode aigu (hernie inguino-scrotale etranglee); et medical (orchi-epididymites). Les suites operatoires ont ete simples dans tous les cas. Conclusion : Le diagnostic et la prise en charge des grosses bourses douloureuses doivent etre precoces afin d'eviter d'eventuelles complications
