Introduction : les accidents de la voie publique (AVP) constituent un enjeu majeur de santé publique au regard de la morbi-mortalité élevée dont ils sont responsables. L’objectif de notre étude était de décrire les attitudes et facteurs associés aux accidents de la voie publique chez les étudiants de la FSS-UL.Méthodes : il s’est agi d’une étude prospective à visée descriptive et analytique menée auprès des étudiants de la 2ème à la 8ème année régulièrement inscrits à la Faculté des Sciences de la Santé de Université de Lomé, pour le compte de l’année académique 2021-2022.Résultats : Au total, 456 étudiants ont correctement rempli le formulaire. L’âge moyen était de 23,38 ± 2,59 ans. Le sex-ratio (H/F) était de 2,3. La fréquence de survenue des accidents chez les étudiants était de 28,5%. Les facteurs associés à la survenue d’accident de la voie publique chez les étudiants étaient le cycle d’étude principalement le doctorat (p-value = 0,001), une distance inférieure à 10km entre le domicile et la faculté (p-value = 0,014), la possession d’un matériel roulant principalement la moto (p-value = 0,001), le non port de casque ou de ceinture de sécurité (p-value = 0,001) et la consommation habituelle de substances psychoactives (p-value = 0,04). Conclusion : les étudiants vivants à proximité de la faculté, en cycle de doctorat possédant des engins à deux roues et ne portant habituellement pas de casque sont plus sujet aux AVP d’où l’introduction du code de sécurité routière dans les curricula de formation. Introduction: Road accidents (RA) constitute a major public health issue given the high morbidity and mortality for which they are responsible. The objective of our study was to describe the attitudes and factors associated with public road accidents among FSS-UL students. Methods: this was a prospective study with a descriptive and analytical aim carried out among students from the 2nd to the 8th year regularly registered at the Faculty of Health Sciences of the University of Lomé, for the year academic 2021- 2022. Results: In total, 456 students correctly completed the form. The average age was 23.38 ± 2.59 years. The sex ratio (M/F) was 2.3. The frequency of occurrence of accidents among students was 28.5%. The factors associated with the occurrence of public road accidents among students were the study cycle, mainly the doctorate (p-value = 0.001), a distance of less than 10km between home and the faculty (pvalue = 0.014).), possession of rolling stock, mainly motorcycles (p-value = 0.001), not wearing a helmet or seat belt (p-value = 0.001) and habitual consumption of psychoactive substances (p-value = 0 .04). Conclusion: students living near the faculty, in the doctoral cycle who own two-wheeled vehicles and do not usually wear a helmet are more subject to road accident, hence the introduction of the road safety code in the training curricula.

L’Ostéogenèse imparfaite (OI) est une maladie rare d’origine génétique. Le diagnostic est essentiellement anténatal, clinique, confirmé à la radiographie standard et par une étude génétique. Elle semble être liée à la formation osseuse insuffisante ou à un défaut de fixation du calcium. Le traitement des OI est médicochirurgical, il repose sur la combinaison du Bisphosphate et l’enclouage centromédullaire pour la correction des déformations et prévenir les risques de fractures. Nous rapportons, un cas de (OI) du tibia de découverte tardive, traitée par une triple ostéotomie diaphysaire stabilisée par des broches de Kirschner. Osteogenesis imperfecta (OI) is a rare disease of genetic origin. The diagnosis is essentially antenatal, clinical, confirmed by standard radiography and by a genetic study. It seems to be linked to insufficient bone formation or a lack of calcium fixation. The treatment of OI is medico surgical; it is based on the combination of Bisphosphonate and intramedullary nailing to correct deformities and prevent the risk of fractures. We report a case of (OI) of tibia treated by a triple diaphyseal osteotomy stabilized by Kirschner wires.

The mode of locomotion of humans and primates leads to changes in their skeleton. Objective: Establish a link between the morphology of the tibia and the locomotive function from a comparative anatomical study between the tibias of bipeds, Homo Sapiens (HS) and Pan troglodytes verus (PTV), and of quadrupeds, Canis lupus familiaris (CLF) and Sus scrofadomesticus (SSD). Materials and methods: It concerned an analytical and comparative study by direct observation involving a sample of 52 tibias. We proceeded by direct observation, to a synthetic analysis of the morphological characteristics of the tibia that we compared in bipeds and in quadrupeds. Results: The tibial diaphyses of HS and PTV presented the same morphological conformation with an italic S aspect in HS and a varus aspect in PTV. With CLF and SSD, they are straighter and the different faces are distributed differently. The proximal epiphyses are voluminous and massive in both classes. In quadrupeds, they present upper tibial articular surfaces which are deformed backwards and a voluminous anterior tibial tuberosity. The distal epiphyses in quadrupeds are convex with more pronounced creases. Conclusion: This comparative study allowed us to demonstrate that the locomotive function has a significant impact on the morphology of the tibia.

Identifier les différents types anatomiques du côlon sigmoïde dans notre milieu et déterminer celui qui expose le plus à la survenue du volvulus du côlon pelvien. Il s’est agi d’une étude prospective transversale du 1er janvier 2007 au 31 décembre 2012 sur une série de 63 malades (33 hommes et 30 femmes) ayant eu une laparotomie pour des pathologies non coliques. Pour tous les patients, les paramètres suivants ont été notés : C1 : la longueur totale du côlon pelvien ; C2 : la longueur de la racine du méso-sigmoïde ; C3 : la hauteur du méso-sigmoïde ; C4 : la largeur maximale du méso-sigmoïde. C1 moyen de toute la série était de 61,3 cm. C2 moyen était de 5,5 cm. La hauteur C3 et la largeur maximale C4 étaient respectivement en moyenne de 14,6 cm et 7,6 cm. La comparaison des paramètres chez l’homme et chez la femme n’a pas montré de différence significative. Ce travail nous a permis de connaître la répartition des différents types de côlons pelviens dans la population de nos malades opérés. Des mensurations réalisées sur le côlon pelvien des patients présentant un volvulus permettront d’attribuer objectivement la vraie paternité de cette urgence chirurgicale à un type anatomique de côlon pelvien. Identifying the different kinds of anatomical sigmoid colon in our environment and determine what exposes the most to the occurrence of pelvic colon volvulus. This is a transverse prospective study from 1 January 2007 to 31 December 2012 on a series of 63 patients (33 men and 30 women) who underwent laparotomy for non-colonic pathologies. For all patients, the following parameters were recorded: C1: total length of the pelvic colon; C2: the length of the root of the meso-sigmoid; C3: the height of the meso-sigmoid; C4: maximum width of the meso-sigmoid. C1 through the entire series was 61,3 cm. C2 average was 5.5 cm. C3 height and maximum width C4 were on average 14,6 cm and 7.6 cm, respectively. Comparison of parameters in men and women showed no significant difference. This study allows us to know the different types of pelvic colons among the population of our operated patients. The measurements performed on the pelvic colon of patients presenting volvulus will help to attribute objectively the true authorship of this surgical emergency to an anatomical type of pelvic colon.

OBJECTIVES:Identifying the different kinds of anatomical sigmoid colon in our environment and determine what exposes the most to the occurrence of pelvic colon volvulus.MATERIALS AND METHODS:This is a transverse prospective study from 1 January 2007 to 31 December 2012 on a series of 63 patients (33 men and 30 women) who underwent laparotomy for non-colonic pathologies. For all patients, the following parameters were recorded: C1: total length of the pelvic colon; C2: the length of the root of the meso-sigmoid; C3: the height of the meso-sigmoid; C4: maximum width of the meso-sigmoid.RESULTS:C1 through the entire series was 61,3cm. C2 average was 5.5cm. C3 height and maximum width C4 were on average 14,6cm and 7.6cm, respectively. Comparison of parameters in men and women showed no significant difference.CONCLUSION:This study allows us to know the different types of pelvic colons among the population of our operated patients. The measurements performed on the pelvic colon of patients presenting volvulus will help to attribute objectively the true authorship of this surgical emergency to an anatomical type of pelvic colon.

UNLABELLED:The iatrogenal lesion of the inferior laryngeal nerve (ILN) during thyroid surgery is an incident, which can have greatest functional after-effects. Its research is recommended during cervicotomy for thyroidectomy and it can be easily found by the presence of Zuckerkandl tubercle, which is a postero-lateral excrescence of the thyroid gland.OBJECTIVES:The main objective of our study was the researching of the presence of this Zuckerkandl tubercle and appreciating the reports with the ILN.PATIENTS AND METHODS:From 1st October 2010 to 30th September 2012, we realized a continuous prospective study on a mono-operator series of 48 patients operated on for thyroidectomy. The Zuckerkandl tubercle has been researched from all the patients and classified according to the classification of Pelizzo et al.RESULTS:From 21 patients (43.75%), the Zuckerkandl tubercle has been well identified and it was grade 3 and grade 2. In those cases, the ILN was very closed to the tubercle. For the 27 other patients (56.25%), the tubercle was practically undetectable or reduced to a small glandular mound (grades 0 and 1). The connections with the nerve in this case were less evident.CONCLUSION:The zuckerkandl tubercle is comparatively frequent and is refound more than one time over 3 in our study. Its presence makes easier the identification of the ILN, which entertains a dangerous connection with the thyroid gland.

L’atteinte iatrogène du nerf laryngé inférieur (NLI) au cours de la chirurgie thyroïdienne est un incident grave qui peut avoir des séquelles fonctionnelles majeures. Sa recherche est recommandée au cours des cervicotomies pour thyroïdectomie et elle peut être facilitée par la présence du tubercule de Zuckerkandl, excroissance postéro-latérale de la glande thyroïde.

Objectives The aim of this study was to describe the epidemiological and therapeutic aspects of osteoarthritis of the hip in children, analyze the outcome, and describe the techniques for its diagnosis in a hospital with poor working conditions.Materials and methods This was a retrospective study including children in the age group of 0-15 years, who were managed for osteoarthritis at the Pediatric Surgery Department of the Lome Teaching Hospital (Togo) between July 2000 and June 2008. The data were collated from patients' records and analyzed for epidemiology, clinical features, treatment, and outcome of osteoarthritis.Results A total of 30 children were included in this study, of whom 17 (24.4%) were girls and 13 (43.3%) were boys. Their mean age was 4 years (range: 1-15 years). Children in the age range of 0-6 years accounted for 73.33% of patients included. Fifteen patients were of the homozygous sickle cell genotype (SS). Treatment included antibiotic therapy and immobilization of the joint. The outcome was excellent in eight AA patients (26.67%); good in three (10%), including one SS, one AS, and one SC; and fair in 19 patients (63.33%), including 14 SS, four AS, and one SC. The average duration of hospital stay was 18 days (range: 2-35 days).Conclusion Sickle cell disease (SS genotype) is the predominant cause of osteoarthritis in children presenting to the Pediatric Surgery Department of the Lome Teaching Hospital. Early diagnosis and appropriate treatment are necessary for a complete cure. (C) 2013 Annals of Pediatric Surgery.

Les jumeaux conjoints du groupe des thoracopages sont des monstres doubles qui resultent d’une anomalie malformative au cours de la grossesse gemellaire et qui presentent un cordon ombilical avec une fusion au niveau de la region thoracique. De tout ce groupe des teratopages, les thoracopages et les omphalopages sont les plus frequemment rapportes dans la litterature. Ce sont des malformations rares qui representent 1 pour 50000 naissances. Le diagnostic morphologique peut etre fait par un examen echographique antenatal. Observations :Nous rapportons deux cas de jumeaux thoraco-omphalopages nes vivants dans deux structures sanitaires du Togo. Il s’agissait de jumelles nees a terme par cesarienne. Chez les premieres, l’examen radiologique et surtout post-mortem a mis en evidence deux foies matures accoles l’un contre l’autre et deux coeurs enveloppes par un meme pericarde. Chez les deuxiemes, il s’agissait d’un coeur et d’un foie unique malforme. Conclusion :Le developpement des techniques chirurgicales et surtout des mesures de reanimation neonatale, permet de nos jours de realiser une separation chirurgicale lorsque ces jumeaux conjoints naissent vivants et surtout lorsque les elements anatomiques thoraco-abdominaux sont bien constitues. Mot cles : Jumeau conjoint, monstre double, teratopage. ABSTRACT Joint twins of the thoracopagus group are dual monsters that result from malformative abnormality during the twin pregnancy and that show one umbilical cord with a fusion over the thoracic area. Among the teratopages, thoracopages and omphalopages are the most frequently reported in the literature. That are rare malformations representing 01 over 50 000 births. The morphologic diagnosis can be done by antenatal sonography. Observations : We report two cases of thoraco-omphalopagus twins born alive in two hospitals in TOGO. That was twins born over time by C-section. For the first case, the radiologic and post-mortem examinations shew two mature livers placed side by side and two hearts wrapped in the same pericardium. For the second case, that was one heart and one liver, both malformed. Conclusion : The surgical techniques development and especially neonatal resuscitation measures allow nowadays achieving a surgical separation when that joint twins are born alive and especially when thoraco-abdominal organs are well constituted. Key words : Conjoined twins, dual monster, teratopagus.

En Afrique la sterilite du couple constitue un drame social. Selon l’OMS, environ 8 a 12 % des couples africains sont touches par une infertilite. La responsabilite masculine dans la sterilite est comprise entre 30 a 40%. Les causes de l’infertilite masculine peuvent etre l’impuissance et/ ou l’alteration du sperme. L’etude de l’alteration du sperme est appreciee par le spermogramme et le spermocytogramme. Ces analyses doivent etre realisees par des laboratoires de biologie de la reproduction. Vu la rarete ou l’absence des laboratoires de biologie de la reproduction dans la plupart des pays en voie de developpement notamment au Togo, ces analyses pourront etre realisees par les laboratoires d’analyses medicales courantes. Or les techniciens des laboratoires d’analyses medicales courantes ne sont inities a la pratique de realisation du spermogramme et du spermogramme et du spermocytogramme et pourtant font face a une demande de ces analyses. L’objectif de ce travail est de fournir aux techniciens des laboratoires d’analyses medicales courantes du Togo et des pays en voie de developpement un outil simple sur les pratiques de realisation du spermogramme et du spermocytogramme. Mots cles : Spermogramme, spermocytogramme, fiche technique. Data sheet of realization and interpretation of the spermogram and the spermocytogram. In Africa the sterility of the couple constitutes a social drama. According to the WHO, about 8 to 12% of the African couples are touched by an infertility. Of the masculine responsibility in the sterility is consisted between 30 to 40%. The reasons of the masculine infertility can be the impotence and / or the impairment of the semen. The study of the impairment of the semen is appreciated by the spermogram and the spermocytogram. These analyses must be achieved by laboratories of reproduction biology. Seen the rarity or the absence of the laboratories of reproduction biology notably in most developing countries to Togo, these analyses will be able to be achieved by the laboratories of current medical analyses. However the technicians of the laboratories of current medical analyses didn't start learning the practice of realization of the spermogram and the spermocytogram and yet makes facing a demand of these analyses. The objective of this work is to provide to the technicians of the laboratories of medical analyses current of Togo and developing countries a simple tool on the practices of realization of the record of semen and the spermocytogramme. Key words : Spermogram, spermocytogram, data sheet.

Objectif : Partager l’expérience de la prise en charge thérapeutique de la gangrène des bourses, au CHUTokoin de Lomé. Malades et Méthode : IL s’est agi d’une étude rétrospective, portant sur les malades traités au CHUTokoin de Lomé pour gangrène des bourses du 01/01/1993 au 31/12/ 2008. Résultats : Soixante-quatre malades tous de sexe masculin ont été traités en 16 ans, soit 4 cas par an. L âge moyen des malades a été de 48,42 ans. Deux aspects cliniques ont été observés : la gangrène constituée (n=33 ; 51,50%) et la lésion en phase de restauration (n=31 ; 48,44 %).Chez 18 malades (28,13%), la maladie a été causée par une affection proctologique. Les facteurs de co-morbidité ont été, dominés par l’infection au VIH, la malnutrition, l’âge avancé, le diabète et l’éthylisme. Le traitement de la gangrène constituée a consisté en une réanimation suivie d’une nécrosectomie et d’une diversion colique ou urinaire selon les cas ; une tri-antibiothérapie ; a complété la chirurgie. Les pansements de la plaie parée ont été réalisés tous les jours. L’évolution a été marquée par 46 guérisons (71,87%) et 18 décès (28,13%). La mortalité a été importante chez les patients ayant présentés des facteurs de comorbidité. Conclusion : La gangrène des bourses, malgré sa rareté, reste une affection grave dont le pronostic ne peut s’améliorer que par un diagnostic précoce et une prise en charge appropriée.Mots clés : Gangrène de Fournier, fascéite nécrosante, traitement, Afrique.Objective: To present the experience of taking care of the gangrene of scrotum at Tokoin Teaching Hospital of Lomé (Togo) Patients and method: It was a retrospective study of treated patients for gangrene of scrotum from first January 1993 to 31 December 2008. Results: Sixty four patients all male have been treated in 16 years that is 4 cases per year. The mean age was 48, 42 years. Two clinical aspects were observed: constituted gangrene (n=33; 51, 50%) and the lesion in restoration phase (n=31; 48, 44%). 18 patients (28, 13%) have presented proctologic affection (mostly anal fistula) which was the main cause of Fournier’s gangrene. Comorbidity factors were dominated by HIV infection, malnutrition, diabetes and alcoholism. The treatment of the constituted gangrene was a resuscitation followed by necrosestomy and colic or urinary diversion according to the cases. Tree antibiotics were used to complete the surgery. The wound dressings were done the following days either. The evolution was marked by 46 recoveries (71, 78%) and 18 deaths (28, 13%). The mortality was meanly high in case of co-morbidity factors. Conclusion: Gangrene of the genital area; though uncommon remain serious affection, of which the prognosis will not be improved if a diagnosed early, with an appropriated management.Key words: Fournier’s gangrene, necrotizing fascitis, treatment, Africa.

A retrospective study was conducted during 8 years to determine the epidemiological features of condyloma and its complications in patients attending urology consultations in Lomé teaching hospital. During this period, 257 cases (218 males, 38 females) of condyloma were diagnosed. The condyloma represented the fifth cause of consultation in urology, after genito-urinary infection (n = 1214), prostatic dysuria (n = 1095), vesicovaginal fistula (n = 849), lower tractus urinary lithiasis (n = 500). The average age of the patients was 28 years (range: 14-57). In 51 cases the condyloma were associated with others sexually transmitted diseases: 25 cases of gonococcal infection, 11 cases of chancroid, 9 cases of vaginal candidiasis, and 6 cases of genital trichomoniasis. We noted 41 cases of urological complications: 19 cases of urinary infection, 13 cases of retention of urine, 7 cases of urinary forked jet, and 2 cases of urethrorrhagia. The results of this study shows that, the condyloma is commun sexually transmitted disease seen in urology clinic. Its classically benign course in patients males, were predominant, in this sex, by the urinary infection and urological mechanical accidents.

A retrospective study was conducted during 8 years to determine the epidemiological features of condyloma and its complications in patients attending urology consultations in Lome teaching hospital. During this period, 257 cases (218 males, 38 femeles) of condyloma were diagnosed. The condyloma represented the fifth cause of consultation in urology, after genito-urinary infection (n = 1214), prostatic dysuria (n = 1095), vagino-vesical fistula (n = 849), lower tractus urinary lithiasis (n = 500). The average age of the patients was 28 years (range: 14-57). In 51 cases the condyloma were associated with others sexually transmited diseases: 25 cases of gonococcal infection, 11 cases of chancroid, 9 cases of vaginal candidiasis, and 6 cases of genital trichomoniasis. We noted 41 cases of urological complications: 19 cases of urinary infection, 13 cases of retention of urine, 7 cases of urinary forked jet, and 2 cases of urethrorragia. The results of this study shows that, the condyloma is common sexually transmited disease seen in urology clinic. Its classically benign course in patients males, were prodomined, in this sex, by the urinary infection and urological mechanical accidents.