Etat Des Lieux Et Evaluation Des Formations En Radiologie Dans Un Pays En Developpement, Cas Du Togo

Objective: to make an inventory and assess the training in radiology in Togo. Methodology: Descriptive study, with opinion survey, carried out from June to August 2016 including students in Master and Residents in radiology of the academic year 2015 - 2016. Results: The response rate was 91%. All the training sites had conventional radiography and functional ultrasound. For 57% of students the quality of practical instruction was 4/5. The availability of teachers was acceptable (3/5) to good (4/5) according to 84%. Competence for examinations varies from bad (2/5) to excellent (5/5) for the Master 1 and from good to excellent in Master 2. The difference in responses was not significant regardless of the year of study or training course (p> 0.05). For the performance and interpretation of radiological examinations, the junior residents were considered mediocre (1/5) to acceptable versus acceptable to seniors. For an ultrasound, this score varied from 1/5 for the juniors residents to 4/5 for the seniors. The competence to carry out a vessels ultrasound Doppler was 1/5 for the junior residents and 2/5 for the senior. Conclusion: Learners in radiology in Togo are generally satisfied with the training they receive. Acquisitions of significant skills have been observed from one level of training to another

Revue Des Doses d’Exposition Et Des Methode d’Optimisation En Tomodensitometrie (TDM) De l’Enfant Au Togo

Objectives: To assess the justification of indications of CT scans and the exposure doses of children during CT scans. Methods: Prospective study of 104 CT-sans of children collected over a period of 6 months. Results: Female children were predominant with a sex ratio female / male of 1.2. The predominant age group was the 10 to 15 years (41%). The CT-Scan of the head was the most practiced exam, with 64.42% (67/104). When analyzing information according to the recommendations of the Guide of well practices of French Society of Radiology (SFR) and the French Society of Biophysics and Nuclear Medicine (SFBMN), only 77% of CT-Scans were justified. Almost half (49.04%) of CT-Scans had a CT-Dose Index (CTDI) and Dose Length Product (DLP) greater than the French reference norms defined for each group of age. The average values of CTDI and DLP are above the norms for all CT-scans of the skull, facial bones and sinuses. Conclusion: The doses administered to children by CT-Scans are above accepted norms. Improved practices continue medical training of radiology manipulators and the creation of a regulatory or an agency of radioprotection is necessary

Echographie Pédiatrique En Pratique Hospitaliere Au Centre Hospitalier Universitaire (CHU) De Kara Au Togo

Purpose: To list pediatric ultrasound exams performed at Kara University Hospital Center in Togo and the pathologies observed. Materials and methods: This was a retrospective and descriptive study of the results of pediatric ultrasound examinations performed in the Department of Radiology and Imaging of Kara University Hospital Center. The study ran from January 1, 2013 to December 31, 2016, over a period of 3 years. Results: The frequency of pediatric ultrasounds was 5.1%. The average age of the patients was 2.16 years with extremes of 1 day to 15 years. There was a male predominance with a sex ratio of 1.4. Abdomino-pelvic ultrasound were the most represented, 92%, followed by cervical ultrasound in 2.6% of cases. Abdominal ultrasound indications were dominated by abdominal pain in 33.6% of cases, followed by palpation of abdominal mass in 15.7%. Cervical ultrasounds were motivated in 5 out of 8 cases by the cervical swelling. Abdomino-pelvic ultrasonography was pathological in 70.1% of cases. Hepatic affections were the most common abdominal abnormality in 37.8% of cases followed by splenic disorders. Hepatic lesions were dominated by European Scientific Journal February 2018 edition Vol.14, No.6 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 444 homogeneous hepatomegaly with 63.2% of cases. Cervical ultrasound was pathological in 6 out of 8 cases. The lesions observed were mainly cervical lymphadenopathy (4 cases out of 6). Conclusion: Ultrasound is a very useful tool in the exploration of pediatric diseases. The abdominal ultrasound is the most performed and hepatic pathologies are the most common

Traumatisme Ouvert de la Main par Introduction dans le Moulin (main de moulin) Chez l’Enfant : Aspects Epidémiologiques, Lésionnels, et Thérapeutiques au Service de Chirurgie Pédiatrique du Centre Hospitalier Universitaire Sylvanus Olympio de Lomé (Togo)

Contexte : la main de moulin se définit comme tout traumatisme de la main causée par une machine servant à moudre des céréales, des légumes ou toute autre denrée alimentaire. Elle est rencontrée dans notre milieu hospitalier motivant notre étude. Objectif : étudier les aspects épidémiologiques, lésionnels et donner un aperçu sur la prise en charge de la main de moulin au service de chirurgie pédiatrique du CHU Sylvanus Olympio de Lomé. Méthodes : il s’agissait d’une étude rétro prospective couvrant une période de 5 ans allant du 01 juin 2017 au 31 Mai 2022. Ont été inclus tous les enfants de 0 à 15 ans pris en charge dans le service de chirurgie pédiatrique du CHU SO Lomé pour un traumatisme ouvert de la main causé par un moulin. Résultats : nous avons enregistré 30 cas des mains de moulin soit 5,23% de tous les traumatismes ouverts de la main. La prédominance était masculine (18 garçons contre 12 filles). La tranche d’âge la plus touchée était celle de 10 à 15 ans avec un âge moyen de 9,07 +/- 4. La circonstance la plus retouvée était l’accident de travail. La majorité des traumatismes ont eu lieu au moulin public. La face de la main la plus touchée était celle plantaire. Le troisième rayon était le plus touché. Sur la face palmaire, la zone I de Verdan était la plus touchée dans 16 cas ainsi que sur la face dorsale dans 4 cas. Les phalanges étaient les plus touchées. La fracture était la lésion la plus fréquente. Les gestes opératoires etaient multiples du fait de la multiplicité des lésions. Conclusion : les mains de moulin chez l’enfant sont caractérisées par des lésions multiples et variées rendant la prise en charge complexe, posant ainsi un problème de santé publique.   Context: mill hand is defined as any trauma to the hand caused by a machine used to grind cereals, vegetables or any other foodstuff. It is encountered in our hospital environment motivating our study. Objective : étudier les aspects épidémiologiques, lésionnels et donner un aperçu sur la prise en charge de la main de moulin au service de chirurgie pédiatrique du CHU Sylvanus Olympio de Lomé. Methods: this was a retro prospective study covering a 5-year period from June 01, 2017 to May 31, 2022. Were included all children aged 0 to 15 years cared for in the pediatric surgery department of CHU SO Lomé for open hand trauma caused by a mill. Results: We recorded 30 cases of mill hands, i.e. 5.23% of all open hand traumas. The predominance was male (18 boys versus 12 girls). The age group most affected was 10 to 15 years, with an average age of 9.07 +/- 4. The most common circumstance was a work accident. The majority of injuries occurred at the public mill. The side of the hand most affected was the plantar side. The third ray was the most affected. On the palmar side, Verdan zone I was most affected in 16 cases, and on the dorsal side in 4 cases. The phalanges were the most affected. Fracture was the most frequent lesion. Multiple surgical procedures were required, due to the multiplicity of lesions. Conclusion: Mill hands in children are characterized by multiple and varied lesions, making management complex and posing a public health problem

Analyse Du Rebut Des Cliches Radiographiques Dans Le Service De Radiologie Et Imagerie Médicale Du Chu Campus De Lomé Au Togo

Purpose: To analyze the waste factors of rejected X-rays films. Methodology: Descriptive and analytical prospective study from 1 January to 30 June 2017 carried out in the department of radiology and medical imaging of the Campus University Hospital of Lomé in Togo. Results: 4912 patients had received 5630 radiographic incidences, including 3288 (58.4%) on the analogy and 2342 (41.5%) on the digital. The reject rate was 12.5%. The vast majority of the X-rays films, 682 (96.9%) were rejected by the radiographers themselves just after development. The resumption frequency ranged from one repeat (550 X-rays films, or 78%) to 4 repeats (8 X-rays films, or 1%). Almost all of the rejected films, 702 (99.7%) came from the analogical room. Chest X-ray was the incidence with more rejection in 33.9% followed by pelvic and lower limb incidences in 21% of cases. More than 2/3 of the rejected films, 473 (67.2%), came from the students' act. The causes of the rejection were mainly centering (25.5%), underexposure (20.17%) and overexposure (12.93). The financial loss caused by the scrap of X-rays films amounted to about 418800F CFA or 638.5 €. Conclusion: Strengthening communication between radiographers and radiologists is necessary to avoid unnecessary repeats of patient’s radiographs

Traumatisme Ouvert de la Main par Introduction dans le Moulin (Main de Moulin) chez l’Enfant : Aspects Epidémiologique, Lésionnel, et Thérapeutique au Service de Chirurgie Pédiatrique du Centre Hospitalier Universitaire Sylvanus Olympio de Lomé (Togo)

Contexte : la main de moulin se définit comme tout traumatisme de la main causée par une machine servant à moudre des céréales, des légumes ou toute autre denrée alimentaire. Elle est rencontrée dans notre milieu hospitalier motivant notre étude.  Objectif : ressortir les aspects épidémiologique, lésionnel et donner un aperçu sur la prise en charge de la main de moulin au service de chirurgie pédiatrique du CHU Sylvanus Olympio de Lomé. Méthodes : il s’agissait d’une étude rétro prospective couvrant une période de 5 ans allant du 01 juin 2017 au 31 Mai 2022. Ont été inclus tous les enfants de 0 à 15 ans pris en charge dans le service de chirurgie pédiatrique du CHU SO Lomé pour un traumatisme ouvert de la main causé par un moulin. Résultats : nous avons enregistré 30 cas des mains de moulin soit 5,23% de tous les traumatismes ouverts de la main. La prédominance était masculine (18 garçons contre 12 filles) soit un sex-ratio de 1,5. La tranche d’âge la plus touchée était celle de 10 à 15 ans avec un âge moyen de 9,07 +/- 4. La majorité des traumatismes ont eu lieu au moulin public (19 cas). Le moulin le plus incriminé était celui à céréales dans 19 cas (63,3%). Tous les patients avaient présenté un traumatisme ouvert de la main. La face de la main la plus touchée était celle plantaire dans 16 cas (53,33%). Le troisième rayon était le plus touché dans 22 cas (73,3%). Sur la face palmaire, la zone I de Verdan était la plus touchée dans 16 cas (53,3%) ainsi que sur la face dorsale dans 4 cas (13,3%). Les phalanges étaient les plus touchées dans 27 cas (90%). La fracture était la plus fréquente dans 18 cas (60%). Ainsi, un parage a été réalisé pour les plaies simples, tendinorraphie pour les lésions tendineuses puis une immobilisation pour la fracture. Conclusion : les mains de moulin chez l’enfant sont caractérisées par des lésions multiples et variées rendant la prise en charge complexe. Introduction: mill hand is defined as any trauma to the hand caused by a machine used to grind cereals, vegetables or any other foodstuff. It is encountered in our hospital environment motivating our study. Objective: to highlight the epidemiological and lesionary aspects and to give an overview of the management of the mill hand in the pediatric surgery department of the Sylvanus Olympio University Hospital in Lomé. Methods: This was a retro prospective study covering a period of 5 years from June 01, 2017 to May 31, 2022. Were included all children aged 0 to 15 years taken in charge in the pediatric surgery department of the CHU SO Lomé for an open trauma of the hand caused by a mill. Results: We recorded 30 cases of mill hands, i.e. 5.23% of all open hand trauma. The predominance was male (18 males versus 12 females), i.e. a sex ratio of 1.5. The age group most affected was 10 to 15 years old with an average age of 9.07 +/- 4. Circumstance. The majority of injuries occurred at the public mill (19 cases). The most incriminated mill was the grain mill in 19 cases (63.3%). All patients had presented an open trauma of the hand. The face of the hand most affected was the plantar one in 16 cases (53.33%). The third ray was the most affected in 22 cases (73.3%). On the palmar side, Verdan's zone I was the most affected in 16 cases (53.3%) and on the dorsal side in 4 cases (13.3%). The phalanges were most affected in 27 cases (90%). Fracture was most frequent in 18 cases (60%). Thus, trimming was performed for simple wounds, tendinoraphy for tendon injuries, and immobilization for fracture. Conclusion: Mill hands in children are characterized by multiple and varied lesions making management complex, thus posing a public health problem

Traumatisme Ouvert de la Main par Introduction dans le Moulin (Main de Moulin) chez l’Enfant : Aspects Epidémiologique, Lésionnel, et Thérapeutique au Service de Chirurgie Pédiatrique du Centre Hospitalier Universitaire Sylvanus Olympio de Lomé (Togo)

Contexte : la main de moulin se définit comme tout traumatisme de la main causée par une machine servant à moudre des céréales, des légumes ou toute autre denrée alimentaire. Elle est rencontrée dans notre milieu hospitalier motivant notre étude.  Objectif : ressortir les aspects épidémiologique, lésionnel et donner un aperçu sur la prise en charge de la main de moulin au service de chirurgie pédiatrique du CHU Sylvanus Olympio de Lomé. Méthodes : il s’agissait d’une étude rétro prospective couvrant une période de 5 ans allant du 01 juin 2017 au 31 Mai 2022. Ont été inclus tous les enfants de 0 à 15 ans pris en charge dans le service de chirurgie pédiatrique du CHU SO Lomé pour un traumatisme ouvert de la main causé par un moulin. Résultats : nous avons enregistré 30 cas des mains de moulin soit 5,23% de tous les traumatismes ouverts de la main. La prédominance était masculine (18 garçons contre 12 filles) soit un sex-ratio de 1,5. La tranche d’âge la plus touchée était celle de 10 à 15 ans avec un âge moyen de 9,07 +/- 4. La majorité des traumatismes ont eu lieu au moulin public (19 cas). Le moulin le plus incriminé était celui à céréales dans 19 cas (63,3%). Tous les patients avaient présenté un traumatisme ouvert de la main. La face de la main la plus touchée était celle plantaire dans 16 cas (53,33%). Le troisième rayon était le plus touché dans 22 cas (73,3%). Sur la face palmaire, la zone I de Verdan était la plus touchée dans 16 cas (53,3%) ainsi que sur la face dorsale dans 4 cas (13,3%). Les phalanges étaient les plus touchées dans 27 cas (90%). La fracture était la plus fréquente dans 18 cas (60%). Ainsi, un parage a été réalisé pour les plaies simples, tendinorraphie pour les lésions tendineuses puis une immobilisation pour la fracture. Conclusion : les mains de moulin chez l’enfant sont caractérisées par des lésions multiples et variées rendant la prise en charge complexe. Introduction: mill hand is defined as any trauma to the hand caused by a machine used to grind cereals, vegetables or any other foodstuff. It is encountered in our hospital environment motivating our study. Objective: to highlight the epidemiological and lesionary aspects and to give an overview of the management of the mill hand in the pediatric surgery department of the Sylvanus Olympio University Hospital in Lomé. Methods: This was a retro prospective study covering a period of 5 years from June 01, 2017 to May 31, 2022. Were included all children aged 0 to 15 years taken in charge in the pediatric surgery department of the CHU SO Lomé for an open trauma of the hand caused by a mill. Results: We recorded 30 cases of mill hands, i.e. 5.23% of all open hand trauma. The predominance was male (18 males versus 12 females), i.e. a sex ratio of 1.5. The age group most affected was 10 to 15 years old with an average age of 9.07 +/- 4. Circumstance. The majority of injuries occurred at the public mill (19 cases). The most incriminated mill was the grain mill in 19 cases (63.3%). All patients had presented an open trauma of the hand. The face of the hand most affected was the plantar one in 16 cases (53.33%). The third ray was the most affected in 22 cases (73.3%). On the palmar side, Verdan's zone I was the most affected in 16 cases (53.3%) and on the dorsal side in 4 cases (13.3%). The phalanges were most affected in 27 cases (90%). Fracture was most frequent in 18 cases (60%). Thus, trimming was performed for simple wounds, tendinoraphy for tendon injuries, and immobilization for fracture. Conclusion: Mill hands in children are characterized by multiple and varied lesions making management complex, thus posing a public health problem

Evaluation of pulmonary computed tomography angiography protocols: A multicenter audit in Togo

Introduction : Pulmonary CT angiography is among the most challenging protocols to execute, with significant inter-center variability in image acquisition protocols and iodinated contrast media injection. This study aimed to ascertain whether the use of iodinated contrast media (ICM) and acquisition protocols are optimized during pulmonary CT angiography procedures. Materials and methods : This multicentric cross-sectional study, descriptive and analytical with a prospective data collection was conducted in three radiology departments in Togo. It encompassed all pulmonary CT angiography examinations carried out from March 1st to June 30th, 2023. Results : In total, 89 patients, of which 52 were females (58.43%), were registered. The average age was 59.97±14.34 years. The average volume of injected ICM was 67.08±14.21 ml. The mean iodine dose was 0.31±0.07 gI/Kg. Catheters of 20 G (44.94%) and 18 G (43.82%) were most frequently used. The mean injection rate was 4.22±0.64 ml/s. The bolus test technique was the most employed (75.28%). The average acquisition delay was 17.77±12.26 seconds, while the average acquisition duration was 10.56±2.56 seconds. The average dose-length product (DLP) was 390.09±236.69 mGy.cm, and the average volumetric computed tomography dose index (CTDI_vol) was 12.31±11.69 mGy. Vascular enhancement was insufficient in 7.87% of cases. No statistically significant difference was found on the rate of insufficient enhancement and optimization factors. Similarly, there was no enhancement difference between bolus test and bolus tracking techniques. Conclusion : The vast majority of examinations allowed for optimal opacification of the pulmonary arteries. However, the optimization measures for the use of iodinated contrast media are not consistently applied

Le fibromatosis colli ou torticolis congénital: son diagnostic et sa prise en charge à propos de deux cas

Le fibromatosis colli (FC) est pseudotumeur rare du muscle sterno-cléido-mastoïdien (SCM), à l'origine d'un torticolis dit congénital chez le nouveau-né ou le nourrisson. Le mécanisme étio-pathogénique de sa survenue est sujet à controverse. Son diagnostic fait appel à l'échographie qui permet de mettre en évidence un épaississement caractéristique du muscle. Nous rapportons deux cas diagnostiqués par l'échographie avec pour un cas une notion de malposition intra-utérine et pour l'autre cas une absence totale de malposition et de traumatisme obstétrical qui pourtant est évoqué comme élément du mécanisme de survenue du FC.Key words: Fibromatosis colli, torticolis congénital, sterno-cléido-mastoïdien, échographi

Revue Des Doses D’exposition Et De La Justification Des Radiographies Standard En Pratique Pédiatrique Au Togo

Aims: To assess the justification of indications and exposure doses to children during radiographics. Methods: Prospective study of 102 X-ray exams of children collected over a period of 6 months in the Department of Radiology of Kara Teaching Hospital. Objectives: To assess the rationale guidance and exposure doses to children when standard radiographic examinations. Methodology: prospective observational study of 102 standard radiographs (Rx) collected in the radiology department of the University Hospital of Kara on a 6 month period. Results: Male children were predominant with a sex ratio boy / girl of 1.3. The predominant age group was the 5 to 10 years. Chest X-rays were the most practiced exam, with 43%. According to the Guide of well practices of French Society of Radiology (SFR) and the French Society of Biophysics and Nuclear Medicine (SFBMN), 80% of exams were justified. The comparison of our results to diagnostic reference levels (DRLs) shows that 43% and 39% of standard X-rays had dosimetric values exceeds the RDLs respectively the entrance Dose (De) and Dose Surface Product (DSP). Conclusion:Our study reveals that compliance guidance assessments to the proper use of medical imaging examinations guide was not always effective but satisfactory. The study dosimetric constants showed that the dose to children exceeded in a large proportion of the French and Belgian DRLs