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Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 487-501页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi Marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena claude cyrille noa ndoua Robinson Enow Mbu Faculty of Medicine and Biomedical Sciences The University of Yaoundé 1 Yaoundé Cameroon Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartil

关键词： Determinants Early Survival Breast Cancer Yaoundé

The Hidden Side of the Story between the Placenta and Preeclampsia: Preliminary Results of a Prospective Cohort of Pregnant Women in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 610-620页

作者： Junie Annick Metogo Ntsama Ambroise Merci Engounou Seme Urielle Julie Tchuente Sutchueng Wilfried Loic Tatsipie Christian Vagoda Henry-Leonard Chatelin Mol Madye Ngo Dingom Felix Essiben cyrille claude noa ndoua Yann chris Eng Odile Fernande Zeh Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was s

关键词： Pre-Eclampsia Doppler Ultrasound Placenta

Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

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The Interest of Endoscopy in the Diagnosis of Fallopian Tubes Diseases at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (Ygoph)

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第3期 487页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi Marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena claude cyrille noa ndoua Robinson Enow Mbu

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 767-774页

作者： cyrille Léger Abega claude cyrille noa ndoua Irène Nadine Kouna Tsala Arielle Fonkou Gladys Ngono Ateba Tobie Eric Ntsobe Jean Cédric Fouda Rosine Mafoma Pascal Foumane Mother and Child Center Douala General Hospital Douala Cameroon Department of Gyneco-Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon University of Yaoundé I Yaoundé Cameroon Faculty of Medecine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Garoua General Hospital Garoua Cameroon

Introduction: Fallopian diseases are often implicated in female infertility. Several radiological and surgical explorations have been proposed in order to evaluate the severity of lesions found in utero-adnexal pathology. Among tools that are used to investigate such pathologies, we have ultrasound, hysterosalpingography and endoscopy. But, in many developing countries like Cameroon, the usage of endoscopy in gynecology is not yet known by many practicians. The objective of our study was to show the interest of endoscopy in the diagnosis of fallopian tube pathologies. Methodology: We conducted a cross-sectional and descriptive study from March 1st, 2017 to May 31st, 2017 at the Gyneco-Obstetrics and Pediatric department of our Hospital. We included all women who presented infertility and underwent ultrasound, hysterosalpingography (HSG) and endoscopy at the Yaoundé Gyneco-obstetrics Hospital. We analyzed epidemiological parameters, clinics, ultrasound, hysterosalpingography and endoscopic finding. We used Cohen’s Kappa test to determine the correlation between HSG/endoscopy and ultrasound/endoscopy in the diagnosis of fallopian tube pathologies. The threshold was significant for a K-value > 0.20. Results: We got a sample of 156 women;the mean age was 32.6 ± 4.5 years. The Secondary infertility dominated in 66.7% of cases;31.1% of women presented a past medical history of sexually transmitted infections and 41.7% did abortions before. Endoscopic lesions were dominated by a fallopian obstruction in 54.5% of cases, 8.3% of adhesions, 33.9% of women presented uterine myomas, 37.8% of ovarian cysts and 1.3% of pelvic endometriosis. The K-values between HSG and endoscopy for distal and proximal tube obstructions were significant with respective thresholds of 0.25 and 0.30. The K-value between ultrasound and endoscopy was not significant with a threshold of 0.015 for the tubal hydrosalpinx. Conclusion: Endoscopy assessment appears as the most efficien

关键词： Fallopian Tube Endoscopy Hysterosalpingography Ultrasound

Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 175-185页

作者： noa ndoua claude cyrille Tchedele Guidebta Hilary Nyada Serge Robert Astrid Ruth Ndolo Kondo Ayissi Gregory Ngo Dingom Anne Madye Tompeen Isidore Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaounde Cameroon Faculty of Medicine and Pharmaceutical sciences of the University of Douala Douala Cameroon

Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% - 2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.2% were term pregnanci

关键词： Ectopic Pregnancy Maternal Morbidity

Endometriosis beyond the Pelvis: A Case Series of Cutaneous Endometriosis and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 77-88页

作者： Tompeen Isidore Nkoro Ombédé G. Anita Mendouga Menye Coralie Belinga Etienne noa ndoua cyrille Foumane Pascal Department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Internal Medicine and Specialities Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Morphologic Sciences and Anatomopatology Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences The University of Ebolowa Ebolowa Cameroon

Introduction: Cutaneous endometriosis is an uncommon but well-known skin disorder that represents about 0.5% to 1% of all endometriosis. The objective of this case series is to report clinical presentation, diagnosis, and management of various forms of cutaneous endometriosis. Material and Methods: It was an observational, retrospective and descriptive review of cases presenting with cutaneous endometriosis among Cameroonian women managed at the gynaecological outpatient department of Yaounde Gynaeco-Obstetric and Pediatric Hospital. All the following parameters were analysed: age, parity, previous pelvic surgery, presenting symptoms and duration, associated symptoms, localizations, imaging, size of the lesion, other localization of endometriosis, management and histopathological results. Results: we reported 4 cases of cutaneous endometriosis, with 3 umbilical endometriosis and 1 abdominal scar endometriosis. Patient age ranged from 28 to 39 years with an average of 33 years. All patients described infertility (two primary and two secondary) and two had a history of abdominal surgery. All patients presented local cyclical signs such as pain, swelling, color change and bleeding. The duration of symptoms varied from 2 to 3 years and the size of lesions ranged from 2 to 3.5 cm for umbilical lesions and was 9 cm for abdominal scar endometriosis. In all cases, no imaging was required for the diagnosis, which was suspected on the basis of patient’s history and the cyclical nature of local signs, followed by wide surgical excision and confirmation on histopathology. Conclusion: Cutaneaous endometriosis is a rare benign condition. Umbilical endometriosis seems to be the main cutaneous localization and can be described as primary or secondary. Even if its diagnosis must be confirmed by histopathology, it should be considered in patient with cutaneous cyclic signs such as pain, swelling or bleeding with or without history of abdominal surgery.

关键词： Endometriosis Cutaneous Endometriosis Umbilical Endometriosis Cyclic Umbilical Swelling Cameroon

Association between Placental Malaria and Severe Pre-Eclampsia in Two University Hospitals of Yaounde City

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1488-1511页

作者： Ayissi Gregory Astrid Ruth Ndolo Kondo Ndoumba Afouba Alice noa ndoua claude cyrille Essiben Félix Meka Esther Belinga Etienne Metogo Junie Engo Engo Samuel Désiré Bodo Edmond Lemaire Tchente Nguefack Charlotte Foumane Pascal Mboudou Emile Télésphore Department of Obstetrics and Gynecology Faculty of Medicine and Biomedicals Sciences University of Yaound I Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Department of Morphological and Anatomo-Pathological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon. Department of Morphological and Anatomo-Pathological Sciences Faculty of Medicine and Biomedicals Sciences University of Yaound I Yaounde Cameroon

Context: Pre-eclampsia and placental malaria, are two diseases that share pathophysiological similarities, such as placental ischemia, endothelial dysfunction and production of pro-inflammatory cytokines. Objective: The objective of our study was to investigate the association between placental malaria lesions and severe pre-eclampsia. Methodology: We conducted a prospective analytical cross-sectional study in two University Hospitals in the city of Yaounde (Yaounde Central Hospital and the Gynaecological Obstetrics and Paediatrics Hospital), and in the laboratory of the Centre Pasteur in Yaounde over an eight-month period (1st January 2021 – 1st September 2021). All patients with pre-eclampsia diagnosed according to the criteria of the International Society for the Study of Hypertension (ISSHP) and free of chronic metabolic or infectious pathology were included in this study. The patients were divided into two groups: group 1 (mild pre-eclampsia) and group 2: severe pre-eclampsia. Socio-demographic, clinical and histopathological characteristics specific to pre-eclampsia and placental malaria were investigated. Statistical analysis was performed with SPSS 23.0 software, Chi 2 was used to compare categorical variables, Student t-test was used to compare means, and logistic regression was used to assess the association between placental malaria lesions and PES. Results: The mean age of our study population was 29.93 ± 7.36 years versus 28.28 ± 7.18 years in patients with mild and severe pre-eclampsia respectively. Pre-eclampsia placental lesions (accelerated villous maturation, infarction) were significantly greater in patients with severe pre-eclampsia (p Conclusion: Placental malaria lesions were significantly associated with severe pre-eclampsia and increased the risk of developing severe pre-eclampsia placental lesions by a factor of 10.

关键词： Mild Pre-Eclampsia Severe Pre-Eclampsia Malaria Placental Lesions Association

The Interest of Endoscopy in the Diagnosis of Fallopian Tubes Diseases at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (Ygoph)

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Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第4期

作者： cyrille Léger Abega claude cyrille noa ndoua Irène Nadine Kouna Tsala Arielle Fonkou Gladys Ngono Ateba Tobie Eric Ntsobe Jean Cédric Fouda Rosine Mafoma Pascal Foumane

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