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Spontaneous Abortions in the Second Trimester of Pregnancy: Research and Analysis of Factors Associated at Laquintinie Hospital in Douala

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1130-1143页

作者： Henri Essome Moustapha Bilkissou merlin boten bounyom Sandrine Ngoumi Ingrid Doriane Ofakem Ilick Astrid Ndolo Kondo Fulbert Mangala Nkwele Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Pascal Foumane Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences of Bamenda University of Bamenda Bamenda Cameroon Institute of Health Sciences of the University of the Mountains of Bangant Bangant Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of Yaound University of Yaound 1 Yaound Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmlima University of Ebolowa Ebolowa Cameroon

Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.

关键词： Spontaneous Abortion Second Trimester Associated Factors Laquintinie

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Urinary Infection during Pregnancy: Case-Control Study in the Maternity Wards of the Teaching Hospitals of Yaoundé Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1735-1756页

作者： Henri Essome Moustapha Bilkissou Fulbert Mangala Nkwele Aurel Mbog Wetjeng Ingrid Doriane Ofakem Ilick Astrid Ndolo Kondo merlin boten bounyom Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon

Introduction: Acute pyelonephritis in pregnancy (APN) is a bacterial infection of the upper urinary tract (pyelitis) and renal parenchyma (nephritis), complicating or associated with an infection of the lower urinary tract. Objective: Study the clinical and para-clinical profile linked to their occurrence of APN during pregnancy in the city of Yaoundé. Methodology: This was a case-control analytical study lasting 07 months with retrospective data collection and covering a period of six years from January 2015 to December 2020 in 03 teaching hospitals in the city of Yaoundé. The data was recorded on a pre-tested technical sheet. We recruited the files of pregnant women in whom a urinary infection had been diagnosed using urine culture. The cases were the files of pregnant women with signs of APN and the controls were the files of pregnant women without signs of APN. The matching criteria were: recruitment site, age and term of pregnancy. Incomplete files were excluded. Statistical analyzes were carried out with Epi-Info 7 and Excel 2016 software. Statistical significance was set at a P value Results: We recruited: 55 cases and 110 controls. The factors associated with the occurrence of APN in pregnancy after logistic regression were: free union (OR: 2.19;P = 0.030), sexual intercourse during pregnancy (OR: 4.47;P = 0.001), positive HIV serology (OR: 5.52;P = 0.001), pre-gestational diabetes (OR: 10.9;P = 0.02) and a history of urinary infection during pregnancy (OR: 11.86;P = 0.001). Conclusion: Acute pyelonephritis in pregnancy is an uncommon but serious pathology. Its risk factors in our context are free union, sexual intercourse during pregnancy, positive HIV serology, pre-gestational diabetes, and a history of urinary infection during pregnancy.

关键词： Associated Factors Acute Pyelonephritis Pregnancy Yaoundé

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Pregnancy Preferences in Females of Reproductive Age with Sickle Cell Disease at Laquintinie Hospital: A Cross-Sectional Analysis

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 744-757页

作者： Eposse Ekoube Charlotte Jeannette Disso Massako Mangala Fulbert Nkwele Mandeng Ma Linwa Edgar Puepi Djike Yolande merlin boten bounyom Erero F. Njiengwe Épée Patricia Hassanatou Iyawa Dora Mbonjo Bitsie Emmanuel Heles Nsang Soumaiyatou Abba Ngo Linwa Esther Eleonore Ndolo Kondo Astrid Grâce Tocki Toutou Moustapha Bilkissou Essome Henri Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Paediatric Unit Douala Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Females with sickle cell disease (SCD), despite having a delayed pubertal development, are subject to many worries relating to their abilities to conceive, their capacity to maintain a maternofetal-risk-free pregnancy till term and give birth to healthy children without sickle cell disease. Knowing that unplanned pregnancies are more likely to increase maternofetal morbidity and mortality, we sought out to explore the pregnancy preferences in female patients with sickle cell disease to promote healthy conception and childbirth in this vulnerable population. Methodology: We conducted a cross-sectional study involving female patients of child-bearing age with sickle cell disease followed at Laquintinie Hospital Douala or who were members of a local sickle cell association. Pregnancy preferences were determined using the Desire to Avoid Pregnancy (DAP) scale. Factors associated with pregnancy preferences were determined using multivariable linear regression model. Threshold for significance was set at p Results: Seventy-seven patients were included with a mean age of 24.71 ± 5.53 years. Forty patients (51.95%) had one sexual partner and thirteen women (32.5%) used contraceptive methods. Most patients (46.0%) responded “Strongly Agree” or “Agree” to the statement “it would be a good thing for me if I became pregnant in the next 3 months”. The mean DAP score was 1.63 ± 0.91 [1.28 ± 0.82 in those who had a sexual partner and 1.99 ± 0.86 in those who had no sexual partner]. Factors that were positively associated with DAP score were students (b = 0.32, 95% CI [0.21, 0.95], p = 0.003), monthly income ≥ 100,000 FCFA (b = 0.24, 95% CI [0.07, 0.81], p = 0.022), and not having a sexual partner (b = 0.26, 95% CI [0.11, 0.85], p = 0.012). Conclusion: Most female patients with SCD have a low desire to avoid pregnancy. This is especially true for patients who are not students, have a partner and have a low monthly income.

关键词： Pregnancy Preferences Sickle Cell Disease Laquintinie Hospital Cameroun

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Profile of Full-Term Births in Maternity Wards of Public Hospitals in Douala Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 705-720页

作者： Henri Essome merlin boten bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Fulbert Mangala Nkwele Irène Cyrielle Edjoa Mboe Michel Roger Ekono Alphonse Ngalame Nyong Robert Tchounzou Moustapha Bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Théophile Nana Njamen Valère Mve Koh Pascal Foumane Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences of Sangmelima University of Ebolowa Ebolowa Cameroon

Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.

关键词： Profile Delivery Term Malaria Douala

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Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 758-778页

作者： Henri Essome merlin boten bounyom Astrid Ndolo Kondo Ingrid Doriane Ofakem Ilick Charlotte Epossè Ekoube Rita Bono Betoko Hassanatou Iyawa Fulbert Mangala Nkwele Théophile Nana Njamen Robert Tchounzou Alphonse Ngalame Nyong Charlotte Irène Cyrielle Edjoa Mboe Moustapha Bilkissou Junie Ngaha Yaneu Marga Vanina Ngono Akam Gervais Mounchikpou Ngouhouo Grâce Tocki Toutou Michel Roger Ekono Nelly Noubi Pascal Foumane Training Teaching and Research Unit in Gynecology Obstetrics and Reproduction Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laquintinie Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 1 Yaound&#233 Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Ebolowa Ebolowa Cameroon

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potenti

关键词： Newborn Low Birth Weight Gestational Age Douala

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World Journal of Gastroenterology 2008年第40期14卷 6115-6121页

作者： Didier merlin Department of Medicine Division of Digestive DiseasesEmory University School of Medicine

Recently, inflammatory bowel disease （IBD） has been the subject of considerable research, with increasing attention being paid to the loss of intestinal epithelial cell barrier function as a mechanism of pathogenesis. Ste20-related proline/alanine-rich kinase （SPAK） is involved in regulating barrier function. SPAK is known to interact with inflammation-related kinases （such as p38, JNK, NKCC1, PKCS, WNK and MLCK）, and with transcription factor AP-1, resulting in diverse biological phenomena, including cell differentiation, cell transformation and proliferation, cytoskeleton rearrangement, and regulation of chloride transport. This review examines the involvement of Ste20-1ike kinases and downstream mitogen-activated protein kinases （MAPKs） pathways in the pathogenesis and control of intestinal inflammation. The primary focus will be on the molecular features of intestinal inflammation, with an emphasis on the interaction between SPAK and other molecules, and the effect of these interactions on homeostatic maintenance, cell volume regulation and increased cell permeability in intestinal inflammation.

关键词： Inflammatory bowel diseases WNK NKCCl Barrier function Ste20-related proline/alanine-rich kinase

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Excessive Weight Gain during Pregnancy and Prognosis of Childbirth in Douala (Cameroun)

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 242-250页

作者： Henri Essome Valere Mve Koh Michel Ekono merlin boten Jean Paul Engbang Matio Bewekedi Pascal Foumane Douala Laquintinie Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon University Hospital Center of Yaoundé Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Gyneco-Obstetrics and Pediatric Hospital of Yaoundé Yaoundé Cameroon

The objective was to describe the maternofetal outcome of childbirth in women with excessive weight gain during pregnancy. We conducted a cross-sectional analytical study over a period of 03 months in the Obstetrics Department of Laquintinie Hospital in Douala (HLD). Our study population consisted of any pregnant in labor or waiting for a caesarean section. We compared two groups of pregnant women with excessive weight gain during pregnancy (exposed) and those without excessive weight gain during pregnancy (unexposed). We recorded 240 pregnant women who gave birth at the HLD maternity, 59 of whom had excessive weight gain during pregnancy, which gave us a proportion of 24.6%. The only sociodemographic characteristic associated with excessive weight gain during pregnancy was the married marital status of the pregnant women (OR: 2.0 (1.1 - 3.8) P = 0.023). Pregnant women with maternal complications associated with excessive weight gain had an average elevated uterine height of 35.4 (P = 0.007). The increase in caesarean section rate (P = 0.094) and the onset of pregnancy-related hypertension (HTA) showed differences close to significance (P = 0.063). Mean birth weight was higher (P = 0.023) in pregnant women with excessive weight gain during pregnancy. Ultimately, excessive weight gain during pregnancy has deleterious effects on the course of pregnancy and childbirth. It promotes the onset of pregnancy HTA and macrosomia.

关键词： Excessive Weight Gain Pregnancy Maternofoetal Outcome

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Kaolin Clay Consumption and Pregnancy:Prevalence,Hematological Consequences and Outcome of Labour in the Douala

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Open Journal of Obstetrics and Gynecology 2017年第12期7卷 1166-1173页

作者： Henri Essome Jean Paul Engbang Gaella Penda Ndedi Mve Koh Valere merlin boten Pascal Foumane DieudonnéAdiogo Douala Laquintinie Hospital DoualaCameroon Faculty of Medicine and Pharmaceutical Sciences The University of DoualaDoualaCameroon Yaounde University Health Center YaoundéCameroon Faculty of Medicine and Biomedical Sciences The University of Yaoundé IYaoundéCameroon Gynecological-Obstetric and Pediatric Hospital of Yaoundé YaoundéCameroon

Objective: To determine the prevalence, haematological repercussions and prognosis of childbirth in the event of consumption of kaolin during pregnancy. Materials and Methods: It was a study over a period of 3 months at the Laquintinie Hospital Douala. It compared two groups of women, one of whom had consumed kaolin during pregnancy (exposed group) and the other had not consumed it (non-exposed group). Results: A total of 342 women were included in our study, 121 (35.4%) of whom had consumed kaolin during pregnancy. Women exposed to this consumption (P < 0.05) after univariate analysis were those of pregnant women from the Far North (OR = 3.37, CI: 1.29 - 8.79, P = 0.013), single (OR = 1.65, CI = 1.05 - 2.59, P = 0.029), those with primary education (OR = 2.25, CI = 1.06 - 4.79, P = 0.035) and those with HIV (OR = 2.75, IC = 1.02-7.43, P = 0.045). Consumption was more frequent in the first trimester of pregnancy (37%) and in the third quarter (34%), at a predominantly weekly rate (47.9%). The most frequently cited reasons were envy (82%), and nausea (45%). This consumption was associated with a risk of premature delivery (RR = 2.26, IC = 1.27 - 4.05, P = 0.001), yellowish amniotic fluid (RR = 4.66, IC = 1.81 - 11, P = 0.001), birth weight < 2500 g in newborns (RR = 1.72, IC = 3.36 - 9.56, P = 0.025), but increased the probability of delivery (RR = 1.94, IC = 0.96 - 3.90, P = 0.039). For the hematological aspect, the occurrence of anemia (RR = 1.55, IC = 0.97 - 2.31, P = 0.003) and a decrease in mean hemoglobin concentration (RR = 1.29, IC = 0.83 - 2.03, P = 0.041) were associated with kaolin in pregnancy. After multivariate logistic regression, the complications included premature delivery, yellowish colour of the amniotic fluid and decreased hemoglobin. Conclusion: The use of kaolin is a frequent feeding behavior in pregnancy, mainly motivated by envy, which nevertheless presents serious maternal and fetal complications.

关键词： Kaolin Pregnancy Anemia Prognosis Childbirth Douala

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Recent advances in orally administered cell-specific nanotherapeutics for inflammatory bowel disease

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World Journal of Gastroenterology 2016年第34期22卷 7718-7726页

作者： Xiao-Ying Si Didier merlin Bo Xiao Institute for Clean Energy and Advanced Materials Faculty of Materials and EnergySouthwest University Chongqing 400715 China Institute for Biomedical Sciences Center for Diagnostics and TherapeuticsGeorgia State University Atlanta GA 30302 United States Atlanta Veterans Affairs Medical Center Decatur GA30033 United States

Inflammatory bowel disease(IBD) is a chronic relapsing disease in gastrointestinal tract. Conventional medications lack the efficacy to offer complete remission in IBD therapy,and usually associate with serious side effects. Recent studies indicated that nanoparticle-based nanotherapeutics may offer precise and safe alternative to conventional medications via enhanced targeting,sustained drug release,and decreased adverse effects. Here,we reviewed orally cell-specific nanotherapeutics developed in recent years. In addition,the various obstacles for oral drug delivery are also reviewed in this manuscript. Orally administrated cell-specific nanotherapeutics is expected to become a novel therapeutic approach for IBD treatment.

关键词： Oral administration Nanotherapeutic Cell specificity Inflammatory bowel disease

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Classic Ehlers-Danlos syndrome and cardiac transplantation-Is there a connection?

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World Journal of Cardiology 2020年第8期12卷 368-372页

作者： merlin G Butler Departments of Psychiatry and Behavioral Sciences University of Kansas Medical CenterKansas CityKS 66160United States

Ehlers-Danlos syndrome(EDS)is a heterogeneous group of connective tissue disorders comprised of several *** EDS is an autosomal dominant disorder with stretchable skin,delayed wound healing with poor scarring,joint hypermobility with subluxations or dislocations,easy bruisability,hernias,aneurysms and cardiac *** in genomics technology using next-generation sequencing has led to the discovery of causative genes for connective tissue disorders,hereditary cardiomyopathies and cardiovascular diseases including several genes for connective tissue disorders.A 55 year-old male exhibited thin stretchable skin,atrophic scars,easy bruising,joint pain and dislocations requiring multiple knee surgeries and a Beighton hyperflexibility score of 6 out of *** was found to have a heterozygous missense COL5A1 gene variant involving exon 3 at nucleotide c:305T>A with an amino acid position change at ***102Asn consistent with classic *** had a heart transplant at 43 years of age due to cardiac failure of unknown *** patient with classic EDS is brought to medical attention and should be of interest to cardiologists,heart transplant specialists and surgeons,particularly in individuals with unexplained cardiac failure and then diagnosed prior to surgical intervention to avoid poor wound healing,scarring and other tissue involvement(e.g.,vascular anomalies,blood pressure instability,aneurysms)as components of EDS.

关键词： Ehlers-Danlos syndrome Next-generation sequencing Surgical complications Beighton hypermobility scale Cardiac failure and transplantation

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