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Helicobacter Pylori Infections in Peptic Ulcer Perforations: A Retrospective Analysis in Two Referral Hospitals in Douala, Cameroon

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Surgical Science 2020年第10期11卷 298-311页

作者： Francois Adrien Morel Bokalli Chi Fru McWright Jerry Brown Njoh Aseneh Takere Maseoli Mbachan ngomba divine mokake Jules Clément Assob Nguedia Marcelin Ngowe Ngowe Department of Medicine Faculty of Health Sciences University of Buea Buea Cameroon Laquintinie Hospital Douala Cameroon Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Biomedical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Perforations are major complications of peptic ulcer disease and surgical emergencies with important mortality and morbidity. Helicobacter pylori (H. pylori) has been identified as one of the commonest factors associated with peptic ulcer disease. However, little is known about its implication in cases of perforations in Cameroon. We aimed to determine the frequency of Helicobacter pylori infections in cases of perforated peptic ulcers, describe clinical features and outcomes of these cases in Cameroon. Method: A hospital-based retrospective cross-sectional study was conducted through the review of patients’ records admitted for peptic ulcer perforations in Laquintinie and Douala General Hospitals over a period of 5 years (January 2014 - December 2018). We defined H. pylori infection as;positive result on tissue biopsy at time of surgery. We used SPSS version 23.0 to analyse data and set an alpha value at P = 0.05. Results: We reviewed 115 cases of peptic ulcer perforation, with a mean age of 40 years and sex ratio (M:F) of 5:1. All patients underwent emergency laparotomy, 48 (41%) cases had a biopsy report and the prevalence of H. pylori infection in these cases was 47.9 %. Smoking, alcohol consumption and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) use, were not associated with peptic ulcer perforation. The morbidity was at 43.7% and mortality at 14%. Mortality was increasing with a higher Mannheim Peritonitis Index score (OR: 23.51, 95% CI: 4.197 - 143.003, P-value: 0.000). Conclusion: We observed a high prevalence of H. pylori infection in patients with peptic ulcer perforations. We recommend systematic H. pylori screening in cases of perforations and that larger studies should be carried out to evaluate the association of H. pylori infection with peptic ulcer perforation in Sub-Saharan Africa.

关键词： Perforated Peptic Ulcers Helicobacter pylori Infections Clinical Features Outcome

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A Retrospective Analysis of the Patterns and Outcomes of Tile B and Tile C Pelvic Fractures in Cameroon

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Open Journal of Orthopedics 2023年第4期13卷 157-167页

作者： Chunteng Theophile Nana Tsiagadigui Tsiagadigui Jean Gustave Ngo Yamben Marie-Ange Batchom Daudet Bombah Freddy Muluem Kenedy mokake divine ngomba Ekani Boukar Mahamat Ali Mahamat Takou Bougoue Andre Gaetan Simo Wambo Tagakou Mboula Christian Fotso Ndasi Henry Pius Fokam Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Pelvic fractures constitute about 2% - 8% of all fractures. This incidence may rise up to 25% in poly-traumatised patients. These fractures have a high mortality rate due to the fact that they occur usually as a result of high energy trauma, and most of the injured are poly-traumatised with concomitant haemodynamic instability. The aim of this study is to describe the patterns of injury and complications of unstable pelvic fractures treated in a level III hospital in Cameroon. Methodology: This was a hospital based retrospective analysis of files of patients admitted and treated for unstable pelvic fractures at the Regional Hospital Limbe within a period of 10 years (from 1st of January 2009 to 31st of December 2018). Results: A total of 139 cases of pelvic fractures were identified, amongst which 77 were unstable;68 were finally analyzed. The ages ranged from 18 to 80 years with a mean of 39 ± 5 years. The age group from 20 - 40 years was most represented (58.88%, n = 40). There were 45 males and 23 females giving a sex-ratio of 2:1. Road traffic injuries accounted for most of the cases (73.53%, n = 50). Forty-five (66.2%) were classified Tile B and 23 (33.82%) were Tile C, and 15 cases were open fractures (22.06%). Associated lesions were recorded in 30 cases, fractures of the lower extremity being the most common (33.33%, n = 10). Most of the cases were definitively treated surgically (80.89%, n = 55). The most common complications were surgical site infections (23.64%, n = 13). Conclusion: Unstable pelvic fractures are relatively common. Young males in the age group 20 - 40 years are the most affected, and the most common cause of injury was road traffic accident. Surgical site infections, pressure ulcers, severe anaemia and thrombo-embolism are common complications.

关键词： Unstable Pelvic Fracture Patterns Complications Cameroon

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