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Multiple Cranial Nerve Palsies in Otolaryngology Consultation: An Atypical Clinical Presentation Revealing Myasthenia Gravis

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第6期11卷 306-316页

作者： Adèle-Rose Ngo Nyeki Paul Cedric Mbonda Léonel Atanga Yannick Mossus Roger Meva’a Victor Sini Mambo olive ngaba David Mindja Francois Djomou Callixte Kuate Richard Njock Alexis Ndjolo Department of Ophthalmology-ENT-Stomatology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon Department of Neurology General Hospital of Yaoundé Yaoundé Cameroon Department of Neurology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Myasthenia gravis is a chronic autoimmune neuromuscular disease, presents with weakness and fatigability of striated skeletal muscles. It is a rare disease in Cameroon. We report an uncommon case of myasthenia gravis in a patient with feeding difficulties, notion of oronasal reflux and swallowing disorders as first complaints. Observation: We report the case of a 29-year-old woman consulted at our department of Otolaryngology and Cervico-Facial Surgery for dysphagia and swallowing disorders. She also presented with facial diplegia, oculomotor paralysis, nasal voice, and dysarthria which has been evolving for several years now. The clinical examination revealed multiple cranial nerve palsies. The complementary workup showed a decrement of more than 50% in the electroneuromyography and the presence of anti-acetylcholine receptor autoantibodies in the blood workup. A diagnosis of myasthenia confirms clinical presumption. We initially observed a worsening of neuromuscular disorders despite the pyridostigmine treatment and subsequently a clear improvement of the clinical features concerning swallowing and speech disorders, oculomotricity and facial diplegia under a treatment combining prednisone and azathioprine. Conclusion: Myasthenia gravis is a rare and potentially fatal autoimmune neuromuscular disease. We thus highlight the atypical clinical presentation and therapeutic itinerary of our patient and the importance to think about this clinical diagnosis in front of any multiple cranial nerve paralysis in otolaryngology consultation.

关键词： Clinical Case Dysphagia Swallowing Disorders Facial Diplegia Nasal Voice Myasthenia Autoimmune Paralysis Cranial Nerves

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Correlation between Computed Tomography and Histopathology Findings of Sinonasal Tumors

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第5期12卷 347-357页

作者： Louise Mouangue-Mbonjo Djibril Samaké Emmanuel Nchinda Choffor Esthelle Geneviève Stéphanie Minka Ngom Florent Dimitri Badang Ahmadou Njifou Njimah Louis Richard Ndjock olive Nicole ngaba Mballa Mambo Pouka Otorhinolaryngology and Cervico-Maxillo-Facial Surgery Unit of Central Hospital of Yaounde Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon

Background: A diverse range of pathologies affect the sinonasal cavities, because of the nonspecific nature of the symptoms, most patients with sinonasal masses are diagnosed late when the disease is at an advanced stage. The diagnostic challenge of identifying the nature of sinonasal masses before treatment would guide therapeutic strategies. Our objective was to evaluate the accuracy of computed tomography in the preoperative diagnosis of sinus masses at the Central Hospital of Yaoundé. Method: A retrospective chart review was conducted;CT scan reports and pathology reports of patients operated for sinonasal masses between January 2012 and November 2022 were compared. Results: Forty-five patients met the inclusion criteria for the study. The average age was 39.98 ± 18.34 years, with extremes of 15 and 87 years. The sex ratio H/F is 0.76 with a female predominance. The median time to consultation was 14 [12 - 18] months, with extremes of 11 and 36 months. The most frequently encountered histological type was benign tumors with sinonasal polyposis (PNS) in the lead, i.e. 34.1% of cases. The types adenocarcinoma, adenoid cystic carcinoma and non-Hodgkin’s lymphoma were represented equally in 6.8% of cases. Management was dominated by Caldwell-Luc surgery, i.e. 59.1% of cases. The frequency of disease recurrence after surgical treatment was 18.2%. As for the mortality rate, it was 11.4%. The concordance rate of the character of malignancy on imaging compared to histology was 90.9%. This level of concordance was statistically significant according to the Gamma test (p Conclusion: Preoperative CT scans correlate with histology and have a prognostic role in surgically treated sinonasal masses.

关键词： Computed Tomography Histology Sinonasal Tumors

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Facial and Periorbital Emphysemas Following a Violent Sneezing: An Atypical Clinical Situation

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 136-142页

作者： Adèle-Rose Ngo Nyeki Caroline Mvilongo Esthelle Minka Ngom Valentin Fokouo Roger Meva’a Léonel Atanga Yannick Mossus Claudine Nkidiaka Luc Meka Abakar Taimou Serge Abogo David Mindja olive ngaba Godefroy Koki Francois Djomou Richard Njock ENT Ophthalmology and Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Essos Hospital Center Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon ENT Department Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General Hospital Douala Cameroon Bertoua Regional Hospital Bertoua Cameroon

Introduction: Facial emphysema is the presence of air in the subcutaneous tissues of the facial region. They can be clinically recognized by the crackling sensation felt when the affected area is palpated. Observation: The authors describe left orbito-facial emphysema that occurred after a violent sneezing episode in a 36-year-old patient. He had significant edema of the left facial and ipsilateral periorbital region associated with major emphysema and complete closure of the left eye. Nasal cavities endoscopy revealed inflammation of the distal orifice of the nasolacrimal duct. The clinical ophthalmologic examination performed in emergency showed left chemosis, slight ocular hypertonia of mechanical origin, and a slight decrease in visual acuity. Pupillary reflexes and retinography were normal. A craniofacial computed tomography (CT) revealed a significant left orbital emphysema, a fracture of the left medial orbital wall (ethmoidal lamina papyracea) with intraconal fat incarceration without entrapment of the medial rectus and significant air infiltration of all the left hemifacial soft tissues. A broad-spectrum antibiotic and anti-inflammatory treatment were instituted, as well as practical advice to prevent a recurrence. We observed progressive resorption of the edema with a return to the normal of the soft tissues and the palpebral cleft in 15 days. Conclusion: These atypical cases can be serious. It is essential to exclude signs of visual deficit and ocular compression. Multidisciplinary management is important.

关键词： Sneezing Orbital Fracture Emphysema Pneumorbitia

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Meta-analysis of 21st century studies shows that deforestation induces profound changes in soil characteristics, particularly soil organic carbon accumulation

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Forest Ecosystems 2025年第01期 46-55页

作者： Abubakari Said Mgelwa Mbezele Junior Yannick ngaba Bin Hu Geshere Abdisa Gurmesa Agnes Godfrey Mwakaje Mateg Pascale Bernadette Nyemeck Feifei Zhu Qingyan Qiu Linlin Song Yingying Wang Yunting Fang Heinz Rennenberg CAS Key Laboratory of Forest Ecology and Management Institute of Applied Ecology Chinese Academy of Sciences Key Laboratory of Stable Isotope Techniques and Applications College of Natural Resources Management & Tourism Mwalimu Julius K.Nyerere University of Agriculture & Technology Center of Molecular Ecophysiology (CMEP) College of Resources and Environment Southwest University Higher Technical Teacher'Training College of Ebolowa University of Ebolowa (HTTTC) Multipolar Consulting Firm Qingyuan Forest CERN Chinese Academy of Sciences Forest Ecology & Stable Isotope Center College of Forestry Fujian Agriculture and Forestry University University of Chinese Academy of Sciences

Deforestation is one of the most serious environmental problems facing humankind. It continues to escalate rapidly across many regions of the world, thereby deteriorating the forest soil quality. This has prompted a large number of field-based studies aimed at understanding the impacts of deforestation on soil properties. However,the lack of comprehensive meta-analyses that utilized these studies has limited our deeper understanding of how different soil properties, including the soil organic carbon(SOC) pool, respond to deforestation. To address this critical knowledge gap, we conducted a meta-analysis of 144 studies to explore the impacts of deforestation on soil chemical, physical, and biological properties, with special emphasis on the long-term changes in SOC, such as concentrations, stocks, and sequestration. The results revealed that deforestation significantly decreased soil organic matter, electrical conductivity, and base saturation by 52%, 50%, and 98%, respectively. While deforestation increased soil total nitrogen content and decreased available phosphorus content by 51% and 99%,respectively, it resulted in slight decreases in some chemical properties, including soil pH(1%) and base cations(1%–13%). Deforestation significantly increased bulk density by 27% and soil erosion by 47%, but significantly decreased soil aggregate stability by 39% and saturated hydraulic conductivity by 63%. Soil microbial biomass C and N concentrations and enzyme activities were significantly decreased as a consequence of deforestation. Soil biological properties were much more affected by deforestation than soil physical and chemical *** the SOC, the land use conversion from forest to pasture significantly increased SOC concentrations,stocks, and sequestration rates(11%–13%), whereas the land use conversions from forest to both plantation and cropland significantly decreased SOC concentrations, stocks, and sequestration rates(10%–43%). This observed decline i

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Detection of the Production of Klebsiella Pneumoniae Carbapenemase, New Delhi Metallo-Beta-Lactamase and Oxacillinase-48-Type Carbapenemases by Gram-Negative Bacilli in Resource-Limited Setting

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Advances in Microbiology 2021年第10期11卷 579-590页

作者： Cecile Okalla Ebongue Gabin Gaël Simo Jean Pierre Nda Mefo’o Grace Dalle Ngondi Emmanuel Roddy Mengue Guy Pascal ngaba Dieudonne Adiogo Laboratory of Clinical Biology General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences Douala Cameroon Laboratory Unit Laquintinie Hospital Douala Cameroon Laboratory Unit Gyneco-Obstetric and Pediatric Hospital Douala Cameroon

Background: The increasing resistance of bacteria to various antibiotics is a worldwide public health issue. Carbapenems that have elicited great hope in treating infections caused by multidrug-resistant germs have seen their efficacy narrowed over time with the emergence of other novel resistance mechanisms, notably the production of Carbapenemases. Methods: A prospective cross-sectional study was conducted from May 2017 to May 2018 in Douala (Cameroon) to detect carbapenemase-producing Gram-negative bacilli. Isolated strains were identified using the Vitek2TM system. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on agar plates with 20 selected commercially available antibiotic discs. The bacterial strains were tested for the production of three Carbapenemases (OXA-48, NDM, KPC), using an immuno-chromatographic technique, with the “RESIST-3 O.K.N. K-SeT” rapid detection kit. Results: During the study period, 1687 strains of Gram-negative bacilli were isolated in selected laboratories with a total of 200 multi-resistant strains identified (11.9%). Among the multi-resistant strains, E. coli was the species most represented in Enterobacteriaceae (27.5%) followed by K. pneumoniae (15.5%) and the non-fermenting Gram-negative bacilli were predominantly P. aeruginosa (20.5%). These strains mainly came from urine and pus, i.e. 41% and 32% respectively. Thirty-two (16%) strains produced one of the Carbapenemases with a higher frequency at the General Hospital (84%). NDM-type carbapenemase was the most frequently identified (8.5%), OXA-48 type 7.5%, and no KPC production was observed. Among the Enterobacteriaceae 22.9% produced Carbapenemases and only 5.1% of the non-fermenting bacilli produced these enzymes. The isolates strains were completely resistant to all antibiotics except Amikacin and Fosfomycin. The strains producing the NDM-type carbapenemase

关键词： Carbapenemases Gram-Negative Bacilli Multidrug-Resistance Cameroon

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Assessing GastroPanel serum markers as a non-invasive method for the diagnosis of atrophic gastritis and <i>Helicobacter pylori</i>infection

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Open Journal of Gastroenterology 2012年第3期2卷 113-118页

作者： Dominique Noah Noah Marie Claire Okomo Assoumou Servais Albert Fiacre Eloumou Bagnaka Guy Pascal ngaba Ivo Ebule Alonge Lea Paloheimo Oudou Njoya Biohit Helsinki Finland District Hospital of Bonassama Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Douala General Hospital Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde Yaounde Cameroon University Teaching Hospital Yaounde Yaounde Cameroon Yaounde Central Hospital Faculty of Medicine and Pharmaceuticals Sciences University of Douala Douala Cameroon

Gastric colonization by Helicobacter pylori increases the risk of gastric disorders, including atrophic gastritis which can be diagnosed based on levels of serum biomarkers like Gastrin and Pepsinogen. We therefore examined the efficacy of a serological-based method namely GastroPanel Blood kit, in diagnosing and scoring gastritis associated to Helicobacter pylori infection. Patients with dyspeptic symptoms were prospectively recruited on voluntary basis at the Yaounde Central Hospital and University Teaching Hospital, from March to July 2011. The degree of atrophy was classified according to levels in patient serum of pepsinogens I and II (PGI and PGII) and Gastrin 17 (G17) and compared with histological profiles as reference method. A specific ELISA test was used for the detection of H. pylori IgG antibodies. In total, 86 volunteers from 21 to 83 years old (mean = 46.4 ± 3.3) were enrolled, including 74.4% of women and 25.6% of men. The prevalence of gastritis was statistically similar between Gastro Blood Panel test and histology used as reference method (89.5% versus 83.7%: p > 0.20). Diagnosis based on serum makers showed high sensitivity (93.1%) in comparison with the reference method. However, the serological based method has diagnosed more atrophic gastritis than the reference (17.4% versus 7.0%: p 0.05). Furthermore, the prevalence of H. pylori infection did not differ significantly between serological method (84.9%) and reference method (81.4%). These results suggest that diagnosis of atrophic gastritis and H. pylori infection obtained with an optional serological method (GastroPanel) is in a strong agreement with the biopsy findings, and thus can be a useful non endoscopic assessment of stomach mucosal atrophy in patients with dyspepsia.

关键词： Diagnosis Atrophic Gastritis Helicobacter pylori Pepsinogen Gastrin

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Hypercoagulability in the Context of Pre-Eclampsia: Case-Control Study at the Laquintinie Douala Hospital (Cameroon)

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1708-1727页

作者： Henri Essome Marie Solange Ndom Idjem Théophile Nana Njamen Thomas Egbe Obinchemti Merlin Boten Grace Tocki Toutou Grégory Eddie Halle Guy Pascal ngaba Pascal Foumane Laquintinie Douala Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences of Douala University of Douala Douala Cameroon Faculty of Health Sciences of Buea University of Buea Buea Cameroon Kribi District Hospital Kribi Cameroon Faculty of Biomedical Sciences of Yaoundé University of Yaoundé 1 Yaoundé Cameroon

Introduction: Preeclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etio-pathogenesis involves, among other things, hypercoagulability, which alone accounts for about 15% of his deaths. Our objective was to study the parameters of coagulation (prothrombin level, activated cephalin time) in pregnant women with preeclampsia and non-preeclampsia at Laquintinie Hospital in Douala. Methodology: We carried out an analytical cross-sectional case-control study from November 01st, 2018 to May 31st, 2019, in the gynecology and obstetrics department of Laquintinie Hospital in Douala. We included preeclampsia and non-preeclampsia pregnant women with a gestational age greater than or equal to 20 weeks amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, prothrombin level (PL) and activated cephalin time (ACT). Hypercoagulability was defined by the presence of at least one of the following abnormalities: PL > 100%, ACT 25

关键词： Preeclampsia Hypercoagulability Prothrombin Cephalin Lacintinia

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Antibiotics Susceptibility Profile of Staphylococcus aureus Clinical Isolates Collected in Hospitals in the City of Douala (Cameroon)

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Journal of Biosciences and Medicines 2022年第8期10卷 188-200页

作者： Jean Pierre Nda Mefo’o Yanne Sabekob Grace Dalle Ngondi Emmanuel Roddy Mengue Elodie Ngo Malabo Nancy Handa Guy Pascal ngaba Dieudonné Adiogo Cécile Okalla Ebongue Laboratory of Clinical Biology Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Laboratory Laquintinie Hospital Douala Cameroon Kansas City University of Medicine and Biosciences Kansas City MO USA Laboratory Unit of the Gyneco-Obstetric Douala Pediatric Hospital Douala Cameroon

Introduction: Staphylococcus aureus is one of the most important agents involved in community and hospital-acquired infections. Due to the multi-drug resistance of strains to antibiotics, treatment to eradicate it is becoming more difficult and poses a global public health problem. Methodology: This was a cross-sectional study conducted from March to August 2020 in hospitals in the city of Douala, including all S. aureus isolates from diagnostic samples. Strain identification and antibiotic susceptibility testing were performed using the Vitek2 CompactTM (BioMerieux). Results: During the study period, 136 non-repetitive S. aureus strains were identified with a high frequency of methicillin-resistant S. aureus of 78.7%. The majority of the strains originated from the Douala General Hospital (66.9%) and was most frequently isolated from blood culture samples (55.1%). The study of biochemical characteristics showed that most of the strains identified had between 87% and 99% homology with the reference strain. The most active antibiotics were Quinupristin/Dalfopristin (94.2%), Linezolid (87.8%) and Vancomycin (84.2%). Methicillin resistance was associated with decreased susceptibility of S. aureus to other antibiotics such as Gentamycin (44.9%), Erythromycin (38.2%), Tetracycline (38.3%), Trimethoprim (21.4%), Ciprofloxacin (19.1%) and Levofloxacin (24.0%). Inducible MLSb and constitutive resistance phenotypes were identified with 26.7% and 22.8% respectively. Conclusion: The sensitivity of S. aureus strains differs from one antibiotic family to another, and remains good for molecules that are not available in our context. The high frequency of Methicillin-Resistant S. aureus shows the continuous progression of multi-resistant strains of S. aureus and their decreased sensitivity to usual antibiotics becomes more and more alarming.

关键词： Staphylococcus aureus Multidrug Resistance MRSA Douala

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The Clinical Features and Outcomes of Four Neonates Born to Mothers with a Severe Form of COVID-19 and a Positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital in Cameroon

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Open Journal of Pediatrics 2020年第4期10卷 642-651页

作者： Dominique Enyama D. Noukeu Njinkui I. Rakya D. Djomo Tamchom R. Tiokeng Nenzeko C. Mbakop Tchogna M. C. Bissa S. R. Wekang Tcheuffa D. Kamdem A. Ngalame H. Neng D. Mwadjie Ndongo Eteme F. Kemta Lekpa S. R. Simeni Njonnou S. P. Choukem G. P. ngaba E. T. Mboudou Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon The University of Dschang Taskforce for the Elimination of COVID-19 (UNITED#COVID-19) Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaounde Cameroon

Background: A novel viral respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for a worldwide pandemic. The effects of this new disease in pregnant women and newborns are actually not well known. Methods: We investigated the clinical features and outcomes of four neonates born to mothers with a severe form of COVID-19 and a positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital (Cameroon) from April 20 to June 5, 2020. Results: All four mothers were symptomatic and had a positive RT-PCR for SARS CoV-2 from nasopharyngeal swab on admission. All of them delivered prematurely through cesarean section because of severe respiratory distress and one died shortly after delivery. The four premature male infants were born between 30 weeks and 35 weeks 2 days of gestation and had birth weights ranging from 1090 g to 2950 g. All infants had 1-minute Apgar scores that ranged from 7 to 8 and 5-minute Apgar scores varying between 8 and 9. They were isolated from their mothers immediately after birth and received formula feeding. Three of the four infants were tested using nasopharyngeal swab specimens for RT-PCR 24 to 48 hours after birth and were negative for COVID-19. All the infants were treated in a dedicated area at the neonatal care unit and presented with mild respiratory distress on admission with a Silverman score that varied between 2 and 4/10. During their hospitalization, all the infants also presented with jaundice and underwent phototherapy. Three of the

关键词： COVID-19 Infected Mothers Premature Newborns Severe Respiratory Distress Outcome Cameroon

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Materno-Fetal Outcomes of COVID-19 Infected Pregnant Women Managed at the Douala Gyneco-Obstetric and Pediatric Hospital—Cameroon

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1279-1294页

作者： Alphonse Nyong Ngalame Humphry Tatah Neng Rakya Inna Dominique Tamchom Djomo Diane Estelle Modjo Kamdem Bilkissou Moustapha Julie Ngo Batta Diomede Njinkui Noukeu Dominique Enyama Rodrigue Tiokeng Yannick Onana Yves Moumbe Martial Zanga Jules Fils Ndongo Armand Kamga Robert Tchounzou Ultrich Keumayou Lemone Chingnabo Toudjirob Djiallati Emmanuel Passoret Estella Toyoum Ramadji Jean Blaise Ebimbe Servais Albert F. Bagnaka Eloumou Darolles Wekam Mwadjie Guy Pascal ngaba Emile Telesphore Mboudou Gynecology and Obstetrics Unit Douala Gyneco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Ngaoundere Ngaoundere Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Introduction: The first case of the novel coronavirus (COVID-19) pandemic in Cameroon was confirmed on March 6, 2020. Though widely considered that pregnant women are more susceptible to respiratory tract infections, the available body of literature on the effect of COVID-19 on pregnancy outcomes is shy from being conclusive. In Cameroon, the Douala Gyneco-Obstetric and Pediatric Hospital (DGOPH) was one of the main frontline tertiary health facilities for the management of severe forms of the disease. After four months of managing COVID-19 cases in the general population and especially in pregnant women at the DGOPH, we decided to take a stop, analyze our findings from the patients managed in order to drive future policies and clinical practices via informed decisions. Overall objective: To describe and understand the clinical burden of patients managed for COVID-19 in pregnancy or post-partum at the DGOPH. Methodology: Cross-sectional and descriptive study covering four months—March 24th to July 24th 2020 at DGOPH. Using a pretested questionnaire, we systematically enrolled all patients who fulfilled the inclusion criteria, with analysis done using proportions from an excel spreadsheet. Results: A

关键词： COVID-19 DGOPH Pregnancy Outcome Mortality

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