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Optimum Threshold Estimation of Thorax CT Scan for COVID-19 Diagnosis in a Single Center in Cameroon

Advances in Infectious Diseases 2023年第1期13卷 12-20页

作者： Anne Esther Njom Nlend Landry Bonyomo serges Abogo serges nga nomo Luc Meka Moise Nna Beatrice Meva’a Arsene Brunelle Sandie Christiane Nsahlai Essos Hospital Center Yaoundé Cameroon Health Ebene consulting Research Department Yaoundé Cameroon Higher Institute of Medical Technology Yaoundé Cameroon Ministry of Public Health Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon African Population and Health Research Center Yaoundé Cameroon

Objective: To evaluate the lung CT scan as a possible predictive diagnostic method for COVID-19 in the Cameroonian context. Methods: We designed a cross sectional study. Suspected cases of COVID-19 during the first wave at the national social insurance fund (NSIF) hospital were screened with both COVID-19 with lung CT scan and a PCR test. Univariate analysis was performed for sample description and multivariate analysis to assess the correlation between positive results for the PCR and other parameters. We estimated the optimum threshold of sensitivity/specificity, and area under curve using the empirical method and package. Results: A total of 62 suspected COVID-19 cases were recorded, predominantly males (Sex Ratio = 2.2) with a median age of 58.5 (IQR = 19.7). Among our 62 patients, 29 (46.8%) were confirmed COVID-19 cases with positive PCR results. All the patients had a thorax CT scan with a median impairment of 40% (IQR = 20%). The optimum threshold estimate for CT scan for COVID-19 infection diagnosis was 60% (95% CI = 25% - 80%). Overall, the sensitivity and specificity estimates were 0.30 (95% CI = 0.15 - 0.49) and 0.87 (95% CI = 0.70 - 0.96), respectively, leading to an Area Under Curve (AUC) estimate of 0.59 (95% CI = 0.46, 0.71). Conclusion: In this setting, lung CT scan was neither sensitive nor specific to predict COVID-19 disease.

关键词： COVID-19 CT Scan Lung Diagnosis

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Usefulness of the Surgical Apgar Score to Predict the Occurrence of Major Complications in the Early Post-Operative Period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

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Open Journal of Anesthesiology 2024年第3期14卷 51-65页

作者： Charles Emmanuel Toussaint Binam Bikoi Francis Ateba Ndongo Serge Vivier nga nomo Édouard Léa Mekoui Ze Fidèle Binam Department of Anesthesia and Intensive Care University of Ebolowa Ebolowa Cameroon Yaounde Mother and Child Center Chantal Biya Foundation University of Garoua Garoua Cameroon Department of Anesthesia and Intensive Care Catholic University of Central Africa Yaounde Cameroon

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the “Laquintinie” Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at P Results: Of the 88 patients studied, the SAS was 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 - 0.2) and p = 000. Conclusion: The study found a specific and powerful link between the SAS score < 4 and the occurrence of complications in the early postoperative period, in favor of its relevance in predicting them.

关键词： Early Postoperative Complications Major Surgeries Surgical Apgar Score

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Recognition of Warning Signs by the Patient with Ischemic Stroke and Impact on Emergency Department Admission Times

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Open Journal of Emergency Medicine 2021年第4期9卷 162-170页

作者： nga nomo Serge Kuitchet Aristide Iroume Cristella Djomo Tamchom Chewa Gisèle Hubel Kenne Jemea Bonaventure Nkoumou Samson Pierre René Binyom Binam Fidèle Department of Anesthesia and Intensive Care Essos Hospital Center Yaounde Cameroon Higher Institute of Medical Technology University of Douala Douala Cameroon Departement of Anesthesia and Intensive Care Regional Hospital of Maroua Maroua Cameroon Faculty of Medicine and Biomedical Science University of Ngaoundere Ngaoundere Cameroon Departement of Anesthesia and Intensive Care University Hospital Center of Yaounde Yaounde Cameroon Faculty of Medicine and Biomedical Science University of Yaounde Yaounde Cameroon Departement of Anesthesia and Intensive Care Douala Gynaeco-Obstetric and Paediatric Hospital Douala Cameroon Faculty of Health Science University of Buea Buea Cameroon

The general objective of this study was to assess the impact of the recognition of warning, signs of ischemic stroke, on the reduction of emergency admission times and the improvement of the prognosis of the patient suffering from ischemic stroke in the emergency department of the Yaounde central hospital. Methods: This was a prospective study with a descriptive and analytical aim carried out in the medical emergency department of the central hospital of Yaounde over a period of 3 months, going from October to December 2020. All patients admitted to emergency departement, during this period, for a diagnosis of ischemic stroke confirmed by a brain CT scan were included in the study. The data was collected on a survey sheet divided into 3 sections: the patient, the assessment of his knowledge and his reaction to the stroke. The variables studied were socio-demographic data, cardiovascular risk factors and warning signs of stroke. Data analysis was conducted with Census and Survey Processing System (CSPRO). Results: During the study period, 62 patients met the inclusion criteria. Adults under 50 (41.94%) were the most represented age group. The mean age of the patients was 52.3 years with ranges ranging from 36 to 82 years. The sex ratio was 1.38 in favor of women. The most common unmodifiable cardiovascular risk factor was age over 55 years 44%. High blood pressure 61% was the most common modifiable risk factor. More than half of the study population had no knowledge of the warning signs of ischemic stroke. The most well-known warning sign was 40% mouth deformation. The anamnesis noted that the we

关键词： Warning Signs Ischemic Stroke Emergencies

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Incidence and Management of Early Postoperative Hypoxemia after Abdominal Surgery at Teaching Hospital

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Open Journal of Anesthesiology 2024年第10期14卷 209-220页

作者： nga nomo Serge Vivier Mpeyou Sani Mohamed Kuitchet Aristide Binam Bikoi Charles Maiwong Betila Venloah Dominique Djomo Tamchom Iroume Bifouna Cristella Raissa Ngouatna Serge Jemea Bonaventure Metogo Mbengono Junette Fidèle Binam Department of Surgery and Specialties Higher Institute of Medical Technology Yaounde Cameroon Department of Physiology Faculty of Basic Medical Sciences University of Calabar Calabar Nigeria Department of Surgery and Specialties University of Garoua Garoua Cameroon Department of Surgery and Specialties University of Ebolowa Ebolowa Cameroon Department of Anesthesia and Intensive Care Catholic University of Central Africa Yaounde Cameroon Department of Surgery and Specialties University of Buea Buea Cameroon Department of Surgery and Specialties University of Yaounde I Yaounde Cameroon Department of Surgery and Specialties University of Douala Douala Cameroon

Background: Oxygen saturation refers to the quantity of oxygenated hemoglobin in the blood, that is to say the level of oxygen measurable in the red blood cells when they have passed through the lungs. The aim of this study was to describe the management of early postoperative hypoxemia after abdominal surgery at the Yaounde General Hospital (YGH). Method: This is a quantitative, observational study, with a descriptive aim, which took place in the anesthesiology department of the YGH, over a period of 2 months from August 1st to October 1st, 2023. The study included all the patients ≥18 years, of both sexes who had abdominal surgery under general anesthesia and were willing to participate during the time of data collection. The variables studied were the sociodemographic and clinical characteristics, risk factors for oxygen desaturation, postoperative variations in SPO2 and therapeutic tools. Results: We collected 30 patients among whom 11 presented with early postoperative hypoxemia i.e. a frequency of 36.7%. The age of the patients ranged from 18 to 63 years and the mean was 42.47 ± 13.5 years on average. The sex ratio was 0.5. Hysterectomy was the most commonly performed surgery (23.3%). The most common comorbidity was high blood pressure (30%). Half of the patients had midline incision. Supra-umbilical surgery predominated (56.7%), intraoperative blood loss ≥500 ml in 46.7% of cases. Upper abdominal surgery with, subcostal incision and blood loss ≥500 ml are statistically significant risk factors for the occurrence of early postoperative hypoxemia (P Conclusion: Hypoxemia is the result of impaired respiratory function favored by the conditions encountered during the early postoperative period.

关键词： Abdominal Surgery Postoperative Hypoxemia Incidence Management

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