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Cervical Myelopathy: Diagnostic Aspects, Surgical Treatment and Evolution of Patients Operated upon in Yaounde

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Open Journal of Modern Neurosurgery 2024年第1期14卷 72-82页

作者： Bello Figuim Djoubairou Ben Ousmanou Oumarou Haman Nassourou Ndome Toto Orlande Amadou Tidjani Djientcheu vincent de paul Yaounde Central Hospital Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaounde Cameroon Yaounde Military Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Douala General Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Higher Institute of Health Sciences Université des Montagnes Bangangté Cameroon

Introduction: Although cervical myelopathy is the most common degenerative cervical spine pathology in adults, the indications and approaches of surgical treatment have not yet been clearly defined in the literature. Very few studies exist regarding these aspects in our setting, and they are mostly outdated. This study aimed to describe the diagnostic aspects, current surgical treatment with technical improvements, and progression in patients. Patients and Methods: We conducted a multicentre retrospective descriptive study over a 10-year period between January 2011 and January 2020 in three referral centres in Yaoundé. All patients who underwent surgery for cervical myelopathy were included. Results: Fifty-two patients were recruited. The rate of operated cervical myelopathies among all degenerative spinal pathologies was 14.05%. The M/F sex ratio was 3/1, and the average age was 52 ± 10 years. All included patients had gait problems, 90.38% demonstrated motor deficiency, and 67.30% experienced at least three levels of compression. Surgery was decided based on the Nurick grade;a posterior approach was applied to 86.54% of patients. Postoperative progression showed a neurological improvement of 82% with an average follow-up of 4 years. Conclusion: In this study, the patients who underwent surgery were relatively young, their clinical presentations were mostly advanced, and surgical management showed good results in well-selected cases.

关键词： Cervical Myelopathy Diagnosis Treatment Evolution Cameroon

Surgical Management of Lumbar Spinal Canal Stenosis with Instrumentation at the Yaounde Central Hospital: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion

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Open Journal of Modern Neurosurgery 2024年第3期14卷 179-189页

作者： Orlane Toto Ndome Nassourou Oumarou Haman Dimitri Fogue Jean Bruno Ndoumou Ronaldo Fonju Anu Indira Baboke vincent de paul Djientcheu Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Neurosurgery Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon department of Neurosurgery Yaounde General and Central Hospitals Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon

Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patient

关键词： Lumbar Spinal Canal Stenosis Instrumentation Surgery Quality of Life

Metastatic Spinal Tumors: Diagnostic Methods, Management and Prognosis at the Yaounde Central Hospital and Yaounde General Hospital

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Open Journal of Modern Neurosurgery 2024年第2期14卷 158-169页

作者： Nassourou Oumarou Haman Figuim Bello Orlane Ndome Toto Roland Ndouh Nchufor Nya Durand Bakop Ronaldo Foalou Anu vincent de paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Neurosurgery department Yaounde General Hospital Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon department of Neurosurgery Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Neurosurgery Douala General Hospital Douala Cameroon Facuty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to december 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly

关键词： Metastases Spinal Tumors Diagnosis Prognosis Spinal Cord Compression

Current Epidemiology of Intracranial Metastases in Two University Teaching Reference Hospitals of the Town of Yaounde, Cameroon: Analysis of 35 Cases Recorded in the Neurosurgery departments

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Open Journal of Modern Neurosurgery 2024年第2期14卷 124-136页

作者： Nassourou Oumarou Haman Ronaldo Fonju Anu Orlane Ndome Toto Bello Figuim Indira Baboke Marguerite Gwladys Nzedzou vincent de paul Djientcheu department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon department of Neurosurgery Yaounde General Hospital Yaounde Cameroon department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Neurosurgery Douala General Hospital Douala Cameroon department of Neurosurgery Garoua General Hospital Garoua Cameroon

Background: The incidence of intracranial metastases (ICMET) has been steadily rising, and its frequency with respect to primary brain tumours is relatively high. Objective: The objectives of this study were to elucidate the current epidemiology and describe the clinical, diagnostic and therapeutic features of ICMET in Yaounde. Method and findings: A descriptive cross-sectional study was done in the neurosurgery departments of the General and Central Hospitals of Yaounde during the period from January 2016 to december 2022. We included all medical booklets of patients admitted for a tumoral intracranial expansive process with our target population being patients with histological evidence of ICMET, and did a retrospective inclusion of data using a pre-established technical form aimed at collecting sociodemographic data, clinical data, paraclinical data, and the treatment procedures. Analysis was done using the SPSS statistical software. A total of 614 cases of intracranial tumors were included among whom 35 presented histological evidence of ICMET. This gives a frequency of 5.7%. The sex ratio was 0.94, the mean age was 55.68 +/- 14.4 years, extremes 28 and 86 years and the age range 50 - 59 was affected in 28.57% of cases. The clinical presentation included signs of raised intracranial pressure (headache, blurred vision, vomiting) in 26 cases (74.3%), motor deficit 48.6%, seizures 17.1%. The mode of onset was metachronous in 71.4% and synchronous in 28.6%. The imaging techniques were cerebral CT scan in 82.9%, cerebral MRI in 40%, TAP scan in 22.9%. The metastatic lesions were supratentorial in 94.3% and single in 62.9%. The primary cancers found were breast cancer (31.4%), lung cancer (25.7%), prostate cancer (17.1%), thyroid cancer (5.7%), colon cancer (2.9%), and melanoma (2.9%). The therapeutic modalities were total resection (68.6%), radiotherapy (37.1%). Conclusion: Intracranial metastases are relatively frequent. There is a female sex predominance and the ag

关键词： Intracranial Metastases Epidemiology Yaounde

Cardiac Surgery at Yaoundé General Hospital by a Local Team: Activity Report from September 2022 to January 2024

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World Journal of Cardiovascular Surgery 2024年第6期14卷 87-94页

作者： Laurence Carole Ngo Yon Charles Mve Mvondo Hermann Nestor Tsague Kengni Zephanie Kobe Fokalbo Sépolin Lowe Mireille Dakleu Alain Patrick Menanga William Ngatchou Djomo vincent de paul Djientcheu department of Cardiothoracic and Vascular Surgery Yaound General Hospital Yaound Cameroon department of Surgery and Specialities Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon department of Clinical Sciences Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences University of Yaound Yaound Cameroon

Introduction: The practice of cardiac surgery (CS) in sub-Saharan Africa faces a number of challenges. We report on the surgical activities of the first 17 months of the program launched at the Yaoundé General Hospital (YGH), describing the types of interventions and the early results. Patients and Methods: This was a descriptive cross-sectional study including patients who underwent CS from September 2022 to January 2024 at the YGH. Clinical, operative and postoperative data were collected and analysed retrospectively by R software. Results: A total of 37 patients underwent CS during the study period, divided into 23 (62.2%) open-heart and 14 (37.8%) closed-heart cases. Males predominated (sex ratio 1.17). The median age and interquartile range (IQR) were 36 years (9 - 51). Isolated valve surgery, in 15 (40.5%) cases, was the most common procedure in open-heart surgery cases. Closed-heart surgery involved closure of the patent ductus arteriosus in 9 (24.3%) cases, coronary artery bypass grafting in 3 (8.1%) cases, and pericardectomy in 2 (5.4%) cases. The median duration of extracorporeal circulation and aortic cross-clamping was 101 min (IQR 84 - 143) and 74 min (IQR 54 - 112) respectively. The median duration of mechanical ventilation was 2 hours (IQR 2 - 3). The median intensive care unit stay and median hospital stay were 2 days (IQR 2 - 3) and 7 days (IQR 5 - 8) respectively. Operative mortality was 2 (5.4%). Conclusion: Cardiac surgery remains a major challenge for African populations. The early results achieved by the local team are satisfactory. An increase in surgical activity should be strongly encouraged to facilitate local training and ensure the sustainability of the activity.

关键词： Cardiac Surgery Sub-Saharan Africa Cameroon

Influence of Some Physico-Chemical Exposure Factors on the Carbocysteine Content of an Opened Pharmaceutical Product

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American Journal of Analytical Chemistry 2022年第12期13卷 495-505页

作者： Jean-Kisito Kouame Mariette desiree Yehe Carine Nina able vincent de paul Ovi Hervé Tazoh Broh Claude Bérenger Ngalemo Ngantchouko Gildas Komenan Gbassi National Public Health Laboratory (NPHL) Food Control Service Abidjan Ivory Coast department of Analytical Sciences and Public Health UFR Pharmaceutical and Biological Sciences Félix Houphou&euml t Boigny University Abidjan Ivory Coast

The aim of this study was to investigate the stability of Carbocysteine (CBC) contained in a reference substance (RS) and in a sample of opened RHINATHIOL® 5% syrup (RNTL 5%) under the effect of some physicochemical parameters (temperature, light, time, pH, bile salts). The developed method was linear, precise and accurate according to USP 38. The co-efficient of determination R2 for linearity was 0.9993. The respective RSD of intra-day and inter-day between days (1st, 2nd and 3rd day) were respectively 0.338% and the interval from 0.05% to 0.387%. The average recovery rate ranged from 98.490% to 100.450%. The detection and quantification limits were 0.0001 mg/mL and 0.001 mg/mL respectively. The method was applied to four samples of opened syrup containing CBC and the CBC content in these samples was found to be in accordance with USP 38. The CBC content in the opened sample of RNTL 5% was obtained by UV-visible spectrophotometry at 217 nm and was 4.887 g/100mL. The study of the influence of physico-chemical factors on the content of CBC in RS and RNTL 5% showed that the evolution of CBC contents in each drug matrix remained dependent on pH and temperature. However, these levels remained stable in the presence of light.

关键词： Influence Physico-Chemistry Content Carbocysteine Stability

Simulation and Visualisation of Functional Landscapes:Effects of the Water Resource Competition Between Plants

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Journal of Computer Science & Technology 2007年第6期22卷 835-845页

作者： vincent Le Chevalier Marc Jaeger 梅兴 paul-Henry Cournède Ecole Centrale Paris Laboratory of Applied Mathematics and Systems Grande Voie des Vignes 92295 Chatenay-MalabryFrance INRIA Futurs DigiPlante TeamCIRAD AMAPTA A-51/PS2 34398 Montpellier Cedex 5France Sino-French Laboratory LIAMA Institute of AutomationChinese Academy of Sciences

Vegetation ecosystem simulation and visualisation are challenging topics involving multidisciplinary aspects. In this paper, we present a new generic frame for the simulation of natural phenomena through manageable and interacting models. It focuses on the functional growth of large vegetal ecosystems, showing coherence for scales ranging from the individual plant to communities and with a particular attention to the effects of water resource competition between plants. The proposed approach is based on a model of plant growth in interaction with the environmental conditions. These are deduced from the climatic data （light, temperature, rainfall） and a model of soil hydrological budget. A set of layers is used to store the water resources and to build the interfaces between the environmental data and landscape components： temperature, rain, light, altitude, lakes, plant positions, biomass, cycles, etc. At the plant level, the simulation is performed for each individual by a structural-functional growth model, interacting with the plant＇s environment. Temperature is spatialised, changing according to altitude, and thus locally controls plant growth speed. The competition for water is based on a soil hydrological model taking into account rainfalls, water runoff, absorption, diffusion, percolation in soil. So far, the incoming light radiation is not studied in detail and is supposed constant. However, competition for light between plants is directly taken into account in the plant growth model. In our implementation, we propose a simple architecture for such a simulator and a simulation scheme to synchronise the water resource updating （on a temporal basis） and the plant growth cycles （determined by the sum of daily temperatures）. The visualisation techniques are based on sets of layers, allowing both morphological and functional landscape views and providing interesting tools for ecosystem management. The implementation of the proposed frame leads to encouraging resu

关键词： landscape visualisation plant growth models natural phenomena simulation water cycle models

Advantages of a Biomimetic Stiffness Profile in Pitching Flexible Fin Propulsion

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Journal of Bionic Engineering 2010年第2期7卷 113-119页

作者： paul Riggs Adrian Bowyer Julian vincent Biomimetics Group Mechanical Engineering DepartmentUniversity of Bath

The use of oscillating flexible fins in propulsion has been the subject of several studies in recent years, but attention israrely paid to the specific role of stiffness profile in thrust *** profile is defined as the variation in localchordwise bending stiffness (EI) of a fin, from leading to trailing *** this study, flexible fins with a standard NACA0012shape were tested alongside fins with a stiffness profile mimicking that of a Pumpkinseed Sunfish (Lepomis gibbosus).The finswere oscillated with a pitching sinusoidal motion over a range of frequencies and amplitudes, while torque, lateral force andstatic thrust were *** the range of oscillation parameters tested, it was shown that the fin with a biomimetic stiffness profile offered a significantimprovement in static thrust, compared to a fin of similar dimensions with a standard NACA0012 aerofoil *** fin also produced thrust more consistently over each oscillation cycle.A comparison of fin materials of different stiffness showed that the improvement was due to the stiffness profile itself, andwas not simply an effect of altering the overall stiffness of the *** of the same stiffness profile were observed to follow thesame thrust-power curve, independent of the stiffness of the moulding *** fins were shown to produce up to26% greater thrust per watt of input power, within the experimental range.

关键词： biomimetic propulsion stiffness pitching flexible fin

Gout: A Possible Cause of Lumbal Canal Stenosis. Cases Report in Sub-Saharan Area and Literature Review

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Open Journal of Modern Neurosurgery 2023年第4期13卷 166-174页

作者： Alain Jibia Bernard Azanmene Arielle Lekane Ernestine Bikono Ignatius Esenee vincent-de-paul Djientcheu Faculty of Medicine and Biomedical Sciences of Garoua Garoua Cameroun Neurosurgery department Yaounde Central Hospital Yaounde Cameroun Neurosurgery Unit Essos Hospital Center Yaounde Cameroun Rheumatology department Yaounde Central Hospital Yaounde Cameroun Neurosurgery department Garoua Regional Hospital Garoua Cameroun

Introduction: Gout is defined as an arthritic condition resulting from the deposition of monosodium urate crystals in and/or around joints, following long-standing hyperuricemia. This may cause gouty arthritis in joints and tophi in soft tissues. Spinal gout is rare and never mentioned in our context. It can appear as acute back pain, radiculopathy, spinal cord compression, spondylodiscitis or neoplasic/infectious epiduritis. Our aim was to share our surgical experience and proceed of a Literature review. Cases Presentation: Between January and August 2022, two patients male were surgically cared, aged of 42 and 60 years old. The gout was unknown in the youngest and poorly followed in the eldest. There was no past medical history of tuberculosis or immunodeficiency in both. The early diagnosis retained was unspecific lumbar spondylodiscitis due to clinical features: Patients complained both of lower back pain with initial fever. It was of a progressive left L5S1 deficit with erectile defect and dysuria in the first case and a progressive paraplegia without sphincter disorders in the second case. We proceeded with a lumbar laminectomy with a biopsy on both patients. The spinal tophus was ligamentous in one case and arthro-ligamentous in the other. There was a progressive motor recovery from postoperative Day-2 till postoperative Month-1. A probabilistic antituberculosis treatment was promptly initiated postoperatively based on radioclinic features while waiting for histologic proof. The Polymerase Chain Reaction (PCR) of Mycobacterium tuberculosis was negative and the histology was of a chronic calcified osteitis with dense fibrosis in both. The anti-gout treatment was implemented after 15 days with blood test evidence. A rheumatologic follow-up was also initiated and adjuvant physio-therapy. The results were very satisfactory from 4 - 6 months with independent walking. Discussion Conclusion: Spinal Gout may be suggested in 40-male-old faced with any acute rachialgia

关键词： Gout Lumbar Canal Stenosis Neurosurgery Spinal Gout