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Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 175-185页

作者： Noa Ndoua Claude Cyrille Tchedele Guidebta Hilary Nyada Serge Robert Astrid Ruth Ndolo Kondo Ayissi Gregory Ngo Dingom anne Madye Tompeen Isidore Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaounde Cameroon Faculty of Medicine and Pharmaceutical sciences of the University of Douala Douala Cameroon

Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality, estimated to occur in 1% - 2% of pregnancies worldwide. This condition also has an adverse effect on the fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility after medical treatment of patients with methotrexate (MTX) in patients with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic pregnancy were included in this study. Statistical analysis was performed using SPSS. 23. The Chi-2 statistical test was used to compare qualitative variables. Binary logistic regression method was performed to identify independent risk factors associated with infertility after medical treatment of tubal ectopic pregnancy (TEP). The significance level was set at 0.05. Results: The mean age in our study population was 27.8 ± 3.8 years. According to the past medical history, 52.9% had a pelvic inflammatory disease (PID) and the most frequently germ found was C. trachomatis (47.1%). Almost 15% of our study population had previous surgery for EP. The median Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The route of administration of methotrexate was intramuscular in all our patients, and the single-dose protocol was used most frequently (58.6%). After medical treatment of the EP, we found a spontaneous conception rate of 58.6%. After multivariate analysis, we were unable to confirm that there was an association between a history of sexually transmitted infections (STIs) and fertility prognosis. Conclusion: The spontaneous fertility rate after medical management of EP was 58.6%, of which 73.2% were term pregnanci

关键词： Ectopic Pregnancy Maternal Morbidity

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Normal Range of Neutrophile to Lymphocyte Ratio in Healthy, Chronic Kidney Disease Stage 4 - 5 and Hemodialysis Participant in a Sub-Saharan African Context

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Open Journal of Nephrology 2024年第1期14卷 104-114页

作者： Fouda Menye Epse Ebana Hermine Danielle Elimby Lionel Thierry Sevele Deussi De Ngaha Bogne Takam Yvan Halle marie-Patrice Eveline Ngouadjeu Dongho Department of Medicine and Specialties General Hospital of Douala Douala Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Department of Internal Medicine and specialties Faculty of Medicine and Pharmaceutic Sciences of Douala Douala Cameroon

Background: Neutrophile to lymphocyte ratio (NLR) is a well-established marker of inflammation. It has been reported to be high in chronic kidney disease (CKD) and it is described as a prognosis factor in hemodialysis patients. However, limited data are available about the normal range of NLR in healthy adults as well as CKD patients including hemodialysis black Africans in Sub-Saharan countries. We sought to study NLR in healthy and advanced CKD in a single Cameroonian health facility. Methods: Blood samples were obtained from blood donors, CKD stage 4 and non-dialysis stage 5, and hemodialysis patients for more than 6 months. Patients with confounding factors such as positive CRP, infection, and recent use of steroids were excluded. RNL means standard deviations (SDs), and 95% confidence intervals (95% CI) were determined. RNL range was defined as percentiles P2.5 to P97.5. Results: A total of 102 participants were included. Mean age was 40.45 ± 9.97 years and 58.8% were male. Age and sex distribution were similar in the three groups. Leucopenia and neutropenia were common in all the groups. Means NLR was 1.29 ± 0.57 (95% CI 1.08 - 1.49) range between 0.55 to 2.67;2.31 ± 1.3 (95% CI 1.75 - 2.88) with range between 0.69 to 4.31 and 2.14 ± 0.98 (95% CI 1.85 - 2.44) with range between 0.77 to 4.32 respectively in controls, CKD, and hemodialysis participants. NLR was comparable in CKD and hemodialysis patients (p = 0.99). Compared to controls, NLR was significantly elevated in CKD (p = 0.043) and hemodialysis patients (p Conclusion: Our data suggest that the normal range for NLR in adult nongeriatric healthy and advanced CKD patients including those on chronic hemodialysis may vary between 0.55 to 2.67 and 0.69 to 4.32 respectively.

关键词： NLR CKD Hemodialysis Cameroon

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Prevalence and Factors Associated with Anemia among People Living with Human Immunodeficiency Virus Followed at the Outpatient Treatment Centre of Panzi General Referral Hospital in Eastern Democratic Republic of Congo

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Journal of Biosciences and Medicines 2024年第3期12卷 259-274页

作者： Marlene Abedi Zalufa Jean-Paulin Mbo Mukonkole Aline Byabene Kusinza Nicolas Vignier Dieudonné Bihehe Masemo David Willy Shamputi Omari Mukanga Lampard marie Hatem Department of Internal Medicine Panzi General Referral Hospital Bukavu Democratic Republic of Congo Evangelical University in Africa Bukavu Democratic Republic of Congo Statistics Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo International Centre for The Advanced Research and Training-ICART Panzi Foundation Bukavu Democratic Republic of Congo Faculty of Medicine University of Kisangani Kisangani Democratic Republic of Congo Service des Maladies Infectieuses et Tropicales CHU Avicenne Bobigny France Sorbonne University Paris France School of Public Health Department of Social and Preventive Medicine Université de Montréal Montréal Canada

Introduction: Anemia in people living with human immunodeficiency virus (PLHIV) is a major health problem. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite treatment, and such persistent anemia continues to adversely affect prognosis, regardless of drug response. Scientists have identified some of the factors involved. However, the mechanisms put in place have not been effective in overcoming them. Examples include the withdrawal of zidovudine from antiretroviral treatment lines, iron and folate supplementation, etc. Anemia is still a major concern in HIV-positive patients. The aim of this study is to assess the prevalence of anemia and its associated factors among PLHIV followed up at the outpatient treatment centre (CTA) of the Panzi General Reference Hospital (HGR) in South Kivu, Democratic Republic of Congo (DRC). Method: We conducted a cross-sectional, comparative study of 276 HIV-infected adults on antiretroviral therapy (ART) followed up at the CTA of Panzi HGR. Socio-demographic and nutritional parameters were collected using a survey questionnaire, and clinical assessment and nutritional status were performed at the centre. Hemoglobin, seric albumin and viral load determinations were performed at the HGRP laboratory. We constructed univariate and multivariate logistic regression models to assess factors associated with anemia in people living with HIV/AIDS. Results: We found a prevalence of anemia of 39.4%, including 4.1% severe anemia, 17.7% moderate anemia and 17.5% mild anemia. After multivariate adjustment, the factors associated with anemia in our PLHIV were: moderate undernutrition (aOR = 1.26;95% CI: 1.50 - 4.20;p = 0.001), severe undernutrition (aOR = 115.4;95% CI: 2.04 - 164.52;p = 0.021), hypoalbuminemia (aOR = 2.11;95% CI: 1.87 - 5.10;p = 0.004) and the lower degree of dietary diversity (aOR = 1.56;95% CI: 1.10 - 4.32;p = 0.034). Conclusion: The prevalence of anemia in PLHIV on ART is high.

关键词： Anemia HIV/AIDS Undernutrition PANZI Hospital

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Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké University Hospital Center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba Christian Yao Pacôme Monemo Richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-marie Karidioula Vincent Achi Vincent Kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké

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Hereditary polyposis syndromes remain a challenging disease entity:Old dilemmas and new insights

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World Journal of Gastrointestinal Surgery 2023年第1期15卷 1-8页

作者： Frederik Rønne Pachler Anna Byrjalsen John Gásdal Karstensen anne marie Jelsig Danish Polyposis Registry GastrounitCopenhagen University Hospital-Amager and Hvidovre HospitalHvidovre 2650Denmark Department of Clinical Genetics University Hospital of CopenhagenRigshospitaletCopenhagen 2100Denmark Department of Clinical Medicine University of CopenhagenHvidovre 2650Denmark

In this editorial we present an overview and insights of the management of hereditary polyposis *** primary focus was on familial adenomatous polyposis,juvenile polyposis syndrome and Peutz-Jegher *** testing has become increasingly available and is easier than ever to integrate into clinical ***,several genes have been added to the expanding list of genes associated with hereditary polyposis syndromes,allowing for precise diagnostics and tailored *** evaluation of patients with hereditary polyposis syndromes is paramount in the surveillance *** endoscopic procedures include both diagnostic procedures and surveillance as well as therapeutic *** for endoscopic procedures in the upper and lower gastrointestinal canal were *** is still a key component in the management of patients with hereditary polyposis *** increased cancer risk in these patients often render prophylactic procedures or intended curative procedures in the case of cancer *** interventions in the upper and lower gastrointestinal canal were described with relevant *** of chemopreventive medications is *** drugs have been investigated,including nonsteroidal anti-inflammatory *** has been demonstrated that cyclooxygenase-2 inhibitors may lower the number of *** medications are currently under investigation,but none have,to date,consistently been able to prevent development of disease.

关键词： Hereditary polyposis Familial adenomatous polyposis Juvenile polyposis syndrome Peutz-Jegher syndrome

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Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 487-501页

作者： Um Esther Meka Ngo Junie Annick Metogo Ntsama Kodoumé Motolouze Naomi marie Laurene Ndtoungou Schouame Obalemba Etienne Atenguena Claude Cyrille Noa Ndoua Robinson Enow Mbu Faculty of Medicine and Biomedical Sciences The University of Yaoundé 1 Yaoundé Cameroon Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction Yaoundé Cameroon Yaoundé General Hospital Yaoundé Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartil

关键词： Determinants Early Survival Breast Cancer Yaoundé

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Giant Cerebriform Nevus Cell Nevus of the Scalp: A Case Report

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Open Journal of Modern Neurosurgery 2024年第1期14卷 8-13页

作者： Mohamed El Hassimi Cissé N’daraw Ndoye anne Aurore Sankale Pauline Diousse Abdoulaye Diop Alvine Nah Doe Sagar Diop Momar Codé Ba Seydou Boubakar Badiane Neurosurgery Department of CHU Mère-Enfant “Le Luxembourg” Bamako Mali Neurosurgery Department of CHNU de Fann Dakar Sénégal Plastic and Cosmetic Surgery Department of CHU Le Dantec Dakar Sénégal Dermatology Department of Thiès Regional Hospital Thiès Sénégal

Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.

关键词： Giant Nevus Tumor of the Scalp Resection

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Watson-Jones Anatomical Approach for Open Reduction and Internal Fixation of Proximal Femoral Fractures without Image Intensifier in a Low-Resource Setting

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Open Journal of Orthopedics 2024年第4期14卷 173-186页

作者： Loïc Fonkoue Gaspary Fodjeu Kennedy Olivier Muluem Olivier Ngongang Theophile Nana marie Ange Ngo Yamben DésiréAkaba Urich Tambekou Daniel Eone Handy Department of Orthopaedics and Trauma Yaound&#233 General Hospital Yaound&#233 Cameroon. Department of Surgery and Specialities University of Yaound&#233 1 Yaound&#233 Cameroon Department of Orthopaedics and Trauma Yaound&#233 Emergency Center Yaound&#233 Cameroon Department of Orthopaedics and Trauma Yaound&#233 Central Hospital Yaound&#233 Cameroon

Introduction: Standard procedures for surgical fixation of proximal femoral fractures (PFF) require an image intensifier which in developing countries remains a luxury. We hypothesized that, with a well-codified technique, the Watson Jones approach (WJA) without image intensifier nor traction table, can allow open reduction and internal fixation (ORIF) of PFF using Dynamic hip screw (DHS), with satisfactory outcome. Patients and methods: Forty one consecutive patients (mean age 59.5 ± 21.6 years, 61% males) who were followed in a Teaching Hospital for PFF treated by ORIF using the WJA and DHS from January 2016 to December 2020 were reassessed. The outcome measures were the quality of the reduction, the positioning of the implants, the tip-apex distance (TAD), the rate and delay of consolidation, the functional results using Postel Merle d’Aubigné (PMA) score, the rate of surgical site infection (SSI) and the overall mortality. Logistic regression was used to determine factors associated with mechanical failure. Results: The mean follow-up period was 33.8 ± 15.0 months. Fracture reduction was good in 31 (75.6%) cases and acceptable in 8(19.5%) cases. Implant position was fair to good in 37 (90.2%) patients. The mean TAD was 26.1 ± 3.9 mm. Three patients developed SSI. Consolidation was achieved in 38 (92.6%) patients. The functional results were good to excellent in 80.5% of patients. The overall mortality rate was 7.3%. There were an association between mechanical failure and osteoporosis (p = 0.04), fracture reduction (p = 0.003), and TAD (p = 0.025). In multivariate logistic regression, no independent factors were predictive of mechanical failure. Conclusion: This study shows that ORIF using DHS for PFF via the Watson-Jones approach without an image intensifier can give satisfactory anatomical and functional outcomes in low-resource settings. It provides and validates a reliable and reproducible technique that deserves to be diffused to surgeons in austere areas o

关键词： Proximal Femoral Fracture Watson-Jones Approach Dynamic Hip Screw Low Resource Setting

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GIS-Based Multi-Criteria Decision Analysis (MCDA) and Analytical Hierarchy Process (AHP) Techniques to Derive Flood Risks Management on Rice Productivity in Gishari Marshland

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Journal of Geoscience and Environment Protection 2024年第3期12卷 222-249页

作者： Jean Nepo Nsengiyumva Emmanuel Nshimiyimana Jean marie Ntakirutimana Phocas Musabyimana Yvonne Akimana Fred Shema Set Niyitanga Séverin Hishamunda Callixte Musinga Mpamabara Eliezel Habineza Department of Agricultural Engineering Rwanda Polytechnic IPRC Gishari Rwamagana Rwanda Department of Environmental Information System University of Lay Adventist of Kigali Kigali Campus Kigali Rwanda School of Environmental Science and Engineering Department of Environmental Engineering Suzhou University of Science and Technology Suzhou China Department of Agricultural and Resources Economics School of Agriculture and Environmental Sciences Jomo Kenyatta University of Agriculture and Technology Kigali Campus Kigali Rwanda Department of Smart Agriculture System Hankyong National University Anseong Kyonggi South Korea

Floods are phenomenon with significant socio-economic implications mainly for human loss, agriculture, livestock, soil loss and land degradation, for which many researchers try to identify the most appropriate methodologies by analyzing their temporal and spatial development. This study therefore attempts to employ the GIS-based multi-criteria decision analysis and analytical hierarchy process techniques to derive the flood risks management on rice productivity in the Gishari Agricultural Marshland in Rwamagana district, Rwanda. Here, six influencing potential factors to flooding, including river slope, soil texture, Land Use Land Cover through Land Sat 8, rainfall, river distance and Digital Elevation Model are considered for the delineation of flood risk zones. Data acquisition like Landsat 8 images, DEM, land use land cover, slope, and soil class in the study area were considered. Results showed that if the DEM is outdated or inaccurate due to changes in the terrain, such as construction, excavation, or erosion, the predicted flood patterns might not reflect the actual water flow. This could result unexpected flood extents and depths, potentially inundating rice fields that were not previously at risk and this, expectedly explained that the increase 1 m in elevation would reduce the rice productivity by 0.17% due to unplanned flood risks in marshland. It was found that the change in rainfall distribution in Gishari agricultural marshland would also decrease the rice productivity by 0.0018%, which is a sign that rainfall is a major factor of flooding in rice scheme. Rainfall distribution plays a crucial role in flooding analysis and can directly impact rice productivity. Oppositely, another causal factor was Land Use Land Cover (LULC), where the Multivariate Logistic Regression Model Analysis findings showed that the increase of one unit in Land Use Land Cover would increase rice productivity by 0.17% of the total rice productivity from the Gishari Agricultural Ma

关键词： Multi Criteria Decision Analysis (MCDA) Analytical Hierarchy Analysis (AHA) GIS RS and DEM

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Atlas of Elbow Soft Tissue Pathologies Using Magnetic Resonance Imaging at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix (Burkina Faso)

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Open Journal of Medical Imaging 2024年第2期14卷 43-55页

作者： Milckisédek Judicaël Marouruana Some Pakisba Ali Ouedraogo Aïda Ida Tankoano Wendiwoumyan Judicaël Congo Bassirou Kindo Bénilde marie Ange Kambou Rabiou Cisse Department of Medical Imaging The Ouahigouya Regional University Hospital University of Ouahigouya Burkina Faso Department of Medical Imaging Souro Sanou University Hospital Nazi Boni University Bobo Dioulasso Burkina Faso Department of Medical Imaging Bogodogo University Hospital Joseph Ki Zerbo University Ouagadougou Burkina Faso Department of Medical Imaging Yalgado Oudraogo University Hospital Joseph Ki Zerbo University Ouagadougou Burkina Faso

Introduction: The elbow is a superficial joint, particularly exposed to direct impact, forced movement, and overstrain. Our work aimed to study magnetic resonance imaging (MRI) pathologies of the soft tissues of the elbow through illustrative cases. Methodology: This was a retrospective and prospective cross-sectional study covering a period of one year, from June 2020 to June 2021, at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix. Results: In general, this study found that the pathologies diagnosed on MRI were lateral epicondylitis, subcutaneous type V elbow lipoma and liposarcoma, anteromedial cortical fracture of the radial cup, cortical detachment fracture of the lateral epicondylitis, medial epicondylitis, villonodular articular synovitis, simple dermo-hypodermatitis, sequellar fibrosis of the ulnar nerve, Workman's syndrome (median and ulnar nerves) and osteoarthritis of the elbow. Lateral epicondylitis was the most frequent pathology, and most patients consulted for elbow pain predominantly associated with pressure on the epicondyle, with relative functional impotence and, occasionally, elbow swelling. Conclusion: MRI, as a complement to ultrasound and radiography, remains the most informative examination for exploring soft-tissue pathologies of the elbow.

关键词： Magnetic Resonance Imaging Soft Tissue Elbow

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