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Treatment of Synovial Cysts in Relation to the Tibial Tunnel of Anterior Cruciate Ligament Grafts by Filling the Tunnel with Acrylic Cement

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Surgical Science 2024年第4期15卷 289-298页

作者： Saint Luc Mungina Sedou Charlène Tshitala Mbombo yannick Toko Kiama Kevin Ndangi Ezechiel Nkodia Dieudonné Mwangala Rossyl Kivudi Dominique Saragaglia Luc Mokassa Bakumobatane Department of Surgery University Clinics of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Matete General Reference Hospital Kinshasa Democratic Republic of Congo Department of Orthopedic Surgery Osteoarthritis Surgery and Sports Tromatology at the Grenoble Hospital and University Center Grenoble France National Border Hygiene Program Kinshasa Democratic Republic of Congo

Introduction: Synovial cyst of the tibial tunnel in connection with anterior cruciate ligament (ACL) reconstruction is a rare but particularly troublesome complication. Medical treatment is often doomed to failure, and surgical treatment usually consists of excising the cyst and filling the tunnel with bone. The aim of this study was to evaluate the results of filling the tunnel with acrylic cement. Hypothesis: Filling the tibial bone tunnel with acrylic cement should eliminate communication between the joint cavity and the pre-tibial surface and prevent cyst recurrence. Patients and Methods: This retrospective series is composed of 13 patients, 9 men and 4 women, mean age 48.5 years (31 to 64) operated on between 2011 and 2019 for an intra- and extraosseous synovial cyst consecutive to the tibial tunnel of an ACL graft. Between 1983 and 2016, 12 of the patients had had a bone graft without bone block fixation (DI-DT or Mac Intosh) and one patient, a bone-bone transplant (KJ). The cyst was of variable size, located on the anteromedial aspect of the proximal end of the tibia, and often painful, warranting consultation. At the time of the initial operation, 9 patients had undergone meniscectomies (6 medial, 2 lateral, 1 double). In 7 knees, there were 7 cartilage lesions in the femorotibial and/or patellofemoral compartments (one stage 1 lesion, 2 stage 2 lesions, 4 stage 3 lesions, and no stage 4 lesions). Only 2 knees had neither cartilage nor meniscus lesions. After curettage of the bone tunnel /− removal of the non-resorbed or PEEK interference screw, the tunnel was filled with acrylic cement /− reinforced with a ligament staple to prevent expulsion. All patients underwent regular follow-up consultations until recovery. Results: At a maximum follow-up of 8 years, only 1 cyst recurred, representing a 7.69% failure rate. It was reoperated with another technique, which involved filling the tibial bone tunnel with bone graft taken from a half-bank head. After recovery

关键词： Arthro-Synovial Cyst Tibial Tunnel ACL Graft Filling Acrylic Cement

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Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

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Surgical Science 2024年第5期15卷 311-320页

作者： Eric Patrick Savom Richard II Mbele Mahamat yannick Ekani Boukar Abdal Deudeu Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang Marc Leroy Guifo Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaoundé Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

关键词： Perforation of the Terminal Ileum Simple Suture Resection Morbidity Mortality

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Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé

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Surgical Science 2024年第4期15卷 265-277页

作者： Eric Patrick Savom Gaël Tsanga Nomo Richard II Mbele Mahamat yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the Universityof Yaoundé I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaound&#233 Cameroon

Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.

关键词： Malignant Obstruction Common Bile Duct Palliative Treatment Morbidity Mortality

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Surgical Management of Perforated Colon Tumours in Yaoundé: A Multicentre Retrospective Review of 30-Day Postoperative Outcome

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Surgical Science 2024年第5期15卷 330-341页

作者： Eric Patrick Savom Richard II Mbele Colman Tamboh Tankou Mahamat yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Daniel Biwole Biwole Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon Yaoundé University Teaching Hospital Yaound&#233 Cameroon

Introduction: Colon cancer is often diagnosed late in our context and there is a high prevalence of complicated forms, this including perforation. The optimal surgical treatment remains controversial. The aim of this study was to improve the short-term postoperative outcomes of patients operated upon for perforated colon cancer, by identifying factors associated with complications occurring within 30 days after surgery. Patients and methods: We carried out an analytical observational study, with a retrospective collection of data from the files of patients operated upon for an in situ tumoral colon perforation. This was done in four referral hospitals in the city of Yaoundé. The period was from the 1st of January, 2012 to the 31st of December, 2021. Cox regression identified the factors associated with postoperative morbidity and mortality. Results: We collected files of 46 patients. The mean age was 54.7 ± 19.9 years with a sex ratio of 1.4. The clinical presentation on admission was dominated by the presence of signs of peritoneal irritation (91.3%) and bowel obstruction (28.3%). The diagnosis was made preoperatively in 16 cases (34.8%). The surgical procedures consisted of colectomy with anastomosis in 28 cases (60.9%) and without anastomosis in 14 cases (30.4%). Postoperative morbidity was 60.9% dominated by surgical site infection (37%). Postoperative mortality was 39.1%. The existence of generalized peritonitis was associated with the occurrence of postoperative complications (p = 0.019). The main factors associated with postoperative mortality were resection with primary anastomosis (p = 0.027), enterocutaneous fistula (p = 0.005). Conclusion: Colic resection with primary anastomosis or ideal colectomy is associated with an increased risk of mortality and should therefore not be performed in this setting.

关键词： Perforated Colon Cancer Postoperative Morbidity and Mortality Colectomy Acute Generalized Peritonitis

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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in Cameroon

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Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang Eric Patrick Savom Achille Aimé Bekolo Otiti Fred Dikongue Dikongue Mahamat yannick Ekani Boukar Richard II Mbele Cédric Paterson Atangana Daniel Biwole Biwole Arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and Methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in Cameroon. Data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BMI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. Conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. Compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair Composite Biface Mesh Postoperative Outcomes

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Long Term Administration of Lannea acida Rich. (Anacardiaceae) Reverses the Imidacloprid-Induced Fertility Impairments in Adult Male Rat through Androgenic and Antioxidant Properties

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Journal of Biosciences and Medicines 2024年第3期12卷 62-76页

作者： Aimé Césaire Momo Tetsatsi Gladis Komguep Djuidje Prechmy Carole Ngueyong Nsamou Karl Gombeu Zeugang yannick Tchatat Petnga Désiré Alumeti Munyali Esther Ngadjui Pepin Alango Nkeng-Effouet Pierre Watcho Faculty of Health Sciences The University of Bamenda Bamenda Cameroon Animal Physiology and Phytopharmacology Laboratory Faculty of Science University of Dschang Dschang Cameroon Laboratory of Immunology and Molecular Biology The Evangelical University of Cameroon Bandjoun Cameroon School of Medicine and Community Health Evangelical University in Africa Bukavu DR Congo Alango Foundation Center for African Phytomedicine Dschang Cameroon

Aim: The harmful effects of pesticides have been largely documented in recent times. But effective therapeutic solutions to pesticide related male infertility are yet to be established. This study investigated the curative effects of Lannea acida on imidacloprid (IMI)-induced hypofertility in male Wistar rats. Methods: Rats of 150 – 200 g were administered IMI (22.5 mg/kg) for two weeks and partitioned into control (distilled water, vitamin E, clomiphene citrate) or test (aqueous (340 mg/kg), methanol (170 mg/kg) extract) groups for eight weeks treatment. Animals were sacrificed at the end of the treatment and samples were collected for sperm, antioxidant and hormonal analysis. Fertility tests were performed from treatment day 47 for fertility indices estimation. Results were expressed as mean ± SEM and one way ANOVA was applied using STATISTICA Software. Results: Exposition to IMI resulted in a significant decrease in sperm count, motility, viability and normality, testosterone and LH, coupled to an increase in oxidative stress markers. Moreover, IMI impaired male fertility evidenced by a significant drop in fertility index and litter size. Similar to clomiphene citrate and vitamin E, plant extracts significantly improved the sperm parameters, sexual hormones and decreased the oxidative stress markers. More importantly, the fertility index and litter size were restored, especially with the aqueous extract. Conclusion: Present results indicate that L. acida possesses curative potentials against IMI-induced hypofertility through its androgenic and antioxidant properties. However, the effects the extract on spermatozoa DNA structure and the fertility of offsprings from exposed parents are yet to be studied to conclude on total recovery from IMI toxicity.

关键词： Imidacloprid Lannea acida Hypofertility Male Rat

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Urological Emergencies at the University Hospital of Brazzaville: Epidemiological, Clinical, and Therapeutic Aspects

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Open Journal of Urology 2024年第5期14卷 333-345页

作者： Roland Bertile Banga-Mouss yannick Dimi Nyanga Irène Ondima Armel Melvin Atipo Ondongo Steve Aristide Ondziel-Opara Joseph Junior Damba Nick Arnaud Monabeka Christ Ondzé Daniella Gloire Ngassiele Gidmard Onguele Henock Songa Jetsvy Mayala Anani Wensels Severin Odzebe Prosper Alain Bouya Departement of Urology and Andrology University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.

关键词： Urological Emergencies Urinary Retention Hematuria Renal Colic

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Antiseptic Efficacy of A Soap Made from Biosurfactants Isolated from Bacillus and Lactobacillus against Pathogenic Bacteria

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Advances in Microbiology 2024年第1期14卷 31-58页

作者： Frédéric yannick Okouakoua Christian Aimé Kayath Nicaise Saturnin Mokémiabeka Varelle Bervanie Ngala Elenga Digne Nedjea N’goma-Mona Ndelani Nkalla Lambi Sandra Paola Elenga Wilson Christ Dieuveil Bayakissa Malanda Rodinet Tsana Junior Patrick Sergy Bissoko1 Moïse Doria Kaya-Ongoto Duchel Jeanedvi Kinavouidi Etienne Nguimbi Laboratoire de Biologie Cellulaire et Molé culaire (BCM) Facult&eacute des Sciences et Techniques Universit&eacute Marien N’gouabi Brazzaville Congo Institut National de Recherche en Sciences Exactes et Naturelles (IRSEN) Avenue de l’Auberge Gascogne Brazzaville Congo

The aim of our study was to use a biosurfactant produced by Bacillus and Lactobacillus isolates as an antiseptic in the formulation of local soap. A total of 60 isolates were characterized by microbiological techniques (30 Bacillus and 30 Lactobacillus) and the ability to produce biosurfactants was demonstrated by a hydrocarbon emulsification index (E24). The emulsification indexes (E24) varied from 9% to 100% for Bacillus and from 33% to 100% for Lactobacillus as well. The antagonistic assay showed that biosurfactants were able to inhibit the formation of biofilms and growth of pathogens such as Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, Salmonella typhirium, Shigella boydii and Proteus mirabilis. The biosurfactant consortium (BioC) from Bacillus consortium and from Lactobacillus was able to inhibit biofilm formation and the pathogens growth. The BioC was stable to alkaline pH and the temperatures stability of Biosurfactant was ranging from 50°C to 90°C. The soap was made by the cold saponification process using one biosurfactant consortium formulated. This soap has a pH of 10 and showed good cleaning power and good foam stability. Similarly, the soap showed good antiseptic power and disinfection power against all pathogens tested. Handwashing is critical to preventing disease transmission. The persistence of pathogens in waste water was evaluated. The BioS produced showed good disinfection power against all pathogens tested. The valor of reduction on the hands and in the waste water was significantly more than compared to the control soaps used. This soap could be used in the prevention, fighting, and treatment of bacterial and viral infections.

关键词： Antiseptic Soap Biosurfactants Bacillus Lactobacillus Disinfection Pathogens bacteria

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Near obstructing painful anorectal mass and facial rash in a man with monkeypox: A case report

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World Journal of Clinical Cases 2023年第30期11卷 7418-7423页

作者： Kesiena Akpoigbe Jones yannick Joan Culpepper-Morgan Department of Gastroenterology Columbia University Medical Center Health+Hospitals/Harlem AffiliationNew YorkNY 10037United States Department of Internal Medicine Columbia University Medical Center Health+Hospitals/Harlem AffiliationNew YorkNY 10037United States

BACKGROUND Monkeypox(MPX)is a zoonotic infection that is endemic in Western and Central Africa along the Congo River *** has a high case fatality rate especially in younger age *** belongs to the virus family orthopoxvirus like *** is transmitted from wild animals to humans but human to human transmission has been *** is often a self-limited infection in endemic ***,attention has been given to MPX with the spread of infection to Europe and the United States of America(USA).There is currently sporadic infection of MPX in the USA especially amongst men who have sex with men(MSM).It is a serious life-threatening infection in human immunodeficiency virus/acquired immunodeficiency syndrome co-infected individuals especially those who are treatment naïve with severe *** SUMMARY We report a 38-year old man who presented with rectal pain,and anal,torso,and facial *** computed tomography scan showed a near obstructive rectal mass with peri-anal *** was *** was started on tecovirimat(TPOXX)and HAART *** treatment provided included vaccinia immunoglobulin following his clinical *** This case highlights a rare presentation of MPX with peri-anal fistula and near obstructive rectal mass,and the significance of MPX as a differential diagnosis in proctitis in MSM in addition to other sexually transmitted infection like gonorrhea and chlamydia.

关键词： Proctitis Monkeypox Human Immunodeficiency Virus Men who have sex with Men Tecovirimat Vaccinia Immunoglobulin Case report

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Incorporating geotechnical and geophysical investigations for underground obstruction detection:A case study

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Underground Space 2023年第4期11卷 116-129页

作者： Yaohui Liu yannick C.H.Ng Yunhuo Zhang Ping Yang Taeseo Ku School of Mechanics and Civil Engineering China University of Mining and TechnologyXuzhou 221000China Department of Civil and Environmental Engineering National University of Singapore117576Singapore Geotechnical&Tunnel Division Land Transport Authority Singapore219428Singapore Department of Geotechnical Engineering College of Civil EngineeringTongji UniversityShanghai 200092China Department of Civil and Environmental Engineering Konkuk UniversitySeoul 05029South Korea

Determining the location and boundary of underground obstructions and/or anomalies is a common problem and often a great chal-lenge for tunneling and underground *** this study,geotechnical investigations(penetration tests and borehole drilling/sam-pling)and geophysical investigations(surface wave method and cross-hole seismic method)were conducted with the aim of identifying the location and boundary of rock obstructions in Changi East,*** surface wave method is frequently used in the sites with lateral homogeneity in previous studies,but its application in the sites with rock obstructions is *** experimental results of this study indicate that the surface wave method is also able to determine the upper surface of rock obstructions,but difficult to identify the lateral and bottom boundaries of rock *** improve the precision of detection,the full waveform inversion(FWI)method was used to process the data from the cross-hole seismic *** results indicate that the inversion precision of P-wave is higher than that of *** horizontal and vertical ranges of rock obstructions in the P-wave inversion results are 14–26 m and 7.5–11.0 m respectively,roughly consistent with the results of penetration tests(about 15–25 m)and borehole log(8.85–10.80 m).This result proves that the sequential application of first-arrival time analysis and FWI can effectively delineate the boundary of rock ***,the results of various detection methods were analyzed and compared in this *** the advantages of various methods,we propose a cost-effective and high-precision workflow containing both geotechnical and geophysical investigations.

关键词： FWI Geotechnical and geophysical investigations Cross-hole seismic method Surface wave method Obstruction detection

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