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Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology department of the Yaounde Central Hospital

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 348-358页

作者： Achile Aurele Mbassi Florent Ymele Fouelifack Fatoumata Touda Dehukwe Maguira Roosvelt Dongmo Tiodjou Magloire Sida Biwole department of surgery and specialties Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon department of Urology and Andrology Yaounde Central Hospital Yaounde Cameroon Gynecology and Obstetrics Unit Yaounde Central Hospital Yaounde Cameroon Associative Group for Research Education and Health La Falaise “GARES-Falaise” Dschang Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon The higher institute of medical technology of nkolondom Yaounde Cameroon

Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1st, 2016 to April 30th, 2021) at the Urology department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of

关键词： Epidemiology Clinical Male Infertility Central Hospital Yaounde

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Knowledge, Attitude and Practice of Breast Self-Examination amongst Women in Two Communities of Cameroon

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 773-793页

作者： Florent Ymele Fouelifack Rene Pierre Binyom Anyimbi Mosman Ofeh Jeanne Hortence Fouedjio Robinson Enow Mbu department of Obstetrics and Gynecology of higher institute of medical technology of nkolondom Yaounde Cameroon Obstetrics and Gynecology Unit of Yaounde Central Hospital Yaounde Cameroon Research Education and Health Associative Group GARES-Falaise Dschang Cameroon department of surgery Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Breast cancer is a major health problem in the world. It is the most common cancer in women and is equally the leading cause of cancer death in women. Though in controversy Breast self-examination (BSE) remains a useful tool in early diagnosis of breast cancer. The aim of this study was to evaluate the knowledge, attitude and practice of BSE amongst women in Yaoundé and Monatele. We carried out a cross sectional study in two communities of Cameron over a period of eight months, targeting females older than 15 years. After obtaining authorization, we randomly interviewed 402 consenting participants, using a pretested questionnaire. Data were entered using CS Pro 7.3 and analysed using SPSS 23. Of a total of 402 participants, 256 (63.7%) in Monatele and 146 (36.3%) in Yaoundé VI, the mean age was 26.55 ± 9.57 years. Exactly 50% (201) had earlier heard of BSE. Health personnel and media represented the main sources of information on BSE. Of the total, 46 (11.4%) knew BSE should be done monthly. Fifty-three percent had poor knowledge and 51.0% had a generally low attitude towards BSE. Out of 402 participants, 65.2% reported not practicing BSE. For those practicing, 71.6% had poor practices. The main reason for not practicing was lack of knowledge. Poor knowledge increased poor practice. In conclusion half of the women had heard about BSE even though the majority had a poor knowledge on BSE and very low overall attitude and practice. Health personnel and media played a key role in passing of information. Increasing the number of health campaigns, multiplying TV shows and health talks about breast self-examination will improve knowledge and hence attitude and practice.

关键词： Knowledge Attitude Practice Breast Self-Examination

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Morbi-Mortality Linked to Unsafe Abortions—Difficulties in Accessing Safe Abortions in Cameroon: Meta-Analysis and Systematic Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 342-359页

作者： Florent Ymele Fouelifack Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Christophe Saha Lontsi Mvong Vendeline Amaelle Goretti Guy Sadeu Wafeu Robinson Enow Mbu Department of Surgery and Specialties at the Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Gynecology and Obstetrics Unit of the Yaoundé Central Hospital Yaoundé Cameroon Maga District Hospital Maga Cameroon Public Health of higher institute of medical technology of nkolondom Yaoundé Cameroon CIVITAS Cameroon Human Rights and Humanitarian Action Yaoundé Cameroon Public Health Option Epidemiology Yaoundé Cameroon Information Communication and technology American University Yaoundé Cameroon Centre for the Development of Best Practices in Health (CDBPSH) National Coordinator of Building Medical Research in Africa (BMR Africa) Yaoundé Cameroon Family Health Ministry of Public Health Yaoundé Cameroon

Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I2 and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider b

关键词： Morbi-Mortality Unsafe Difficulties Access Safe Abortion Cameroon

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Morbidity and Mortality Linked to Unsafe Abortions in Cameroon—Difficulties in Accessing Safe Abortions: Systematic Review and Meta-Analysis. A Study Proposal

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Open Journal of Obstetrics and Gynecology 2022年第10期12卷 1102-1112页

作者： Florent Ymele Fouelifack Ako William Takang Mosman Anyimbi Ofeh Jenny Ornella Manewoun Nsen Abeng Guy Sadeu Wafeu Christophe Lontsi Saha department of surgery and specialties Higher Institute of Medical Technology of Nkolondom-Yaoundé Yaoundé Cameroon Gynecology and Obstetrics Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Monatélé District Hospital Monatélé Cameroon higher institute of medical technology of nkolondom Yaoundé Cameroon Human Rights and Humanitarian Action National Coordinator of CIVITAS Cameroon Yaoundé Cameroon Systematic Reviews and Meta-Analysis Coordinator of Cochrane Cameroon Yaoundé Cameroon Public Health Option Epidemiology Faculty of Health Sciences Catholic University of Central Africa Yaoundé Cameroon

Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I2 and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.

关键词： Mortality Morbidity Difficulties Access Unsafe Abortion Cameroon

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Longitudinal Epigastric Incision for Caesarean Section in a Morbidly Obese Patient in a Low-Resource Setting (Cameroon): A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第8期11卷 929-934页

作者： Florent Ymele Fouelifack Wilfried Loic Tatsipie Armand Kamga Talom Anyimbi Ofeh Mosman Hortence Fouedjio department of surgery and specialties Higher Institute of Medical Technology of Nkolondom Yaounde Cameroon Obstetrics and Gynecology Unit Yaounde Central Hospital Yaounde Cameroon Research Education and Health Associative Group GARES-Falaise Dschang Cameroon department of Gynecology and Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Obesity is a metabolic condition associated with a significant morbidity and mortality rate. In the pregnant context, this risk is even higher because of the contingent of metabolic and haemodynamic complications present in the ante-, intra- and post-partum periods. In these people, the recommended delivery method is caesarean section, which is not easy to perform. Our aim is to explain the particularities and advantages of epigastric incision in obese women during a caesarean section. The authors report the case of a patient who was admitted to the maternity ward of the Yaounde Central Hospital for management of a post-date, and in whom an elective caesarean section was indicated with an epigastric approach. The vertical supra umbilical incision should be recommended because it is subject to fewer complications and reduces the operating time and hospital stay.

关键词： Obesity Caesarean Section Epigastric Incision

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Unmet Needs for Family Planning among Adolescent Girls Giving Birth in Three Teaching Hospitals in Yaoundé

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 849-862页

作者： Florent Ymele Fouelifack Christiane Catherine Ticki Mengue Mosman Anyimbi Ofeh Loic Dongmo Fouelifa Jeanne Hortence Fouedjio department of surgery and specialties Higher Institute of Medical Technology of Nkolondom Yaoundé Cameroon Obstetrics and Gynecology Unit of the Yaoundé Central Hospital Yaoundé Cameroon Research Education and Health Development Group “GARES-Falaise” Dschang Yaoundé Cameroon Faculty of Health Sciences University of Lomé Lomé Togo School of Armies Health Services of Lomé Lomé Togo department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences of University of Yaoundé I Yaoundé Cameroon

Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.

关键词： Adolescent Girls Unmet Need Family Planning

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Liver resection versus liver transplantation for hepatocellular carcinoma within the Milan criteria based on estimated microvascular invasion risks

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Gastroenterology Report 2023年第1期11卷 385-397页

作者： Pinghua Yang Fei Teng Shilei Bai Yong Xia Zhihao Xie Zhangjun Cheng Jun Li Zhengqing Lei Kui Wang Baohua Zhang Tian Yang Xuying Wan Hao Yin Hao Shen Timothy M Pawlik Wan Yee Lau Zhiren Fu Feng Shen department of Hepatic surgery IV and Clinical Research institute The Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghaiP.R.China department of Liver surgery and Organ Transplantation The Changzheng HospitalNaval Medical UniversityShanghaiP.R.China department of General surgery The Affiliated Zhongda HospitalSoutheast UniversityNanjingJiangsuP.R.China department of Hepatic surgery II and Clinical Research institute The Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghaiP.R.China department of Biliary surgery IV and Clinical Research institute The Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghaiP.R.China department of Chinese Traditional Medicine The Eastern Hepatobiliary Surgery HospitalNaval Medical UniversityShanghaiP.R.China department of surgery The Wexner Medical CenterOhio State UniversityColumbusOHUSA Faculty of Medicine the Chinese University of Hong KongPrince of Wales HospitalShatinNew TerritoriesHong Kong SARChina

Background:Preoperative prediction of microvascular invasion(MVI)in hepatocellular carcinoma(HCC)may optimize individualized treatment decision-making.This study aimed to investigate the prognostic differences between HCC patients undergoing liver resection(LR)and liver transplantation(LT)based on predicted MVI risks.Methods:We analysed 905 patients who underwent LR,including 524 who underwent anatomical resection(AR)and 117 who underwent LT for HCC within the Milan criteria using propensity score matching.A nomogram model was used to predict preoperative MVI risk.Results:The concordance indices of the nomogram for predicting MVI were 0.809 and 0.838 in patients undergoing LR and LT,respectively.Based on an optimal cut-off value of 200 points,the nomogram defined patients as high-or low-risk MVI groups.LT resulted in a lower 5-year recurrence rate and higher 5-year overall survival(OS)rate than LR among the high-risk patients(23.6%vs 73.2%,Phigher 5-year OS rate than AR among the high-risk patients(24.8%vs 63.5%,P=0.001;86.7%vs 65.7%,P=0.004),with HRs of LT vs AR for recurrence and OS being 0.24(95%CI,0.11–0.53)and 0.17(95%CI,0.06–0.52),respectively.The 5-year recurrence and OS rates between patients undergoing LT and AR were not significantly different in the low-risk patients(19.4%vs 28.3%,P=0.129;85.7%vs 77.8%,P=0.161).Conclusions:LT was superior to LR for patients with HCC within the Milan criteria with a predicted high or low risk of MVI.No significant differences in prognosis were found between LT and AR in patients with a low risk of MVI.

关键词： hepatocellular carcinoma microvascular invasion liver resection liver transplantation prognosis

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Spontaneous Bacterial Peritonitis and Short-Term Prognosis in a Group of Decompensated Cirrhotic Patients in Yaounde: A Cross-Sectional Study

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Open Journal of Gastroenterology 2020年第8期10卷 203-213页

作者： Mathurin Pierre Kowo Sylvain Raoul Simeni Njonnou Nelly Karelle Weyou Noubissi Firmin Ankouane Andoulo Gabin Ulrich Kenfack Larissa Pessidjo Djomatcho Hortense Gonsu Kamga Bernadette Ngo Nonga department of Internal Medicine and specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Yaounde University Teaching Hospital Yaounde Cameroon department of Internal Medicine and specialties Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon higher institute of medical technology Yaounde Cameroon department of Microbiology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon department of surgery Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Introduction: Spontaneous bacterial peritonitis (SBP) is among the most common infections in cirrhotic patients. Data on SBP are rare in Cameroon. This prompted us to carry out this study on patients with decompensated cirrhosis of the liver in Yaounde University Hospital Centre (YUHC). Methods: We carried out a cross-sectional study from December 2015 to June 2016 in three units of YUHC. All patients with decompensated liver cirrhosis were included. Our sampling was consecutive. Diagnosis of cirrhosis was performed, based on clinical, biological and ultrasound criteria. A neutrophil count greater than 250 cell/mm3 in ascites fluid defined an SBP. Data on socio-demography, clinical presentation, and outcomes were collected. Results: We included 34 decompensated cirrhotic patients (15 males). Patients mean age was 57.5 ± 2 years (SBP positive: 48.7 ± 21.3 versus without SBP: 59.8 ± 19.5, p = 0.22). SBP diagnosis was made in 6 (17.7%) patients. Compared to patients with decompensated liver cirrhosis and without SBP, positive SBP patients had a higher pulse rate (p = 0.002) and respiratory rate (p = 0.02). The patients with SBP were more likely to present these other clinical features: pulse rate >100 (RR: 4.2, [95% CI: 0.7

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