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Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the essos hospital centre (EHC), Yaoundé, Cameroon

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Open Journal of Pediatrics 2022年第3期12卷 594-605页

作者： Anne Esther Njom Nlend Dominique Kamtchoua Ndjenje Arsène Brunelle Sandie Higher Institute of Medical Technology Nkolodom University of Douala Yaoundé Cameroon essos hospital centre Yaoundé Cameroon African Population and Health Research Center Dakar Senegal

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the essos hospital centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for t

关键词： Neonatal Jaundice Transcutaneous Bilirubin Measurement Total Serum Bilirubin Screening in Full Term Infant

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Associated Factors to Immunization Timeliness and Completion in Preterm and Low Birth Weight Infants at essos hospital Center Yaounde

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Open Journal of Pediatrics 2021年第1期11卷 9-18页

作者： Marie Kouya Annie Carole Nga Motaze Jeannette Epée Ngoue Arsène Brunelle Sandie Paul Olivier Koki Ndombo Anne Esther Njom Nlend Higher Institute of Medical Technology Nkolondom University of Douala Douala Cameroon essos hospital centre Unit of Neonatology Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaoundé Cameroon Pan African University of Nairobi Nairobi Kenya

Introduction: Vaccination is very often delayed in premature and low birth weight infants. However, timely vaccination is even more important in this population because of their increased susceptibility to infection. Objective: To assess immunization practice and factors associated with vaccine promptness and completeness in former preterm and low-birth-weight infants. Methods: We conducted a retrospective analytical cross-sectional study (January 2017 to February 2019). Main Measurement: Promptness and completeness at each contact, Statistical analysis was performed using R software version 3.6.2, logistic regression was used to estimate the Odds Ratio (OR) and their 95% Confidence Interval (CI). Results: We recruited 310 children aged 12 to 36 months born before 37 weeks with low birth weight, 163 (52.6%) of whom were female. Two hundred and fifty-three had received the vaccines at the indicated age, with promptness rate of 81.6%, and 97.7% had completed routine immunization at 9 months. The mean age at vaccination initiation was 6 days ± Prematurity Low Birth Weight Immunization Timeliness Completion

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Outcomes of Fetal Macrosomia and Associated Factors: A Case-Control Facility Based Study

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Open Journal of Pediatrics 2023年第2期13卷 196-206页

作者： Anne Esther Njom Nlend Josepha Gwodog Arsene Brunelle Sandie essos hospital centre Yaoundé Cameroun Higher Institute of Medical Technology Yaoundé Cameroon Health Ebene Consulting Research Department Yaoundé Cameroon African Population and Health Research Center Dakar Senegal

Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024);non-screening for gestational diabetes (p = 0.027);history of caesarean section (p = 0.041);weight gain ≥16 kg (p 0.001);maternal HIV (p = 0.047);birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.

关键词： Fetal Macrosomia Gestational Diabetes Maternal Obesity Birth Weight Fetal Growth

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Clinical, Psycho-Social and Metabolic Profile of Women with Hirsutism in Yaounde

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Open Journal of Endocrine and Metabolic Diseases 2022年第11期12卷 225-237页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga Laurence Carole Ngo Yon Mesmin Dehayem Sandrine Ongnesseck Nengom Eliane Ngassam Vanessa Balla Eugène Sobngwi Jean Claude Mbanya Internal Medicine Essos Hospital Centre Yaoundé Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon National Obesity centre Diabetes and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Regional hospital of Nkongsamba Nkongsamba Cameroon

Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in Yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology

关键词： Hirsutism hyperandrogenism Yaoundé Ferriman and Gallwey

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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

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Evaluation of SON’OR^(█),a Medical Device for Provoked Otoacoustic Emissions and Brainstem Evoked Response Audiometry Made in Cameroon

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Journal of Biomedical Science and Engineering 2017年第8期10卷 376-389页

作者： Jean Espoir E.Vokwely Jean Valentin F.Fokouo Guy Merlin Ngounou Dalil Asmaou Esthelle G.Minka Ngom Martin Kom Richard L.Njock G.Bengono Alexis Ndjolo Otorhinolaryngology Service Centre Hospitalier d’EssosYaoundeCameroon Regional hospital Bertoua BertouaCameroon National Advanced School of Engineering YaoundeCameroon BENDO Company YaoundeCameroon General hospital YaoundeCameroon General hospital DoualaCameroon Laquintinie hospital DoualaCameroon Cameroon Society of Otolaryngology and Head and Neck Surgery YaoundeCameroon Chantal Biya International Research Center YaoundeCameroon

Background: There is a huge gap in the audiological care in Africa by comparison with Western countries. Its main reason is the prohibitive cost of the medical devices used to screen or diagnose patients. A Cameroonian team tackled this problem by developing a medical device (SON’OR©) which integrates a new instrumentation amplifier structure dedicated to perform otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA). The major technical challenges to perform OAE and BERA are the synchronization and the amplification of signals of very low amplitude. In this work, we emphasize on the general criteria necessary and indispensable to achieve an optimal amplification. The application of a novel instrumentation amplifier structure characterized by its optimized noise factor in the case of BERA and OEA emissions provides simulations and experimental results fully in line with forecasts. The design of SON’OR©is based on general techniques of electronic instrumentation to which we associated the new instrumentation amplifier structure. Objective: To report the clinical evaluation of SON’OR©as a screening and diagnostic tool. Methods: We conducted a cross sectional comparative study in centre hospitalier d’essos in Yaoundé. We tested SON’OR©on two sets of subjects, one for OAE with OTODYNAMICS Echoport ILO 292-II as gold standard and the other for BERA with NEUROSOFT NEURO AUDIO©as gold standard. Each patient was tested with both devices and then we studied the inter device differences and calculated the sensitivity, specificity, positive predictive value and negative predictive value for each test. Results: We got 52 subjects for OEA and 51 for BERA testing. Sex ratio was 1 woman for 2 men in both groups. Mean age was 24.86(SD = 10.53) and 26.33 (10.55) for OAE and BERA groups respectively. SON’OR©had good performances, showing sensitivity of 92.85%/95%, specificity of 96.77%/90.47%, positive predictive value of 95.21%/93.4

关键词： SON’OR^(█) Brainstem Evoked Response Audiometry Otoacoustic Emissions Cameroon Neonatal Hearing Screening

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Respiratory Distress in Full and Post Term Neonates: Prevalence, Etiologies and Outcomes in a Tertiary Health Center in Yaoundé

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Open Journal of Pediatrics 2021年第3期11卷 351-359页

作者： Didi Stanine Mefo Kue Jeannette Epee Ngoue Annie Carole Nga Motaze Aude Sabine Nanfack Anne Esther Njom-Nlend Higher Institute of Medical Technology Nkolondom Department of Clinical Sciences University of Douala Douala Cameroon Department of Pediatrics Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon Cameroon Society of Perinatal Medicine Yaoundé Cameroon essos hospital centre National Social Insurance Fund Yaoundé Cameroon Ministry of Economy and Development Yaoundé Cameroon

Introduction: Respiratory pathologies are top listed amongst neonatal morbidities. Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). Patients and Method: This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included. Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. Results: We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%. Main etiologies were pneumonia (44%), followed by transient tachypnea (35.4). Perinatal asphyxia (OR = 9.412, P

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An Overview of Adolescent Pregnancy in Yaoundé, Cameroon

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1191-1201页

作者： Christiane Jivir Fomu Nsahlai Claude-Audrey Meguieze Fatimatouz Zahra’ou Esther Ngo Um Meka Eric Nseme Etouckey Marie Therese Abena Obama Obstetrics and Gynecology Essos Hospital Centre Yaoundé Cameroon Department of Obstetrics and Gynecologist Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Background: Adolescent pregnancy is high risk and every area should have data specific to it. We here attempted to determine the characteristics of adolescent pregnancy in Cameroon, with special reference to antenatal care (ANC). Materials and Methods: The present cross-sectional descriptive study was carried out in four secondary level hospitals in Yaounde, Cameroon from March to May 2022. Our study included adolescent pregnant females between ages 10 and 19 who received prenatal/post-partum care at these facilities. Results: We studied 101 adolescent pregnant females (pregnant or post-partum). The mean age was 17.6 ± 1.3 years. Most of them were single, Christian, had a secondary level of education, lived in a two-parent home and were from the Central region. ANC was provided by midwives for most of them but prenatal work-up was not done most of the time. Overall quality of ANC was considered poor. Conclusions: Adolescent pregnant females were mainly high-school students and lived at home with both parents. ANC quality was considered poor. These data may be important to improve reproductive health care and may be generalizable to some extent.

关键词： Adolescent Antenatal Care Yaoundé

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Facial and Periorbital Emphysemas Following a Violent Sneezing: An Atypical Clinical Situation

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 136-142页

作者： Adèle-Rose Ngo Nyeki Caroline Mvilongo Esthelle Minka Ngom Valentin Fokouo Roger Meva’a Léonel Atanga Yannick Mossus Claudine Nkidiaka Luc Meka Abakar Taimou Serge Abogo David Mindja Olive Ngaba Godefroy Koki Francois Djomou Richard Njock ENT Ophthalmology and Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon essos hospital Center Yaoundé Cameroon Central hospital of Yaoundé Yaoundé Cameroon ENT Department Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General hospital Douala Cameroon Bertoua Regional hospital Bertoua Cameroon

Introduction: Facial emphysema is the presence of air in the subcutaneous tissues of the facial region. They can be clinically recognized by the crackling sensation felt when the affected area is palpated. Observation: The authors describe left orbito-facial emphysema that occurred after a violent sneezing episode in a 36-year-old patient. He had significant edema of the left facial and ipsilateral periorbital region associated with major emphysema and complete closure of the left eye. Nasal cavities endoscopy revealed inflammation of the distal orifice of the nasolacrimal duct. The clinical ophthalmologic examination performed in emergency showed left chemosis, slight ocular hypertonia of mechanical origin, and a slight decrease in visual acuity. Pupillary reflexes and retinography were normal. A craniofacial computed tomography (CT) revealed a significant left orbital emphysema, a fracture of the left medial orbital wall (ethmoidal lamina papyracea) with intraconal fat incarceration without entrapment of the medial rectus and significant air infiltration of all the left hemifacial soft tissues. A broad-spectrum antibiotic and anti-inflammatory treatment were instituted, as well as practical advice to prevent a recurrence. We observed progressive resorption of the edema with a return to the normal of the soft tissues and the palpebral cleft in 15 days. Conclusion: These atypical cases can be serious. It is essential to exclude signs of visual deficit and ocular compression. Multidisciplinary management is important.

关键词： Sneezing Orbital Fracture Emphysema Pneumorbitia

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Prevalence and Correlates of Macrovascular Complications at Type 2 Diabetes Diagnosis in a Tertiary hospital in Yaoundé, Cameroon

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Journal of Diabetes Mellitus 2023年第4期13卷 269-283页

作者： Francine Mendane Ekobena Martine Claude Etoa Etoga Mesmin Dehayem Carole Laurence Ngo Yon Pauline Ngo Balôgôg Guy Dieudonné Mvogo André Pascal Kengne Eugène Sobngwi Jean Claude Mbanya Internal Medicine Unit Essos Hospital Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Endocrinology and Metabolic Diseases Unit Yaoundé Central Hospital Yaoundé Cameroon Faculty of Medicine and pharmaceutical Sciences University of Douala Douala Cameroon Medical Analysis Laboratory Essos Hospital Center Yaoundé Cameroon Department of Public Health Kesmonds International University Ngaoundéré Cameroon Department of Medicine University of Cape Town Cape Town South Africa Non-Communicable Diseases Research Unit South African Medical Research Council Cape Town South Africa

Introduction: The presence of vascular complications at type 2 diabetes (T2D) diagnosis is a heavy burden for developing countries. We aimed to determine the prevalence and correlates of macrovascular complications at T2D diagnosis in Yaoundé, Cameroon. Materials and Methods: We conducted a cross-sectional study at the essos hospital Center in Yaoundé from January 2017 to June 2021. We recruited patients newly diagnosed with T2D who, simultaneously, with assessed macrovascular complications including stroke, myocardial infarction (MI) and arterial foot ulcer (AFU). Correlates were investigated using Chi square test and logistic regressions. The significance level was set at 5%. Results: In all, 286 newly diagnosed diabetic patients (51.7% being men) were included. The mean age was 52.6 ± 12.3 years. Prevalent cardiovascular risk factors at diabetes diagnosis were a dyslipidemia (63.6%), sedentary lifestyle (57.7%) and family history of type 2 diabetes (51.6%). The prevalence of macrovascular complications was 17.5% with 8.4% stroke, 5.6% myocardial infarction and 3.4% arterial foot ulcer. Hypertension was associated with all macrovascular complications (p Conclusion: Macrovascular complications are frequent at type 2 diabetes diagnosis and are represented by stroke and myocardial infarction in our study, highlighting the importance of cardiovascular risk evaluation and reduction in people with diabetes right from diagnosis.

关键词： Diabetes Mellitus Macrovascular Complications Cameroon

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