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Cerebral Gliomas Patterns at the general hospital of douala, Cameroon

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Open Journal of Modern Neurosurgery 2018年第4期8卷 389-405页

作者： Aurélien Ndoumbe Mathieu Motah Bea Jesse Ikango Mireille Moumi Amadou Fewou Albert Mouelle Sone Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Neurosurgeon Service of Surgery General Hospital of Douala Douala Cameroon Pathology Faculty of Medicine & Biomedical Sciences University of Yaoundé I. Head Service of Pathology General Hospital of Douala Douala Cameroon

The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the general hospital douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.***.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.

关键词： Cerebral Gliomas Clinical Manifestations Histological Nature Management Outcome

Immuno-Histochemical Profile of Breast Cancers at the general hospital of douala-Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1377-1388页

作者： Ekono Michel Roger Guy Ngaha Yaneu Junie Neng Humphry Tatah Messakop Yannick Azoumbou Mefant Thérèse Ze Ngbwa Mimi Flore Essome Henri Essola Basile Engbang Jean-Paul Tchente Nguefack Charlotte Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Obstetrics and Gynecology Ebolowa Regional Hospital Ebolowa Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: The aim of the study was to describe the immunohistochemical aspects of breast cancers at douala general hospital, Cameroon. Methodology: This was a descriptive study with retrospective data collection, conducted from January 1st 2010 and December 31st 2019. It was focused on histologically proven breast cancers followed up at douala general hospital. Results: We collected 285 cases of breast cancer, all female, representing an annual frequency of 28.5 cases. The mean age of the patients was 48 ± 13 years. The most frequent histological form was infiltrating ductal carcinoma (83.9%), with grade II predominating (38.6%). Immunohistochemical analyses were performed on 89 patients (31.23%). The triple-negative subtype was the most common class (35.95%), followed by Luminal A (32.60);Human Epidermal Receptor 2-class and Luminal B tumors were observed at a frequency of 13.48% each. Treatment consisted mainly of surgery (78.60%) combined with chemotherapy (65.97%) and/or radiotherapy (63.16%). Hormonal treatment was used in only 10.18% of patients. Targeted therapy was exceptional (4%). Conclusion: Triple-negative phenotype is the most common. However, potentially hormone-sensitive tumors account for almost half of all patients, who are relatively young. Individualized treatments are rare. It is important to systematize these analyses for all breast cancers, with a view to appropriate management in our environment.

关键词： Breast Cancer Immunohistochemistry douala general hospital of Cameroon

Pediatric Traumatic Brain Injury Pattern at the general hospital, douala, Cameroon

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Open Journal of Modern Neurosurgery 2019年第1期9卷 49-60页

作者： Aurélien Ndoumbe Mathieu Motah Angéline Rolande Assomo Dah Mireille Moumi Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Neurosurgeon Service of Surgery General Hospital of Douala Douala Cameroon

Traumatic brain injury is the most common injury during childhood comprising 60% to 90% injuries in children. Pediatric traumatic brain injury has peculiarities as compared to adults, such as less severe injuries and better prognosis. The purpose of this work was to study the pattern of pediatric traumatic brain injury at the general hospital, douala, Cameroon. This was a retrospective cross-sectional study, from January 1st, 2008 to December 31st, 2017. Included were all complete medical records of children aged 0 to 15 years old treated for traumatic brain injury, and excluded records of obstetric trauma. Data analysis was done by SPSS software version 18.0. One hundred and three cases of pediatric head injuries were recorded during the study period (frequency 10.43%). The mean age was 7.42 ± 5.028 years, and the sex ratio was 2.67 in favor of boys. Road traffic accidents were the most common etiology (44.7%). 83.5% of the patients were transferred to the emergency department of the douala general hospital in second intention and by non-medical transport. The traumatic brain injury was mild in 61.20%. The brain computed tomography scan was performed in 99% of the cases and the most observed lesion was cerebral edema (32.74%). Twenty-eight patients underwent surgical operation. 90.28% of patients have recovered fully, and the global mortality was 3.88%. The prevalence of pediatric traumatic brain injuries at the general hospital, douala during the last ten years was 10.43%. Most of the patients recovered fully and the mortality was low.

关键词： Traumatic Brain Injury Pediatrics Computed Tomography Scanning Treatment Outcome

Epidemiology, Clinical Presentations and In-hospital Mortality of Venous Thromboembolism at the douala general hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2018年第2期8卷 123-132页

作者： Félicité Kamdem Bertrand Hugo Mbatchou Ngahane Ba Hamadou Agborbessong Mongyui Marie Solange Doualla Ahmadou Musa Jingi Anastase Dzudie Yves Monkam Henri Ngote Sidick Mouliom Caroline Kenmegne Jaff Kweban Fenkeu Romuald Hentchoya Albert Kana Aminata Coulibaly Henry Luma Internal Medicine Service Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality worldwide. It is also the most common complication in hospitalized patients. Aims:?To?study the in-hospital prevalence of VTE, describe the socio-demographic characteristics of patients, determine the frequency of risk factors, describe the clinical presentations, and determine the short term outcome of VTE in hospitalized patients in a low-income tertiary hospital setting.?Methods: We carried out a cross-sectional descriptive retrospective study over a period of 6 years and 4 months (January 2008 to April 2014) in the douala general hospital—Cameroon. Patients were cases of confirmed venous thromboembolic disease (VTE).?Results: A total of 78 case files were retained for this study, giving an in-hospital prevalence of 4.4 per 1000 admissions. There were 42 (53.8%) males and 36 (46.1%) females. Their ages ranged from 18 to 89 years (median: 53 years, [IQR: 40?-?61]).?There were 37 (47.4%) cases of Deep Vein Thrombosis (DVT), 31 (39.7%) cases of Pulmonary Embolism (PE), and 10 (12.8%) cases of PE associated with DVT (12.8%). The main risk factors were obesity (44.9%), hypertension (37.2%), immobility (20.5%), and long-haul travel (17.9%). The most frequent clinical presentations in PE were dyspnea (80.5%) and chest pain (65.9%). There were 8 (10%) in-hospital deaths. Conclusion: About twelve cases of VTE are seen yearly at the DGH, with an in-hospital mortality of ten percent. Obesity and hypertension were the main risk factors, with dyspnea and chest pain being the main clinical manifestations in PE, and lower limb swelling the main symptom in DVT.

关键词： Epidemiology Clinical Presentation Mortality Venous Thromboembolism Cameroon Sub-Saharan Africa

Prenatal Diagnosis of Congenital Malformations in douala general hospital

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Open Journal of Obstetrics and Gynecology 2015年第15期5卷 839-848页

作者： Tchente Nguefack Charlotte Nzesseu Djomo Aurore Brulet Charlotte Barla Esther Belley Priso Eugene Faculty of Medicine and Pharmaceutics Science University of Douala Douala Cameroon Obstetrics and Gynecology Unit Douala General Hospital Douala Cameroon Faculty of Health Science University of Mountains Bagangté Cameroon Cabinet Médical Dr Brulet Douala Cameroon Pediatrics Unit Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Science University of Yaoundé Yaoundé Cameroon

To determine the prevalence of congenital malformations and the proportion of cases diagnosed before birth;to specify this proportion according to the type of malformation and the sonographer qualification. Methods: It was a cross-sectional study carried out at the douala general hospital in the obstetric and neonatal units over a period of 42 months, from January 2008 to June 2012. The procedure consisted of;firstly an explanation of the study purpose with consent of parents obtained, thereafter, the parents were interviewed and data extracted from their files. The new born had a complete clinical exam. Morphological and biological assessment were done to ascertain diagnosis if needed. They were then followed up for 48 hours. Data were analysed using SPSS. Statistical analyses were mainly descriptive: mean, median, mode and frequency were calculated. Results: During this period, 6048 neonates were examined, 99 of whom had a malformation giving a prevalence of 1.64%. Musculoskeletal defects were the most common (36.4%), followed by digestive tract defects (22.2%). Ultrasounds were carried out mainly in the second term. Among the malformed babies, only 16.2% were diagnosed during the prenatal period. The obstetricians did better than radiologist in the prenatal diagnosis of congenital malformations. All the urinary tract malformations and 33.3% of the polymalformations were diagnosed by prenatal echography. Among the malformed babies, 33% died within the first 48 hours of life and poly-malformed babies were more concerned (66.7%). Conclusion: The prevalence of congenital birth defect was 1.64%. The rate of prenatal diagnosis remained low, meanwhile one third of the affected babies die after births. An early diagnosis would anticipate on medical care at birth and allow therapeutics abortions when indicated.

关键词： Birth Defects Prevalence Antenatal Diagnosis Outcome douala Cameroon

Evaluation of Bleeding Risk by Hemostatic Parameters in Hemodialysis at the douala general hospital: Comparison between Patients on Hemodialysis before 3 Months and after 12 Months

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Open Journal of Nephrology 2023年第1期13卷 31-38页

作者： Fouda Menye Epouse Ebana Hermine Danielle Elimby Lionel Dongmo Tsague Elvire Ali Nasser Ngo Bitoungui Valentina Josiane Halle Marie Patrice Ngouadjeu Dongho Eveline general hospital of douala Douala Cameroon Faculty of Medicine and Biomedical Sciences of Yaounde Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences of Dschang Dschang Cameroon Faculty of Medicine and Pharmaceutical Sciences of douala Douala Cameroon

Background: Bleeding disorders are common and may be a life-threating complication among patients with End Stage Kidney Disease (ESKD), especially for those in hemodialysis (HD). Bleeding risk can be evaluated by hemostatic parameter such as platelet count, prothrombine time (PT) or activated prothromplastin time (aPTT) and may be influenced by duration in HD. Objective: Evaluate bleeding risk in HD patients by analyzing some hemostatic parameters according to duration in dialysis. Patients and methods: We conducted a cross sectional study of 3 months (March to May 2022) in the HD center of the douala general hospital. All consenting adult patients with ESKD admitted in HD for less than 3 months or more than 12 months were included. Bleeding risk was evaluated by platelet count, PT, aPTT and fibrinogen. Chi-square test and logistic regression were used to compare data and evaluate association with hemostatic disorder. Results: A total of 80 (60% male) patients were included;30 patients were on HD for less than 3 months and 50 for more than 12 months. Median age was 45 [30 - 60] years in the first group and 43 [30 - 55] years in the second group. Increased bleeding risk was noted in 50% (n = 40) of patients and was similar in both groups. Thrombocytopenia was more common in patients on HD ≥ 12 months (20% (n = 6) vs 44% (n = 22), p = 0.02). Prolong aPTT was more common in HD patients ≥ 3 months (OR = 6.6 [1.88 - 23.5], p = 0.0013) and those with HD catheter (OR = 21.3 [4.6 - 45.7], p < 0.001). Fibrinogen and PT were comparable in both groups. HD catheter was associated with prolong PT (OR = 5.3 CI [1.5 - 8.9], p = 0.03). Conclusion: Increased bleeding risk is common in HD patients. Thrombocytopenia is common in HD patients ≥ 12 months, while prolong aPTT are mainly found in HD patients ≤ 3 months with catheter and may reflect heparin overdose.

关键词： Thrombocytopenia Prolongactivated Prothromplastin Time Hemodialysis Cameroon

Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the douala general hospital in Cameroon

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Open Journal of Blood Diseases 2023年第2期13卷 83-91页

作者： Eveline Ngouadjeu Dongho Brice Utrich Afana Clémence Olemba Jean Pierre Nda Mefo’o Cécile Ebongue Okalla Abdou Temfomo Jules Clement Nguedia Assob Henry Namme Luma Department of Internal Medicine Douala General Hospital Douala Cameroon Department of Biological Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Microbiology Virology and Immunology Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaounde Cameroon

Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the douala general hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Con

关键词： Haemolytic Anaemia Internal Medicine DGH

Hygienic and Dietary Measures in Cameroonian Hypertensive Patients Followed at the douala general hospital: Knowledge, Compliance and Effect on Blood Pressure Control

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World Journal of Cardiovascular Diseases 2023年第1期13卷 21-31页

作者： Félicité Kamdem Grace Eugénie Makota Ndongo Christelle Noche Domngang Hamadou Ba Jaff Fenkeu Kweban Glwadys Ngono Atéba Sidick Mouliom Henri Ngoté Lade Viché Caroline Kenmegne Marie Solange Ndom Ebongue Siddikatou Djibrilla Elysée Claude Bika Léle Samuel Kingue Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Institut Supérieur des Sciences de la Santé Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Intensive Care Unit Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of N’Gaoundéré N’Gaoundéré Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Physiology and Medicine of Physical Activities and Sports Unit University of Douala Douala Cameroon

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the douala general hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the douala general hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

关键词： Hypertension Hygienic and Dietary Measures Blood Pressure Control Knowledge Compliance

Spectrum of Meningitis in Adult at the douala general hospital

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World Journal of Neuroscience 2014年第2期4卷 144-151页

作者： Yacouba N. Mapoure Henry N. Luma Dieudonné Gnonlonfoun Paul M. Ossou-Guiet Xaverie Biloa Jacques N. Doumbe Hugo Bertrand N. Mbatchou Benjamin Clet N. Tchaleu Julius Y. Fonsah Albert S. Mouelle Alfred K. Njamnshi Department of Clinical Sciences Douala General Hospital Douala Cameroon Department of Clinical Sciences The University of Douala Douala Cameroon Department of Clinical Sciences Université des Montagnes Douala Cameroon Department of Neurology Brazzaville University Teaching Hospital Brazzaville Congo Department of Neurology National University Hospital Centre Cotonou Bénin Department of Neurology The University of Yaoundé I Yaoundé Cameroon Department of Neurology Yaoundé Central Hospital Yaoundé Cameroon

Objectives: Describe the clinical, aetiological and prognostic features of infectious meningitis in adults at the douala general hospital (DGH). Patients and Methods: We carried out a 5-year retrospective cross-sectional study at the DGH, on data from the registers of the bacteriology and biochemistry laboratories. Cases of meningitis were identified from the results of the cerebrospinal fluid (CSF) analysis, and the patient clinical file was obtained. Cases files of patients aged 15 years and above were included. For each patient, sociodemographic, clinical features and hospital mortality data were extracted. Results: During study period, 1877 CSF analyses were recorded and 135 were enrolled for data analysis. Up to 74 patients (55%) were male and the mean age was 40.04 ± 12.5 years. The time lapse between the onset of symptoms and consultation was 12.24 ± 11.16 days. The main clinical signs were meningeal syndrome (96.3%), neck stiffness (71.1%), reduced alertness (64.4%) and confusional states (55.6%). The main aetiology was bacterial (45.19%) withStreptococcus pneumoniae?(45.90%) and?Neisseria meningitis?(29.51%) leading. The other aetiologies were viral (21.48%), fungal with?Cryptococcus neoformans?(20%) and meningeal tuberculosis (13.33%). Fifty eight patients (42.9%) had a positive HIV serology. The mean duration of hospitalization was 9.05 ± 8.1 days, and the total in-hospital mortality was 25.18%. 117 patients (86.8%) had received antibiotherapy before diagnosis. Conclusion: The clinical features of meningitis in the DGH are as in classical description. However, the mortality is high and the major aetiologies appear to be associated with HIV infection at least in part. Prospective multi-centric studies are needed to provide more evidence for the development of staged management guidelines in our resource-limited settings.

关键词： Meningitis Signs Aetiologies Mortality Adults douala Cameroon