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Clinical Presentations and Outcome of Cardiovascular Emergencies in yaounde: A Cross-Sectional Study

World Journal of Cardiovascular Diseases 2018年第2期8卷 133-142页

作者： Ba Hamadou Yaya Toure Kalissou Ahmadou Musa Jingi Sylvie Ndongo Amougou Sandrine Edie Dikosso Rodrigue Njouoguep Samuel Kingue Department of internal medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon internal medicine Service Cardiology Unit Yaounde Central Hospital Yaounde Cameroon yaounde Emergency Center Yaounde Cameroon

Background: Cardiovascular emergencies have become a public health problem with a high burden in low-income settings. This is due to the high rates of cardiovascular risk factors that are fast reaching epidemic?proportions. There is paucity of data on cardiovascular emergencies to guide repost strategies in our setting. Our aim was to determine the clinical presentation and outcome of cardiovascular emergencies at yaounde Emergency Center.?Methods: We carried out this cross-sectional study between June 2015 and May 2017. We included all patients with confirmed cardiovascular emergency. We consecutively collected data on socio-demography, symptoms on admission, past history, clinical findings, and final diagnosis at discharge or in the event of death. Results: Of the 8285 patients admitted for medical emergencies, 388 (4.7%) were cardiovascular emergencies. Their mean age was 59.5 ± 13.8 years, and 59% were males. The Medical Emergency Aid Service was the means of transporting 4% of patients. The median time of arrival at the hospital was 48 hours. Symptoms on admission were mainly weakness of a limb (43.8%), and altered consciousness (33.5%). The most common cardiovascular emergencies were ischemic stroke (30.9%), hypertensive emergency (21.4%), and hemorrhagic stroke (16.5%). The most common comorbidity was diabetes (21.9%). The death rate in the 24 - 72 hours was 14.4%. The causes of death were hypertensive emergency (35.7%), and hemorrhagic stroke (30.3%). Conclusion: Stroke and hypertensive emergency were the most frequent cardiovascular emergencies. The early mortality was high. Hemorrhagic stroke and hypertensive emergencies accounted for most cases of death.

关键词： Cardiovascular Emergencies Ischemic Stroke Hemorrhagic Stroke Cameroon

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Spontaneous bacterial peritonitis:A severe complication of liver cirrhosis

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World Journal of Gastroenterology 2009年第44期15卷 5505-5510页

作者： Jan Lata Oldich Stiburek Marcela Kopacova Department of internal medicine and Hepatogastroenterology University Hospital and Faculty of MedicineMasaryk University637 00 BrnoCzech Republic 2nd Department of medicine Charles University in PrahaFaculty of Medicine at Hradec KraloveUniversity Teaching Hospital500 05 Hradec KráloveCzech Republic

This report presents a survey of current knowledge concerning one of the relatively frequent and severe complications of liver cirrhosis and associated ascites-spontaneous bacterial peritonitis. Epidemiology,aetiology... 详细信息

关键词： Liver cirrhosis Portal hypertension Ascites Spontaneous bacterial peritonitis

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Acute Coronary Syndrome Occurring in a Sub-Saharan Patient Treated with a Reduced Dose of Sorafenib for an Unresectable Hepatocellular Carcinoma: Case Report

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Open Journal of Gastroenterology 2020年第3期10卷 45-51页

作者： Antonin Wilson Ndjitoyap Ndam Murielle Lema Helles Pierre Mathurin Kowo Mazou Temgoua Ngou Etienne Atenguena Blaise Mounpou Aicha Yap Tangie Ngek Larry Paul Talla Jerome Boombhi Alain Menanga Firmin Ankouane Andoulo Elie Claude Ndjitoyap Ndam Department of internal medicine and Specialities Faculty of Medicine and Biomedical SciencesUniversity of Yaounde IYaoundeCameroon Hepatogastroenterology and Oncology unit Yaounde General HospitalYaoundeCameroon

Sorafenib is a chemotherapy used as first line treatment in primary liver cancers. It is an oral antiangiogenic treatment which reduces the progression of the tumor. Some mild or severe side effects have been reported among which some uncommon cardiac events: myocardial infarction and cardiogenic stroke. Sorafenib treatment remains expensive and not frequently used in Sub-Saharan countries. Thus, few studies have described its side effects in this milieu. We report a case of acute coronary syndrome occurring in a 75-year-old female patient, without cardiovascular risks factors, after nine months of sorafenib chemotherapy at a reduced dose for an unresectable hepatocellular carcinoma in a Sub-Saharan Africa country. The management was conducted by cardiologists, in collaboration with gastroenterologists and oncologists. We decided to completely stop sorafenib chemotherapy. We observed a reduction of the pain 48 hours after her admission, and a regression of electrocardiographic signs after 8 days. In conclusion, the sorafenib treatment can be associated with cardiac events despite the dose reduction.

关键词： Acute Coronorary Syndrome Sorafenib Hepatocellular Carcinoma Hepatitis C Virus yaounde

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Serum uric acid level in newly diagnosed essential hypertension in a Nepalese population:A hospital based cross sectional study

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Asian Pacific Journal of Tropical Biomedicine 2014年第1期4卷 59-64页

作者： Bibek Poudel Binod Kumar Yadav Arun Kumar Bharat Jha Kanak Bahadur Raut Department of Biochemistry Manipal College of Medical Sciences(MCOMS)Manipal Teaching Hospital(MTH) Research Institute of Clinical medicine Chonbuk National University Medical School and Hospital Department of Biochemistry Institute of MedicineTribhuvan University Teaching Hospital(Institute of MedicineTUTH) Department of internal.medicine Institute of MedicineTribhuvan University Teaching Hospital(Institute of MedicineTUTH)

Objective:To develop the missing link between hyperuricemia and ***:The study was conducted in Department of Biochemistry in collaboration with Nephrology unit of internal medicine *** was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National *** 205newly diagnosed and untreated essential hypertensive cases and age-sex matched nonnotensive controls were enrolled in the *** potential confounding factors of hyperuricemia and hypertension in both cases and controls were *** acid levels in all participants were ***:Renal function between newly diagnosed hypertensive cases and nonnotensive healthy controls were *** mean serum uric acid observed in newly diagnosed hypertensive cases and in nonnotensive healthy controls were(290.05±87.03)μmol/L and(245.24±09.38)μmol/L respectively.A total of 59(28.8%)participants of cases and 28(13.7%)participants of controls had hyperuricemia(odds ratio 2.555(95%CI:1.549-4.213),P<0.00l).Conclusions:The mean serum uric acid leveb and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.

关键词： Newly diagnosed hypertension Serum uric acid Hyperuricemia Joint National Committee

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Primary intestinal lymphangiectasia in an adult patient:A case report and review of literature

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World Journal of Gastroenterology 2020年第48期26卷 7707-7718页

作者： Rudolf Huber Georg Semmler Alexander Mayr Felix Offner Christian Datz Department of internal medicine General Hospital OberndorfTeaching Hospital of the Paracelsus Medical University SalzburgOberndorf 5110Austria Department of Pathology General Hospital FeldkirchFeldkirch 6800Austria

BACKGROUND Primary intestinal lymphangiectasia(PIL),first described in 1961,is a rare disorder of unknown etiology resulting in protein-losing *** disease is characterized by dilatation and leakage of intestinal lymph vessels leading to hypoalbuminemia,hypogammaglobulinemia,and *** the severity and location of lymph vessels being affected can vary considerably,the range of associated symptoms is wide from mild lower-limb edema to generalized edema,abdominal and/or pleural effusion,and recurrent diarrhea,among *** usually developing in early childhood,we present the case of a 34-yearold woman with ***,we performed a literature review systematically assessing clinical presentation,and provide a practical approach to facilitate diagnosis and therapy of PIL in *** SUMMARY Our patient presented with unspecific symptoms of abdominal discomfort,fatigue,nausea,and recurrent edema of the lower ***,a striking collinearity of clinical symptoms with female hormone status was ***,polyglobulia,hypoalbuminemia,hypogammaglobulinemia,and transient lymphocytopenia were *** to suspicion of a bone marrow disease,an extensive diagnostic investigation was carried out excluding secondary causes of polyglobulinemia and *** diagnosis of primary intestinal lymphangiectasia was established after 22 wk by histological analysis of biopsy samples obtained via ***,the patient was put on a high-protein and low-fat diet with medium-chain triglycerides supplementation leading to significant improvement of clinical symptoms until 2 years of *** PIL can be the reason for cryptogenic hypoalbuminemia,hypogammaglobulinemia,and lymphopenia in *** to difficulty in correct diagnosis,treatment initiation is often delayed despite being effective and *** leads to a significant disease burden in affected *** is increasingly been

关键词： Primary intestinal lymphangiectasia Waldmann´s disease Protein losing enteropathy Hypoproteinemia Case report

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Utility, Appropriateness of Request and Report of Computed Tomography Scan for the Diagnosis of Paranasal Sinuses Pathologies in a Sub-Saharan Africa Urban Setting

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Open Journal of Radiology 2021年第4期11卷 175-186页

作者： Yann Chris Mannel Eng Armel Philippe Awana Ambroise Merci Seme Engoumou François Djomou Odile Fernande Zeh Faculty of medicine and Biomedical Sciences The University of Yaounde I Yaounde Cameroon Jamot hospital Yaounde Cameroon Ear Nose and Throat Unit Yaoundé University Teaching Hospital Yaounde Cameroun Yaoundé Gyneco-Obstetrical and Pediatric hospital Yaounde Cameroon

Background: Computed tomography (CT) Scan is the imaging of choice for the diagnosis of sino nasal (SN) pathologies in sub-Saharan African setting. However, it is often requested by non experienced practitioners. We aimed to describe the utility and the appropriateness of CT Scan request forms and results in the diagnosis of SN pathologies. Method: We conducted a retrospective cross-sectional study in four health facilities in Yaoundé, Cameroun, from October 2018 to September 2019. All patients to whom SN CT Scan was performed were called for an appointment. After informed consent, data on the appropriateness and conformity of the request form were collected and compared to the guidelines of the French society of radiology. CT Scan results were also collected and the quality of the report was evaluated. Results: A total of 206 SN CT Scan request forms and reports were included, with a mean patient age of 37.7 ± 16.1 years. The request form was conformed to guidelines in 8.3% of cases and was found appropriate in 62.6% of cases. No CT Scan report had all the items required, and 159 (77.2%) reports were useful. The most common diagnosis in patients with abnormal results was chronic sinusitis (49.5%) and SN polyp or polyposis (19.4%). Conclusion: Most of SN CT Scan requested were appropriate and useful. However, the conformity of request forms and reports to the guidelines is low. Suggesting the need for capacity building for the diagnosis of SN pathologies especially for non specialists like general practitioners and nurses.

关键词： Appropriateness Conformity CT Scan Request Form Report Sino Nasal Pathologies

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Overlap of concurrent extrahepatic autoimmune diseases is associated with milder disease severity of newly diagnosed autoimmune hepatitis

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 21-27页

作者： Tobias Mühling Helmut Rohrbach Wolfgang Schepp Felix Gundling Department of Gastroenterology Internal Medicine ⅡUniversity of WürzburgWürzburgGermany Department of Pathology Academic Teaching Hospital BogenhausenTechnical University of MunichMunich 81925Germany Department of Gastroenterology Hepatology and Gastrointestinal OncologyAcademic Teaching Hospital BogenhausenTechnical University of MunichMunich 81925Germany Department of internal medicine Division of GastroenterologyGastrointestinal Oncology and DiabetologyKemperhof KoblenzKoblenzGermany

Background:Concurrent extrahepatic autoimmune disorders(CEHAID)are frequently observed in autoimmune hepatitis(AIH).It is not clear whether there is any prognostic significance of CEHAID on *** aim of this study was to examine the prognostic impact of CEHAID and the correlation with the disease severity of ***:This study included 65 hospitalized subjects who fulfilled the accepted criteria for AIH during an 8-year period(2009–2016).All records were manually screened for presence of associated autoimmune *** severity of AIH was assessed by liver laboratory tests including the ratio of aspartate aminotransferase to alanine aminotransferase(AST/ALT)and liver ***:Among the enrolled patients,52(80%)were female(median age 61 years,IQR 45–75).Fifty-six(86.2%)were classified as type-1 *** 26(40%)patients at least one additional extrahepatic autoimmune disease was ***-four subjects were referred to our hospital because of acute presentation of AIH(supposed by an acute elevation of hepatic enzymes)for subsequent liver biopsy resulting in initial diagnosis of *** group was stratified into 3 subgroups:(A)AIH alone(n=14);(B)overlap with primary biliary cirrhosis(PBC)/primary sclerosing cholangitis(PSC)(n=11);and(C)with CEHAID(n=9).AST/ALT ratio was the lowest in subgroup C(median 0.64,IQR 0.51–0.94;P=0.023),compared to subgroup A(median 0.91,IQR 0.66–1.10)and subgroup B(median 1.10,IQR 0.89–1.36).Patients with AIH alone showed a trend to the highest grade of fibrosis(mean 2.3;95%CI:1.5–3.0)with no statistical significance compared to subjects with CEHAID(lowest grade of fibrosis;mean 1.5;95%CI:0.2–2.8;P=0.380)whereas the ongoing inflammation was ***:AST/ALT ratio and extent of fibrosis were lower in subjects with AIH and CEHAID,compared to subjects with only ***,the occurrence of CEHAID might be a predictor for lower disease severity of newly diagnosed acute onset AIH,possibly caused by an e

关键词： Autoimmune hepatitis Concurrent extrahepatic autoimmune disease Serum aminotransferase activities

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Histological Types of Gastric Cancer and <i>Helicobacter pylori</i>Infection in Yaoundé

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Journal of Cancer Therapy 2015年第8期6卷 701-708页

作者： Firmin Ankouane Mathurin Kowo Bernadette Ngo Nonga Fidèle Vouffo Jude-Marcel Nzoumé Oudou Njoya Elie Claude Ndjitoyap Ndam Department of internal medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Histopathology Laboratory University Hospital Teaching of Yaounde Yaounde Cameroon

Introduction: The diffuse type of gastric adenocarcinoma has been found to be more prevalent in low risk countries like Cameroon. The objective of this study was to determine the most frequent histological type of gastric cancer found in Yaoundé and its association to the Helicobacter pylori infection. Materials and Methods: The registries of histopathology laboratories of 4 reference hospitals in Yaoundé, Cameroon have been reviewed for registered primitive gastric malignancies from July 2009 to May 2014. Paraffin blocks mounted on slides and stained with Hematoxylyn and Eosin of gastric cancer cases were re-stained Giemsa to search for Helicobacter pylori and they were classified using the criteria of Lauren in intestinal type or diffuse type. Results: Forty-two cases were reviewed: 25 (59.5%) of them were intestinal type of gastric adenocarcinoma, 11 (26.2%) were diffuse type, 4 (9.5%) were malignant gastric lymphoma, 1 (2.4%) was a stromal tumor, and 1 (2.4%) was a colloid carcinoma. The most common site of location was the proximal gastric portion (52.2%). The overall prevalence of Helicobacter pylori infection was 88.1%, most common with the intestinal type (100%) and malignant lymphoma (100%) than with the diffuse type (72.2%) (p = 0.007). Conclusion: The most common type of gastric adenocarcinoma in Cameroon is the intestinal type and Helicobacter pylori infection is more common in the intestinal type and malignant gastric lymphoma than in the diffuse type. The Helicobacter pylori eradication campaigns are needed.

关键词： Helicobacter pylori Stomach Neoplasms Adenocarcinoma Lymphoma Non-Hodgkin Cameroon

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Esophageal squamous cell cancer in a highly endemic region

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World Journal of Gastroenterology 2016年第9期22卷 2811-2817页

作者： Akwi W Asombang Violet Kayamba Mpala M Lisulo Kathryn Trinkaus Victor Mudenda Edford Sinkala Stayner Mwanamakondo Themba Banda Rose Soko Paul Kelly Division of Gastroenterology and Hepatology University of Missouri School of Medicine Department of internal medicine University of Zambia School of Medicine University Teaching Hospital Tropical Gastroenterology and Nutrition Group University of Zambia School of Medicine University Teaching Hospital Washington university School of medicine Biostatistics Shared Resource Siteman Cancer Center Department of Pathology University of Zambia School of Medicine Blizard Institute Barts and The London School of Medicine Queen Mary University of London

AIM: To identify risk factors associated with esophageal cancer in Zambia and association between dietary intake and urinary 8-iso prostaglandin F2α(8-iso PGF2α).METHODS: We conducted a prospective, case control study at the university teaching hospital. Subjects included both individuals admitted to the hospital and those presenting for an outpatient upper endoscopy. Esophageal cancer cases were compared to age and sex-matched controls. Cases were defined as patients with biopsy proven esophageal cancer; controls were defined as subjects without endoscopic evidence ofesophageal cancer. Clinical and dietary data were collected using a standard questionnaire, developed a priori. Blood was collected for human immunodeficiency virus(HIV) serology. Urine was collected, and 8-iso PGF2α was measured primarily by enzyme-linked immunosorbent assay and expressed as a ratio to ***: Forty five controls(mean age 54.2 ± 15.3, 31 male) and 27 cases(mean age 54.6 ± 16.4, 17 males) were studied. Body mass index was lower in cases(median 16.8) than controls(median 23.2), P = 0.01. Histopathologically, 25/27(93%) were squamous cell carcinoma and 2/27(7%) adenocarcinoma. More cases smoked cigarettes(OR = 11.24, 95%CI: 1.37-92.4, P = 0.02) but alcohol consumption and HIV seropositivity did not differ significantly(P = 0.14 for both). Fruit, vegetables and fish consumption did not differ significantly between groups(P = 0.11, 0.12, and 0.10, respectively). Mean isoprostane level was significantly higher in cases(0.03 ng/mg creatinine) than controls(0.01 ng/mg creatinine)(OR = 2.35, 95%CI: 1.19-4.65, P = 0.014).CONCLUSION: Smoking and isoprostane levels were significantly associated with esophageal cancer in Zambians, but diet, HIV status, and alcohol consumption were not.

关键词： Gastrointestinal cancer Non-communicable diseases Zambia

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Relevance of Chest CT Scan Requests in Two university teaching hospitals in a Developing Country

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Open Journal of Radiology 2018年第2期8卷 84-90页

作者： Armel Philippe Awana Ambroise Merci Seme Engoumou Julienne Onguene Medza Patrice Esame Ndive Odile Fernande Zeh Pierre Ongolo Zogo Samuel Nko’o Amvene yaounde Jamot hospital Yaounde Cameroon Faculty of medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Vitro Fertilisation yaounde Gynaecological Endoscopic Surgery and Human Reproductive teaching hospital Yaounde Came-roon yaounde Gynaecology Obstetrics and Pediatrics hospital Yaounde Cameroon yaounde Central hospital Yaounde Cameroon yaounde university teaching hospital Centre Yaounde Cameroon

Chest investigation is common in hospital practice. Chest X-ray is readily available and usually the first chest investigation. Thoracic CT scan constitutes an alternative and complimentary chest investigation. It is currently the most efficient investigation for the chest and its contents. Objectives: To evaluate the relevance of chest CT Scan requests in two university teaching hospitals in Cameroon. Material and Methods: We conducted a cross-sectional, retrospective and descriptive study at the Radiology and imaging units of the yaounde Central hospital and the yaounde university teaching hospital Centre. Included in our study were files of patients who had a chest CT scan investigation during three years. Results: We had a study population of 323 subjects. The age interval was 23 months to 91 years old. Pulmonologist were the most prescribers with 27.2%. We had 80% conformity of indications with French Society of Radiology (FSR) standards. 50 over of 323 indications were not recommended by the FSR. Conclusion: There is a conformity rate of 80% between indications and the FSR recommendations.

关键词： CT Scan Chest Relevance Request Prescribers

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