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Twin gestation: Is induction of labor possible in highly selected cases?

Open Journal of Obstetrics and Gynecology 2012年第3期2卷 213-219页

作者： R. E. Mbu J. Fouedjio Y. Fouelifack J. T. Ngo Batta F. N. Tumasang S. N. Ako R. N. Tonye M. B. Mbu R. J. I. Leke Biostatistics and Epidemiology Unit Ministry of Secondary Education Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Division Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Cameroon and the Maternity Unit Central Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Maternity Unit Central Hospital Yaounde Yaounde Cameroon

Induction of labor has been in practice for several decades but the decision to induce labor in multifetal gestations has not been accepted by many practitioners in contemporary obstetrics. The aim of this study was to compare maternal and fetal outcomes among women with uncomplicated twin gestations who were induced at term and those who were not. It was a cross-sectional analytic study that lasted ten years, (1st January 2000 to 31st December 2009 inclusive) at the maternity of the central hospital, yaounde, Cameroon. 158 women were enrolled, 79 were induced and 79 went into labor spontaneously. Maternal and fetal outcomes, duration of labor, the prevalence of caesarean section were compared in the two groups. The average age of the women in the groups was 26, 75 ± 3.65 years (range 15 - 41 years). For those who were induced, indication was premature rupture of membranes in 44 (56%) of cases. The characteristics of induced and none induced women were similar, except for the number of antenatal consultations (P ≤ 0.001). There was a significant difference in the duration of labor in the two groups (6 hrs versus 9, 75 hrs;P ≤ 0.001). The overall rate of vaginal delivery in the two groups was 87, 97% (n = 139), 88.87% in the group that was induced versus 86.07% in the group that labor was spontaneous (OR 1, 22;95% IC 0, 51-2, 92;p ≤ 0.90). With respect to primary outcomes, there were no statistically significant differences between the group that labor was induced and that which labor was spontaneous. The prevalence of caesarean delivery was similar in the two groups (10%, 12% vs 13%, 92%;OR 0%, 7%;95% IC 0, 27-1, 85;P ≤ 0.50). The main indications for caesarean section were acute fetal distress and failed induction. The first and fifth minute APGAR scores less than 7 in the first twins delivered in the two groups were similar. The 312 children delivered in both arms did not show any complications at birth. However, there were 3 neonatal deaths (1 vs 2). There were n

关键词： Induction Twins Rupture

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Laparoscopic Radical Cystectomy in a Low-Middle Income Country: A 5-Year Review of a Single Institution;Operative Data, Oncologic Results and Morbidity

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Open Journal of Urology 2023年第11期13卷 484-494页

作者： Axel Stéphane Nwaha Makon Landry Oriol Mbouche Landry Tchuenkam Laure Kamkui Dadje Marcella Derboise Biyouma Bertin Nginkeu Njinou Pierre Joseph Fouda Maurice Aurelien Sosso Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Urology Unit Department of Surgery Douala Laquintinie Hospital Douala Cameroon Department of Surgery Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaounde Cameroon Bali Medical and Surgical Center of Urology (BMSCU) Douala Cameroon yaounde central hospital Yaounde Cameroon

Introduction and Objective: Laparoscopic radical cystectomy (LRC) is an alternative to open approach with lower morbidity and better oncologic outcome. We aim to share our experience on laparoscopic radical cystectomy and to evaluate our morbidity and oncological outcome in our settings. Methodology: An observational study in the Douala Medico-Surgical Urology Centre on 5 patients who underwent laparoscopic cystectomy with or without lymph node dissection and external urine diversion between April 2014 to July 2016 was conducted. The overall survival rate was subsequently estimated. Results: Four men and one woman underwent laparoscopic radical cystectomy during the 5-year study period with a mean age of 54.5-year-old. Three patients were submitted to ileal conduits, one to neobladders, and one patient to uretero-cutaneostomies. The mean operative time was 300 ± 17 minutes and the mean length of hospital stay was 9 ± 3 days. Three patients had minor complications according to Clavien and Dindon Classification treated conservatively without need for further operation. Four patients had transitional cell carcinoma and one Squamous cell carcinoma types. Everyone had negative resection margin while only two had negative lymph node. The median survival years in our study was 2.5 years, the overall survival rates at 2 years were 60%, 40% at 3 years and 20 at 5years. 2 patients die after one year due to renal failure and intercurrent disease. Conclusion: Laparoscopic radical cystectomy carried lower morbidity and cancerological outcome compare to open surgery making it a good alternative for bladder oncologic surgery.

关键词： Radical Cystectomy Laparoscopy Oncology Findings Bladder Cancer

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Diagnostic Value of the Thoracic Ultrasonography Compared to Conventional Chest X-Rays in Pneumonia for Children between 0 to 15 Years: Case Study in Two hospitals in Yaoundé

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Open Journal of Radiology 2019年第1期9卷 10-19页

作者： Seme Engoumou Ambroise Merci Mbede Maggy Awana Armel Philippe Bilounga Ndengue Priscille Edith Onguene Julienne Zeh Odile Fernande Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Center for Research and Applied Endoscopic Surgery in Reproduction Health Yaounde Cameroon Yaoundé central hospital Yaounde Cameroon Yaoundé Jamot hospital Yaounde Cameroon Yaoundé Gyneco-Obstetrical and Pediatric hospital Yaounde Cameroon

Introduction: The diagnosis of pneumonia is usually made based on clinical manifestations and chest X-ray. The use of ultrasound in detecting pulmonary diseases in general, and especially consolidation syndrome has been demonstrated. The objective of this study was to determine the accuracy of thoracic ultrasound compared to chest X-ray in the diagnosis of infectious pneumonia in children. Methods: Children between 0 to 15 years were included in our study. The lung ultrasound results obtained were compared with those of the chest X-ray used as the reference. Our data were introduced into the EpiInfo 3.5.4 software and analyzed with the EpiInfo 3.5.4 and IBMSPSS Statistics version 20.0 softwares. Microsoft Office Excel 2016 was used to produce Charts. Continuous quantitative variables were presented. Cohen’s Kappa concordance test was applied with confidence interval of 95%. Results: 52 children were enrolled in the study. In imaging, the dominant sign was consolidation syndrome (75.0%) of cases by chest radiography, and in 78.8% of cases by lung ultrasound (p Conclusion: Our study demonstrated that lung echography is a non-ionizing and reliable tool in the diagnosis of childhood’s pneumonia.

关键词： Lung Ultrasound Chest X-Ray Pneumonia Children Yaoundé Cameroon

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Congenital Lipodystrophy: A Case Series Report from Cameroon

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Open Journal of Pediatrics 2020年第1期10卷 231-235页

作者： Suzanne Sap Ngo Um Jocelyn Tony Ritha Mbono Yannick Tekel Isabelle Mekone Mesmin Dehayem Koki Ndombo Department of Paediatrics University of Yaounde I Yaounde Cameroon Mother and Child Center of the Chantal Biya Foundation Yaounde Cameroon University of Douala Douala Cameroon yaounde central hospital Yaounde Cameroon

Congenital lipodystrophy is a group of rare syndrome characterized by the absence of subcutaneous tissue. Affecting less per million live birth, this condition associate metabolic disturbance including severe insulin resistance and progeroid appearance. Diagnosis may be fortuitous or related to complications as presented in the present case series. Lipodystrophy can be generalized or localized. Acquired lipodystrophy is associated with some drugs like antiretroviral. Thus, the condition is well described in African HIV patients but data on congenital forms from Sub Saharan Africa are sparse, justifying the present report. We present four cases, with peculiar appearance associated with increased blood triglycerides. Two on four of the patients presented diabetes mellitus. Genetic testing was not available, questioning the actual guidelines of diagnosis for our context.

关键词： Lipodystrophy Diabetes Children

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Reproductive Health Needs of Women Living with HIV/AIDS in yaounde, Cameroon

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World Journal of AIDS 2014年第1期4卷 8-14页

作者： Robinson E. Mbu William A. Takang Hortence J. Fouedjio Ekane Joan Flobert Y. Fouelifack Florence N. Tumasang Rebecca N. Tonye Robert J. I. Leke Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Maternity Unit Central Hospital Yaounde Cameroon Maternity Unit Central Hospital Yaounde Cameroon

The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled;the mean age was 29 ± 7.8 years;the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased

关键词： Reproductive Health Needs Family Planning Unmet Needs Cancer of the Cervix Sexually Transmitted Infections

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Predictive Factors for the Occurrence of Pharyngostoma after Laryngectomy and Total Pharyngo-Laryngectomy in yaounde and Douala

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第1期12卷 44-54页

作者： Andjock Nkouo Yves Christian Bola Siafa Antoine Meva’a Biouele Roger Christian Kambou Fohom Armelle Ngono Ateba Gladys Mindja Eko David Njock Richard Djomou Francois Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon Anesthesiology and Reanimation Service Douala General Hospital Douala Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon

Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Multiple risk factors are known. The data from our environment concerning this condition are few. Thus, in order to contribute to the study of this complication in our environment, we proposed to carry out this study, whose objective was to determine the predictive factors for the occurrence of pharyngo-cutaneous fistula or pharyngostoma after total laryngectomy and total pharyngo-laryngectomy in yaounde and Douala. Patients and Methods: This was a retrospective, cross-sectional, descriptive study conducted in the 5 Ear-Nose-Throat (ENT) department of hospital in the city of yaounde and Douala. The study took place between January 2009 and December 2020. All patients who underwent total laryngectomy or total pharyngo-laryngectomy with a follow-up of at least one month were included in the study. Incomplete records were excluded, as well as those of patients who died before one month of postoperative follow-up. Results: We selected 48 cases of total laryngectomies (TL) and total pharyngo-laryngectomies (TPL), and identified 37 cases of pharyngostoma. 45 men (93.8%) and 3 women (6.3%). The mean age was 56.4 years with extremes ranging from 37 to 86 years. Smoking and alcoholism were noted in 75% and 79.2% of our patients respectively. A tracheotomy before TL and TPL was found in 41.7%. 100% of the tumours found were T3 or T4. The surgery was in 34 cases (70.8%) TL and in 14 cases (29.2%) TPL. Pharyngostomas were observed in 37 cases among 48 patients operated on, i.e. a frequency of 77.1%. The average delay of appearance was 7 to 14 days. We had spontaneous healing with pressure dressing and nasogastric tube feeding in 35 patients (77.8%) and two patients benefited from pectoralis major flap treatment;the healing time was 21 to 30 days. We did not find any co

关键词： Pharyngostoma Predictive Factors yaounde and Douala

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Maternal and Fetal Outcomes Following Labour at Term in Singleton Pregnancies with Meconium-Stained Amniotic Fluid: A Prospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2018年第9期8卷 790-802页

作者： Julius Sama Dohbit Evelyne M. Mah Felix Essiben Edmond Mesumbe Nzene Esther U. N. Meka Pascal Foumane Joel Noutakdie Tochie Benjamin Momo Kadia Felix A. Elong Philip Njotang Nana Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Gynaeco-Obstetric and Pediatric hospital Yaounde Cameroon central hospital of yaounde Yaounde Cameroon Department of Surgery and Anesthesiology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Foumbot District hospital Foumbot Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé central hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The c

关键词： Meconium Stained Amniotic Fluid Labour Maternal and Neonatal Outcomes

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Extraspinal Incidental Findings at Lumbar Spine Magnetic Resonance Imaging in Two hospitals:Prevalence and Clinical Importance

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Open Journal of Radiology 2017年第4期7卷 241-248页

作者： Odile Fernande Zeh Emilienne Guegang Goujou Armel Philippe Awana Julienne Onguene Medza Joshua Tambe Claude Sandra Raissa Abomo Ngodo Maxwell Goudjou Sandjong Joseph Gonsu Fotsin Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon yaounde Gynaecology Obstetrics and Pediatrics hospital YaoundeCameroon Jordan Medical Center YaoundeCameroon yaounde General hospital YaoundeCameroon yaounde Jamot hospital YaoundeCameroon Jacques Monod hospital Le Havre MontivilliersFrance

Objective: To assess the importance of incidental extraspinal findings on Magnetic Resonance Imaging of the lumbar spine in two hospital facilities. Materials and Methods: It was a descriptive and retrospective study from November 2015 to March 2016. The records of patients who had done a Magnetic Resonance Imaging (MRI) scan of the lumbar spine were re-read in search of incidental findings. The incidental findings found were classified using Colonography Reporting and Data System(C-RADS) classification of extracolonic lesions to assess clinical significance. The prevalence of incidental findings was calculated for each facility, as well as the distribution according to age, the organs involved and the clinical importance. A non-detection rate was calculated by confronting the findings of the study with the original reports. Results: The prevalence of incidental findings was respectively 33% (19 out of 36) in Jordan Medical Center (JMC) in yaounde and 27.74% (106 out of 292) in Jacques Monod hospital. The extraspinal incidental findings were classified mainly as extracolonic 2 (E2): 58% in each facility. The percentage detection of incidental findings was 5% at JMS and 1.7% at Jacques Monod hospital. Conclusion: Extraspinal incidental findings are frequent in both hospitals. However, the rate of detection remains very low.

关键词： Incidental Findings Magnetic Resonance Imaging Lumbar Spine Extraspinal Lesions

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Epidemiology of Venous Thrombo-Embolic Disease in yaounde: A Cross-Sectional Study in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2019年第5期9卷 360-369页

作者： Sylvain Raoul Simeni Njonnou Chris Nadège Nganou-Ngnindjo Ba Hamadou Bonaventure Jemea Ahmadou Musa Jingi Jerome Boombhi Aimée Tiodoung Timnou Marie-Josiane Ntsama Essomba Lydienne Alida Tonye Aicha Mefire Yap Murielle Florence Helles Lema Liliane Mfeukeu-Kuate Sylvie Ndongo Amougou Samuel Kingue Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Ya-oundé Cameroon yaounde central hospital Yaoundé Cameroon Department of Surgery and Specialties FMSB University of Yaounde I Yaoundé Cameroon yaounde University Teaching hospital Yaoundé Cameroon yaounde General hospital Yaoundé Cameroon

Background: Venous thromboembolic disease (VTE) is one of the main causes of cardiovascular death and a public health problem worldwide. It is?one of the most complications in admitted patients, particularly inlow-income settings. The epidemiological data on VTE are still lacking. Methods: We carried out a cross-sectional study in three hospitals in Yaoundé. We retrospectively reviewed records of patients admitted for VTE from January 2013 to December 2017. We collected data on socio-demography, clinical presentation, venous Doppler/pulmonary CT scan, and outcome. Results: We included 93 patients (43 males) with VTE. Their mean age was 53.3 ± 16.6 years. There were 46 (49.5%) cases of Deep Vein Thrombosis (DVT), 36 (38.7%) cases of Pulmonary Embolism (PE), and 11 (11.8%) cases of PE associated with DVT. The main risk factors were obesity/overweight (58.1%), immobility (43%), HIV infection (22.6%), prior admission (22.6%), and long trip (19.4%). The most frequent clinical presentation for PE was dyspnea (100%), tachypnea (87.2%), and chest pain (70.2%). For DVT, limb pain (93%), calf stiffness (86%), limb volume > 3 cm (82.4%) were the most common presentation. There were 9 (9.7%) in-hospital deaths. Mean hospital stay was 20.7 ± 30.8 days. Conclusion:VTE is underdiagnosed in our setting. Obesity and immobility were the main risk factors. Dyspnea and tachypnea were the main clinical presentation for PE whereas limb pain and calf stiffness were the main symptoms for DVT. In-hospital mortality is still high.

关键词： Venous Thromboembolic Disease Epidemiology yaounde Sub-Saharan Africa

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Impact of Surgical Treatment of Patella Tendon Rupture Regarding Return to Sports in yaounde

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Open Journal of Orthopedics 2022年第5期12卷 225-235页

作者： Olivier K. Muluem Loic Fonkoue Ngo Yamben Marie-Ange Sylvain N. Vofo Mohamadou E. Guemse Gael Dongmo Koufagued Kaldadak Daniel Handy Jean Bahebeck Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon yaounde General hospital Yaounde Cameroon National Centre for the Rehabilitation of Patients with Disabilities Yaounde Cameroon yaounde Military hospital YaoundeCameroon

Introduction: Patella tendon rupture (PTR) is a cause of handicap in athletic patients. Surgery remains the actual therapeutic modality with a variety of techniques that permits a return to sport. Our objective was to evaluate the return to sporting activities after surgical repair of a PTR. Method: We conducted a retrospective cohort study over five years from January 2016 to April 2021. We included athletes from 18 to 65 years of operating for a PTR. We evaluated: the knee functional score, the level of satisfaction, Lysholm score, VISA-P questionnaire, and return to sports. Results: A total of twenty-one cases of PTR were identified. The median age was 36 years (18 - 63). After surgery, the median follow-up was 17 months (12 - 55). All patients were able to walk at 3 months. A total of 17 patients (85%) returned to sports. The median return to sports was 6 months (5 - 11). Patients who return to a similar sport with a similar initial level of sporting activity were 45% (9 patients). The median time to return to sports for patients at a similar level of sport was 7.5 months (6 - 13). Functional scores were satisfactory;with a VISA-P score of 90/100 (25 - 100) and a Lysholm score of 98/100 (40 - 100). Conclusion: Surgical repair of PTR in athletes offers good results regarding return to sports in terms of proportion and timing whatsoever the technique. The use of protection band wires is reserved for patients with relative satisfaction during suture repair.

关键词： Athletes Return to Sport Patella Tendon Surgical Treatment Protection Band Wire

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