Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, ...Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, justifying the present report. Case Report: We reported the cases of 3 female patients, diagnosed with hypothyroidism, presenting in addition pulmonary stenosis. The diagnosis was late in all the patients and we noticed clinical improvement under levothyroxine. Conclusion: Association congenital hypothyroidism and cardiac defect is not rare. Our patients are female with no history of consanguinity, presenting congenital hypothyroidism with a gland in situ associated with pulmonary stenosis. Systematic screening of other births defects is thus recommended in affected patients.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Rheumatic heart disease (RHD) is the commonest cause of</span><span style="font-family:Verdana;"> valvu...<strong>Background:</strong><span style="font-family:Verdana;"> Rheumatic heart disease (RHD) is the commonest cause of</span><span style="font-family:Verdana;"> valvular heart disease in low and middle-income countries (LMICs). The low cardiologist to patient ratio leaves a big challenge of RHD prevention and management to general practitioners in Cameroon. This makes it important to assess the aptitude of senior medical students who are doctors-to-be on RHD. This could thus give a base on which to increase awareness and decrease the burden of the disease. Therefore, we sort to evaluate the knowledge, attitudes, and practices (KAP) of senior medical students on rheumatic heart disease.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">General objective: </span></b><span style="font-family:Verdana;">To determine the level of knowledge, attitudes on rheumatic heart disease, and assess practices towards RHD and its prevention.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A cross-sectional study was conducted in four medical schools in Cameroon for a period of 3 months </span><span style="font-family:Verdana;">(from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">,</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">2019)</span><span style="font-family:Verdana;">. The senior medical students were recruited using a structured self-administered questionnaire and electronic forms. Data were entered into an excel spreadsheet and analysed with IBM SPSS version 25.0 for windows. The knowledge level was divided into tertiles (poor, moderate and good) while the attitudes and practices were divided into poor or good. Association to KAP was evaluated and Statistical significance was set at P</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;"><</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In total, 509 senior medical students (6</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> year) were recruited. The mean age was 24.6 (SD</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">1.7) with 53.2% of students in the 19 to 24 years-old range. There were more females (51.7%) and level 6 students (50.1%). </span><span style="font-family:;" "=""><span style="font-family:Verdana;">Most of the students had moderate knowledge (58.2%), with good attitudes and practices on rheumatic heart disease and its prevention. One-quarter of the students had good knowledge, attitudes, and practices on rheumatic heart disease. Lecture on RHD, history of sore throat and study in faculty of health science (FHS) was associated with good knowledge, attitudes, and practices on RHD. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Despite having most of the senior medical students (6</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> years) in Cameroon with moderate to good knowledge of RHD, only a third has an above-average knowledge. There is a modest knowledge of RHD that could be used as an important foundation upon which to build RHD educational programs to expand awareness and understanding. Every 1 in 4 senior medical students have good knowledge, attitude and practice on RHD.</span></span>展开更多
Introduction: The Child health booklet has been shown to be an essential tool for monitoring the implementation of interventions with a high impact on reducing infant and child mortality. Objective: To describe the op...Introduction: The Child health booklet has been shown to be an essential tool for monitoring the implementation of interventions with a high impact on reducing infant and child mortality. Objective: To describe the opinion of child health providers about child health records. Methodology: Cross-sectional survey of health professionals on content, ease of use and recommendations for a health record of the ideal child. Results: About 3/4 (75%) of participants considered medical follow-up useful and 91.5% wanted it to be conducted at all levels of health care. According to 93% of them, all health care providers should be involved. However, almost two-thirds (65.5%) had never been trained to use the child’s health record. About half (54.2%) of them had already seen the national manual and only 43.7% had ever filled it out, 82.2% of whom found it very difficult. With regards to the assessment of the content, 44.4% to 57.7% of respondents were dissatisfied with 12 of the 16 subheadings of the handbook. As for an ideal child health record, the majority recommended that it should contain indicators related to: childbirth, growth, monitoring of preventive activities and advice to parents. Conclusion: Child health booklets available in health facilities in Cameroon are not optimally used to reduce infant and child morbidity and mortality. It is important to review the content of the child’s health booklets in order to adapt it to the Cameroonian context.展开更多
AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-s...AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.展开更多
AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National...AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.RESULTS Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.展开更多
Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of t...Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of the disease. The purpose of the study was to describe and compare the growth of children living with HIV with those not infected and to identify the associated factors. Method: This was an analytical case control study conducted in a pediatric hospital, Yaoundé from January 25th to June 20th 2019. Our study population consisted of 164 children with an age range from 06 weeks to 19 years old of which we had 41 HIV-infected cases and 123 uninfected controls matched by sex and age plus or minus 02 months. Anthropometric parameters were measured according to the standards described by the WHO. The data was entered and analyzed using Epi info 3.5.4, WHO Anthro and WHO Anthropoplus softwares. The chi-square and the Fisher’s exact tests were used to compare qualitative variables, with a significance threshold set at P less than 5%. Results: Of the 41 cases, 15 (36.6%) had at least one anthropometric index (weight for age, height for age, weight for height) -2 Z score versus 05 for controls (4.1%). 36.6% of cases had growth retardation (Height for age -2 Z score) compared to 4.1% in controls with a significant difference (p = 0.000). In 18.2% of cases, underweight was found (Weight for age -2 Z score) with a significant difference compared to controls (p = 0.000). Wasting was present in 10% of infected children (P = 0.240). We found 7.3% obesity/overweight in cases and 25.2% in controls (P = 0.003). We did not find any associated factor with growth disorders in our study. Conclusion: Infected children are smaller in weight and size. After multivariate analysis, there remained a significant difference between cases and controls regarding stunting, obesity and overweight. No factors studied were associated with the growth disorders detected, which suggests that growth disorders in children and adolescents living with HIV are due to the disease itself. Hence the need for health workers is to strengthen the prevention of mother and child transmission and the monitoring of the growth of HIV-infected children in order to improve the long-term prognosis.展开更多
文摘Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, justifying the present report. Case Report: We reported the cases of 3 female patients, diagnosed with hypothyroidism, presenting in addition pulmonary stenosis. The diagnosis was late in all the patients and we noticed clinical improvement under levothyroxine. Conclusion: Association congenital hypothyroidism and cardiac defect is not rare. Our patients are female with no history of consanguinity, presenting congenital hypothyroidism with a gland in situ associated with pulmonary stenosis. Systematic screening of other births defects is thus recommended in affected patients.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Rheumatic heart disease (RHD) is the commonest cause of</span><span style="font-family:Verdana;"> valvular heart disease in low and middle-income countries (LMICs). The low cardiologist to patient ratio leaves a big challenge of RHD prevention and management to general practitioners in Cameroon. This makes it important to assess the aptitude of senior medical students who are doctors-to-be on RHD. This could thus give a base on which to increase awareness and decrease the burden of the disease. Therefore, we sort to evaluate the knowledge, attitudes, and practices (KAP) of senior medical students on rheumatic heart disease.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">General objective: </span></b><span style="font-family:Verdana;">To determine the level of knowledge, attitudes on rheumatic heart disease, and assess practices towards RHD and its prevention.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methodology: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A cross-sectional study was conducted in four medical schools in Cameroon for a period of 3 months </span><span style="font-family:Verdana;">(from January 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">,</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">2019)</span><span style="font-family:Verdana;">. The senior medical students were recruited using a structured self-administered questionnaire and electronic forms. Data were entered into an excel spreadsheet and analysed with IBM SPSS version 25.0 for windows. The knowledge level was divided into tertiles (poor, moderate and good) while the attitudes and practices were divided into poor or good. Association to KAP was evaluated and Statistical significance was set at P</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;"><</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In total, 509 senior medical students (6</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> year) were recruited. The mean age was 24.6 (SD</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">1.7) with 53.2% of students in the 19 to 24 years-old range. There were more females (51.7%) and level 6 students (50.1%). </span><span style="font-family:;" "=""><span style="font-family:Verdana;">Most of the students had moderate knowledge (58.2%), with good attitudes and practices on rheumatic heart disease and its prevention. One-quarter of the students had good knowledge, attitudes, and practices on rheumatic heart disease. Lecture on RHD, history of sore throat and study in faculty of health science (FHS) was associated with good knowledge, attitudes, and practices on RHD. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Despite having most of the senior medical students (6</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 7</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> years) in Cameroon with moderate to good knowledge of RHD, only a third has an above-average knowledge. There is a modest knowledge of RHD that could be used as an important foundation upon which to build RHD educational programs to expand awareness and understanding. Every 1 in 4 senior medical students have good knowledge, attitude and practice on RHD.</span></span>
文摘Introduction: The Child health booklet has been shown to be an essential tool for monitoring the implementation of interventions with a high impact on reducing infant and child mortality. Objective: To describe the opinion of child health providers about child health records. Methodology: Cross-sectional survey of health professionals on content, ease of use and recommendations for a health record of the ideal child. Results: About 3/4 (75%) of participants considered medical follow-up useful and 91.5% wanted it to be conducted at all levels of health care. According to 93% of them, all health care providers should be involved. However, almost two-thirds (65.5%) had never been trained to use the child’s health record. About half (54.2%) of them had already seen the national manual and only 43.7% had ever filled it out, 82.2% of whom found it very difficult. With regards to the assessment of the content, 44.4% to 57.7% of respondents were dissatisfied with 12 of the 16 subheadings of the handbook. As for an ideal child health record, the majority recommended that it should contain indicators related to: childbirth, growth, monitoring of preventive activities and advice to parents. Conclusion: Child health booklets available in health facilities in Cameroon are not optimally used to reduce infant and child morbidity and mortality. It is important to review the content of the child’s health booklets in order to adapt it to the Cameroonian context.
文摘AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.
文摘AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.RESULTS Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.
文摘Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of the disease. The purpose of the study was to describe and compare the growth of children living with HIV with those not infected and to identify the associated factors. Method: This was an analytical case control study conducted in a pediatric hospital, Yaoundé from January 25th to June 20th 2019. Our study population consisted of 164 children with an age range from 06 weeks to 19 years old of which we had 41 HIV-infected cases and 123 uninfected controls matched by sex and age plus or minus 02 months. Anthropometric parameters were measured according to the standards described by the WHO. The data was entered and analyzed using Epi info 3.5.4, WHO Anthro and WHO Anthropoplus softwares. The chi-square and the Fisher’s exact tests were used to compare qualitative variables, with a significance threshold set at P less than 5%. Results: Of the 41 cases, 15 (36.6%) had at least one anthropometric index (weight for age, height for age, weight for height) -2 Z score versus 05 for controls (4.1%). 36.6% of cases had growth retardation (Height for age -2 Z score) compared to 4.1% in controls with a significant difference (p = 0.000). In 18.2% of cases, underweight was found (Weight for age -2 Z score) with a significant difference compared to controls (p = 0.000). Wasting was present in 10% of infected children (P = 0.240). We found 7.3% obesity/overweight in cases and 25.2% in controls (P = 0.003). We did not find any associated factor with growth disorders in our study. Conclusion: Infected children are smaller in weight and size. After multivariate analysis, there remained a significant difference between cases and controls regarding stunting, obesity and overweight. No factors studied were associated with the growth disorders detected, which suggests that growth disorders in children and adolescents living with HIV are due to the disease itself. Hence the need for health workers is to strengthen the prevention of mother and child transmission and the monitoring of the growth of HIV-infected children in order to improve the long-term prognosis.
