Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the w...Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.展开更多
Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women ...Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.展开更多
Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the manage...Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the management of breast cancer by reducing its overall mortality and recurrences. Methods: We conducted a retrospective and descriptive study by using the records of patients treated in the radiotherapy department of the Douala General Hospital from January 2015 to December 2019. Data concerning radiation-induced toxicities were collected using a pre-established and pre-tested survey and transferred to the CTCAE Version 4.0 software. Data analysis was performed using SPSS version 20.0. Results: A total of 206 records were selected. The average age was 46.7 ± 8.2 years. The most represented histological type was invasive ductal carcinoma (n = 187, 90.7%). Multimodality treatment was used in every patient in our series with chemotherapy, surgery, and adjuvant radiation therapy (n = 88, 42.7%) been the most represented. More than half of the participants (n = 108, 52.4%) received a total dose >50 grays, only 89 (43.2%) received the classical fractionation of 2 grays/cession, and the average duration of radiation therapy was 36.8 ± 15.4 days. We encountered 155 (75.2%) side effects. There were more acute toxicities than late toxicities, at 115 (74.1%) versus 40 (25.8%). The main acute lesions were radiodermatitis (68.6%), breast pain (16.5%), radiation pneumonitis (12.2%), and acute pericarditis (2.6%). As late lesions, we identified radiodermatitis (52.5%), radiation pneumonitis (32.5%), and lymphoedema (15%). A total dose >50 grays [p 0.001, OR: 2.7 (1.58 - 4.9)], and conservative surgery [p = 0.04, OR: 2.3 (1.3 - 4.1)], seemed to increase the occurrence of early side effects on bivariate analysis. However, after multivariate logistic regression, only a total dose >50 grays [p = 0.005, OR: 2.1 (1.1 - 6.7)] remained a predictive factor associated to early side effects. We found no factors related to late side effect occurrences. Conclusion: The frequency of side effects of radiation therapy for breast cancer at the Douala General Hospital remains relatively high. Both early and late lesions remained present with early toxicities been the most common. Meticulous strategies along with an enhancement of both human and materials resources are paramount in order to reduce their frequency and morbidity.展开更多
Background: The use of assisted reproductive technique (ART) is becoming more common in infertility. During ART most patients undergo ovarian stimulation. In this study we study the correlation between ovarian reserve...Background: The use of assisted reproductive technique (ART) is becoming more common in infertility. During ART most patients undergo ovarian stimulation. In this study we study the correlation between ovarian reserve markers: Anti-Mullerian hormone (AMH) and antral follicle count (AFC), and the response to ovarian stimulation at in vitro fertilization (IVF) centres in Douala Cameroon. Methods: This was a hospital based cross-sectional sectional analytic study carried out over a period of 3 years, 4 months at Clinique de l’Aéroport, Clinique Odyssée and Clinique Urogyn. Inclusion criteria were: Female partners of infertile couples undergoing ovarian stimulation for an in vitro fertilization cycle, patients who had both ovaries and had done either AMH, AFC or both before ovarian stimulation. Patients were divided into three groups based on the number of oocytes retrieved: low ovarian response for ≤3 oocytes, normal ovarian response for 4 - 15 oocytes and high ovarian response for >15 oocytes. Data obtained was analyzed by SPSS version 25.0. Results: The ages of participants ranged from 20 - 4 7 years, with a mean age of 34.11 ± 5.11 years. Most of them had secondary infertility (57.9%). The GnRH antagonist protocol was mainly used, and ovulation was triggered using HCG predominantly. On Multivariate analysis, age and history of PCOS were significantly associated with ovarian response in the low and high ovarian response groups, respectively. Conclusion: AMH has a better predictive value than AFC, however, it is less sensitive but more specific than AFC.展开更多
Introduction: Psychological distress can affect every worker’s mental health or working ability, and specifically the healthcare workers. It is essential to prevent and treat it in order to anticipate predictable con...Introduction: Psychological distress can affect every worker’s mental health or working ability, and specifically the healthcare workers. It is essential to prevent and treat it in order to anticipate predictable consequences. The aim of this study was to investigate the epidemiological characteristics of psychological distress among the healthcare workers in the city of Douala. Material and Methods: This cross-sectional study was carried out during the 1st semester of 2023 in two reference hospitals of the city of Douala. All volunteer staff from the targeted hospitals were involved. We collected data using a mixed questionnaire that included the working conditions, as of the socioprofessional and psychological characteristics of the healthcare workers. We measured the level of psychological distress using the Kessler scale. Analysis was performed using the Chi-2 test and multivariate analysis. Threshold value was & = 5%, p Results: The participation rate was 86.3%. Women (81.7%) and nurses (77.6%) predominated in the sample. The mean age was 35.38 ± 8.9 years, and individuals in their thirties accounted for 46.79% of the sample. The prevalence of psychological distress was 19.5%. The psychological distress was categorized as mild (48.72%), moderate (18.46%) or severe (32.82%). Risk factors for psychological distress included being of the catholic faith (OR = 3.6, p = 0.04), poor sleep quality (OR = 3.9, p = 0.001) and long working hours (OR = 2.2, p = 0.002). Overtime was the only protective factor identified (OR = 0.6, p = 0.04). Conclusion: Nearly 1 out of 5 healthcare workers suffered from psychological distress exacerbated by poor working and living conditions. There is an urgent need to improve their working conditions to prevent the development of more severe consequences.展开更多
Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing t...Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.展开更多
Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in dev...Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.展开更多
Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, expla...Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.展开更多
Yogurt is a traditional dairy product well known in all the regions of the world. In Cameroon, the most popularly known type is “kossam” also called curdled milk. Kossam is a set of milk based beverage from northern...Yogurt is a traditional dairy product well known in all the regions of the world. In Cameroon, the most popularly known type is “kossam” also called curdled milk. Kossam is a set of milk based beverage from northern Cameroon presenting great symbolic, economic and social values for local population [1]. 150 Kossam samples were collected from neighborhoods of PK8, Bonamoussadi, Nyalla, cite des palmier, Deido and Bedi community and later on reconstituted into 50 different samples of 350 mL, each containing 1/3 of 3 individual samples. They were analyzed for their physiochemical properties such as: PH, titratable acidity, density, brix and dry matter using most at times the standard Association of Official Analytical Chemists (AOAC) methods with slight modifications and results compared to a licensed brand sold in the Cameroonian market. The results of the study showed that, the physico-chemical properties of the locally made yogurts were different within the different samples. Analysis of variance revealed a significant difference in the levels of the parameters analyzed in the different yogurt samples (p −1 Kg/L), Brix (8˚ - 24˚B), Dornic (23˚ - 160˚D). others contents per 100 g fresh matter are as follows: dry matter (average mean of 16.54%). Hence, the significant variations in the physico-chemical properties of kossam are a call for concern since as it impacts on the health of the population consuming this product.展开更多
In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intraute...In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.展开更多
Background: Among medical technologies that use ionizing radiation, CT is currently the radio diagnostic technic that can deliver the highest radiation to the Patient compared with other conventional procedures. In de...Background: Among medical technologies that use ionizing radiation, CT is currently the radio diagnostic technic that can deliver the highest radiation to the Patient compared with other conventional procedures. In developing countries, the uses and risks of CT have not been well characterized. Objective: To estimate the lifetime attributable risk (LAR) incidence and mortality for cancer for each procedure for adult’s patients who had Computed Tomography examinations in 10 imaging centers in the city of Douala-Cameroon so as to provide a reference data. Materials and Methods: We conducted a cross-sectional study describing radiation dose associated with the 8 most common types of diagnostic CT studies performed on 1287 consecutive adult patients at 10 Douala radiology department. We estimated lifetime attributable risks of cancer by study type from these measured doses. Estimation of LAR for cancer incidence and mortality was based on the effective dose, patient’s sex and age at exposure using the BIER VII preferred models. Results: Mean effective dose from CT scans examinations varied from: 0.30 and 8.81 mSv. The highest doses were observed for lumbar spine CT (8.81 mSv), followed by abdomen-pelvis procedure (6.46 mSv), chest-abdomen-pelvic CT (6.61 mSv), chest CT (3.90 mSv), cervical Spine CT (3.05 mSv), head CT (1.7 mSv) and lower for sinus CT (0.30 mSv). The LAR values of all cancer from patients’ CT scans obtained vary from 67.13 excess per 100,000 (about 1 in 1489) and 0.45 excess per 100,000 (about 1 in 222,222). All cancer risk was high for lumbar spine CT in women 20 years old (67.13 excess deaths in 100,000 scans) followed by chest-abdomen-pelvic CT (50.36 excess deaths in 100,000 scans) and abdomen-pelvic CT (49.22 excess deaths in 100,000 scans) for the same age group. The LAR of incidence and mortality values were higher from female’s patients than males and higher for younger than older patients. Conclusion: This study was set out to estimate the LAR values associated with adult common CT scans procedures. The data indicates, LAR risks related to induced cancer from CT exposures were estimated to be low. This risk can be relatively significant for younger age group compared to older age group. The LAR values obtained will help to better evaluate radiation exposure risk, before ordering a CT scans examinations.展开更多
Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Doual...Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.展开更多
Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, ...Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .展开更多
Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behav...Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.展开更多
Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The ob...Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.展开更多
Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This...Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This study, conducted at the hemodialysis unit of the General Hospital of Douala (GHGD), aimed to address this gap by assessing the 36-week survival of hemodialysis patients with CKD, thus providing essential data to enhance clinical practices and inform public health decisions. Methods: We conducted a prospective study at GHGD over a period of 9 months, monitoring 262 hemodialysis patients. Sociodemographic data, comorbidities, the presence of infections, adherence to regular hemodialysis sessions, and the week of death were collected using a structured survey form. The Kaplan-Meier estimator and Cox regression model were used to analyze patient survival. Results: The mean age of the patients was 49 ± 14 years. Adherence to hemodialysis sessions (HR = 0.19, p Burkholderia cepacia (p = 0.006), and for those who were divorced (p = 0.001). Conclusion: Strengthening infection prevention and providing psychosocial support for patients with CKD are crucial measures to improve patient care and develop public health strategies tailored to local needs.展开更多
Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures os...Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.展开更多
The Douala-Buea Region(DBR;4°-5°N,9°-10°30’E),a portion of the southern Cameroon passive margin,developed on the Proterozoic granito-gneissic basement and the Cretaceous to Recent volcanosedimenta...The Douala-Buea Region(DBR;4°-5°N,9°-10°30’E),a portion of the southern Cameroon passive margin,developed on the Proterozoic granito-gneissic basement and the Cretaceous to Recent volcanosedimentary cover,was explored in order to evaluate the lithology and tectonics controls on its landscape usingthequalitativeandquantitative geomorphological analyses based on 30 m resolution Digital Elevation Models(DEM)and field evidences.This area displays an uneven and complex landscape differentiated into four morphological units:Douala,Nkondjock,Kumba and Buea Units.The Douala Unit corresponds to the Coastal Plain and is extended on the Douala-Kribi/Camposedimentarybasin.The Nkondjock Unit represents a middle plateau developed on a Proterozoic granito-gneissic basement.The Kumba Unit matches with the southernmost volcanic Western Cameroon High Plateau.The Buea Unit corresponds to the Mount Cameroon stratovolcano.The relief analysis through mountain-front sinuosity(Smf,1.19–1.43)and relative relief ratio(Rr,0.10–2.31)vary from one unit to another.The drainage network analysis including drainage patterns,stepped longitudinalriverprofiles,theassociated morphometric indexes,notably the concavity index(IC,0.56–0.88),deviation(D,267–2912 m),basin asymmetry factor(A_(F),6.37–42.12),hypsometric integral(HI,0.10–0.29),valley floor width to valley height ratio(V_(f),0.36–2.75),elongation ratio(R_(e),0.30–0.50),watershed slope(S,6.88–88.88)and stream length gradient index(SL,0–3332)vary from one basin to another too.These results also show the heterogeneous and uneven DBR landscape controlled by its lithology and active tectonics.The drainage system reveals concave to concavo-convex longitudinal river profile shapes with knick points,asymmetric basins,and fault reactivations,and highlights the tectonics activity that used to occur through the time and their control on the morphology.Together,they document the lithostructural controls on the DBR landscape evolution,extendable in the whole SW Cameroon margin.展开更多
This paper is aimed at identifying the risk factors that mainly contribute to reckless driving and other related causes of road accidents along the Douala-Dschang highway of Cameroon. The research work started with th...This paper is aimed at identifying the risk factors that mainly contribute to reckless driving and other related causes of road accidents along the Douala-Dschang highway of Cameroon. The research work started with the collection of accident reports for 2018 and 2019 from security officials in charge of road safety and the police stations of the different localities included in the sample of the study. Three hundred and eighty-two (382) road accidents re<span style="font-family:Verdana;">ports were collected and analyzed using the 2020 version logit regression</span><span style="font-family:Verdana;"> model of XLSTAT. </span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">From these analyses, it appears that, of the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">382 </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">accidents recorded during this period, six factors were identified and classified as follows: causes of accidents related to speed and carelessness, location of the accident, type of vehicle at fault, day the accident occurred, time of the accident and the age of drivers involved. These results </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">could contribute to reduce the gravity of accidents along the Douala-Dschang highway and develop other policies in the program for road safety. In addition, this study can as much as possible equally contribute to reorienting road construction trends and development techniques in our environment.</span></span></span>展开更多
<strong>Background:</strong><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The breast cancer is an abnormal prolife...<strong>Background:</strong><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The breast cancer is an abnormal proliferation of mammary gland cells. This condition as well as other cancers is globally increasing in the world. It is the most frequent malignancy of women in the world and is a public health problem. Generally in Africa and central Africa in particular, few studies have been realized in search of risk factors of breast cancer. It’s all in this optical we began the study to determine the risk factors of this disease in the city of Douala. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We conducted a case-control </span><span style="font-family:Verdana;">study, gave retrospectives collect on five years and prospectives collect on seven</span><span style="font-family:Verdana;"> months. The studied population was all women aged 18 years and above with breast cancer diagnostic on histological plan for cases;and women from 18 </span><span style="font-family:Verdana;">years or more with normal physical examination and mammography. W</span><span style="font-family:Verdana;">e h</span><span style="font-family:Verdana;">ave done our research in three reference hospitals of the city of Douala and</span><span style="font-family:Verdana;"> two laboratories of pathological anatomy. The data were collected at the search</span><span> </span><span style="font-family:Verdana;">files and the patients where interviewed. The parameters studied were: socio-demographic profile, clinic and Para clinic parameters, and the histological type. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">At the end of this study, breast cancer is predominantly on young women in the city of Douala with a middle age of 44.08 ± 2.6 years. The most significant risk factors were age, age of the first birth ≥ 30 years, age of the first sexual act ≤ 18 years, low economic level, tobacco, hormonal contraceptive, parity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Finally, the malignancy of the breast takes a primordial place within the feminine population of Douala with many risk factors likes causes.</span></span></span></span></span>展开更多
文摘Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.
文摘Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.
文摘Background: Conventional radiation therapy is a technique that uses ionizing radiation to destroy tumor cells. Along with surgery, chemotherapy, hormonotherapy and target therapy, it plays a crucial role in the management of breast cancer by reducing its overall mortality and recurrences. Methods: We conducted a retrospective and descriptive study by using the records of patients treated in the radiotherapy department of the Douala General Hospital from January 2015 to December 2019. Data concerning radiation-induced toxicities were collected using a pre-established and pre-tested survey and transferred to the CTCAE Version 4.0 software. Data analysis was performed using SPSS version 20.0. Results: A total of 206 records were selected. The average age was 46.7 ± 8.2 years. The most represented histological type was invasive ductal carcinoma (n = 187, 90.7%). Multimodality treatment was used in every patient in our series with chemotherapy, surgery, and adjuvant radiation therapy (n = 88, 42.7%) been the most represented. More than half of the participants (n = 108, 52.4%) received a total dose >50 grays, only 89 (43.2%) received the classical fractionation of 2 grays/cession, and the average duration of radiation therapy was 36.8 ± 15.4 days. We encountered 155 (75.2%) side effects. There were more acute toxicities than late toxicities, at 115 (74.1%) versus 40 (25.8%). The main acute lesions were radiodermatitis (68.6%), breast pain (16.5%), radiation pneumonitis (12.2%), and acute pericarditis (2.6%). As late lesions, we identified radiodermatitis (52.5%), radiation pneumonitis (32.5%), and lymphoedema (15%). A total dose >50 grays [p 0.001, OR: 2.7 (1.58 - 4.9)], and conservative surgery [p = 0.04, OR: 2.3 (1.3 - 4.1)], seemed to increase the occurrence of early side effects on bivariate analysis. However, after multivariate logistic regression, only a total dose >50 grays [p = 0.005, OR: 2.1 (1.1 - 6.7)] remained a predictive factor associated to early side effects. We found no factors related to late side effect occurrences. Conclusion: The frequency of side effects of radiation therapy for breast cancer at the Douala General Hospital remains relatively high. Both early and late lesions remained present with early toxicities been the most common. Meticulous strategies along with an enhancement of both human and materials resources are paramount in order to reduce their frequency and morbidity.
文摘Background: The use of assisted reproductive technique (ART) is becoming more common in infertility. During ART most patients undergo ovarian stimulation. In this study we study the correlation between ovarian reserve markers: Anti-Mullerian hormone (AMH) and antral follicle count (AFC), and the response to ovarian stimulation at in vitro fertilization (IVF) centres in Douala Cameroon. Methods: This was a hospital based cross-sectional sectional analytic study carried out over a period of 3 years, 4 months at Clinique de l’Aéroport, Clinique Odyssée and Clinique Urogyn. Inclusion criteria were: Female partners of infertile couples undergoing ovarian stimulation for an in vitro fertilization cycle, patients who had both ovaries and had done either AMH, AFC or both before ovarian stimulation. Patients were divided into three groups based on the number of oocytes retrieved: low ovarian response for ≤3 oocytes, normal ovarian response for 4 - 15 oocytes and high ovarian response for >15 oocytes. Data obtained was analyzed by SPSS version 25.0. Results: The ages of participants ranged from 20 - 4 7 years, with a mean age of 34.11 ± 5.11 years. Most of them had secondary infertility (57.9%). The GnRH antagonist protocol was mainly used, and ovulation was triggered using HCG predominantly. On Multivariate analysis, age and history of PCOS were significantly associated with ovarian response in the low and high ovarian response groups, respectively. Conclusion: AMH has a better predictive value than AFC, however, it is less sensitive but more specific than AFC.
文摘Introduction: Psychological distress can affect every worker’s mental health or working ability, and specifically the healthcare workers. It is essential to prevent and treat it in order to anticipate predictable consequences. The aim of this study was to investigate the epidemiological characteristics of psychological distress among the healthcare workers in the city of Douala. Material and Methods: This cross-sectional study was carried out during the 1st semester of 2023 in two reference hospitals of the city of Douala. All volunteer staff from the targeted hospitals were involved. We collected data using a mixed questionnaire that included the working conditions, as of the socioprofessional and psychological characteristics of the healthcare workers. We measured the level of psychological distress using the Kessler scale. Analysis was performed using the Chi-2 test and multivariate analysis. Threshold value was & = 5%, p Results: The participation rate was 86.3%. Women (81.7%) and nurses (77.6%) predominated in the sample. The mean age was 35.38 ± 8.9 years, and individuals in their thirties accounted for 46.79% of the sample. The prevalence of psychological distress was 19.5%. The psychological distress was categorized as mild (48.72%), moderate (18.46%) or severe (32.82%). Risk factors for psychological distress included being of the catholic faith (OR = 3.6, p = 0.04), poor sleep quality (OR = 3.9, p = 0.001) and long working hours (OR = 2.2, p = 0.002). Overtime was the only protective factor identified (OR = 0.6, p = 0.04). Conclusion: Nearly 1 out of 5 healthcare workers suffered from psychological distress exacerbated by poor working and living conditions. There is an urgent need to improve their working conditions to prevent the development of more severe consequences.
文摘Introduction: Pregnancy as much as childbirth constitutes a risky situation, potentially fraught with sometimes dramatic complications: maternal death. Objective: We conducted this study with the aim of establishing the profile of those giving birth in our context with the aim to anticipate operationally in the future on morbidity but more on maternal deaths. Methodology: We conducted, using a structured questionnaire, a prospective descriptive study in representative maternity wards in the city of Douala;the study variables were socio-economic, anthropometric, obstetrical and clinical. Statistical analyses were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables and the percentages. Results: We recruited 305 births for our study. The average age of our births was 28.7 years ± 6.1 with an average height of 161.6 cm ± 5.06;an average body mass index at the start of pregnancy of 28.0 kilograms/square meter and 31.3 kilograms/square meter at delivery;the average weight gain was 8.4 g ± 5.37;an average gestation of 2.84±1.90;an average parity of 2.2 ± 2.1 with an average birth interval of 27.7 months ± 23.7. The average gestational age was 39.2 weeks ± 1.21 with pregnancy pathology dominated by malaria;85.9% began their prenatal follow-up before the 14th week of amenorrhea. Conclusion: The profile of childbirth in urban Cameroon does not seem potentially dystocic compared to that of the same regional and racial area.
文摘Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.
文摘Introduction: Anthropometry applied to newborns is a reliable indicator of the quality of fetal growth. The latter is influenced by genetic, racial and nutritional factors varying from one population to another, explaining why a standard cannot be applied to all populations. Research question: should the Caucasian frame of reference be dogmatically applied in our African context? Multicenter studies are therefore necessary;hence the interest of this work, the main objective of which was to describe the anthropometric profile of full-term newborns in the city of Douala. Methodology: We carried out a cross-sectional study with an analytical aim and prospective data collection in the maternity wards of the Douala General Hospital, Laquintinie Hospital, District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given consent. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using structured and pre-tested survey sheets. The study variables were obstetric and anthropometric. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The average anthropometric parameters of the full-term newborn in the city of Douala were: average weight: 3305 grams, average height: 49.8 centimeters, average head circumference: 34.6 centimeters, average upper arm circumference: 11.3 centimeters, circumference average thoracic: 32.8 centimeters. The percentile distribution showed a 10th percentile at 2656 grams and a 90th percentile at 3966 grams for weight defining the limits for small-for-gestational-age neonates and macrosomes. Conclusion: The anthropometric data of the full-term newborn in the city of Douala were: an average weight of 3305.4 grams, an average height of 49.8 centimeters, an average head circumference of 34.2 centimeters, an average upper arm circumference of 11.3 centimeters, and an average thoracic circumference of 32.8 centimeters with higher valuesin male newborns.
文摘Yogurt is a traditional dairy product well known in all the regions of the world. In Cameroon, the most popularly known type is “kossam” also called curdled milk. Kossam is a set of milk based beverage from northern Cameroon presenting great symbolic, economic and social values for local population [1]. 150 Kossam samples were collected from neighborhoods of PK8, Bonamoussadi, Nyalla, cite des palmier, Deido and Bedi community and later on reconstituted into 50 different samples of 350 mL, each containing 1/3 of 3 individual samples. They were analyzed for their physiochemical properties such as: PH, titratable acidity, density, brix and dry matter using most at times the standard Association of Official Analytical Chemists (AOAC) methods with slight modifications and results compared to a licensed brand sold in the Cameroonian market. The results of the study showed that, the physico-chemical properties of the locally made yogurts were different within the different samples. Analysis of variance revealed a significant difference in the levels of the parameters analyzed in the different yogurt samples (p −1 Kg/L), Brix (8˚ - 24˚B), Dornic (23˚ - 160˚D). others contents per 100 g fresh matter are as follows: dry matter (average mean of 16.54%). Hence, the significant variations in the physico-chemical properties of kossam are a call for concern since as it impacts on the health of the population consuming this product.
文摘In this report, we present a case of a term abdominal pregnancy managed in St Padre Pio Hospital Douala (Cameroon). The 28-year-old G2P1001 woman whom we received to our facility at 15 weeks gestation with an intrauterine pregnancy confirmed by ultrasonography. She returned at 21 weeks with a history of syncope and blood transfusion in another facility. An obstetrical ultrasonography done that day revealed a live fetus located at the upper right side within the peritoneal cavity. She continued with her routine Antenatal visits, and at each visit, an ultrasonography was done, revealing a slowly growing fetus. At 38 weeks, a laparotomy was carried out, and the live male baby weighing 2500 grammes was extracted. The placenta was implanted in the uterus;it was removed with minimal blood loss of approximately 400 mls. The mother was heamodynamically stable post-operatively. The newborn presented with mild cyanosis, an oxygen saturation of 80%, which resolved after 24 hours of oxygen administration. Both mother and baby were discharged from the hospital one week after laparotomy in a stable state. This case illustrates that intra-abdominal pregnancies, though rare and complex, can be managed to term and produce viable fetuses. Practitioners should, therefore, understand the challenges in its management.
文摘Background: Among medical technologies that use ionizing radiation, CT is currently the radio diagnostic technic that can deliver the highest radiation to the Patient compared with other conventional procedures. In developing countries, the uses and risks of CT have not been well characterized. Objective: To estimate the lifetime attributable risk (LAR) incidence and mortality for cancer for each procedure for adult’s patients who had Computed Tomography examinations in 10 imaging centers in the city of Douala-Cameroon so as to provide a reference data. Materials and Methods: We conducted a cross-sectional study describing radiation dose associated with the 8 most common types of diagnostic CT studies performed on 1287 consecutive adult patients at 10 Douala radiology department. We estimated lifetime attributable risks of cancer by study type from these measured doses. Estimation of LAR for cancer incidence and mortality was based on the effective dose, patient’s sex and age at exposure using the BIER VII preferred models. Results: Mean effective dose from CT scans examinations varied from: 0.30 and 8.81 mSv. The highest doses were observed for lumbar spine CT (8.81 mSv), followed by abdomen-pelvis procedure (6.46 mSv), chest-abdomen-pelvic CT (6.61 mSv), chest CT (3.90 mSv), cervical Spine CT (3.05 mSv), head CT (1.7 mSv) and lower for sinus CT (0.30 mSv). The LAR values of all cancer from patients’ CT scans obtained vary from 67.13 excess per 100,000 (about 1 in 1489) and 0.45 excess per 100,000 (about 1 in 222,222). All cancer risk was high for lumbar spine CT in women 20 years old (67.13 excess deaths in 100,000 scans) followed by chest-abdomen-pelvic CT (50.36 excess deaths in 100,000 scans) and abdomen-pelvic CT (49.22 excess deaths in 100,000 scans) for the same age group. The LAR of incidence and mortality values were higher from female’s patients than males and higher for younger than older patients. Conclusion: This study was set out to estimate the LAR values associated with adult common CT scans procedures. The data indicates, LAR risks related to induced cancer from CT exposures were estimated to be low. This risk can be relatively significant for younger age group compared to older age group. The LAR values obtained will help to better evaluate radiation exposure risk, before ordering a CT scans examinations.
文摘Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.
文摘Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .
文摘Introduction: Sickle cell anaemia is a hereditary disease that combines physical and psychological manifestations, including suicidal tendencies. So far, to our knowledge, no study has been conducted on suicidal behaviours among people with sickle cell disease in Cameroon. This is what justifies our study on the prevalence and factors related to suicidal behaviors in our study population. Methods: We conducted a cross-sectional, analytical study of 171 sickle cell patients aged from 12 years upwards who came to the sickle cell disease care service of the Laquintinie Hospital in Douala, over a period of 6 months, that is, from 1 January to 31 June 2022. Data were collected using a structured questionnaire with questions on suicidal behaviours based on the “MINI” (Mini International Neuropsychiatric Interview). The data were processed using the SPSS 26.0 software. The related factors were studied in both a bivariate and multivariate analysis. Results: Female sickle cell patients accounted for 60.2% of the sample. The mean age was 23.36 ± 8.42 years. Suicidal ideation was prevalent in 56% of cases and 13% attempted suicide. The factors most associated with suicidal ideation were: primary level of education (OR = 0.08 (0.09 - 0.79);p = 0.03), feeling unworthy of life (OR = 0.40 (0.08 - 1.96);p = 0.02), not often being considered by those around them (OR = 2.97 (1.26 - 6.99);p = 0.01), lack of family support (OR = 0.34 (0.15 - 0.77);p = 0.01). Meanwhile, the factors associated with suicide attempts were: the fact of being rarely exposed to suicide-related media (OR = 4.17 (1.40 - 71.80);p = 0.03), and a constant feeling of sadness when returning home (OR = 18.02 (1.59 - 20.55);p = 0.01). Conclusion: More than half of sickle cell patients had had suicidal thoughts and 1/6 had made at least one suicide attempt, women and young adults being the most concerned. It is therefore necessary to ensure optimum psychological care for patients with sickle cell disease.
文摘Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.
文摘Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This study, conducted at the hemodialysis unit of the General Hospital of Douala (GHGD), aimed to address this gap by assessing the 36-week survival of hemodialysis patients with CKD, thus providing essential data to enhance clinical practices and inform public health decisions. Methods: We conducted a prospective study at GHGD over a period of 9 months, monitoring 262 hemodialysis patients. Sociodemographic data, comorbidities, the presence of infections, adherence to regular hemodialysis sessions, and the week of death were collected using a structured survey form. The Kaplan-Meier estimator and Cox regression model were used to analyze patient survival. Results: The mean age of the patients was 49 ± 14 years. Adherence to hemodialysis sessions (HR = 0.19, p Burkholderia cepacia (p = 0.006), and for those who were divorced (p = 0.001). Conclusion: Strengthening infection prevention and providing psychosocial support for patients with CKD are crucial measures to improve patient care and develop public health strategies tailored to local needs.
文摘Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.
文摘The Douala-Buea Region(DBR;4°-5°N,9°-10°30’E),a portion of the southern Cameroon passive margin,developed on the Proterozoic granito-gneissic basement and the Cretaceous to Recent volcanosedimentary cover,was explored in order to evaluate the lithology and tectonics controls on its landscape usingthequalitativeandquantitative geomorphological analyses based on 30 m resolution Digital Elevation Models(DEM)and field evidences.This area displays an uneven and complex landscape differentiated into four morphological units:Douala,Nkondjock,Kumba and Buea Units.The Douala Unit corresponds to the Coastal Plain and is extended on the Douala-Kribi/Camposedimentarybasin.The Nkondjock Unit represents a middle plateau developed on a Proterozoic granito-gneissic basement.The Kumba Unit matches with the southernmost volcanic Western Cameroon High Plateau.The Buea Unit corresponds to the Mount Cameroon stratovolcano.The relief analysis through mountain-front sinuosity(Smf,1.19–1.43)and relative relief ratio(Rr,0.10–2.31)vary from one unit to another.The drainage network analysis including drainage patterns,stepped longitudinalriverprofiles,theassociated morphometric indexes,notably the concavity index(IC,0.56–0.88),deviation(D,267–2912 m),basin asymmetry factor(A_(F),6.37–42.12),hypsometric integral(HI,0.10–0.29),valley floor width to valley height ratio(V_(f),0.36–2.75),elongation ratio(R_(e),0.30–0.50),watershed slope(S,6.88–88.88)and stream length gradient index(SL,0–3332)vary from one basin to another too.These results also show the heterogeneous and uneven DBR landscape controlled by its lithology and active tectonics.The drainage system reveals concave to concavo-convex longitudinal river profile shapes with knick points,asymmetric basins,and fault reactivations,and highlights the tectonics activity that used to occur through the time and their control on the morphology.Together,they document the lithostructural controls on the DBR landscape evolution,extendable in the whole SW Cameroon margin.
文摘This paper is aimed at identifying the risk factors that mainly contribute to reckless driving and other related causes of road accidents along the Douala-Dschang highway of Cameroon. The research work started with the collection of accident reports for 2018 and 2019 from security officials in charge of road safety and the police stations of the different localities included in the sample of the study. Three hundred and eighty-two (382) road accidents re<span style="font-family:Verdana;">ports were collected and analyzed using the 2020 version logit regression</span><span style="font-family:Verdana;"> model of XLSTAT. </span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">From these analyses, it appears that, of the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">382 </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">accidents recorded during this period, six factors were identified and classified as follows: causes of accidents related to speed and carelessness, location of the accident, type of vehicle at fault, day the accident occurred, time of the accident and the age of drivers involved. These results </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">could contribute to reduce the gravity of accidents along the Douala-Dschang highway and develop other policies in the program for road safety. In addition, this study can as much as possible equally contribute to reorienting road construction trends and development techniques in our environment.</span></span></span>
文摘<strong>Background:</strong><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> The breast cancer is an abnormal proliferation of mammary gland cells. This condition as well as other cancers is globally increasing in the world. It is the most frequent malignancy of women in the world and is a public health problem. Generally in Africa and central Africa in particular, few studies have been realized in search of risk factors of breast cancer. It’s all in this optical we began the study to determine the risk factors of this disease in the city of Douala. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We conducted a case-control </span><span style="font-family:Verdana;">study, gave retrospectives collect on five years and prospectives collect on seven</span><span style="font-family:Verdana;"> months. The studied population was all women aged 18 years and above with breast cancer diagnostic on histological plan for cases;and women from 18 </span><span style="font-family:Verdana;">years or more with normal physical examination and mammography. W</span><span style="font-family:Verdana;">e h</span><span style="font-family:Verdana;">ave done our research in three reference hospitals of the city of Douala and</span><span style="font-family:Verdana;"> two laboratories of pathological anatomy. The data were collected at the search</span><span> </span><span style="font-family:Verdana;">files and the patients where interviewed. The parameters studied were: socio-demographic profile, clinic and Para clinic parameters, and the histological type. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">At the end of this study, breast cancer is predominantly on young women in the city of Douala with a middle age of 44.08 ± 2.6 years. The most significant risk factors were age, age of the first birth ≥ 30 years, age of the first sexual act ≤ 18 years, low economic level, tobacco, hormonal contraceptive, parity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Finally, the malignancy of the breast takes a primordial place within the feminine population of Douala with many risk factors likes causes.</span></span></span></span></span>
