Tricuspid valve infective endocarditis in a patient with psoas abscess complicated by septic pulmonary emboli and severe tricuspid regurgitation in Cameroon: challenges in the diagnosis and management in a resource limited setting (a case report).

Infective endocarditis of the tricuspid valve is rare in non-intra-venous drug abusers. Few cases of psoas abscess complicated by tricuspid infective endocarditis have been reported. A 61-year-old man underwent a laminectomy. Three weeks later he developed persistent fever, abdominal pain, back pain and hip pain, weight loss, gradually and abdominal distension. Abdomino-thoracic computed tomographic scan showed a left psoas muscle abscess and cavitary pulmonary lesions suggestive of septic pulmonary emboli. Two dimensional transthoracic echocardiography showed an oscillating mass on the anterior leaflet of the tricuspid valve compatible with a vegetation. There was severe tricuspid regurgitation with right atrial and right ventricular dilatation. Secondary psoas abscess though rare is an important cause of bacteremia and there is a potential of bacteremia progressing to serious systemic infection like tricuspid endocarditis which can be fatal without prompt and appropriate treatment.

Prevalence and factors associated with substance use among students in tertiary institutions in Buea, Cameroon.

Introduction: substance use is a major global public health problem. About 5.6% of the global population aged 15-64 years consumed a drug at least once in 2016. The use of substances by youth, especially students in tertiary schools is increasing rapidly worldwide. This rise in substance use is associated with a negative impact on student's health, as well as their professional and social life. Methods: in a cross-sectional institution-based survey we recruited 650 students by convenience sampling from 3 randomly selected tertiary institutions within the Buea municipality. Data was collected using a pre-tested self-administered World Health Organization (WHO) model core questionnaire to collect information on sociodemographic data and use of various substances. The data collected were entered into Microsoft Excel 2016 and exported to SPSS version 24. Descriptive analysis was done to examine findings, and multivariate logistic regression models were used to determine factors independently associated with substance use. Results: of the 650 students recruited, 625 consented and completed the questionnaire, for which 67.4% were females with a mean age of 22.2 ± 2.837 years. The overall prevalence of substance use was 89.9%. The prevalence of multiple substance use was 29.9%. The most currently used substances were tobacco (26.2%), alcohol (19.7%), tramadol (2.8%) and cannabis (2.0%). The main reason for substance use was to relieve stress (relax) 91.7%. The main negative effects reported were quarrel or arguments (18%) and loss of money (16.7%). Peers (66.9%) were the prime source of substance use. On multivariate analysis, male sex was the principal predictor for substance use (95% CI): 0.801 (1.128, 4.398). Conclusion: the prevalence of substance use is high among students in tertiary institutions in Buea. Multilevel, value-based, comprehensive, and strategic long-term intervention plans are required to curb this problem.