Change of site of intra-articular injection of hypertonic dextrose resulted in different effects of treatment.

Most minimally invasive treatments for dysfunction of the temporomandibular joint (TMJ) are empirical, and aimed at the painful trigger points with the purpose of preventing muscular spasm and restoring normal function. In this prospective study I investigated whether the choice of site of injection of hypertonic dextrose affected the benefits of treatment of internal derangement and pain. I studied 72 patients with pain and clicking as a result of dysfunction of the TMJ. Patients were divided into four groups with four separate sites for intra-articular injection. Dextrose was injected into the superior joint space, inferior joint space, retrodiscal tissue, and anterior capsule injection. Results showed that the retrodiscal site was the most effective for reducing clicking and subsequently improving derangement, while the inferior joint space was the best site for the relief of pain, and the extracapsular site should be used in cases of hypermobility. In conclusion, the injection site should be selected according to the symptoms being treated, and could be used as an adjunct to other sites to improve outcome.

Aspects cliniques et prise en charge des accidents de travail survenus en milieu industriel à Douala

Introduction : Les statistiques générales des accidents de travail sont en régression dans le monde, mais restent élevées dans les pays émergents et sous-développés. L'absence de données scientifiques locales sur les risques professionnels et la méconnaissance des caractéristiques générales des accidents de travail a motivé la conduite de cette étude dont l'objectif était de décrire les aspects cliniques et la prise en charge des accidents de travail survenus en milieu industriel à Douala au Cameroun entre 2000 et 2009.Méthodologie : L'étude était rétrospective et descriptive. Elle s'est déroulée du 25 mars au 23 mai 2014 dans les cinq centres de la Caisse Nationale de Prévoyance Sociale de Douala. Nous avons colligé tous les dossiers exploitables des victimes d'accidents de travail survenus en milieu industriel pendant la période 2000-2009. Les résultats ont été présentés sous forme univariée et bivariée. Résultats : Mille soixante-quatre (1064) cas ont été retenus sur les 1471 dossiers étudiés (72,33%). L'échantillon était à prédominance masculine et la moyenne d'âge était de 35,7± 7,41 ans. La majorité des victimes était des ouvriers (54,4%). Ils travaillaient dans les industries du secteur du bois (38,3%) ou du secteur du pétrole, gaz et chimie. La majorité des lésions était légère et modérée (53,20%), localisées aux mains (35,8%), aux membres inférieurs (17,6%) et aux yeux (13,2%). Il s'agissait de lésions cutanéo-muqueuses ou ostéo-articulaires. Les victimes avaient reçu des premiers soins, dans 74,10% dans des formations sanitaires situées hors de l'entreprise. La majorité des victimes (51,8%) avait effectué des examens radiographiques exploratoires, 47,2% avaient été consultées par des médecins et 313 victimes avaient été hospitalisées pendant 1 à 2 jours (56,5%), 88 victimes pendant 3-7 jours (28,3%) et 48 victimes pendant plus de 7 jours (15,2%). La quasi-totalité des victimes a eu un arrêt de travail avec ITT supérieure à 7 jours (64,5%). Sept-cent-cinquante-deux victimes ont guéri (70,70%) et 237 (22,30%) ont consolidé. Conclusion : Les victimes d'accidents de travail à Douala pour la période 2000-2009 sont des jeunes ouvriers travaillant dans l'industrie du bois, du pétrole, gaz et chimie et de la métallurgie. La prise en charge a étéeffectuée en dehors de l'entreprise et met en exergue les difficultés fonctionnelles des centres médicaux d'entreprise

[Epidemiologiy of obesity among university students in Douala, Cameroon]. / Épidémiologie de l'obésité en milieu estudiantin à Douala, Cameroun.

PURPOSE: To determine the prevalence of obesity, its risk factors, and its health risks among students of the University of Douala. METHODS: In April, 2011, 2696 students volunteered to participate in a screening campaign for diabetes, high blood pressure (HBP), and obesity. Their physical activity (PA) level was also evaluated. RESULTS: The sample consisted of 1276 (47.3%) men and 1420 (52.7%) women with a mean age of 23.8 ± 3.5 years. The general prevalence of obesity was 4.1%, and it was more common among women (p = 0.043). The age group most highly affected was those 35 years or older, with a prevalence of 39.5% (p<0.02). Among the obese, the risk level was high in 78 (70.9%) women. The prevalence of HBP was higher among obese than non-obese students (20.9% vs. 12.5%, p = 0.019), and the prevalence of diabetes five times higher (4.5% vs. 0.8%, p = 0.003). Obesity was highly associated with alcohol consumption (p = 0.01), physical inactivity (p = 0.007), and family history of diabetes (p = 0.008). CONCLUSION: Obesity is a worrisome disorder among students in Douala. Educating students about this topic and developing an obesity prevention and management program may improve their health.

[Epidemiology of obesity in the work milieu, Douala, Cameroon]. / Epidémiologie de l'obésité en milieu du travail à Douala, Cameroun.

Obesity is a worldwide public health problem, and its burden has been poorly explored in Cameroon, especially in work place. We therefore carried out in April 2010, an analytic cross-sectional study aiming to determine the prevalence of obesity, associated risk factors and health risk in six randomly selected enterprises based in Douala. Among the 552 participants, 383 (69.4%) were males. Most of the workers (55.4%) were aged less than 35 years old. There was 191 (34.60%) office staff as against 361 (65.40%) labourers. In each participant, blood pressures, and fasting blood glucose were recorded, as well as obesity indexes comprising body mass index and waist circumference. They were calculated and data analyzed using SPSS 16 and Win Pepi 11.8. The prevalence of obesity in workers was 23.4%, and was more pronounced in women than in men (36.1% vs 17.8%; P < 0.005). The workers aged > or = 45 years old exhibited highest obesity rate than other age group (P = 0.03). Importantly, the prevalence of hypertension was two fold greater in obese workers than non obese (P < 0.005; RR = 2.1; IC 95%: 1.57-2.83). 271 (49.1%) of the workers were overweight. Among the obese subjects, those with visceral obesity: 56 (43.4%) females with a waist circumference > 88 cm and 41 (31.8%) men with a waist circumference > 102 cm were at very high health risk. Obesity was significantly associated with excessive alcohol consumption (P = 0.013) and high salt diet (P = 0.022). This study reveals a high burden of obesity in the work place in Douala and outlines the urgent needs of implementation of prevention programme in that milieu.

Management of ureteral stones by extracorporeal shock wave lithotripsy using Lithostar lithotriptor.

In 282 patients 290 ureteral stones were treated with extracorporeal shock wave lithotripsy using the Lithostar lithotriptor. Stones were in the upper ureter in 198 units (68.3%), middle ureter in 36 (12.4%) and lower ureter in 56 (19.3%). The average stone mass was 11.9 mm. and the mean number of shock waves was 4,913 for all levels with a mean kv. of 16.9. The average number of sessions was 1.5 for all sites. Auxiliary measures in the form of ureteral catheterization were done in 24 patients (8.5%) and internal stenting in 12 (4.25%), all of whom had upper or middle ureteral stones. Disintegration of the stones was achieved in 99% of the upper, 93.7% of the middle and 91.7% of the lower ureteral stones. However, clearance of fragments within 3 months from the last session was achieved in 94.8% of the upper, 87.5% of the middle and 91.7% of the lower ureteral stones for an overall stone-free rate of 93.3%.