Imaging of developmental delay in black African children: A hospital-based study in Yaoundé-Cameroon.

Background: The purpose of this study was to describe the anomalies observed on imaging for developmental delay in black African children. Methods: It was a descriptive cross-sectional study, which included children aged between 1 month to 6 years with developmental delay and had done a brain MRI and/or CT scan. Results: We included 94 children, 60.6% of whom were males. The mean age was 32.5 ± 6.8 months. A history of perinatal asphyxia found in 55.3% of cases. According to the Denver developmental II scale, profound developmental delay observed in 35.1% of cases, and severe developmental delay in 25.5%. DD was isolated in 2.1% of cases and associated with cerebral palsy, pyramidal syndrome, and microcephaly in respectively 83%, 79.8%, and 46.8% of cases. Brain CT scan and MRI accounted for 85.1% and 14.9% respectively. The tests were abnormal in 78.7% of the cases, and cerebral atrophy was the preponderant anomaly (cortical atrophy = 80%, subcortical atrophy = 69.3%). Epileptic patients were 4 times more likely to have abnormal brain imaging (OR = 4.12 and p = 0.05),. We did not find a link between the severity of psychomotor delay and the presence of significant anomalies in imaging. Conclusion: In our context, there is a high prevalence of organic anomalies in the imaging of psychomotor delay, which were dominated by cerebral atrophy secondary to hypoxic ischemic events.

ESTABLISHMENT OF LOCAL DIAGNOSTIC REFERENCE LEVEL FOR ROUTINE PAEDIATRIC COMPUTED TOMOGRAPHY EXAMINATIONS IN BAFOUSSAM WEST CAMEROON.

The main purpose of this study was to determine local diagnostic reference level (LDRL) for routine computed tomography (CT) examination in Bafoussam, western Cameroon. The exposure parameters and dose quantities were collected manually. This retrospective, evaluative and comparative study was conducted to determine LDRLs for routine head CT examination in Bafoussam, to optimize these procedures in the region. The 75th percentile values of the calculated volume CT dose index (CTDIvol) and dose length product (DLP) were proposed as LDRL. The sample was classified in four age groups: < 1, 1-5, 5-10 and 10-15 y. The LDRLs obtained for the four age groups were: 24 mGy and 381.32 mGy.cm, 42.5 mGy and 875.55 mGy.cm, 45.85 mGy and 939.62 mGy.cm, 57.12 mGy and 1222.3 mGy.cm, respectively. The 75th percentile CTDIvol and DLP dose values for this study are higher than international values. We propose a coordinating discussions and collaboration about patient's and specific equipment's change information's, between radiologists, medical imaging technicians and medical physicist, which can reduce absorbed doses and improved medical practice in hospitals.

Clinical, biochemical, and biomolecular aspects of congenital adrenal hyperplasia in a group of Cameroonian children and adolescents.

OBJECTIVES: Congenital adrenal hyperplasia (CAH) remains one of the most challenging endocrine disorders to diagnose, manage, and treat, especially in Africa where there is lack of neonatal screening program, and limited access to care. Data on biomolecular anomaly are sparse, therefore type of mutations are unknown, increasing management challenges and genetic counseling. The present study aims to describe clinical, biomolecular aspects of a group of Cameroonian patients. METHODS: We did an observational retrospective study at the pediatric endocrinology unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde from May 2013 to December 2019, including all patients diagnosed with CAH. RESULTS: We consecutively included 31 patients aged less than 21 years, diagnosed CAH. Median age at diagnosis was 1.71 years (IQR 0.08-2.57 years). Abnormal genitalia was the main complain in 48.4%(n=15). The most prevalent genetic anomaly found in our study population (n=24) was on CYP11, found in 16 patients (66.6%) followed by CYP21A2 mutation found in 8 patients. Homozygous mutation of p.Q356X was found in half of patients with 11 hydroxylase deficiency. This mutation was mostly found in people from semi-Bantu tribes, declared non consanguineous. CONCLUSIONS: 11 hydroxylase deficiency is the most prevalent form of CAH found in this group of Cameroonian children.

Pancreatic and splenic tuberculosis mimicking a pancreatic cancer with splenic metastases in an immunocompetent adolescent: a case report.

We present a case of pancreatic and splenic tuberculosis (TB) in a 15-year-old human immunodeficiency virus-negative patient who was initially misdiagnosed as suffering from a pancreatic carcinoma with splenic metastases. Pancreatic and splenic TB are extremely rare in young immunocompetent patients, with a nonspecific clinical presentation, making the diagnosis elusive.

Sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor with no previous asbestos exposure.

Sarcomatoid malignant peritoneal mesothelioma is the rarest and most lethal form of peritoneal mesothelioma. We present the case of a sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor in a 54-year-old female with no previous asbestos exposure. This clinical presentation is extremely rare and is the first documented in Cameroon.

EVALUATION OF IRRADIATION DOSES DELIVERED TO PATIENTS IN COMPUTED TOMOGRAPHY EXAMINATIONS IN 10 RADIOLOGY DEPARTMENTS IN DOUALA-CAMEROON.

Computed tomography (CT) scan is currently the most irradiating radio diagnostic procedure for the patients. The effective dose delivered by a CT-scan exploration corresponds to 1-20 years of natural irradiation of an individual. Hence, there is need to evaluate this medical exposure, in order to provide indicators and propose guidelines for its daily practice. The purpose of this work was to assess patient exposure levels due to CT-scan exams and propose a local diagnostic reference levels for the most common CT examinations performed in the radiology units of Douala/Cameroon. Data from 1775 CT scans, amongst which 10 different types of common CT examinations on adults and children, were collected, of which 1378 were adult CT scans and 397 were pediatric CT scans. The dose-length product (DLP) values in the adult population for head, abdomen-pelvic and lumber spine CT scans were high as compared to the Institute for Radiological Protection and Nuclear Safety recommendations and previous local DRL with an increase of 36, 15 and 23%, respectively. A general decrease of the DLP for CT-scans examinations in the pediatric population was observed.

Gastric outlet obstruction secondary to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl: a case report.

Gastric outlet obstruction encompasses a broad spectrum of conditions characterized by complete or incomplete obstruction of the distal stomach, which interrupts gastric emptying and prevents the passage of gastric contents beyond the proximal duodenum. Idiopathic hypertrophic pyloric stenosis is the most common cause with an incidence of 1.5-3 per 1000 live births. However, it is excluded; other causes in children such as peptic ulcer disease are relatively rare. We report a case of an acquired gastric outlet obstruction due to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl. Beyond the rarity of this clinical event, this case highlights the challenges of the aetiological diagnosis of gastric outlet obstruction with subsequent therapeutic issues, and is the first documented case in Cameroon.

Clinical predictors of significant intracranial computed tomography scan findings in adults experiencing headache disorder.

INTRODUCTION: Radiological assessments for adult headache disorder show significant intracranial findings in 2.5% to 10% of performed computed tomography scans (CT-scans), leading to an overuse consideration for CT-scan requests by physicians in headache-experiencing patients. Therefore, we undertook this study in order to determine predictors of significant intracranial CT-scan findings in adults experiencing headache disorder; in order to help physicians better select patients who need imaging, which would subsequently decrease the costs of headache disorder management and the useless irradiation rates. METHODS: We carried out a cross-sectional study in the medical imaging departments of Yaounde Central Hospital and Douala Laquintinie Hospital, which are two teaching hospitals in Cameroon, over a period of five months. We consecutively and non-exhaustively included all consenting patients aged eighteen years and above, referred to the radiology department to perform a head CT-scan as aetiological workup of headache disorder, from either a traumatic or non-traumatic mechanism. Patients having a known brain lesion and those with a Glasgow coma scale less than thirteen were excluded. The clinical history of patients was taken and a complete physical examination was performed. Demographic data, clinical characteristics of the headache, results of neurological and physical examinations were collected and correlated to the results of head CT-scan. RESULTS: We enrolled 169 patients in the study, 56.2% were males, with a sex ratio of 1.3; sudden onset of headache increased by two the risk of discovering significant intracranial pathology (p = 0.032). Occipital and cervical location of headache, headache evolving by crisis, and recurrent paroxysmal headache were rather significantly correlated to no structural brain finding. An abnormal neurological examination with specifically abnormal stretch reflexes, aphasia, loss of consciousness, raised intracranial signs, weakness, and meningeal signs were predictive of structural intracranial pathology. Otorrhagia, epistaxis, and periorbital ecchymosis in addition were predictive in post-traumatic headaches. CONCLUSION: Abnormal results from neurological examination are the best clinical parameters to predict structural intracranial pathology on CT-scan in adult patients experiencing headache disorder. In case of post-traumatic headaches, in addition, otorrhagia, epistaxis, and periorbital ecchymosis are too highly predictive.

Profil des malformations et anomalies fœtales à l'échographie anténatale à l'Hôpital Régional de Ngaoundéré - Cameroun

Objectifs : Evaluer l'apport de l'échographie obstétricale dans le dépistage anténatal des malformations foetales, il s'agit plus spécifiquement de déterminer la prévalence des malformations anténatales à l'échographie, d'identifier les différents types de malformations dépistées, de rechercher les facteurs de risque associés aux malformations observées, d'établir le pronostic vital sur la base de l'échographie anténatale et de confronter les résultats de l'échographie au diagnostic post natal. Matériel et méthodes : Il s'agissait d'une étude transversale descriptive, effectuée de novembre 2017 à janvier 2019 soit 15 mois à l'Hôpital Régional de Ngaoundéré. Elle concernait toutes les femmes ayant présentées une malformation foetale au cours de l'échographie obstétricale réalisée à l'aide d'un échographe de marque GE LOGIQ 7 par voie trans-abdominale ou trans-vaginale, par un médecin radiologue d'au moins dix ans d'expérience. Un interrogatoire et un examen clinique étaient également réalisés chez toutes les femmes retenues. Les variables étudiées étaient : l'âge de la mère, l'âge de la grossesse, les résultats de l'échographie obstétricale et les caractéristiques des malformations dépistées. L'analyse statistique a été faite grâce aux logiciels Sphinx V.5.1.0.7 et Excel 2010. Résultats : Les malformations foetales représentaient 0,62% de toutes les échographies et 1,21% des échographies obstétricales. L'âge moyen des mères était de 26 ans avec des extrêmes de 16 à 45 ans. Les primipares étaient les plus représentées soit 43%, suivies des multipares avec 40% et des pauci pares avec 17%. 70,7% des malformations ont été dépisté au deuxième trimestre, les malformations du système nerveux central occupaient le premier rang (46,34%), suivi des malformations de l'appareil urinaire (19,51%), de la paroi abdominale (14,63%), du squelette (9,76%) et du système digestif (4,88%), l'on a observé une malformation du tissu mou du cou (2,44%) et pulmonaire (2,44%). 94,7% des malformations étaient associées à des affections du liquide amniotique et 5,3% à une tachycardie foetale, 14,63% de grossesses portaient des malformations considérées comme incompatibles avec la vie et 24,39% des foetus malformés étaient décédés in utéro. L'antécédent de malformation dans la fratrie était de 5,7% et la notion de consanguinité était de 28,6%. Le taux de concordance entre le diagnostic anténatal et postnatal était de 95,65%

Urethral Duplication with a Cystic Phallic Urethra Associated with a Uterus Didelphys, Partial Agenesis of the Tibia, and an Equinovarus Foot.

Urethral duplication is a rare congenital malformation, especially in females. It may be associated with complex urogenital malformations, but the association with a cystic phallic urethra and a uterus didelphys is exceptional. We report a case of a newborn with urethral duplication, with the accessory urethra exteriorized by a large cyst, associated with a uterus didelphys and bone malformations. We discuss the clinical, radiographic, and therapeutic aspects as well as a literature review.

Characteristics of patients and patterns of chronic venous disease of the lower limbs in a referral hospital in Cameroon.

OBJECTIVE: The objective of this study was to investigate the magnitude of chronic venous disease (CVD) in sub-Saharan Africa, specifically the characteristics of the patients, the symptoms, the signs, and the severity. METHODS: From December 2013 to December 2016, a cross-sectional study was conducted of all consecutive patients with CVD aged ≥18 years and attending the outpatient clinic of the Yaoundé General Hospital in Cameroon. We recorded information on demographics, relevant medical history, symptoms, lifestyle, and clinical presentation. A duplex ultrasound examination investigated veins to seek obstruction and reflux (duration ≥0.5 second). The full Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification was used to describe CVD, and severity was assessed by the Venous Clinical Severity Score (VCSS). Statistical significance was at P < .05. RESULTS: Altogether, 319 patients (503 affected legs) were enrolled; 54.3% of patients were men with a mean age of 44.5 years (18-85 years) and CVD duration of 3 months to 45 years (mean, 2.3 years). Patients had such risk factors as obesity (32.6%), family history of CVD (17.7%), multiparity, and lifestyle requiring long standing periods (64.8%). Only 15% of women older than 49 years were using birth control pills, and none older than 49 years were receiving hormone replacement therapy. Only 42.9% of patients had previously been treated for CVD, mainly with venoactive drugs (34.1%). Of the 503 legs, 366 (72.76%) were symptomatic in the following proportion: leg heaviness, 236 (64.48%); sensation of swelling, 236 (64.48%); pain, 194 (53%); sensation of "pins and needles," 87 (23.77%); night cramps, 89 (24.39%); and itching, 66 (18.03%). Men had more symptoms (P = .027). The mean total VCSS was 4.62 ± 4.15 (range, 1-21). The most frequent VCSSs were 0, 2, 3, and 4, and the components of the VCSS most frequently represented were pain, varicose veins, and edema.Patients were assigned to CEAP classes as follows. The C class included C0, 6.1%; C1, 35.4%; C2, 39.6%; C3, 42.7%; C4a, 11.9%; C4b, 4.9%; C5, 1.5%; and C6, 10.13%. The E class designated etiology as primary in 446 (88.66%), secondary in 49 (9.7%), and congenital in 8 (1.59%). The A class identified superficial veins in 365 (72.56%), deep veins in 218 (43.33%), and perforator veins in 22 (4.37%); no venous location was identified in 31 (6.16%). According to the P classification, of the 466 legs of level II and III CEAP, 289 (62%) had reflux, 43 (9.2%) had obstruction, 22 (4.6%) had both reflux and obstruction, and 113 (24.3%) had no venous disease identifiable, with no sex influence on the frequency of reflux (P = .27) but a higher proportion of obstruction in men (P = .00029). CONCLUSIONS: Patients have many risk factors and are young with a male predominance. Most patients are symptomatic with advanced disease. The etiology is primary in most patients, and reflux is more common.

Knowledge on Irradiation, Medical Imaging Prescriptions, and Clinical Imaging Referral Guidelines among Physicians in a Sub-Saharan African Country (Cameroon).

BACKGROUND: Clinical imaging guidelines (CIGs) are suitable tools to enhance justification of imaging procedures. OBJECTIVE: To assess physicians' knowledge on irradiation, their self-perception of imaging prescriptions, and the use of CIGs. MATERIALS AND METHODS: A questionnaire of 21 items was self-administered between July and August 2016 to 155 referring physicians working in seven university-affiliated hospitals in Yaoundé and Douala (Cameroon). This pretested questionnaire based on imaging referral practices, the use and the need of CIGs, knowledge on radiation doses of 11 specific radiologic procedures, and knowledge of injurious effects of radiation was completed in the presence of the investigator. Scores were allocated for each question. RESULTS: 155 questionnaires were completed out of 180 administered (86.1%). Participants were 90 (58%) females, 63 (40.64%) specialists, 53 (34.20%) residents/interns, and 39 (25.16%) general practitioners. The average professional experience was 7.4 years (1-25 years). The mean knowledge score was 11.5/59 with no influence of sex, years of experience, and professional category. CIGs users' score was better than nonusers (means 14.2 versus 10.6; p < 0.01). 80% of physicians (124/155) underrated radiation doses of routine imaging exams. Seventy-eight (50.3%) participants have knowledge on CIGs and half of them made use of them. "Impact on diagnosis" was the highest justification criteria follow by "impact on treatment decision." Unjustified requests were mainly for "patient expectation or will" or for "research motivations." 96% of interviewees believed that making available national CIGs will improve justification. CONCLUSION: Most physicians did not have appropriate awareness about radiation doses for routine imaging procedures. A small number of physicians have knowledge on CIGs but they believe that making available CIGs will improve justification of imaging procedures. Continuous trainings on radiation protection and implementation of national CIGs are therefore recommended.

Ultrasonographic prevalence and characteristics of non-palpable thyroid incidentalomas in a hospital-based population in a sub-Saharan country.

BACKGROUND: Thyroid incidentalomas (TI) are highly prevalent asymptomatic thyroid nodules with ultrasound as the best imaging modality for their detection and characterization. Although they are mostly benign, potential for malignancy is up to 10-15%. In sub-Saharan Africa little data exists on the prevalence and risk categorization of TI. The aim of this study was to determine the prevalence and ultrasound characteristics of non-palpable thyroid incidentalomas among adults in sub-Saharan setting. METHODS: A cross sectional study was carried out between March and August 2015, at two university teaching hospitals. Sampling was consecutive and included all adults aged ≥ 16 years, presenting for any ultrasound other than for the thyroid, with no history or clinical signs of thyroid disease, and no palpable thyroid lesion. Ultrasound was done using 4 to 11 MHz linear probes. Subjects with diffuse thyroid abnormalities were excluded. Variables studied were age, gender, thyroid volume, ultrasound characteristics of thyroid nodules, TIRADS scores. Differences were considered statistically significant for p-value < 0.05. RESULTS: The prevalence of TI was 28.3% (126 persons with TI /446 examined). This prevalence was 46.2% in population ≥ 61-year-old; 6.3% in population ≤ 20-year-old; 33.3% for females and 18.4% for males (p < 0.001). Of the 241 TI found, 49.4% were cysts, 33.6% solid, 17.0% mixed; 37.8% <5 mm and 22% >10 mm. Solid TI were mainly hyperechoic (42.0%), 3/81 were markedly hypoechoic. Sixty-nine out of 126 persons with TI (54.8%) had at least two nodules. Solitary nodules were predominant in the age group ≤20 years. Of 241 TI, 129 (53.5%) were classified TIRADS 2, 81 (33.6%) TIRADS 3, 25 (10.4%) TIRADS 4A, 6 (2.5%) TIRADS 4B, and none TIRADS 5. Characteristics associated with increased risk of malignancy where mostly founded on solid nodules (p < 0.000) and nodules larger than 15 mm (p < 0.001). CONCLUSION: Thyroid incidentalomas were very frequent with a prevalence of 28.3% and potential risk of malignancy in 12.9%. Prevalence had a tendency to increase with age and in female. Cystic nodules were the most prevalent. Potential for malignancy would be increased for larger and solid nodules.

Epidemio-clinical and CT-scan profile of adult headache disorders in a sub-Saharan Africa country

Objective: Given the little availability of MRI in sub-Saharan Africa, we carried out this study focusing on CT-scan in adult headache disorder, in order to determine epidemiological and clinical profile of adult patients undergoing CT-scan for headache disorder, and the organic pathologies discovered in sub-Saharan Africa.Method: We carried out a multicentric prospective cross-sectional study in medical imaging departments of Yaounde Central Hospital and Douala Laquintinie Hospital, which are two teaching hospitals in Cameroon. We consecutively and non-exhaustively included all consenting patients aged eighteen years or above, referred to radiology department to undergo a head CT-scan as aetiological workup of headache disorder, from either traumatic or non-traumatic mechanism. Patients with a Glasgow coma scale less than thirteen were excluded. We interviewed eligible patients, and performed a neurological examination and a complete physical examination before they underwent head CT-scan. The scanning was performed using a brand HITACHI ECLOS 16 slices CT-scan, in helical mode with or without contrast enhancement according to the clinical context. The reading was done by experimented radiologists

Derivation, validation and comparative performance of a simplified chest X-ray score for assessing the severity and outcome of pulmonary tuberculosis.

INTRODUCTION: To derive and validate against the Ralph et al. score, a simplified chest X-ray (CXR) score (SCS) for predicting the outcome of smear-positive pulmonary tuberculosis (SPPTB) among patients with high prevalence of human immunodeficiency virus (HIV) infection. METHODS: CXR for 636 SPPTB patients (377 men, median age 31 years) from the Yaounde Jamot Hospital (Cameroon) were examined for the presence of tuberculosis lesions, and estimation of the proportion of lungs affected. SPPTB's evolution was based on sputum smear examination after 2 months of treatments. Logistic regressions were used to derive the SCS with internal validation via bootstrap resampling. Receiver operating characteristic curves (AUC) analyses were used to validate, determine of the optimal cut-offs and compare models' performance. RESULTS: HIV co-infection was present in 191 (30%) patients. Sputum smear non-conversion was found in 45 (7.1) patients after 2 months of treatment. The SCS was expressed as proportion of lung affected plus 23 if cavitation is present. The AUC (95% confidence interval) was 0.718 (0.640-0.795), with little variation in bootstrap validation, and no sizable difference from the Ralph et al. model [0.714 (0.633-0.7860), P = 0.717 for the difference). Both models had good calibration (Hosmer-Lemeshow P ≥ 0.183). The optimal cut-off for predicting non-conversion of the sputum at 2 months was 52 for the SCS (sensitivity/specificity 66.7%/62.8%) and 74.5 (62.2%/74.3%) with Ralph et al. score. CONCLUSIONS: The outcome of SPPTB among patients with high prevalence of HIV can acceptably be predicted by simple scores comprising baseline CXR variables, including the Ralph et al. score and the SCS from this study.

Students' perspectives on research and assessment of a model template designed to guide beginners in research in a medical school in Cameroon.

BACKGROUND: Research activities for medical students and residents (trainees) are expected to serve as a foundation for the acquisition of basic research skills. Some medical schools therefore recommend research work as partial requirement for certification. However medical trainees have many difficulties concerning research, for which reason potential remedial strategies need to be constantly developed and tested. The views of medical trainees are assessed followed by their use and appraisal of a novel "self-help" tool designed for the purposes of this study with potential for improvement and a wider application. METHODS: This study was a cross-sectional survey of volunteering final-year medical students and residents of a medical school in Cameroon. RESULTS: This study surveyed the opinions of a total of 120 volunteers of which 82 (68%) were medical students. Three out of 82 (4%) medical students reported they had participated in research activities with a publication versus 10 out of 38 residents (26%). The reported difficulties in research for these trainees included referencing of material (84%), writing a research proposal (79%), searching for literature (73%) and knowledge of applicable statistical tests (72%) amongst others. All participants declared the "self-help" tool was simple to use, guided them to think and better understand their research focus. CONCLUSION: Medical trainees require much assistance on research and some "self-help" tools such as the template used in this study might be a useful adjunct to didactic lectures.

Pratique de l'hysterosalpingographie a l'hopital regional de Ngaoundere

OBJECTIFS:Decrire la pratique et les resultats de l'HSG dans le Service d'Imagerie Medicale de l'Hopital regional de N'Gaoundere.MeTHODES: Il s'agit d'une etude transversale descriptive. Les donnees ont ete collectees de janvier a decembre 2012 au travers d'un questionnaire. Les 120 hysterosalpingographies effectuees durant la periode d'etude ont ete incluses. Elles representaient 72;8 des examens radiologiques specialises et 3 de toutes les radiographies. L'age moyen des patientes etait de 33 ans. Les patientes avec une gestite de 0 a 1 representaient 80;5 et celles avec une parite de 0 a 1 representaient 90. Les antecedents etaient domines par les infections genitales (75); puis les avortements spontanes (10) et les avortements provoques (8). ReSULTATS L'indication principale de l'HSG etait l'infertilite (67;50); suivie du bilan tubaire apres myomectomie (16;90); des avortements a repetition (5;83); de la pelvialgie chronique (5) et des metrorragies (5). Le produit de contraste utilise etait iode hydrosoluble; et le volume moyen administre etait de 22 ml. En moyenne; six cliches ont ete realises par patiente. Dans 65;83 aucun effet indesirable n'a ete observe. Les effets indesirables observes etaient la douleur (26;3); l'hemorragie (5;30) et le malaise vagal (2;6). 89;47 des HSG avaient une lesion. Les pathologies observees etaient les obstructions tubaires (36; 66); les malformations uterines (12;5); les hydrosalpinx (8;35); les suspicions de myome (6;70); les beances du col (5;83); les synechies uterines (5;83) et les adherences peritoneales (5;83). CONCLUSION L'HSG est l'examen radiologique specialise le plus pratique dans le bilan de l'infertilite feminine a Ngaoundere. Ses resultats sont comparables aux autres series africaines. La douleur est le principal effet indesirable

Prevalence des anomalies transitionnelles lombosacrees dans une population de sujets camerounais souffrant de lombalgies chroniques

INTRODUCTION :Les vertebres transitionnelles lombosacrees (VTLS) et le spina bifida occulta (SBO) peuvent entrainer des lombalgies en particulier chez des sujets jeunes. Du fait de leur origine genetique; leur distribution pourrait varier en fonction des races ; pourtant leur prevalence demeure largement inconnue en Afrique. OBJECTIFS : Determiner la prevalence des VTLS et du SBO chez des noirs africains souffrant de lombalgie chronique. PATIENTS ET MeTHODES 575 radiographies du rachis lombaire (incidences de face et de profil) de patients noirs africains souffrant de lombalgie chronique ont ete revues a la recherche de VTLS de SBO. Les VTLS ont ete classees selon le systeme de Castellvi. Les proportions d'anomalies par sexe ont ete comparees par le test de Fisher. ReSULTATS L'age median des sujets etait de 44 ans [15 a 80 ans] et le sex ratio femme/homme de 1.03. La prevalence globale des VTLS et du SBO etait de 13;6 et 2;1 respectivement. Les VTLS etaient plus frequentes dans la population masculine avec une predominance du type IIa. La frequence du SBO n'etait pas influencee par le sexe. CONCLUSION :La prevalence de VTLS et de SBO chez le sujet noir africain souffrant de lombalgies est similaire a celles retrouvees dans les series caucasiennes et asiatiques

Prevalence and determinants of extrapulmonary involvement in patients with pulmonary tuberculosis in a Sub-Saharan African country: a cross-sectional study.

BACKGROUND: Determinants of extrapulmonary involvement during pulmonary tuberculosis (PTB) have not been extensively investigated. We assessed the prevalence and determinants of extrapulmonary involvement during PTB in a Sub-Saharan African country with a high prevalence of both TB and human immunodeficiency virus (HIV) infection. METHODS: The medical records of patients aged ≥ 15 y, admitted for a first episode of TB to the Pneumology Service of Yaoundé Jamot Hospital, Cameroon, between 2009 and 2010 were considered. Determinants of extrapulmonary involvement were investigated through logistic regression. RESULTS: A total of 984 patients (58.9% male), with a median age (25(th)-75(th) percentiles) of 32 (25-41) y were admitted for a first episode of TB, including 629 (63.9%) with isolated PTB, 127 (12.9%) with isolated extrapulmonary TB (EPTB), and 228 (23.2%) with both PTB and EPTB (PTB/EPTB). Therefore, the prevalence of EPTB among those with PTB was 26.6% (228/857). The main determinants of EPTB among patients with PTB were male sex (adjusted odds ratio (OR) 2.71, 95% confidence interval (95% CI) 1.71-4.03), HIV infection (OR 2.20, 95% CI 1.36-3.55), absence of fibrotic lung lesions (OR 1.96, 95% CI 1.23-3.14), smear-negative PTB (OR 7.20, 95% CI 4.13-12.56), anaemia (OR 1.60, 95% CI 1.03-2.50), and leukopenia (OR 2.59, 95% CI 1.12-5.98). CONCLUSIONS: About a quarter of patients with PTB in this setting also have extrapulmonary involvement. EPTB is less contagious, less frequent than PTB, and less well addressed by programs in developing countries, while its identification is important for optimizing care. The presence of determinants of EPTB among patients with PTB should motivate active investigation of extrapulmonary involvement in order to improve management.

Facteurs predisposant au traitement chirurgical dans la prise en charge de la pelviperitonite a Yaounde; Cameroun

Contexte et objectifs: Les facteurs d'echec de l'antibiotherapie en cas de pelviperitonite sont peu connus. L'objectif de cette etude etait de determiner les facteurs predisposant du traitement chirurgical dans la prise en charge de la pelviperitonite. Methodologie: Il s'agissait d'une etude cas-temoins avec collecte retrospective des donnees; concernant tous les cas de pelviperitonite traitees a l'Hopital Gyneco-Obstetrique et Pediatrique de Yaounde du 1er janvier 2007 au 31 decembre 2011. Resultats: Quatre-vingt-douze malades ont ete incluses; parmi lesquelles 75 patientes (75/92 ; 81;5) n'avaient recu que le traitement medical (groupe temoin) et dix-sept (17/92 ; 18;5) avaient necessite une prise en charge chirurgicale (groupe cas); soit une incidence de la chirurgie dans le traitement des pelviperitonites de 18;5. Les facteurs predisposant au traitement chirurgical etaient: un age 25 ans [P