Predictive values of ultrasound characters associated with malignant thyroid nodules in Yaoundé: a cross-sectional study.

Introduction: most ultrasound criteria are defined in developed countries and commonly used in practice to assess the malignancy risk of thyroid nodules. This practice does not take into consideration some aspects of our context as delay of consultation and insufficient iodine intake. The objective of this study was to determine the predictive values of ultrasound characters associated with malignant thyroid nodules in our environment. Methods: we conducted a cross-sectional, prospective, and analytical study in three hospitals in Yaoundé over a six-month period in 2022. Our sample consisted of thyroid nodules with ultrasound, cytopathological, and histopathological data. The ultrasound characters and histology status of category III thyroid nodules and higher in Bethesda score were analysed in univariate and multivariate statistics to determine their predictive values. Results: eighty-nine nodules were obtained according to our inclusion criteria. The sex ratio was 0.46 and the average age of the patients was 46 years (IQR=42-59). The cancer prevalence in our sample was 22.47%. On ultrasound assessment, the characters associated to malignant histology (p<0.05) were nodules count, echogenicity, echostructure, presence or absence of microcalcifications, margins, and type of vascularization. Positive predictive values ranged from 26.15 to 57.14%, while negative predictive values ranged from 12.5 to 33.3%. Conclusion: taken alone, the ultrasound characters of suspected thyroid nodules have poor predictive values. There was a high variability in sensitivity but that was generally good (60-95%) while specificity was low. The prediction of malignant thyroid nodules is correlated with the association of at least two ultrasound criteria supported by clinical arguments.

Profil clinique de la surdité de l'enfant à Yaoundé / Clinical profile of child deafness in Yaounde

In Cameroon, the prevalence of deafness in children is 3.6%. The aim of this study was to describe the clinical profile of these hearing impaired children at the time of diagnosis. Patients and methods.This was a descriptive cross-sectional study that took place between November 2020 and June 2021 and involved 127 hearing impaired children. Results.The mean age of these children was 9.2 ± 3.9 years, with extreme values of 1 and 15 years. The sex ratio was 1.3. The average number of children in the siblings was 3.5 ± 1.8 children and 30.7% occupied the 1st rank in their siblings. The average birth weight was 3269 ± 0.685g. The neonatal history was found in 11.81% of the cases while the postnatal history related to 32.28% of the cases. Maternal alcoholism and parental genital infections were found during pregnancy. Familial deafness was found in one of the mothers (0.4%) and in the siblings in 3.1% (n=4). At the time of diagnosis, the median age was between 0 and 24 months, the mode of onset was old and 96.9% of children had bilateral deafness. The absence of reaction to noise and the delay of language were the most found modes of revelation. Moderate and severe deafness were the most represented and were mostly sensory or mixed. Among these deaf children, 4%presented a handicap or an associated pathology. Conclusion.The causes of child deafness in Yaoundé are acquired in perinatal period. This deafness is diagnosed in the perilingual period and remains dominated by bilateral deafness, whether severe or profound

Thyroid heterotopia revealed by a cervical subcutaneous nodule: a clinical case report.

Thyroid heterotopia is an abnormal localization of normal thyroid tissue coexisting with a normal organ on a normal localization. It is a rare condition with a frequency that is not well known in the literature. We report a case of thyroid heterotopia in a 30 month-old girl referred for a painless lower antero-cervical nodule that has been developing for one year with past history no contributory. The clinical examination found a subcutaneous formation mobile in relation to the different deep and superficial planes with bilateral angulomandibular micro-lymphadenopathy. Ultrasounds of the soft parts of the neck showed hypoechogenic tissue reminiscent of thyroid tissue, the thyroid was in place. The thyroid hormone profile was normal. In the absence of a functional scintigraphy device, the diagnosis was confirmed with a pathology exam after surgery. We discuss the diagnostic relevance of thyroid heterotopia in front of any anterior nodular formation of the neck.

Effectiveness of amoxicillin alone in the treatment of uncomplicated acute otitis media: a systematic review protocol.

INTRODUCTION: Amoxicillin is the first-line antibiotic recommended by most scientific societies for the treatment of uncomplicated acute otitis media (AOM) in children and adults. In low-income and middle-income countries however, absence of setting-specific recommendations and antibiotic resistance, promoted by higher population density and over-the-counter antibiotic availability, could hamper the effectiveness of amoxicillin. We aim to provide updated information to enable evidence-based decisions for first-line therapy of uncomplicated AOM in our setting. METHODS AND ANALYSIS: We will conduct a systematic review of all randomised controlled trials on the clinical effectiveness of amoxicillin for the treatment of uncomplicated AOM in children above 6 months and adults. The search will include studies published from the generation of the included databases to 31 December 2017. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and study quality will be assessed by the Risk of Bias Assessment Tool from the Cochrane Handbook for randomised trials. A meta-analysis will be conducted for homogeneous studies, eventually, using the fixed-effect model. Subgroup analysis will include age groups, amoxicillin dosage, treatment duration, effectiveness criteria, time of trial realisation, study quality and region of the world involved. ETHICS AND DISSEMINATION: Formal ethical approval is not required, as primary data will not be collected. The results will be disseminated through a peer-reviewed publication and presented at scientific meetings. PROSPERO REGISTRATION NUMBER: CRD42017080029.

Kidney function, urinalysis abnormalities and correlates in equatorial Africans with sickle cell disease.

BACKGROUND: Little is known about the renal profiles of individuals with sickle cell disease (SCD) in equatorial Africa, the global epicenter of SCD. We evaluated the kidney function, urinalysis abnormalities and their correlates in a group of Cameroonians homozygous for SCD. METHODS: This was a cross-sectional study of 4-month duration involving 72 homozygous SCD patients (39 men, 54%), recruited during routine visit or vaso-occlusive crisis at the Yaoundé Central Hospital in Cameroon. Clinical and laboratory data were used to evaluate the renal and urinalysis parameters, and potential effects of SCD-related clinical and hematological variables on those parameters investigated through linear and logistic regression models. RESULTS: The mean serum creatinine increased with increasing age, translating into a decreasing estimated glomerular filtration rate (eGFR) with age (P < 0.001). One patient (1.4%) had an eGFR of <60 mL/min and nine others (12.5%) had 60 ≤ eGFR ≤ 90 mL/min. The eGFR was lower in women and decreased with increasing systolic blood pressure. The prevalence of proteinuria (>200 mg/g) was 93% and the main urinalysis abnormalities were leukocyturia (77.8%), albuminuria (40.3%), hematuria (13.9%) and cristalluria (9.7%). None of the predictive clinical, hematological and urinary factors studied was associated with proteinuria or albuminuria, while hematuria and leukocyturia were associated with increasing age and male gender. CONCLUSIONS: Cameroonians homozygous for SCD present a high prevalence of proteinuria and urinalysis abnormalities, and a slight renal impairment. Age, blood pressure variables and gender seem to be the main determinants. Urinalysis abnormalities and kidney function assessment should be an active pursuit in women with SCD.