[Late presentation of anorectal atresia: a case report]. / Atrésie rectale membraneuse: présentation tardive à propos d'un cas.

Anorectal atresia and rectal stenosis are rare types of anorectal malformations, accounting for only 1-2% of cases. We here report one case of anorectal atresia. The study involved a female newborn baby delivered at term via vaginal birth, weighing 3600g, who was admitted with failure to pass meconium, abdominal bloating and fever on day 6 of life. Clinical examination showed a temperature of 39ºC, distended abdomen, normal anal location and peremeability, with prolapsed pinkish mass and no signs of necrosis. A cannula trocar stylet was inserted between the mass and rectal mucosa and stopped at about 3cm from the anal margin. Abdominal X-ray without treatment showed distended bowels and air-fluid levels, with no evidence of hollow-organ perforation. Due to suspicion of complete anorectal atresia, 16 gauge needle was inserted into the membrane and meconium was collected abundantly with considerable abdominal deflation. Surgical excision of the membrane was then performed. The postoperative course was uneventful and newborn baby was discharged at postoperative day 3. Anal dilatations were performed to treat anal stenosis. At 6-months´ follow-up, functional outcome was satisfactory. Anorectal atresia manifesting as failure to pass meconium associated with mass protruding through the anus has not yet been described in the literature. Membrane puncture confirmed the diagnosis. Membrane was resected with good outcome.

[Prognosis and survival of esophageal cancer in Cameroon: a prognostic study]. / Facteurs pronostiques du cancer de l'œsophage au Cameroun: étude multicentrique.

INTRODUCTION: Esophageal cancer is rare. Poor prognosis is due to delayed diagnosis. Five year survival is less than 20%. This study aimed to investigate the factors associated with survival of patients with esophageal cancer in Cameroon. METHODS: We conducted a prognostic study in the General Hospitals in Yaoundé and in Douala over a period of 11 years from 1 January 2005 to 31 December 2015. The parameters studied were those associated with survival. Survival was established on the basis of the date of diagnosis and of the date of death or of the last visit. SPSS software (Statistical Package for Social Sciences) version 23 allowed for data analysis. Kaplan Meier curve was used to estimate the survival function. Log RankTest allowed for comparison among the different groups. Cox regression helped to highlight the different factors associated with it. Significance level was set at 0.05. RESULTS: We collected data from 49 medical records. The average age of patients was 57.83 years. There was a male predominance (71.4%; n=35) with a sex ratio of 2.49. The follow-up period was 3.2 months. Median survival was 6.67 months (CI 95% [1.33-10.4]) and the average survival time was 7.99 months (CI 95% [4.42-11.17]). Multivariate-adjusted analysis showed that stage IV was a predictive factor of mortality (HR = 2.79; CI95% [1.13-6.89], p = 0.025]). CONCLUSION: Esophageal cancer is a rare disease with poor prognosis. Prognostic factor is the tumor stage.

Knowledge, Attitude, and Practice on Breast Cancer among Health Professionals in Douala References Hospitals, Cameroon.

In Cameroon, patients with breast cancer are more often diagnosed at stage III and IV, hence the need of preventives actions. Knowledge and attitude of medical personnel may influence their practice with regards to screening and early detection of breast cancer. Very few is known about this subject in Cameroon. The objective was to describe the knowledge, attitude, and practice of health care professionals on breast cancer risk factors, diagnostic methods, and screening. This was a cross-sectional study conducted during a 6-month period, among health professionals of Douala General Hospital and Laquintinie Hospital, Cameroon.Data were collected using a self-administered questionnaire which included demographic characteristics, questions on breast cancer risk factors, screening, and diagnostic methods. Marks were attributed to each question and calculated for each section. Participants fell in four categories of knowledge, attitude, and practice: very weak, weak, good, and excellent. The software XLStat7.5.2 was used for data analysis. Overall, 445 health professionals were interviewed. The average age was 39 ± 9 years. The level of knowledge, attitude, and practice was accessed respectively as weak (50.1%), very good (64.5%), and poor (36.4%). The personal practice of female workers was poor (43.0%). Compared to participants with very weak to weak knowledge, those with good to excellent knowledge had 1.55-fold odds of excellent attitude p < 0.0001. After multivariate analysis, the factor associated with good to excellent knowledge was the participant qualification (academic degree). These results suggest the need for training of health professionals in Douala references hospitals on breast cancer risks factors, diagnostic, and screening methods.