Determinants of death among tuberculosis patients in a semi urban diagnostic and treatment centre of Bafoussam, West Cameroon: a retrospective case-control study

Introduction: Tuberculosis (TB) remains a worldwide public health problem with 8.6 millions of new cases and 1.3 millions of death annually. Despite the progress recorded in fighting against this disease in the recent years, Africa is still not on the track to achieve the objective to reduce by half the death rate due to this disease by 2015. Methods: A case-control study was conducted on data of patients admitted for tuberculosis between 1996 and 2011 in the Diagnostic and Treatment Center of Baleng. Cases were patients who died from any cause during anti tuberculosis treatment. Logistic regression model was used to identify factors associated to death.Results: In 4201 patients treated during the study period, 3245 (77.24%) were included in the study. The mean age was 35.9 (SD 14.2) and male represent 62.2% (CI 60.6- 63.9) of them. At the end of the follow up, 2883 patients were successfully treated, 362 died during treatment and 132 (36.5%) deaths occurred during the first two months of TB treatment. HIV positive status, Extra-pulmonary TB, sputum smear-negative pulmonary TB and male sex were significant independent risk factors of death with adjusted odds ratio of 4.8 (CI 3.2- 7.4); 3.0 (CI 1.6- 5.4) ; 2.7 (CI 1.7- 4.4) and 1.5 (CI 1.0- 2.3) respectively. Conclusion:The mortality rate of TB patients undergoing TB treatment remains high. Studies are needed  to identify and test efficient interventions of mortality reduction among TB patients in resource limiting  settings.Key words: Tuberculosis, death, factors, Cameroon

Duty cycle modulation - fuzzy logic technique to track the maximum power point of a solar-wind hybrid Source

In this article, we propose a strategy for finding the maximum power point (MPP) of a hybrid plant (solar and wind), in order to maximize the power extracted from this production plant. This strategy exploits the perturbation and observation method, based on fuzzy logic coupled with the Duty Cycle Modulator (DCM). The main objective of this study is to extract the maximum power from this hybrid power plant, while ensuring the precision and speed of convergence towards this point of maximum power. This method, tested under the Matlab / Simulink environment for a 160 kW hybrid power plant, gave results that we compared to those obtained with the Fuzzy - PWM (Pulse Width Modulator) strategy. It emerges that the Fuzzy-DCM strategy gives better precision (around 2.6 times) and a speed (around 2 times) of convergence compared to the Fuzzy-PWM strategy

In vivo and in vitro anti-natriuretic activity of twigs fraction from Dorstenia picta: a possible mechanism.

The present study examine the in vivo effects of Dorstenia Picta (D. picta) on urinary volume and sodium excretion in streptozotocin-induced diabetic rats, and determine a possible mechanism by which the extract increased sodium transport in A6 cells monolayers. Administration of the plant extract at the dose of 150 mg/kg during two weeks decreased urinary volume and sodium excretion. In vitro study showed that, apical application of the plant extract at the dose of 100 µg/mL does not significantly increase sodium transport, whereas basolateral administration provoked a significant (P<0.05) increase of sodium transport in a concentration-dependent manner. The plant extract increases the sodium transport by 69.93% versus 55.41% for insulin and 78.44% for adenosine after 30 min. Preincubation of A6 cells monolayers with inhibitor of all adenosine receptors completely suppressed adenosine and plant extract stimulated sodium transport. Interesting is that, the A1 inhibitor receptor (DPCPX), at 100 nM completely abolished the effect of plant extract. The plant extract increased sodium transport by increase PI3-kinase activity and this effect is strongly inhibited by LY-294002. These data also suggest that, the twigs methanol fraction from Dorstenia picta increase sodium transport via PI 3-kinase pathway and requires A1 adenosine receptor.info:eu-repo/semantics/publishe

Hibiscus noldea (Malvaceae) Aqueous Extract Prevents Insulin Resistance and Protects Pancreatic Islets From Dexamethasone Damages in Rat.

Hibiscus noldea leaves-stems aqueous extract is used in Cameroonian traditional medecine to manage diabetes. To investigate the preventive effect of Hibiscus noldea aqueous extract on dexamethasone-induced insulin resistance, the animals received one of the following treatments: distilled water (10 mL/kg), metformine (200 mg/kg), or H. noldea (100 or 200 mg/kg) concomitantly with dexamethasone (0.5 mg/kg, ip) for ten days. Body weight was evaluated daily and blood glucose levels were measured. At the end of experiment, insulin sensitivity test was performed and lipid profile, transaminases Aspartate amino transferase, Alanin amino transferase, malondialdehyde, superoxide dismutase, catalase, and reduced glutathione were evaluated. Histological analysis of the liver was investigated to estimate glycogen content using Periodic Acid Schiff coloration and histomorphometry of pancreatic islets area was performed.The administration of dexamethasone during ten days induced body weight loss, hyperglycaemia, insulinresistance, an imbalance in lipid profile, an increase in transaminases and oxidative stress. Dexamethasone treatment also induced an increase in the pancreatic islets area and depletion in the levels of hepatic glycogen. Concomitant administration of dexamethasone and the aqueous plant extract prevented the rise in blood glucose levels, reduced insulinresistance, improved lipid profile and oxidative status. The aqueous extract of H. noldea prevented the use of glycogen storage and the increase in pancreatic islet area in dose dependent manner.Conclusion: The stem leaves aqueous extract from Hibiscus noldea have the ability to reduce insulinresistance via its antihyperglycaemic, hypolipidemic and antioxidant activities. These results justify the use of this extract in the management of diabetic state

Aqueous extract of Peperomia pellucida (L.) HBK accelerates fracture healing in Wistar rats

Abstract Background Peperomia pellucida (L.) HBK is consumed as vegetable and used in Cameroonian traditional medicine for the management of diseases and for fracture healing. Therefore the aim of this study was to evaluate the effects of the aqueous whole plant extract of Peperomia pellucida on fracture healing in female Wistar rats. Methods A drill hole injury was created by inserting a drill bit inthe diaphysis of the femur. The aqueous extract of the whole plant of Peperomia pellucida was administered orally at the doses of 100, 200 and 400 mg/kg to adult female Wistar rats. The vehicle (distilled water) was given to the control. Besides these rats, one group of rats without fracture received the extract (400 mg/kg). After 14 days of treatment, the rats were sacrificed under anesthesia and the effects of the extract were evaluated on body weight, the relative weights of organs (femurs, uteri and ovaries) and on hematology. Bone (calcium, phosphorus, alkaline phosphatase) and serum biochemical parameters (calcium, phosphorus, alkaline phosphatase) were also evaluated. Radiological and histological tests were carried out on the femurs. The mineral content of the plant extract was also investigated. Results The extract induced an increase in body weight at high dose and in WBCs count at low doses. Aqueous extract from Peperomia pellucida increased bone calcium at lowest dose but maintained this parameter at normal range at high dose in fractured rat. Alkaline phophatase and phosphorus concentrations reduced significantly (p < 0.01) at the dose of 400 mg/kg as compared to fractured rats. Moreover, radiological tests revealed a dose dependent formation of callus at the level of the fracture gap, confirmed by the formation of a highly dense and compact fibrocartilagenous callus. The mineral content of the plant extract revealed the presence of calcium, phosphorus, magnesium, sodium and potassium. Conclusion The aqueous extract of P. pellucida accelerates bone healing due partly to the mineral content of the extract. These results confirm its traditional use in the treatment of bone fractures