Contribution Of Autopsy To Medical Practice In Cameroon: A 10 year review.

Of 12.000 bodies received at the mortuary of the Yaounde General Hospital, 126 were autopsied in this 10-year retrospective study from 1997 to 2007, giving a rate of 1 autopsy in 100 deaths. 72.2% of cases were males against 27.8% females. The predominant age group was 20-69 years (57.1%). The main causes of death include natural disease (32.5%), physical aggression (20.6%), road traffic accident (19.8%), poisoning (9.5%), asphyxia (7.1%) and firearm injury (6.4%). The indication for autopsy was mainly medico-legal (91.7%). The circumstances of death showed a predominance of natural causes (34.1%), murder (32.6%), and homicide (28.6%). Though the benefits of an autopsy to the family, medical practice and entire community are enormous, the rate of this procedure in our community is low. We recommend public education and advocate for a legislative framework thatregulates autopsy practice, at least, in teaching hospitals in our country

Gynecological cancer profile in the Yaounde population, Cameroon

This population-based retrospective study was carried out in the Yaounde Population Cancer Registry (YPCR) at the General Hospital Yaounde, Cameroon. The aim was to find out the socio-economic, epidemiologic, anatomic and pathologic profile of patients with gynecological cancers in the Yaounde population. The database of the registry was reviewed between January 1, 2004 and June 30 2005 (18 months). All cases of microscopically confirmed gynecological cancers registered within this period were recruited. Defined as gynecological cancers are cancers of the breast (in women), ovary, uterine corpus, vulva, vagina, and cervix. The results showed that gynecological cancers have a monthly incidence of 30 cases. Whereas cancers of the placenta, vagina, breast, and ovary affect younger adults, endometrial, vulval and cervical cancers predominate in the elderly. 58% of the women were aged between 34-54 years. Most patients are from the West (30.55%), Centre (28.90%) and Littoral (10.00%) provinces respectively. The commonest cancers are the breast (48.12%), cervix (40.18%), and ovary (5.82%) at respective average ages of 42.80 years (19-76 years range), 53.08 years (24-78 years range) and 44.22 years (9-75 years range). Cancers of the uterine corpus are rare. Most patients were illiterate, of low to average socio-economic status, presenting at advanced stage of disease. Cancer of the breast is common in the upper social class; while malignancies of the cervix, endometrium, and vagina predominate in the low and middle classes. Only 17.5% of our patients had been previously screened for any form of cancer prior to present disease. We had no data on family history of cancer. We recommend intensive public health education and sensitization of women on primary and secondary prevention especially for cervical and breast cancers. Gynaecological services should be vulgarized and existing ones improved with defined referral and counter referral systems. Further in-depth studies to document trends on cancer survival are recommended. Clinics in Mother and Child Health Vol. 3(1) 2006: 437-44

Chimiotherapie des angiosarcomes de Kaposi au service d'oncologie medicale de L'hopital General de Yaounde, Cameroun

Compte tenu de la séroprévalence de l'infection à VIH/SIDA au Cameroun (5,5%), le service d'oncologie médicale de l'Hôpital Général de Yaoundé, prend en charge par chimiothérapie les patients porteurs d'angiosarcome de Kaposi. Nous avons voulu évaluer la chimiothérapie de l'angiosarcome de Kaposi dans notre service. Une étude descriptive rétrospective a été menée sur une année. Les patients recrutés ont été ceux avec un diagnostic d'angiosarcome de Kaposi. Les données collectées étaient les suivantes : le sexe, l'âge, la localisation, les pathologies associées, la chimiothérapie administrée, les réponses et la tolérance. Les deux dernières données ont été évaluées selon les critères de l'OMS. Au cours de cette année, 57 patients ont été reçus pour un angiosarcome de Kaposi dont 31 (54,4%) hommes et 26 (47,6%) femmes. Les âges extrêmes ont été 14 et 76 ans avec une moyenne de 39,05 ans. La localisation principale était tégumentaire (65,6% des localisations), diffuse pour la plupart des cas. Des 43 patients testés, 38 (88,4%) avaient une sérologie VIH positive et 5 (11,6%) négatifs. Dans notre échantillon, 84,6% ont reçu une polychimiothérapie associant la doxorubucine, la bléomycine et la vincristine. Seuls 20 patients des 38 séropositifs soit 52,6% ont reçu des antiretroviraux. La réponse partielle a été objectivée chez 16 sur 19 (84,2%) de nos patients. La toxicité observée a été hématologique et 13 patients (22,8%) ont été transfusés pour anémie. Nous concluons que la chimiothérapie est bénéfique dans le traitement du sarcome de Kaposi. Des études comparatives ultérieures précisent si le traitement de ces patients améliore la qualité de vie et la survie. Clinics in Mother and Child Health Vol. 3(1) 2006: 469-47

Antioxidant Capacity, Cytoprotection, and Healing Actions of the Leaf Aqueous Extract of Ocimum suave in Rats Subjected to Chronic and Cold-Restraint Stress Ulcers

We evaluated the qualitative chemical composition and tested the antiulcer actions on cold/restraint stress ulcers, the healing effect on chronic acetic acid-induced gastric ulcers, and the in vivo and in vitro antioxidant capacity of Ocimum suave extract. Triterpenes, flavonoids, sugars, phenols, sterols, and multiple bonds were among the phytochemicals detected. The extract (250–500 mg/kg) dose-dependently inhibited the formation of gastric ulcers induced by cold/restraint stress (52.30%–83.10%). The prophylactic actions were associated with significant increases in gastric mucus production. There was significant histological healing of chronic ulcers following 14-day treatment with O. suave extract (250–500 mg/kg). We also evaluated the efficacy of O. suave extract in cold/restraint-induced oxidative stress in rat stomach tissue. O. suave (500 mg/kg) ameliorated the decreased levels of reduced glutathione from 0.85 (control group) to 2.08 nmol/g tissue. The levels of SOD and catalase were also improved in rats treated with O. suave extract. The extract had a high phenol content (899.87 mg phenol/g catechin equivalent), in vitro DPPH radical scavenging activity (89.29%), and FRAP (antioxidant capacity) (212.64 mg/g catechin equivalent). The cytoprotective and ulcer healing effects of the extract are attributed to enhanced mucus production and the antioxidant properties which may likely be associated with the high presence of flavonoids and polyphenols

Burkitt's lymphoma: an epidemiological and anatomo-clinical review of 300 cases seen in Cameroon (Central Africa)

In this data-based retrospective study, we reviewed 300 cases of Burkitt's Lymphoma (BL) diagnosed within ten years from January 1st 1993 to December 31st 2002. The study took place in the Pathology laboratories of the Central Hospital and the General Hospital Yaounde, Cameroon. The aim was to review the anatomo-clinical and epidemiological aspects of the disease in our community, especially with respect to its localization. Previous studies had shown that BL is a common disease and a public health problem in Cameroon. It has also been shown to be predominantly oro-facial like in many other endemic regions. We were prompted by the predominant abdomino-pelvic localization over the oro-facial in our series to find out if the disease was becoming more localized in the former than the later site in endemic areas. We found that BL affected mostly children aged 5-14 years. A slight male predominance was observed (53.3% males against 46% females). Unlike in most previous local and international reports, BL in our series was found to be located in both the oro-facial and abdomino-pelvic sites. The abdomino-pelvic site was more frequent (57.7%). Anatomo-pathological diagnosis of the tumour was mainly by Fine Needle Aspiration Cytology (FNAC). Patients presented with a localized mass and non-constitutional signs of malignancy. Six percent of our patients tested positive for the Human Immunodeficiency Virus (HIV). Other epidemiological and clinical findings were similar to those reported in previous literature. We recommend further in-depth studies, to find out if there are any emerging factors that influence the localization of the disease in endemic areas or if our finding is incidental. Keywords: Burkitt, lymphoma, Localization, abdomen, pelvic, oral, facial Resume:Dans cette étude rétrospective à base de données, nous avons revu 300 cas de lymphome de Burkitt (LB) diagnostiqués pendant une période de 10 ans allant du 1er janvier 1993 au 31 décembre 2002. L'étude a eu lieu dans les laboratoires d'anatomopathologique de l'Hôpital Central et l'Hôpital Général de Yaoundé, Cameroun. Le but était de répertorier les aspects anatomocliniques et épidémiologiques de cette maladie dans nos communautés, en particulier concernant sa localisation. Des études antérieures ont démontré que le LB est une maladie courante et constitue un problème de santé publique au Cameroun. La localisation oro-faciale chez nous, comme dans d'autres régions endémiques a toujours été évoquée. La majorité de nos malades étaient âgés de 5-14 ans. Une légère prédominance du sexe masculin est notée. Contrairement aux études antérieures locales et internationales, le LB dans notre série avait une localisation oro-faciale, et abdomino-pelvienne. La localisation abdomino- pelvienne était prédominante à 57,7%. La quasi totalité du diagnostic anatomo-pathologique était faite par aspiration cytologique à l'aiguille fine. Les patients se présentaient avec une masse localisée et d'autres signes non-constitutionnels de néoplasie. Six pour cent de nos malades était testé positif au Virus d'Immuno Déficience Humaine (VIH). Les autres aspects épidémiologiques et cliniques étaient similaires à ceux reportés dans la littérature. Nous recommandons des études approfondies pour démontrer l'émergence ou non de nouveaux facteurs qui influencent la localisation de la maladie dans les régions endémiques, et pour déterminer si notre observation est isolée. Mots cles: Burkitt, lymphoma, localization, abdomen, pelvienne, oro-faciale Clinics in Mother and Child Health Vol. 2(1) 2005: 223-22

Hemangiopericytome Meninge: Rapport clinico-pathologique d\'un cas

Nous rapportons l\'observation d\'un hémangiopéricytome de localisation méningée (HPCM) chez une femme de 42 ans reçue à l\'Hôpital Général de Yaoundé, Cameroun. Cette tumeur est rare chez nous, et la localisation méningée exceptionnelle. Le diagnostic histologique est difficile, la tumeur étant souvent confondue à un méningiome. La patiente a été opérée et ensuite soumise à une radiothérapie. Elle se porte bien 6 mois après son traitement. Il est recommandé aux pathologistes d\'exclure un probable HPCM en cas de ‘méningiomes atypiques\' primaires, récidivants ou métastatiques. Etant donné le taux de récurrence élevé avec des métastases tardives, un suivi des patients traités de cette tumeur à long terme s\'avère important. Une surveillance à long terme est prévue.The authors report the case of a meningeal hemangiopericytoma (MHPC) in a 42-year-old woman seen at the General Hospital Yaoundé, Cameroon. This tumour is rare in our environment, and the meningeal location is even rarer, difficult to diagnose histologically and often confused with a meningioma. The patient, who was treated by surgery followed by radiotherapy, is well six months after treatment. Pathologists are advised to rule out an MHPC in case of a primary, recurrent or metastatic ‘atypical meningioma\'. Given the high recurrent rate with late metastasis of this tumour, long term follow up of patients is important. A long term surveillance and follow-up is envisaged Keywords: Hemangiopericytoma - meningeal- Cameroon.Clinics in Mother and Child Health Vol. 5 (2) 2008: pp. 937-94

Prevalence and associated risk factors of urinary tract infection in pregnancy at the Douala General Hospital, Cameroon: a case–control study

Introduction. The burden of urinary tract infection (UTI) in pregnancy has been understudied in Cameroon.Aim: to determine the prevalence and risk factors of UTI in pregnancy in a tertiary hospital in Cameroon.Materials and methods. A hospital-based matched case-control study of pregnant women with evidence of UTI and those without who underwent antenatal care and gave birth at the Douala General Hospital from January 2014 to December 2018. Demographic, reproductive health/clinical data were collected using a pre-tested questionnaire and analyzed with SPSS.Results. The prevalence of UTI in pregnancy was 4.41 %. Poor antenatal care uptake (AOR = 5.64; 95 % CI = 2.21–14.33), multiple weekly sexual intercourses (AOR = 4.64; 95 % CI = 0.22–96.94), a history of UTI (AOR = 3.01; 95 % CI = 1.12–8.04) and drying the genitals from back to front (AOR = 5.50; 95 % CI = 1.95–15.44) were associated factors.Conclusion. The prevalence of UTI in pregnancy is low amid multiple associated factors. Screening for UTI in pregnancy should be made the standard of obstetric care in Cameroon

Juvenile Gigantomastia Treated By Reduction Mammoplasty With Nipple-Areola Complex Grafting In The Yaounde General Hospital, Cameroon

Juvenile gigantomastia is a rare benign disorder of the breast. The etiology of this disorder is unknown. The authors present the case of a 13 year-old girl, who presented a six month history of rapid bilateral asymmetric breast enlargement after menarche. The patient underwent bilateral reduction mammoplasty with a nipple-areola complex grafting. A total of 11100g tissue was removed representing 21% of her body weight. Nine months after surgery, the esthetic result was satisfactory and no signs of recurrence were noted. This case is proof that reduction mammoplasty can give satisfactory results even in developing countries.La gigantomastie juvénile est une maladie bénigne rare des seins . L\'étiologie n\'est pas connue. Les auteurs rapportent le cas d\'une jeune fille de 13 ans, qui a présenté en six mois après sa ménarche un développement mammaire rapide, asymétrique et exagéré. Une mammoplastie de réduction avec greffe de la plaque aréolo-mamelonnaire a été réalisée. Au total 11100g de tissu mammaire ont été excisés, soit 21% de son poids corporel. Neuf mois après la chirurgie, le résultat esthétique est satisfaisant et aucun signe de récidive n\'est noté. Ce cas est une preuve que la plastie mammaire de réduction peut être pratiquée avec un résultat satisfaisant même dans les pays en voie de développement.Keywords:Juvénile - Gigantomastie - Yaoundé, Cameroun.Juvénile - Gigantomastie - Yaoundé, Cameroun.Clinics in Mother and Child Health Vol. 5 (2) 2008: pp. 951-95

Healing and Antisecretory Effects of Aqueous Extract of Eremomastax speciosa (Acanthaceae) on Unhealed Gastric Ulcers

Objective. This work investigated the healing and antisecretory effects of the aqueous extract of Eremomastax speciosa on “unhealed gastric ulcers” associated with gastric acid hypersecretion. Materials and Methods. “Unhealed gastric ulcers” were induced using indomethacin following the establishment of acetic-acid-induced chronic gastric ulcers. The extract (200 and 400 mg/kg, per os) was administered concomitantly with indomethacin (1 mg/kg, subcutaneously). The effects of the extract on both basal and histamine-stimulated gastric acid secretion were determined. Mucus secretion and oxidative stress parameters were measured, and histological assessment of ulcer healing was carried out. Results. The extract significantly promoted the healing process in rats subjected to “unhealed gastric ulcers” (82.4–88.5% healing rates). Treatment with the extract significantly reduced the basal (25.95–49.51% reduction rates) and histamine-stimulated (24.25–47.41%) acid secretions. The healing effect of the extract was associated with a significant (p<0.05) increase of mucus secretion and concentrations of antioxidant enzymes compared with the controls. The extract at the highest dose showed normalization of the mucosa, without glandular destruction and with the disappearance of fibrosis and lymphocyte infiltration. Conclusion. The abilities of the extract to increase mucus secretion, to reinforce antioxidant status, and to inhibit acid secretion would be some of the mechanisms by which this extract would accelerate the healing process in “unhealed gastric ulcers.