Crossed Fused Renal Ectopia: A Rare Malformation Diagnosed in Context of Pyelonephritis in Yaounde – Cameroon

The authors report a case of crossed renal ectopia with fusion of the upper renal poles, a rare congenital anomaly of the urinary system in which one of the two kidneys is on the contralateral side, the ureter of the ectopic kidney crosses the midline to plug into the bladder on the normal side. For this 8-year-old male patient, radiological exploration was performed for periumbilical and hypogastric abdominal pain with fever and dysuria caused by a pyelonephritis. Some cases of crossed-renal ectopia remain asymptomatic and the diagnosis is often incidental. Abdominal ultrasound is the first-line imaging technique for the diagnosis which is confirmed by the CT-scan. The interest of this case is both epidemiological, diagnostic and didactic because it is very rare and the medical imaging plays an important role to underpin this diagnosis

Crossed Fused Renal Ectopia: A Rare Malformation Diagnosed in Context of Pyelonephritis in Yaounde – Cameroon

The authors report a case of crossed renal ectopia with fusion of the upper renal poles, a rare congenital anomaly of the urinary system in which one of the two kidneys is on the contralateral side, the ureter of the ectopic kidney crosses the midline to plug into the bladder on the normal side. For this 8-year-old male patient, radiological exploration was performed for periumbilical and hypogastric abdominal pain with fever and dysuria caused by a pyelonephritis. Some cases of crossed-renal ectopia remain asymptomatic and the diagnosis is often incidental. Abdominal ultrasound is the first-line imaging technique for the diagnosis which is confirmed by the CT-scan. The interest of this case is both epidemiological, diagnostic and didactic because it is very rare and the medical imaging plays an important role to underpin this diagnosis

Dementia and cognitive impairment in French-speaking Sub-Saharan Africa: a comprehensive review on moving out of the shadows of neglect

Dementia is a global public health problem with increasing prevalence and incidence worldwide. The African continent is expected to bear the biggest brunt of the burden of dementia by 2050 because of the rapid demographic changes, including rapid population growth, an increase in life expectancy, and ageing. However, French-speaking Sub-Saharan African (FS-SSA) countries are underrepresented in research on dementia in Africa. While the reasons are diverse and complex, linguistic and cultural barriers to research, disproportionately affect these countries and may be significant factors. Any efforts, therefore, to redress the burden of dementia in Africa must consider the specific demographic, cultural, and linguistic characteristics of FS-SSA countries. This scoping review explores the current state of knowledge in dementia and cognitive impairment in Sub-Saharan Africa, highlighting research gaps and specific patterns unique to FS-SSA Africa. We identify pathways for research to bridge the knowledge gaps on dementia in FS-SSA as part of the global endeavor to tackle dementia worldwide

Evaluation de la pertinence des demandes d’angioscanner thoracique pour suspicion d’embolie pulmonaire à Yaoundé

Introduction : L’objectif de la présente étude était d’évaluer la pertinence des demandes d’angioscanner pour suspicion d’embolie pulmonaire (EP) à Yaoundé. Matériel et méthodes : Il s’agissait d’une étude transversale descriptive avec collecte rétrospective et prospective des données. Elle s’est déroulée sur une durée de 7 mois, dans les services de Cardiologie et d’Imagerie médicale de 4 hôpitaux de la ville de Yaoundé. Étaient inclus tous les patients ayant réalisés ou réalisant un angioscanner thoracique pour suspicion d’embolie pulmonaire (EP) durant la période de novembre 2018 à mai 2019. Les variables étudiées étaient les données sociodémographiques, la probabilité clinique de l’EP par le score de Wells, les facteurs prédisposants, ainsi que le recours aux examens paracliniques (D-dimères, échocardiographie, échodoppler des membres). La pertinence de la demande d’angioscanner thoracique a été évaluée selon les recommandations de la Société Européenne de Cardiologie. Le test de Khi carré et le test exact de Fisher ont été utilisés pour rechercher les facteurs associés au diagnostic d’embolie pulmonaire. Une valeur p<0,05 a été considéré comme statistiquement significative. Résultats : Nous avons retenu au total 71 patients dont la moyenne d’âge était de 54 ±15 ans avec des extrêmes de 18 et 89 ans. A l’évaluation du score de Wells, 25 patients (35,2%) avaient une probabilité clinique faible, 40 (56,3%) avaient une probabilité clinique intermédiaire et 6 (8,5%) avaient une probabilité clinique forte. La demande d’angioscanner thoracique était pertinente dans 76% des cas. La proportion d’embolie pulmonaire au scanner était de 39,4% (N=28). Cette fréquence était proportionnelle au degré de suspicion clinique soit 12% en cas de probabilité faible, 47,5% en cas de probabilité intermédiaire, et 100% en cas de probabilité forte. Le facteur le plus associé au diagnostic d’EP était la présence de signes de thrombose veineuse profonde (p=0,012). Conclusion: Les demandes d’angioscanner sont pertinentes dans trois quarts des cas dans notre série. L’utilisation du score de probabilité de Wells est fortement corrélée au diagnostic d’embolie pulmonaire en particulier en présence de signes cliniques de thrombose veineuse profonde. Ces résultats suggèrent de renforcer la sensibilisation des prescripteurs sur l’utilisation courante de ce score afin de limiter le risque d’irradiation et les dépenses financières des patients. English title: Relevance in the request of computed tomography pulmonary angiography for suspected pulmonary embolism in Yaoundé  Introduction: The present study aimed to evaluate the relevance in the prescription of computed tomography pulmonary angiography for pulmonary embolism suspicion in Yaoundé. Materials and methods. We conducted a cross sectional study during a period of 7 months (November 2018 to May 2019) at the cardiology and imaging units of 4 hospitals in Yaoundé. All consenting patients who underwent CTPA were included in the study. The variables studied were socio-demographic data, clinical probability (using Wells score) and paraclinical workups (D-dimers testing, echocardiography, venous ultrasonography). The relevance of prescription was evaluate using the European Society of Cardiology‘s guidelines. Chi square and Fisher tests were used to find association between clinical parameters and diagnostic of pulmonary embolism. A p value<0.05 was considered statistically significant. Results. A total number of 71 patients were recruited; the mean age was 54 ±15.4 years ranging between 18 to 89 years. In assessment of the Wells score, 25 patients (35.2%) had low clinical probability, 40 (56.3%) had intermediate clinical probability and 6 (8.5%) had high clinical probability. We have found that 76% of the request were appropriated according to the current guidelines of the European Society of Cardiology (ESC). The proportion of the pulmonary embolism in our population study was 39.4%. There was a linear relationship between level of clinical suspicion and proportion of pulmonary embolism with 12% in low probability, 47.5% in intermediate probability, and 100% in high Probability. The most associated factor of pulmonary embolism in CTPA was the presence of sign of deep venous thrombosis (p=0,012). Conclusion. The clinical request of computed tomography pulmonary angiography was relevant in three quarter of cases in our population. In case of high clinical suspicion, the diagnostic of pulmonary embolism was always positive. There is an urgent need to reinforce sensibilization of physician about adequate clinical request to reduce the risk of irradiation and high expenditure of the patients