Is thyroid stimulating hormone titration mandatory in the routine work-up of African males from infertile couples?

Background: The impact of thyroid hormones on male reproductive function is still insufficiently understood. The objectives of this study were to determine the frequency of thyroid dysfunction in men from infertile couples and to establish an association between TSH (thyroid stimulating hormone) values and sperm parameters.Methods: We conducted a cross-sectional analytical study on a consecutive series of men managed for couple infertility in two reference hospitals of Yaoundé from November 2017 to May 2018. For each participant, a questionnaire was administered, TSH was assayed using electro-chemo-luminescence and sperm analyzed. Statistical methods used were the Mann-Whitney test and the Spearman correlation coefficient with a significance threshold of 5%.Results: Overall, 123 men were recruited. The median age was 44 years old [38-50 years]; 60 (48.79%) patients had couple infertility lasting between 1 and 5 years. Primary infertility of the couple was the most common (82 cases, 66.70%). After sperm analysis, 86 patients (70%) had one or more anomalies. TSH titration revealed 03 (2.44%) cases of subclinical hyperthyroidism, 05 (4.06%) subclinical hypothyroidism and 115 (93.50%) euthyroidism. Significant associations were found between TSH and sperm parameters in the group of patients with thyroid dysfunction, but none in the euthyroid group.Conclusions: Frequency of dysthyroidism is low among African males from infertile couples. We noted significant correlations between TSH values and sperm parameters. The low frequency of thyroid dysfunction would be against a TSH titration in the routine work-up of these patients

Mycobacterium tuberculosisis the causative agent of tuberculosis in the southern ecological zones of Cameroon, as shown by genetic analysis

BACKGROUND: Tuberculosis (TB) is a major cause of mortality and suffering worldwide, with over 95% of TB deaths occurring in low- and middle-income countries. In recent years, molecular typing methods have been widely used in epidemiological studies to aid the control of TB, but this usage has not been the case with many African countries, including Cameroon. The aims of the present investigation were to identify and evaluate the diversity of the Mycobacterium tuberculosis complex (MTBC) isolates circulating in two ecological zones of Cameroon, seven years after the last studies in the West Region, and after the re-organization of the National TB Control Program (NTBCP). These were expected to shed light also on the transmission of TB in the country. The study was conducted from February to July 2009. During this period, 169 patients with symptomatic disease and with sputum cultures that were positive for MTBC were randomly selected for the study from amongst 964 suspected patients in the savannah mosaic zone (West and North West regions) and the tropical rainforest zone (Central region). After culture and diagnosis, DNA was extracted from each of the MTBC isolates and transported to the BecA-ILRI Hub in Nairobi, Kenya for molecular analysis. METHODS: Genetic characterization was done by mycobacterial interspersed repetitive unit–variable number tandem repeat typing (MIRU-VNTR) and Spoligotyping. RESULTS: Molecular analysis showed that all TB cases reported in this study were caused by infections with Mycobacterium tuberculosis (98.8%) and Mycobacterium africanum (M. africanum) (1.2%) respectively. We did not detect any M. bovis. Comparative analyses using spoligotyping revealed that the majority of isolates belong to major clades of M. tuberculosis: Haarlem (7.6%), Latin American-Mediterranean (34.4%) and T clade (26.7%); the remaining isolates (31.3%) where distributed among the minor clades. The predominant group of isolates (34.4%) corresponded to spoligotype 61, previously described as the “Cameroon family. Further analysis based on MIRU-VNTR profiles had greater resolving power than spoligotyping and defined additional genotypes in the same spoligotype cluster. CONCLUSION: The molecular characterization of MTBC strains from humans in two ecological regions of Cameroon has shown that M. tuberculosis sensu stricto is the predominant agent of TB cases in the zones. Three decades ago, TB was reported to be caused by M. africanum in 56.0% of cases. The present findings are consistent with a major shift in the prevalence of M. tuberculosis in Cameroon

A new isoquinoline and ceramide from the stem barks of Discoglypremna caloneura (Pax) Prain (Euphorbiaceae) with antiproteinase and cytotoxic activities.

peer reviewedTwo new compounds, an isoquinoline (1) and caloneuramide (2), a ceramide were isolated from the stem bark of Discoglypremna caloneura together with seven known compounds namely aurantiamide acetate (3), acetylaleuritolic acid (4), 3α-hydroxylaleuritolic acid 2α-p-hydroxybenzoate (5), mixture of stigmasterol (6) and β-sitosterol (7), mixture of 7-oxo-stigmasterol (8) and 7-oxo-β-sitosterol (9). Their structures were determined based on data from literature and spectroscopic methods. Derivatization reactions on the isoquinoline led to two new compounds, the methylated (10) and acetylated (11) derivatives. Some compounds and extracts were evaluated for their cytotoxic and antiproteinase activity. Antiproteinase effect of compounds 1, 10 and 11 exhibited IC(50) values of 10.77, 1.19 and 3.61 μg/mL respectively; significantly low compared to the standard drug, acetyl salicylic acid (IC(50) = 20.28 μg/mL). Ethyl acetate and methanol extract exhibited moderate cytotoxicity activity on Chang liver cells with CC(50) values of 167.90 ± 2.20 and 106.30 ± 2.03 μg/mL compared to the reference drug cucurmin (CC(50) = 11.05 ± 1.04 μg/mL)

Portage vaginal et profil de sensibilité du Streptocoque du Groupe B Chez la femme enceinte à l'Hopital Gynéco-Obstétrique et Pédiatrique de Yaoundé (Yaoundé)

In order to obtain reliable data on vaginal carriage of Streptococcus agalactiae in pregnant women and to formulate a prevention program of neonatal Group B Streptococcus (GBS) disease, we carried out a prospective cross sectional study for 6 months. The general objective of the study was to evaluate the prevalence of vaginal carriage and the resistance profile of GBS. The study involved 142 pregnant women presenting for antenatal care in Yaoundé Gynecology-Obstetric and Pediatric Hospital (YGOPH). Participants were interviewed using a standard structure questionnaire. Low vaginal swabs were collected and cultured on specific media. A presumptive identification of isolates was made using standard bacteriological methods. Confirmative identification of Group B Streptococcus was done and antimicrobial sensitivity testing was performed. Among the 142 pregnant women GBS colonization was confirmed in 11 (7.7%). The rate of carriage was 3.8% in the first trimester, 7% in the second trimester and 11.1% in the third trimester. The predominant germ was Candida albicans with a frequency of 45.2% among the germs found in monomicrobial culture and Gardnerella vaginalis (77.8%) among the germs in polymicrobial culture, followed by Candida spp (11.8%), S. agalactiae (8.6%) and Escherichia coli (4.3%). The result of antimicrobial sensitivity testing showed that all the GBS strains were sensitive to major antibiotics drugs tested. The highest rates of resistance were found with gentamycin (100%) and Cefuroxim (81.8%). The vaginal carriage of GBS among pregnant women is still high. Thus, well-planned, prospective studies will be necessary to fully appreciate the magnitude of the problem of GBS in our hospitals

C23 Composition chimique et activité antimicrobienne sur des souches responsables d’infections cutanées de l’extrait méthanoïque d’écorces de Vernonia conferta (Asteraceae)

Introduction : Vernonia conferta est une espèce utilisée par les populations camerounaises dans la prise en charge des plaies. L’objectif de ce travail était de déterminer la composition chimique et d’évaluer les propriétés antimicrobiennes de cette plante. Méthodologie : Nous avons mené une étude expérimentale. Le matériel végétal était constitué d’écorces de tronc de V. conferta récoltées dans la région du Centre, département de la Mefou et Afamba, localité de Nkolafamba, L’identification du spécimen a été effectuée à l’Herbier National du Cameroun sous le n° 10046. Le matériel a été nettoyé, séché durant 14 jours à l’abri du soleil, puis pulvérisé dans un broyeur mécanique. L’extraction a été faite par double macération de 72h dans 11 L de MeOH de la poudre d’écorces de V. conferta. Le mélange a été filtré sur du papier filtre Whatman N°3, le filtrat concentré à l’évaporateur rotatif Heidolph® (Hei-VAP ML/G3). L’extrait sec a été conservé à température ambiante à l’abri du soleil. Le criblage phytochimique qualitatif a été réalisé en utilisant les protocoles standards d’Harbonne de 1998. Pour l’isolement et la caractérisation des molécules, l’extrait brut a été dissout dans du MeOH et fixé sur une quantité équivalente de silice (de granulométrie 60 – 200μm / 60A) puis séché à température ambiante. Le mélange a été ensuite séparé sur une colonne chromatographique ouverte éluée au système de solvants n-hexane/AcOEt à des polarités croissantes. La composition qualitative des fractions recueillies a été déterminée à l’aide de la CCM. L’élucidation des structures des composés isolés a été faite grâce aux méthodes de RMN 1H et 13C. L’évaluation de l’activité antimicrobienne a été réalisée par la détermination des CMI et CMB. Pour les CMI, les tests ont été faits en triplicate dans les microplaques stériles de 96 puits. Cinq dilutions d’ordre 2 ont été réalisées (de 50 μg /mL à 1,56 μg/mL). L’incubation a été faite pendant 24 h à 37 °C (bactéries) et à 28 °C (fungi). La croissance des microorganismes a été observée grâce à un indicateur coloré l’iodonitrotétrazolium qui virait au rose en présence de bactéries viables. La CMI est la plus faible concentration à laquelle l’extrait a empêché la croissance visible des bactéries et fungi. L’activité de l’extrait a été classé en : i) très forte, CMI ≤ 5 μg/mL ; ii) forte, 5 μg/mL ≤ CMI ≤ 50 μg/mL ; iii) modérée, 50 μg/mL ≤ CMI ≤ 325 μg/mL et iv) faible, CMI> 325 μg/mL Concernant les CMB, L’ensemencement a été effectué à partir des puits de CMI, sur les géloses Muller Hinton e et Sabouraud et l’incubation s’est faite à 37 °C pendant 24 h (bactéries) et 28 °C (champignons). La CMB/CMF est la plus petite concentration à laquelle l’extrait a empêché la croissance visible des microorganisemes après repiquage. L’effet de l’extrait a été déterminé par le rapport CMB ou CMF/CMI :    ˂ 1, «bactéricide/fongicide absolu», ≤ 4, «bactéricide/fongicide», > 4, «bactériostatique /fongistatique». Résultats : le rendement d’extraction a été de 2,66%, les composés phénoliques et terpénoïdes ont été révélés. Un mélange de β‐sitostérol et de stigmastérol, ainsi que l’acide bétulinique, ont été isolés. L’extrait méthanolique a montré une forte activité antibactérienne sur les souches de S. aureus et E. coli avec une CMI de 1.25 µg / ml et une très forte activité antifongique sur la souche de C. albicans avec une CMI de 0,78 µg / ml, de plus l’effet a été bactéricide et fongistatique. Conclusion : ces résultats démontrent que l’extrait méthanolique d’écorces de V. conferta présente des propriétés antimicrobiennes

Transfusion safety in francophone African countries: an analysis of strategies for the medical selection of blood donors.

BackgroundThe goal of selecting a healthy blood donor is to safeguard donors and reduce the risks of infections and immunologic complications for recipients.Study design and methodsTo evaluate the blood donor selection process, a survey was conducted in 28 blood transfusion centers located in 15 francophone African countries. Data collected included availability of blood products, risk factors for infection identified among blood donor candidates, the processing of the information collected before blood collection, the review process for the medical history of blood donor candidates, and deferral criteria for donor candidates.ResultsDuring the year 2009, participating transfusion centers identified 366,924 blood donor candidates. A mean of 13% (range, 0%-36%) of the donor candidates were excluded based solely on their medical status. The main risk factors for blood-borne infections were having multiple sex partners, sexual intercourse with occasional partners, and religious scarification. Most transfusion centers collected this information verbally instead of having a written questionnaire. The topics least addressed were the possible complications relating to the donation, religious scarifications, and history of sickle cell anemia and hemorrhage. Only three centers recorded the temperature of the blood donors. The deferral criteria least reported were sickle cell anemia, piercing, scarification, and tattoo.ConclusionsThe medical selection process was not performed systemically and thoroughly enough, given the regional epidemiologic risks. It is essential to identify the risk factors specific to francophone African countries and modify the current medical history questionnaires to develop a more effective and relevant selection process

Chirurgie cardiaque au Cameroun. Résultats à un an de la phase pilote.

In the framework of implementation of his national program for control and prevention of cardiovascular diseases, Cameroonian government has set up a cardiac surgery project. We report in this manuscript results of one year follow up of the patients operated during the pilot phase. From September 22 till 26, 2008, 11 patients have been operated in Cameroun. Surgical procedures were 5 mitral mechanic valve replacement, 2 aortic mechanic valve replacement, 1 atrial septal defect closure, 2 pace maker implantation. No intrahospital death was observed. One patient died at 11th month after the operation due to mitral valve thrombosis and attributed to lack of compliance. One patient presented low cardiac output, pneumonia and a pleural effusion. 2 patients presented 2 minor complications consisting of pericarditis and superficial wound infection. The results of the pilot phase of cardiac surgery in Cameroon are effective. However, the sustainability of the program require human, material capacity building, and funding mechanism as well.English AbstractJournal Articleinfo:eu-repo/semantics/publishe