Antibioprophylaxie dans les chirurgies gynécologiques et obstétricales propres et propres contaminées à l’Hôpital Général de Yaoundé, Cameroun

Introduction: Il s'agira de déterminer l’incidence et les facteurs associés à l’infection post opératoire dans les chirurgies gynécologiques et obstétricales propres et propres contaminées. Méthodes: étude de cohorte prospective axée sur la surveillance de l'infection post opératoire chez les patientes opérées d'une chirurgie gynécologique ou obstétricale propre ou propre contaminée au Service de Gynécologie B de l’Hôpital Général de Yaoundé, après une antibioprophylaxie avec la cefazoline. La période d'étude de 18 mois s'est étalée de janvier 2012 à juin 2013. La surveillance des patientes opérées se poursuivait sur les 30 premiers jours post opératoires. Résultats: au total 211 patientes opérées d'une chirurgie gynécologique ou obstétricale propre ou propre contaminée ont été enrôlées dans cette étude. La moyenne d'âge des patientes était de 35,4 ±10 ans; les chirurgies propres contaminées représentaient 76,3% et les chirurgies propres 23,7%. Nous avons  observé au total 06 (2,8%) cas d’infection post opératoire, dont 03 (1,4%) cas d’infection du site  opératoire, 02 (0,95%) cas d’infection urinaire et 01(0,47%) cas d’infection pulmonaire. Les variables significativement associées à l'infection post opératoire étaient la durée de la chirurgie (durée moyenne: 126± 89min vs 82± 50 min; p< 0,04) et le diabète (OR. 40,8; IC à 95%. 2,2-749,2; p<0,000. Conclusion: notre taux d'infection post opératoire global de 2,8% et d'infection du site opératoire de 1,4% vient  renforcer les données de la littérature sur l'efficacité de l'antibioprophylaxie dans les   chirurgies gynécologiques et obstétricales propres et propres contaminées en milieu africain. Cependant le respect des principes d'asepsie péri opératoire et une sélection précise de la classe de chirurgie  devraient être de règle dans notre contexte.Key words: Antibioprophylaxie, chirurgie gynécologique ou obstétricale, infection post opératoire, chirurgie propre, chirurgie propre contaminé

References of Birth Weights for Gestational Age and Sex from a Large Cohort of Singleton Births in Cameroon

Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms

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

Successful management of pregnancy in an African woman with Klippel Trenaunay syndrome Case report Open Access

Abstract Klippel Trenaunay syndrome (KTS) is a rare congenital disease characterized by a triad of cutaneous hemangioma, varicose veins and bone or soft tissue hypertrophy. Cases of pregnancy complicated by KTS are rare. There is an increased risk of thrombo-embolic disease and hemorrhage during pregnancy. Both obstetric and anesthetic management of KTS in pregnancy can be rather complicated. We present a successful management of pregnancy in an African woman with KTS at Yaounde General Hospital, Cameroon