Investissements directs étrangers et durabilité environnementale des entreprises agricoles au Cameroun

Evaluer les effets des Investissements Directs Etrangers (IDE) sur la durabilité environnementale des entreprises agricoles au Cameroun est le but visé dans ce papier. Les données utilisées sont des données secondaires qui issues de la Banque Mondiale, de la WGI et de l’Institut Nationale de la Statistique (INS) à savoir la Balance de Paiement du Cameroun (BP). La période d’étude va de 1977 à 2018. La durabilité environnementale est mesurée par un indice de performance environnementale. Par ailleurs, nous utilisons le modèle de Co intégration d’Engel et Granger (1987) pour le cas des séries temporelles comme outil méthodologique sur les données secondaires. Les résultats de l’estimation du modèle montrent que la pollution de l’environnement évolue en fonction de l’entrée des IDE dans le secteur agricole au Cameroun. Ainsi, l’hypothèse de havre de pollution est vérifiée au Cameroun. De ce fait, nous proposons que les impacts négatifs de ces IDE sur l’environnement soient maîtrisés

Résection endoscopique des polypes colorectaux pédiculés en utilisant un lasso largable au fil catgut chromé : une alternative a la polypectomie conventionnelle? A propos d’une série de cas

L'intérêt de l'endoscopie dans la résection des polypes colorectaux a été rapporté dans plusieurs études. Les techniques de résection endoscopique sont multiples et maîtrisées dans les pays occidentaux. La technique de mucosectomie endoscopique et celle de la pose d'une anse largable en nylon (endoloop) ont élargi le champ des lésions résécables par endoscopie. Toutefois, malgré cette évolution, la vulgarisation de la polypectomie n'est pas effective. En Afrique subsaharienne, la prise en charge de ces polypes de grande taille nécessite souvent une intervention chirurgicale à ciel ouvert ou une évacuation sanitaire onéreuse dans un pays en Occident. Nous rapportons une nouvelle approche de polypectomie endoscopique des polypes pédiculés colorectaux, en utilisant un lasso largable au fil catgut chromé 2/0. Les polypes pédiculés étaient situés soit au niveau du sigmoïde soit au rectum. Après avoir passé le lasso autour du pédicule, le n'ud du lasso est serré autour de celui-ci pour strangulation. En moyenne 6 jours après la procédure, le polype est récupéré dans les selles. Une colonoscopie de contrôle est nécessaire pour confirmer la résection du polype. Cette technique peu coûteuse et accessible, devrait être vulgarisée dans les pays en voie de développement avec des plateaux techniques pauvres. Elle a ses limites et ses inconvénients qui doivent être connus de l'opérateur.Key words: Polypes coliques, catgut, polypectomie endoscopique, coloscopie, endoloop, Cameroun, Afrique subsaharienn

Laparoscopic surgery for groin hernia in a third world country: a report of 9 cases of transabdominal pre-peritoneal (TAPP) repair in Yaoundé, Cameroon

Groin hernia repair is probably the most common procedure in general surgery. Today, in adult hernias, prosthetic repairs are accepted to be superior to "non-mesh" suture repairs. Concerning mesh repair, the (open) LICHENSTEIN and laparoscopic inguinal hernia techniques are recommended as the best evidence-based options. Nevertheless laparoscopic repair techniques still not currently practiced in sub-Saharan countries and particularly in Cameroon. From January 2011 to November 2014, a prospective laparoscopic groin hernia-specific database was queried for all adult patients in the visceral and laparoscopic surgery unit of the National Insurance Health Center of Essos (Yaoundé/Cameroon). Seven patients were recorded. All of them were male with a mean age of 49 years. Two cases were bilateral, 5 unilateral and all of them primary. There were 6 direct and 3 indirect hernias. They underwent 9 Transabdominal Pre-peritoneal (TAPP) repair and none Totally Extra-Peritoneal (TEP) procedure was done. A self-gripping overlapping flap was inserted in all cases. The mean length of the procedure was decreasing with time, from 150 min for our first procedure to 60 minutes for the last one. With a mean follow-up period of 20.2 months, the post-operatives courses were uneventful. Laparoscopic hernia repair in general and TAPP in particularly is a safe and reproducible procedure even in developing countries. African surgeons should be aware of this technique.Pan African Medical Journal 2016; 2

Diaphragmatic Injuries: A Frequent Missed Diagnosis in a Low Income Country

Objectives: To evaluate the current reported incidence of diaphragmatic injuries (DI) and to determine criteria that could help make the diagnosis of DI and improve its recognition in traumatised patients in Cameroon.Design: A retrospective study.Subjects: The cases of all diaphragmatic injuries repaired and diagnosed in two major hospitals in Cameroon.Setting: The General Hospital of Douala and the University Hospital centre of Younde, Cameroon.Results: During a ten-year period we have repaired eight diaphragmatic injuries. Five of them were consecutive to penetrating trauma and three after blunt trauma. All the patients were males. The mean age was 34. 5 years. Seven injuries occurred on the right side. The average Injury Severity Score was 37. 5 and all the patients had associated injuries to other organs. DI represents only 0.05% of all trauma cases. DI is underestimated in Cameroon and under diagnosed because physicians are not trained to think or to recognise it and autopsy is rarely performed after a traumatic death. Although there are no specific signs or symptoms, we have found some criteria which can raise suspicion of DI.Conclusion: Diaphragmatic injury is a very difficult diagnosis, and it is under diagnosed in Cameroon. We suspect that many patients severely injured may have associated DI which is not recognised and may contribute to increased mortality rate after major traum

Contribution of non-timber forest product valorisation to the livelihood assets of local people in the northern periphery of the Dja Faunal Reserve, East Cameroon

A large community of scientists has demonstrated that millions of people located in tropical zones derive a significant proportion of their livelihoods from the extraction of non-timber forest products (NTFPs). Despite these results, questions remain as to whether the valorisation of NTFPs can sustainably contribute to the improvement of the livelihood assets of the extractors. This study therefore evaluated the contribution of NTFP valorisation to the livelihood assets of local people around the northern periphery of the Dja Faunal Reserve (DFR), East Cameroon. To achieve this objective, data collected from 215 households in 32 villages were analyzed using factor analysis, Mann-Whitney U tests, and structural equation modelling. The results suggest that NTFP valorisation significantly contributes to the livelihood assets of local people at the periphery of the DFR. However, NTFP revenue was not significant in predicting their livelihood assets. Moreover, the local conservation management practices were not significant in predicting the livelihood assets in the long run. The results also revealed that individuals who received training and capacity building on good practices such as efficient collection techniques, effective drying techniques, and good conservation techniques earned better revenues and the impact on their livelihood was more significant than for those who did not. These results therefore recommend that the way forward for NTFP valorisation lies at the level of improving its quality and the market

Epidemiology of hepatitis C: related hepatocellular carcinoma in Cameroon

Introduction: hepatocellular carcinoma (HCC) is a global public health problem. Hepatitis C virus (HCV) infection accounts for close to 24% of HCC in developing countries especially when associated with cirrhosis. There exists no vaccine against HCV to prevent the occurrence of HCV-related HCC. A sound knowledge of the epidemiology and prevention of the initial infection is vital. The aim of our study was to determine the epidemiologic profile of HCV-related HCC in Cameroon to improve its’ management. Methods: it was a prospective study of histologically proven HCV-related HCC seen in two University Centers in Yaounde, Cameroon from March 2012 to January 2013. Demographic data (age, gender), alcohol abuse (>80g/day), presence of cirrhosis, tobacco abuse and parenteral exposition were analyzed. Results: twenty-six patients with histologically proven HCV–related HCC were included (18 men (69.2%) and 8 women (30.8%); mean age +/- SD, 61.46+/-10.18 years). A total of 22 (84.6%) patients had a parenteral exposition, 02 (7.7%) patients were alcoholics and 06 (23.1%) patients were smokers. The proportion of patients with cirrhosis was 69.2% against 30.8% cirrhosis-free. Patients with cirrhosis were relatively younger than those cirrhosis-free (mean age +/- SD, 59.05+/-10.05 years vs 66.87+/- 8.72 years, p=0.06). HCV-related HCC was more prevalent in 60 years and above patients (53.8%, 95%CI: 33.4-73.4). The relative risk of HCC among alcoholics patients was high (RR: 1.5, 95%CI: 1.13-1.99, p<0.05). Conclusion: in Cameroon, HCV-related HCC is more prevalent among age older than 60 years, a finding which is relatively less to that found in western countries, male gender is twice more at risk than female gender and cirrhosis frequency is less compared to that observed elsewhere. HCV and alcohol play a synergistic role in the occurrence of HCC in our environment

Successful bovine arch replacement for a type A acute aortic dissection in a pregnant woman with severe haemodynamic compromise.

Acute aortic dissection is very uncommon in pregnant women and the acute type A aortic dissection carries a high mortality rate outside specialized centres. There are a few cases reported with successful outcomes for the mother and the foetus from major cardiac centres. We are reporting our first experience of acute aortic dissection during the third trimester of pregnancy in a patient with Marfan features, profound haemodynamic compromise on arrival and a bovine aortic arch. Both the mother and the baby are doing well two years postoperatively