Périhépatite de découverte percoelioscopique pour infertilité a l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé : Prévalence et corrélation avec les lésions tubo-pelviennes

Dans le but de déterminer la prévalence de la périhépatite en coelioscopie pour infertilité et de rechercher la corrélation avec les lésions  tubo-pelviennes retrouvées, nous avons analysé de façon transversale lestrouvailles percoelioscopiques des patientes opérées pour infertilité à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé de novembre 2008 à octobre 2009. Nous avons enregistré 52 cas de périhépatite sur 130 coelioscopies effectuées pour infertilité ; soit une fréquence de 40%. La moyenne d’âge était de 32,28 ans. Les antécédents les plusretrouvés étaient la pelvialgie chronique (50,8%), la notion d’infection sexuellement transmissible à chlamydia et/ou mycoplasmes (46,9%), la chirurgie pelvienne (27,7%). L’infertilité secondaire était retrouvée chez 73,8% de nos patientes. Une corrélation était notée entre la présence de la périhépatite et la sévérité des lésions tubaires et pelviennesadhérentielles. En conclusion, nous notons une fréquence élevée de la périhépatite chez nos patientes infertiles lors des coelioscopies et une forte corrélation avec la sévérité des lésions tubaires et adhérentielles pelviennes

Aspects Psycho-Sociaux chez Patients Infertiles à laMaternite Principale de l’Hopital Central de Yaoundé, Cameroun

L’infertilité demeure un sujet d’actualité au Cameroun, de part la multitude d’études réalisées sur ce thème. Pourtant l’aspect psycho-social de l’infertilité jusqu’ici n’a réellement pas été exploré. Les objectives étaient de déterminer les caractères sociodémographiques, déterminer la prévalence du stress, de la dépression, le rapport interpersonnel et la prévalence des considérations sociales. Nous avons mené une étude prospective et descriptive étalée sur 10 mois. Tous les couples venus consulter pour infertilité etaient éligibles pour notre étude. Nous avons recensé un total de 104 patients. Notre échantillon était constitué majoritairement de femmes 92 (88,46%) que d’hommes 12 (11,54%). L’âge moyen était de 30,76 ans ± 6,68. La durée moyenne de l’infertilité était de 4,70 ± 3,58 ans. Les troubles psycho-sociaux ont été retrouvés chez nos patients aux proportions suivantes : le stress (84,61%), la dépression (53,85%), de la malédiction (24,0%). L’assimilation de l’infertilité à la sorcellerie était reportée par 36,5% et une moitié consultait des marabouts. Infertilité se trop complique suivant des troubles psychosocial. Il est donc important d’impliquer les travailleurs sociaux dans la prise en charge de ses couples.Mots Clés infertilité ; stress ; dépression ; sexualité ; marabou

Previous Second Trimester Abortion: A risk factor for third trimester uterine rupture in three subsequent pregnancies. Report of three cases

The authors report on three cases of uterine rupture. The first two cases occurred spontaneously and the third occurred in labour. All the patients refused voluntary termination of pregnancy before surgery. The true story was only re-constituted after surgery. Literature on spontaneous rupture of the uterus is scanty but cases occurring after hysteroscopic metroplasty,resectroscopy for Asherman´s syndrome, hysteroscopic fundal perforation, and voluntary termination of pregnancy and in a primiparous woman are reported. Spontaneous uterine rupture though rare should always be considered in the differential diagnosis of a woman who presents with severe pain in the later half of pregnancy, with foetal loss, anaemia, with a stable orunstable hemodynamic status and a past history of unsafe termination of a second trimester pregnancy. Though rare, this possibility should be considered in the differential diagnosis of a prolonged third stage of labour. Thorough clinical history and physical examination of patients remains the cornerstone for accurate diagnosis of uterine rupture

Triple Gestations in Two University Teaching Hospitals in Yaounde, Cameroon

The frequency of triplet pregnancies is increasing due to medically assisted reproduction. This retrospective study, carried out in 2 university hospitals in Yaounde (Cameroon) over a 6-year period, was done to evaluate the complications that occurred during triple pregnancies as well as the mode of delivery of triplets. A total of 43 cases were analyzed. The most common complications that occurred during pregnancy were preterm delivery and pre-eclampsia. Twenty seven women (62.8%) delivered vaginally and 16 (37.2%) were delivered by caesarean section with the most common indications being mal presentation and cord prolapse of the 1st triplet. In patients who have proper antepartum monitoring, it is possible to pre-select cases for trial of vaginal delivery because vaginal delivery is possible and carries no significant risk for the foetuses.Keywords triplet gestations; pre-eclampsia; premature delivery; vaginal delivery; caesarean sectio

Epidemio-Clinical Factors Associated with Caesarean Section in Two Referral Hospitals (Public/Faith-Based), Far-North Region, Cameroon

Caesarean section incurs significant cost and poses a hindrance to healthcare. The aim of the study was to determine maternal, foetal outcomes and cost. This was a cross sectional study conducted at the two health facilities. The study covered an eight month period. The rate of caesarean section was 5.69% and 6.22% at the semi-urban and rural hospital. Adolescents were predominant (27.86%) in the semi-urban group. 70% of the mothers in the rural environment were uneducated. Prenatal consultation of four was carried out by 92% of the rural women. Cephalo-pelvic disproportion remained the main indication for surgery. The type of anaesthesia was general (96.72%) and spinal (83.33%). Post-operative complications were dominated by haemorrhage and infection. The mean cost for surgery was 80.000 F in the semi-urban area. At the rural hospital the cost fixed at 19.000 and 32.000 F. The cost of surgery in the two hospitals is cheap compared to other healthcare facilities in the Country.Keywords caesarean section; maternal and perinatal mortality; maternal morbidity; rural; semi-urban; cos

Efficacy of highly active triple antiretroviral therapy in preventing mother-to-child HIV transmission in the university teaching hospitals in Yaounde, Cameroom

Paediatric HIV-infection rates remain high in Cameroon in spite of the various existing preventive strategies. This study will provide scientific evidence that HIV-infected pregnant women receiving highly active triple antiretroviral therapy would be expected to have significantly lower viral loads and a lower risk of HIV mother-to-child transmission (MTCT) without scheduled Caesarean section. We enrolled 90 newly diagnosed HIV-infected pregnant women who accepted to participate in the study from the 4 Teaching Hospitals in Yaoundé between January 1, 2006 and December 31, 2008. In addition to routine antenatal care, they received two types of potent triple antiretroviral regimens depending on their initial CD4 counts. Drug efficacy and safety were assessed by CD4 count, viral load, liver enzymes level, fasting blood sugar level, blood urea and haemoglobin concentration level before and after treatment and the paediatric seroprevalence rate. Highly active triple antiretroviral therapy was associated with maternal immunological improvement, statistically significant reduction of maternal viral load (P< 0.05) with resultant low paediatric HIV infection rate (1.1%) and minimal maternal biological impairment. Short courses of highly active triple antiretroviral therapy to prevent HIV MTCT is therefore not only efficacious compared to other treatment options like monotherapy, bitherapy, and bitherapy associated with scheduled caesarean section, but also safe and should constitute the mainstay intervention strategy.KEY WORDS: HIV MTCT- Triple antiretroviral therapy- Adverse effects - Paediatric HIV infection rate

Isocaloric Supplements of Whey Protein and Carbohydrate on Responses of Cardiorespiratory and Metabolic Systems and Blood Glucose Levels during Acute Progressive Exhaustive Exercises

Isocaloric Supplements of Whey Protein and Carbohydrates on Responses of Cardiorespiratory and Metabolic Systems and Blood Glucose Levels during Acute Progressive Exhaustive Exercises. JEPonline 2023;26(3):1-14. The purpose of this study was to determine the effects of isocaloric supplements of whey protein and carbohydrate on physiologic functions and performance. Three separated randomized ingestions of whey protein (PRO), carbohydrate (CHO), and mixing of PRO-CHO (MIX) were provided to healthy males prior to performing progressive exercises to exhaustion. Blood glucose levels and physiological variables of the cardiorespiratory and metabolic functions were determined. Higher blood glucose was detected only in the ingestion of CHO. Most of gas exchange and cardiorespiratory variables measured during exercise were similar in all trails, except for the lower diastolic BP in PRO than in CHO and MIX throughout the test. MIX induced a higher VO2 peak than did the other trials. In conclusion, immediate isocaloric ingestions of CHO, PRO, and MIX had exerted no impact on cardiorespiratory functions during high physical demands. Only the ingestion of CHO showed metabolic changes via blood glucose level; whereas, the ingestion of MIX induced a higher endurance performance on VO2 peak

Characterization of a new simian immunodeficiency virus strain in a naturally infected Pan troglodytes troglodytes chimpanzee with AIDS related symptoms

<p>Abstract</p> <p>Background</p> <p>Data on the evolution of natural SIV infection in chimpanzees (SIVcpz) and on the impact of SIV on local ape populations are only available for Eastern African chimpanzee subspecies (<it>Pan troglodytes schweinfurthii</it>), and no data exist for Central chimpanzees (<it>Pan troglodytes troglodytes</it>), the natural reservoir of the ancestors of HIV-1 in humans. Here, we report a case of naturally-acquired SIVcpz infection in a <it>P.t.troglodytes </it>chimpanzee with clinical and biological data and analysis of viral evolution over the course of infection.</p> <p>Results</p> <p>A male chimpanzee (Cam155), 1.5 years, was seized in southern Cameroon in November 2003 and screened SIV positive during quarantine. Clinical follow-up and biological analyses have been performed for 7 years and showed a significant decline of CD4 counts (1,380 cells/mm³in 2004 vs 287 in 2009), a severe thrombocytopenia (130,000 cells/mm³in 2004 vs 5,000 cells/mm³in 2009), a weight loss of 21.8% from August 2009 to January 2010 (16 to 12.5 kg) and frequent periods of infections with diverse pathogens.</p> <p>DNA from PBMC, leftover from clinical follow-up samples collected in 2004 and 2009, was used to amplify overlapping fragments and sequence two full-length SIVcpz<it>Ptt</it>-Cam155 genomes. SIVcpz<it>Ptt</it>-Cam155 was phylogenetically related to other SIVcpz<it>Ptt </it>from Cameroon (SIVcpz<it>Ptt</it>-Cam13) and Gabon (SIVcpz<it>Ptt</it>-Gab1). Ten molecular clones 5 years apart, spanning the V1V4 gp120 <it>env </it>region (1,100 bp), were obtained. Analyses of the <it>env </it>region showed positive selection (dN-dS >0), intra-host length variation and extensive amino acid diversity between clones, greater in 2009. Over 5 years, N-glycosylation site frequency significantly increased (p < 0.0001).</p> <p>Conclusions</p> <p>Here, we describe for the first time the clinical history and viral evolution of a naturally SIV infected <it>P.t.troglodytes </it>chimpanzee. The findings show an increasing viral diversity over time and suggest clinical progression to an AIDS-like disease, showing that SIVcpz can be pathogenic in its host, as previously described in <it>P.t.schweinfurthii</it>. Although studying the impact of SIV infection in wild apes is difficult, efforts should be made to better characterize the pathogenicity of the ancestors of HIV-1 in their natural host and to find out whether SIV infection also plays a role in ape population decline.</p

Credit Information Sharing and Loan Default in Developing Countries: The Moderating Effect of Banking Market Concentration and National Governance Quality

Departing from the existing literature, which associates credit information sharing with improved access to credit in advanced economies, we examine whether credit information sharing can also reduce loan default rate for banks domiciled in developing countries. Using a large dataset covering 879 unique banks from 87 developing countries from every continent, over a nine-year period (i.e., over 6,300 observations), we uncover three new findings. First, we find that credit information sharing reduces loan default rate. Second, we show that the relationship between credit information sharing and loan default rate is conditional on banking market concentration. Third, our findings suggest that governance quality at the country level does not have a strong moderating role on the effect of credit information sharing on loan default rate

Materno-foetal outcome of labour in obese women in Yaounde, Cameroon.

Overweight, obesity or morbid obesity has been shown to have a deleterious effect on the mother and the foetus. Among the various complications are macrosomic babies, increased caesarean section rate, postpartum haemorrhage, foetal distress and foetal death. The objectives of the study were to determine the socio-demographic characteristics of pregnant women with obesity and morbid obesity determine the mean birth weight, foetal length and Apgar score of the babies as well as associated maternal complications. This was a descriptive cross sectional prospective study carried out between the 1st of January and the31st July 2006. Recruitment was carried out in the maternity service of the main teaching hospitals in Yaoundé. All pregnant women in labour or in the immediate postpartum with body mass index greater or equal to 30 were fit for the study. About half of the women were married (46.5%), multi-parous (49%), attained the level of secondary education (59:3%). Most of the women were of low socio-economic status (82%) with the male partners slightly more financially fit than the women (57.1%). The 25-29years age group was most represented (32.6%), with the morbid obesity being preponderant (90.8%). Maternal complications were seen in 64% of the patients. The complications were more frequent in the morbid obesity than in the obesity group. Only uterine atony and placenta retention were seen in the obesity group. Placenta retention and caesarean section (20.5%) was commoner in the morbid obesity group. Stillbirths, small-for-dates, poor Apgar score and foetal macrosomia were reported inthe morbid obesity group. The babies were longer and weighed more with means of 51.3 cm and 3348 g respectively. Obesity and morbid obesity constitute a high risk factor in pregnancy. Pregnancy in these women must therefore be monitored closely in the ante-partum, intra-partum and immediate post-partum periods. Early detection of complications and treatment is paramount if we have to improve on the materno-foetal morbidity and mortality among obese pregnant women