Profil hormonal féminin et pronostic de la réponse à la stimulation ovarienne au cours de l’Assistance Médicale à la Procréation: Expérience du Burkina Faso

Après une année de fonctionnement de la première unité d’Assistance Médicale à la Procréation (AMP) du Burkina Faso, ce travail avait pour objectif d’analyser les résultats préliminaires. Un échantillon de 50 femmes âgées de 24 à 50 ans avec une moyenne 36 ± 5 ans ayant pris part à au moins un cycle de Fécondation in vitro (FIV), a bénéficié de dosages hormonaux à J3 et la réponse ovarienne appréciée par le nombre de follicules matures ponctionnés, le nombre d’ovocytes et d’embryons obtenus. Les anomalies hormonales les plus fréquentes étaient l’hyperoestradiolémie avec 30%, l’hyperprolactinémie avec 24%, l’élévation du taux de FSH (Follicle Stimulating Hormon) avec 10% et la baisse du taux de LH plasmatique (Luteinising Hormon) avec 28%. Le résultat de l’AMP après une année est de 9 grossesses sur 50 soit 18%. Les femmes avec un taux de FSH à J3 inférieur à 12 mUI/mL étaient moins âgées, avaient plus de follicules antraux. Après stimulation ovarienne, elles ont aussi obtenu plus de follicules, d’ovocytes et d’embryons que les femmes ayant un taux de FSH >12 mUI/mL. Le taux de grossesse était plus bas (12,5 contre 19,04) lorsque le taux de FSH était au dessus de 12 mUI/mL et aucune femme n’était enceinte lorsque ce taux excédait 24 mUI/ml. De même, le taux de grossesse était nul lorsque le rapport FSH/LH était supérieur à 2. L’analyse de la réponse ovarienne en fonction du profil hormonal des patientes à J3 du cycle menstruel confirme l’intérêt de ces paramètres dans la sélection des patientes aux chances raisonnables de réussite.Mots Clés: Hypofertilité féminine, hormones, ovaires, FI

Antimicrobial and toxicological activities of five medicinal plant species from Cameroon Traditional Medicine

<p>Abstract</p> <p>Background</p> <p>Infectious diseases caused by multiresistant microbial strains are on the increase. Fighting these diseases with natural products may be more efficacious. The aim of this study was to investigate the <it>in vitro </it>antimicrobial activity of methanolic, ethylacetate (EtOAc) and hexanic fractions of five Cameroonian medicinal plants (<it>Piptadeniastum africana</it>, <it>Cissus aralioides, Hileria latifolia, Phyllanthus muellerianus </it>and <it>Gladiolus gregasius) </it>against 10 pathogenic microorganisms of the urogenital and gastrointestinal tracts.</p> <p>Methods</p> <p>The fractions were screened for their chemical composition and <it>in vivo </it>acute toxicity was carried out on the most active extracts in order to assess their inhibitory selectivity.</p> <p>The agar well-diffusion and the micro dilution methods were used for the determination of the inhibition diameters (ID) and Minimum inhibitory concentrations (MIC) respectively on 8 bacterial species including two Gram positive species (<it>Staphylococcus aureus, Enterococcus faecalis)</it>, and six Gram negative <it>(Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Shigella flexneri, Salmonella typhi) </it>and two fungal isolates (<it>Candida albicans, Candida krusei)</it>. The chemical composition was done according to Harbone (1976), the acute toxicity evaluation according to WHO protocol and the hepatic as well as serum parameters measured to assess liver and kidney functions.</p> <p>Results</p> <p>The chemical components of each plant's extract varied according to the solvent used, and they were found to contain alkaloids, flavonoids, polyphenols, triterpens, sterols, tannins, coumarins, glycosides, cardiac glycosides and reducing sugars. The methanolic and ethylacetate extracts of <it>Phyllanthus muellerianus </it>and <it>Piptadeniastum africana </it>presented the highest antimicrobial activities against all tested microorganisms with ID varying from 8 to 26 mm and MIC from 2.5 to 0.31 mg/ml. The <it>in vivo </it>acute toxicity study carried out on the methanolic extracts of <it>Phyllanthus muellerianus </it>and <it>Piptadeniastrum africana </it>indicated that these two plants were not toxic. At the dose of 4 g/kg body weight, kidney and liver function tests indicated that these two medicinal plants induced no adverse effect on these organs.</p> <p>Conclusion</p> <p>These results showed that, all these plant's extracts can be used as antimicrobial phytomedicines which can be therapeutically used against infections caused by multiresistant agents.</p> <p>Phyllanthus muellerianus, Piptadeniastum africana, antimicrobial, acute toxicity, kidney and liver function tests, Cameroon Traditional Medicine</p

Constructing a transnational timber legality assurance regime: Architecture, accomplishments, challenges

The emerging transnational timber legality assurance regime comprises a set of interrelated policy instruments, both public and private, aimed at controlling trade in illegally logged wood and wood products. The potentially productive interactions among these instruments in the emerging forestry regime create prospects for engendering learning, stimulating cross-fertilization, and enhancing accountability. In this article, we analyze the EU's Forest Law Enforcement Governance and Trade (FLEGT) initiative, interacting with public legal timber regulations and private certification schemes, as the core of an emerging transnational experimentalist regime. An experimentalist regime of this type may provide a promising approach to addressing contentious transnational environmental issues like forest governance where there is no global hegemon to impose a single set of rules. However, experience with FLEGT implementation suggests that there are also a number of outstanding challenges to constructing an effective timber legality assurance regime, which if unresolved could undermine its promise. The argument proceeds in three steps, based on an exhaustive analysis of recent developments. First, we outline the architecture and promise of the emerging timber legality assurance regime. Then, we review key accomplishments to date. Finally, we examine the ongoing challenges facing this innovative regime as it moves forward, and consider how they might be overcome through the adoption of a more consistent experimentalist approach

Characterizations of classical orthogonal polynomials on quadratic lattices

This paper is devoted to characterizations of classical orthogonal polynomials on quadratic lattices by using a matrix approach. In this form we recover the Hahn, Geronimus, Tricomi and Bochner type characterizations of classical orthogonal polynomials on quadratic lattices. Moreover a new characterization is also presented. From the Bochner type characterization we derive the three-term recurrence relation coefficients for these polynomials

Characterizations of classical orthogonal polynomials on quadratic lattices

This paper is devoted to characterizations of classical orthogonal polynomials on quadratic lattices by using a matrix approach. In this form we recover the Hahn, Geronimus, Tricomi and Bochner type characterizations of classical orthogonal polynomials on quadratic lattices. Moreover a new characterization is also presented. From the Bochner type characterization we derive the three-term recurrence relation coefficients for these polynomials

Successful pregnancy with donor eggs in-vitro fertilization after premature ovarian insufficiency in a tertiary hospital in a low-income setting: a case report

Abstract Background Premature Ovarian Insufficiency (POI) is classically defined as 4–6 months of cessation of menses (amenorrhea) in women under 40, associated with menopausal level of serum gonadotropins FSH > 40 IU/L and hypo-estrogenism and is also referred to as hypergonadotropic hypogonadism. This disorder can manifest as primary amenorrhea without the onset of menses (menarche), or as secondary amenorrhea after menarche and pubertal development. The diagnosis of this condition in Cameroon is sometimes difficult because of the high cost of hormonal assays and the few laboratories offering these services. Case presentation The patient was a 38-year-old G2P0020, blood group O Rh positive, genotype AA and BMI 19 kg/m2 who came to our service because of secondary amenorrhea and infertility of 2 years’ duration. She has a history of pulmonary tuberculosis that was treated in Cameroon. After laparoscopy and hormonal profile, the diagnosis of premature ovarian insufficiency was reached. The woman underwent a successful donor egg in-vitro fertilization cycle and delivered a female fetus. Two years later YE requested IVF with autologous eggs, which was not possible, and since then she has remained with one child. Conclusion The diagnosis of premature ovarian insufficiency is difficult in Cameroon because of the high cost of laboratory investigations and difficult access to the tests. In-vitro fertilization with donor egg is a better treatment option. Unfortunately, it is not accessible to most Cameroonians because of lack of technical ability and the existence of cultural and financial barriers

Antimicrobial Activities of a Plethora of Medicinal Plant Extracts and Hydrolates against Human Pathogens and Their Potential to Reverse Antibiotic Resistance

Microbial infections till date remain a scourge of humanity due to lack of vaccine against some infections, emergence of drug resistant phenotypes, and the resurgence of infections amongst others. Continuous quest for novel therapeutic approaches remains imperative. Here we (i) assessed the effects of extracts/hydrolates of some medicinal plants on pathogenic microorganisms and (ii) evaluated the inhibitory potential of the most active ones in combination with antibiotics. Extract E03 had the highest DZI (25 mm). Extracts E05 and E06 were active against all microorganisms tested. The MICs and MBCs of the methanol extracts ranged from 16.667 × 103 μg/mL to 2 μg/mL and hydrolates from 0.028 to 333333 ppm. Extract E30 had the highest activity especially against S. saprophyticus (MIC of 6 ppm) and E. coli (MIC of 17 ppm). Combination with conventional antibiotics was shown to overcome resistance especially with E30. Analyses of the extracts revealed the presence of alkaloids, flavonoids, triterpenes, steroids, phenols, and saponins. These results justify the use of these plants in traditional medicine and the practice of supplementing decoctions/concoctions with conventional antibiotics. Nauclea pobeguinii (E30), the most active and synergistic of all these extracts, and some hydrolates with antimicrobial activity need further exploration for the development of novel antimicrobials

Prospective cohort of COVID-19 patients requiring hospital admission in Douala, Cameroon

International audienceOBJECTIVES: To report characteristics and outcome of COVID-19 patients who required hospital admission in sub-Saharan Africa clinics with no access to invasive mechanical ventilation. METHODS: Between April and June 2021, documented COVID-19 patients with SaO(2) &lt;95% who were admitted in two clinics in Douala (Cameroon) were invited to participate. Data were prospectively collected using a standardized questionnaire. RESULTS: We included 67 patients: 39 males (58%), median age 62 years [50-70]. Comorbidities included hypertension (n=38, 57%), obesity (n=26, 38%), and diabetes (n=16, 24%). No patient reported COVID-19 vaccination. On admission, 35 patients (52%) required O(2) &gt;6L/min. CT scan demonstrated extended lesions (&gt;50%) in 50/61 cases (82%). Most patients received dexamethasone (n=64, 96%), heparin (n=64, 96%), chloroquine/azithromycin (n=59, 88%), and broad-spectrum antibiotics (n=59, 88%). Sixteen patients died (24%), after a median of 11.5 days [7.5-15.5] post-admission. CONCLUSIONS: Despite the lack of invasive mechanical ventilation, 76% of COVID-19 patients survived

Facteurs Associes A L\'infertilite Masculine: Résultats d\'une série de 84 patients suivis à l\'Hôpital Général de Yaoundé.

In order to discriminate factors associated with male infertility in Cameroon , we selected from January 2001 to December 2006 , in the Gynecological Services of the General Hospital of Yaounde 84 infertile patients . The mean age was 38.21 years ±11 (range 25 – 50). Detailed exploration including laparoscopy was done for each female partner and this enabled us to eliminate some eventual disorders (endometriosis, tubo-peritoneal and ovarian sequelae of pelvic inflammatory diseases …) that could be a bias to our study population. Only husbands (without any known disease detrimental to their reproductive health) free from genital pathologies were recruited. Severe oligoasthenozoospermia was present in 51 cases ( 60.72%), followed by azoospermia, 15 cases ( 17. 86%), severe oligoasthenozoospermia associated with necrozoospermia, 13 cases (15. 47%), and a few cases of moderate oligospermia, 5 cases (5.95 %). No risk factor was found in 33 patients (39.28%) capable of altering the sperm. On the contrary we recorded a history of sexually transmitted infection due to Chlamydia trachomatis in 47 patients (55.95%), smoking in 13 patients (15.47%), alcoholism in 10 patients (11.90%), and exposure to pesticides in 2 patients (2.38%). Considering the risk factors found in our patients (within the limits of this study) and the fact that our environment is permanently filled with a “cocktail” of substances potentially detrimental to male fertility , emphasis should be placed on sensitization of our population and more particularly the youths who are vulnerable to sexually transmitted infections, smoking and alcoholism. On the other hand, the government should protect our environment from substances that are harmful to procreation through the concerted efforts of the different ministerial departments concerned.Dans le but de connaître les facteurs associés à l\'infertilité masculine au Cameroun , nous avons de Janvier 2001 à Décembre 2006 sélectionné dans les Services de Gynécologie de l\'Hôpital Général de Yaoundé, 84 patients infertiles d\'âge moyen 38,21 ± 11ans (27- 50), de niveau socio-économique moyen pour 78 d\'entre eux (92,85 %). Cinquante cinq (65, 47%) souffraient d\'une infertilité primaire depuis en moyenne 2,7 ans (1-5) , et 29 (34,53%) d\'une infertilité secondaire depuis en moyenne 3, 5 ans (2 - 6). Des explorations incluant la coelioscopie pratiquées à chaque fois chez les conjointes ont permis d\'éliminer d\'éventuelles pathologies (endométriose, séquelles tubo-péritonéales, voire ovariennes de maladies inflammatoires pelviennes …) susceptibles de biaiser notre population d\'étude. Seuls étaient recrutés les hommes n\'ayant aucune pathologie connue délétère pour la santé reproductive, et dont les partenaires ne présentaient pas de pathologie génitale. L\'oligo-asthénozoospermie sévère (OAS) a été retrouvée chez la majorité des patients , 51 cas (60,72 %), suivi de l\'azoospermie (AZO), 15 cas (17,86 %), l\'oligoasthénozoospermie sévère associée à une nécrozoospermie (0AS + N), 13 cas (15,47 %) , et dans une moindre mesure l\'oligospermie modérée (OM), 5 cas (5,95 %). Aucun facteur de risque susceptible d\'altérer le sperme n\'a été identifié chez 33 patients (39,28 %). En revanche nous avons identifié les antécédents d\'infections sexuelles à Chlamydia trachomatis chez 47 patients (55,95 %), le tabagisme chez 13 patients (15,47 %) , l\'alcoolisme chez 10 patients (11,90 %) , et l\'exposition aux pesticides chez 2 patients (2,38 %). Au regard des facteurs de risque retrouvés chez nos patients (sous réserve d\'une étude plus étendue), et de notre environnent en permanence inondé par un « cocktail de molécules» potentiellement nocives pour la fertilité masculine , un accent devra être mis sur la sensibilisation de nos populations et plus particulièrement la jeunesse actuellement vulnérable aux infections sexuellement transmissibles, au tabagisme et à l\'alcoolisme. Par ailleurs les pouvoirs publics doivent s\'investir à protéger l\'environnement des substances nocives pour la fertilité, à travers une approche intégrée des stratégies sectorielles des départements ministériels concernés. Keywords: Male infertility - Chlamydia - Smoking - Alcoholism - Pesticide.Clinics in Mother and Child Health Vol. 4 (1) 2007: pp. 665-67