Mental Health professionals\u27 Knowledge, Attitudes, and Behaviors related to Adult Attention Deficit Disorder (ADHD) and Screening Pre and Post an Educational Intervention: A Quality Improvement Project

Abstract Background. Attention deficit/hyperactive disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity [DSM-IV-TR] (American Psychiatric Association (APA), 2000). ADHD is the most common childhood psychiatric disorder in the United States; however, there is an increased report of adults with ADHD that has not been well addressed until today. There is a need for a rapid, reliable, standard assessment tool to diagnose adult ADHD [ Alder et al., (2009) cited in French et al., (2019)]. Using the Adult Self-Report Scale (ASRS) in outpatient settings can be a practical tool in identifying adult ADHD and offering appropriate treatment. Purpose: The purpose of this quality improvement project was to increase the knowledge, attitudes, and behaviors of mental health professionals regarding Adult ADHD and the use of the World Health Organization Adult Self-Report Scale (ASRS) for screening Adult ADHD. Methods: Using a Pre-test Posttest design, the sample included 10 mental health professionals (1 psychiatrist, 4 nurse practitioners, and 5 licensed social workers) from an outpatient setting who participated in an educational intervention on adult ADHD and screening using a PowerPoint presentation and discussion. Results: Based on paired t-tests, the results indicated a statistically significant change (p \u3c .05) from pre to post-test scores on knowledge, attitudes, and behaviors of mental health professionals in the diagnosis of adult ADHD and screening. Based on the results, mental health professionals (90%) following the educational intervention expressed that they were very likely to use the World Health Organization Adult Self Report Screening (WHO ASRS) tool as an instrument to improve the diagnosis of adult ADHD. Implications: Although this educational invention was effective, a replication of this study in diverse community mental health clinics is indicated to confirm the findings. Advance Practice Nurses are in the position to develop and implement quality improvement projects which advance the quality of care offered by mental health professionals, and insure accurate diagnosis and treatment of mental health conditions, such as adult ADHD

Knowledge, attitude and practice of staff of 4 hospitals in Yaoundé on the prevention of vertical transmission of hepatitis B

Introduction: Hepatitis B virus infection is a public health concern in Cameroon and worldwide. With hepatitis C virus, it is the first cause of liver cancer in Cameroon. The high prevalence of 11.9% in Cameroon is associated with the premature contamination at the perinatal period, due to vertical transmission, from mother-to-child. To put into practice the preventives measures, actors need a good knowledge on premature contamination of a baby. The general objective of this study was to evaluate the influence of level of knowledge on the attitudes and the professional practices concerning prevention of mother-to-child transmission of hepatitis B (PMTCT/HBV) in Yaoundéhospitals and environs.Methods: We carried out a cross sectional multicentric, KAP study from 10th March to 15th December 2015 in the obstetrics services of 4 hospitals in Yaoundéand environs. For each health care provider who gave his consent, we used a pretested questionnaire to collect socio-demographics and professional data as well as their knowledges, attitudes and practices on PMTCT/HBV. After given a grade to each item, we proceeded to a quantitative analysis of data using SPSS software and Epi info 7th version.Results: 105 health care provider took part in the study, made up of 82 women (79%) and 22 men (21%). The ages were between 23 and 60 years, with a mean age of 40.9 ± 9.2 years. Only 21% of the participants had good knowledges on HBV/PMCT. This knowledge had a significant link with the profession, the professional experience and the duration in the same service. All the nurseaids had inadequate knowledges as well as the elders in the profession. Most of the participants (64.4%) had favorableattitude on PMTCT/HBV and that was significantly associated to good knowledges. (OR:5.34; CI 95% [1.47-19.47], p = 0.006). The practices on PMTCT/HBV were inappropriate in 57.1% of the participants. There were no significant relation between good knowledge and the practices (OR: 1.818, CI 95% [0.705-4.68]; p = 0.213) as well as between good attitudes and practices on PMTCT/HBV (OR: 0.932; CI 95% [0.423-2.058]; p = 0.862).Conclusion: The healthcare provider in hospitals in Yaoundé and its environs are old. Their knowledge on PMTCT/HBV is inadequate and their practices inappropriate. Good knowledge doesn't always lead to good practices of PMTCT/HBV. There exist some obstacles or intermediate variables between good knowledge, good attitudes and appropriate practices of PMTCT/HBV.Keywords: PMTCT/HBV, hepatitis B, healthcare providers, knowledges, attitudes and practice

Recherche et Titrage des Hémolysines Anti-A et Anti-B Chez Les Femmes en periode du postpartum immédiat au Centre Hospitalier et Universitaire de Yaoundé

But de l’étudeLes hémolysines apparaissent suite à une immunisation ABO et peuvent causer, à titre élevé, une hémolyse chez le receveur de sang ou chez le nouveau-né. Cette étude avait pour but de déterminer la fréquence et le titre des hémolysines anti-A et anti-B chez les femmes en période du post-partum immédiat ainsi que les facteurs de risque associés au Centre Hospitalier et Universitaire de Yaoundé.Patients et MéthodesUne étude descriptive et transversale a été menée chez les mères et leurs nouveau-nés. Les groupes sanguins ABO ont été déterminés chez tous les participants. Chez les mères, la recherche et titrage des hémolysines a été faite par la technique d’hémolyse en présence ducomplément à 37°C pendant 30 minutes. Les Khi carrés de Pearson et de Mentel-Haenszel ont servis pour des tests statistiques. Une valeur p<0,05 représentait une différence statistiquement significative. RésultatsSur 251 cas, après groupage sanguin ABO, Cinq mères de groupe AB ont été exclues et 246 retenues pour la recherche d’hémolysines. La fréquence de l’incompatibilité foeto-maternelle ABO était de 22,76% et celle des hémolysines était de 26,8%. Les hémolysines anti-A, anti-B et anti-AB ont été retrouvées respectivement dans 15%, 18,7% et 6,9% des cas. Les titres les plus élevés étaient ceux d’hémolysines anti-A. Les facteurs de risque comprenaient le mariage (p=0,01), la multiparité (p=0,02), le groupe sanguin des mères (p=0,02) et l’incompatibilité foeto-maternelle ABO (p<0,001).ConclusionCes résultats suggèrent la nécessité d’introduire la recherche systématique des hémolysines parmi les tests de suivi immunohématologique des femmes enceintes camerounaises.Mots Clés: Hémolysines anti-A et anti-A, Incompatibilité foeto-maternelle ABO, Maladie hémolytique du nouveau-né, Période du post-partum immédiate

Evaluation des résultats après traitement des lésions intra épithéliales du col utérin par la cryothérapie: étude préliminaire au Centre Hospitalier Universitaire de Yaoundé: A propos de 21 cas

Nous rapportons les résultats d'une série de 21 cas de prise en charge par cryothérapie de lésions intra-épithéliales cervicales au Centre Hospitalieret Universitaire (CHU) de Yaoundé. Notre objectif principal était d'évaluer les résultats préliminaires de la prise en charge des lésions précancéreuses éligibles pour la cryothérapie. Il s'agissait d'une étude transversale  descriptive qui s'est étalée sur 24 mois. Etaient inclus dans l'étude toutes les femmes traitées par cryothérapie. Nous avons exclu les patientes  traitées par une autre méthode, les patientes perdues de vue et les dossiers incomplets. Le statut cervical a été déterminé à 6 semaines, 6 mois et 12 mois. Les complications précoces et tardives ont égalementété répertoriées. Au total 95.2% des lésions étaient cicatrisées à 6  semaines. A 6 mois, toutes les lésions avaient disparu et au 12ème mois, la guérison était effective chez 95.2% des patientes. Les saignements et l'hydrorrhée étaient les principales complications tardives avec des  fréquences respectives de 66.7 % et 95.2%. Aucun cas de sténose   cervicale n'a été répertorié. La cryothérapie peut être utilisée comme  méthode de traitement pour des lésions précancéreuses du col

Cord prolapse, associated factors and fetal outcome: a report of 47 cases from the Yaounde Central Hospital, Cameroon.

Cord prolapse is a condition in which the umbilical cord comes ahead of the presenting part. Fetal demise occurs as a consequence of the compression of the cord by the presenting part. We conducted this study to determine profile of pregnancy and its outcome at the Central Hospital Yaounde, Cameroon. This was an observational, descriptive and retrospective study of deliveries complicated by cord prolapse between January 2003 and December 2006 at the Central Maternity of the Central Hospital Yaounde. Data was retrieved from patient’s files, operation room registers and admission registers. During this period, there were a total of 6924 deliveries amongst which 47 were complicated by umbilical cord prolapse (2.8 per 1000 deliveries). Among the women with cord prolapse, 62.2% were delivered by emergency caesarean section. Fetal demise was reported in 32 % of the women upon admission. An abnormal pelvis was seen in 25.5% of the women. Artificial rupture of membranes was carried out in 40.4%. This study shows that cord prolapse is associated with severe fetal consequences in our unit. A good knowledge of the risk factors, prompt diagnosis and rapid intervention by medical staff are required.KEY WORDS: Cord prolapsed - Perinatal morbidity and mortality - Caesarean section - Vaginal delivery

Hématométrie unilatérale sur utérus didelphe de découverte fortuite chez une multipare Camerounaise de 31 ans : à propos d’un cas et revue de la littérature

L’utérus didelphe est une malformation utérine par défaut de fusion des canaux de Müller entre la 10e et la 13e semaine de gestation, aboutissant à la persistance plus ou moins complète de la dualité de ces canaux. Certains types de malformations utérines ont des conséquences sur la vie reproductrice et exigent la chirurgie pour rétablir la continuité ou vider une collection des voies génitales si elles sont découvertes à temps. Nous vous présentons un cas d’hématométrie unilatérale sur utérus didelphe de découverte fortuite en per opératoire chez une multipare et traitée par hémi hystérectomie en urgence. La rareté de cette pathologie peut amener à omettre le diagnostic. Le diagnostic précoce et par conséquent une meilleure prise en charge permettent de diminuer les complications. L’hématométrie sur utérus didelphe est une urgence gynécologique dont la prise en charge exige la chirurgie. Les gestes doivent être moins mutilants chez les patientes souvent jeunes.Mots Clés hématométrie ; utérus didelphe ; hémihystérectomi

Quality care in vesico-vaginal obstetric fistula: case series report from the regional hospital of Maroua-Cameroon

The World Health Organization (WHO) proposes a successful closure rate for first repair of vesico-vaginal obstetric fistula to be at 85% in each facility, with the continence achievement among the closed cases at 90 %. We are reporting the vesico-vaginal obstetric fistula outcome at the provincial hospital of Maroua- Cameroon from 2005 to August 2007. Among the overall 32 patients with vesico-vaginal fistula operated, 25 patients were at their first operation. The complete closure of vesico-vaginal fistula (VVF) was 23/25 (92%) and among the 23 patients with complete closure 17(74%) had good continence. When we consider only the 25 patients who were at their first operation, the overall closure of VVF was 23/25 (92%) and among them 17/23 (74%) were continent. Large lesion, bladder neck lesions, vaginal adherence and rigid margin are associated with failure/incontinence. These factors must be taken into consideration when preparing patients for surgery or when assigning them to a surgeon within the surgical team

Determinants of contraceptive methods use after voluntary induced abortion at the Yaounde Central Hospital, Cameroon

Background: Abortion is the termination of pregnancy with expulsion of the product of conception before the age of fetal viability- 28 weeks. In Africa, 96% of abortions are unsafe and there is an estimated 1 death for 150 abortions. Few data are available in Cameroon on the determinants of contraception after a voluntary termination of pregnancy. The objective of this study to investigate the determinants of the use of contraceptive methods after a voluntary termination of pregnancy.Methods: The study was descriptive cross-sectional lasting 09 months in the gynecology and obstetrics unit of the Yaounde Central Hospital. We included women admitted to this unit who have already had at least one abortion. All women who did not give their consent were excluded. The data were entered and analyzed using the Epi-info software version 7.2.2.6. The tools used to express our results were the Student's and Whitney's test, the Wald test and the Odd ratios (OR) with their 95% confidence interval. The significance level was 5%.Results: Out of 139 participants, 86 (61.87%) had already used a modern contraceptive method after voluntary termination of pregnancy. The mean age was 27.13±6.16 years with extremes of 16 and 42 years. Being single and having unwanted pregnancies independently increased contraceptive method use after abortions.Conclusions: An intensification of campaigns for behaviour change and men's involvement would further improve the use of contraceptive methods after abortion

Does the Advice to Assume the Knee-Chest Position at the 36th to 37th Weeks of Gestation Reduce the Incidence of Breech Presentation at Delivery?

Breech presentation remains a hazard for the mother and her fetus. To reduce its incidence at delivery, postural techniques have been used, among which the kneechest position. The objective of this study was to assess the effectiveness of this position on cephalic version of breech presentation. It was a prospective randomized study in a group of 102 women with viable fetuses in breech presentation at 36 to 37 weeks of gestation. The 49 womenof the intervention group assumed the knee-chest position for 15 minutes three times a day for one week. The control group had 53 cases. The study and control groups were reviewed after a week to assess the fetal presentation. The version rate was 61% and 20% in intervention and in control groups, respectively (P value = .03). This position should be advised to women with fetus in breech between 36 and 37 weeks of gestation

Postpartum hemoperitoneum due to rupture of a blood vessel on a uterine pseudo tumor: A case report

We are reporting a case of hemoperitoneum followed by early post partum collapse due to bleeding from a ruptured vessel on the surface of an undiagnosed uterine pseudo tumor. There are literature reports of  spontaneous hemoperitoneum from bleeding of superficial vessels over lyingmyomas during pregnancy but a case of rupture of a blood vessel on a  uterine pseudo tumor leading to isolated hemoperitoneum in the immediatepostpartum period is a rare event. We are presenting the literature review and some aspects of the management of this case. The importance of having a high index of suspicion in cases of hemoperitoeum occurring immediately after delivery especially in a low income setting where radiologic imaging techniques like magnetic resonance imaging (MRI); which is the most  sensitive diagnostic tool in cases of ruptured vessels are rare is highlighted