Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin...Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">Vaccination is very often dela...<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">Vaccination is very often delayed in premature and low birth weight infants. However, timely vaccination is even more important in this population because of their increased susceptibility to infection.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Objective</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:;" "=""> <span style="font-family:Verdana;">To assess immunization practice and factors associated with vaccine promptness</span><span style="font-family:Verdana;"> and completeness in former preterm and low-birth-weight infants.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We conducted a retrospective analytical cross-sectional study (January 2017 to February 2019).</span><b><span style="font-family:Verdana;"> Main Measurement: </span></b><span style="font-family:Verdana;">Promptness and completeness at each contact, Statistical analysis was performed using R software version 3.6.2, logistic regression was used to estimate the Odds Ratio (OR) and their 95% Confidence Interval (CI).</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> We recruited 310 children aged 12 to 36 months born before 37 weeks with low birth weight, 163 (52.6%) of whom were female. Two hundred and fifty-three had received the vaccines at the indicated age, with</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">promptness rate of 81.6%, and 97.7% had completed routine immunization at 9 months. The mean age at vaccination initiation was 6 days ±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">11 and the mean weight at vaccination initiation was 2233</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">g ±</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">494. High </span><span style="font-family:Verdana;">prematurity and very low birth weight were associated with a high rate of</span><span style="font-family:Verdana;"> vaccine delay: 61.5% [OR: 15.56;(CI: 3.22</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">118.52;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.002)] and 66.7% [OR: 19.19;(CI: 4.67</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">92.52;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.001)] respectively. Distance > 5 km with EHC [OR: 3.48;(CI: 1.68</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">7.47;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.001)] was associated with poor vaccination. </span><span style="font-family:Verdana;">Women in common-law unions had the lowest vaccine readiness rate </span><span style="font-family:Verdana;">(60.6%), (OR: 3.36;CI: 1.006</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">10.70;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.038). The frequency of occurrence of post </span><span style="font-family:Verdana;">immunization adverse events was 24.5%, with fever type in 94.7%.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"> Almost all premature and/or low-birth-weight children hospitalized at Essos Hospital Center had completed routine immunization at 9 months, and the </span><span style="font-family:Verdana;">majority had received the vaccines in a timely manner. Similar</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">study</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">is</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">needed in rural area.</span>展开更多
Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized contr...Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized controlled single blinded clinical trial in 14 uncontrolled type 2 diabetes patients (HbA1c ≥ 53 mmol/mol) with mean duration of diabetes of 8 [1 - 12] years and median age of 57 [49 - 61] years. Baseline treatment consisted of metformin in monotherapy or metformin plus sulfonylureas. Participants were randomly allocated to 2 groups of add-on 1.2 mg/day subcutaneous liraglutide in group 1 or 100 mg/day of oral vildagliptin in group 2 for 2 weeks. In all participants, insulin secretion in response to mixed meal tolerance test, insulin sensitivity by 80 mU/m<sup>2</sup>/min hyperinsulinemic-euglycemic clamp, body composition, and lipid profile were measured before and after intervention. Results: At the end of intervention, insulin sensitivity remained unchanged both with liraglutide from 6.6 [4.2 - 7.9] to 6.9 [4.3 - 10.8] mg/kg/min;p = 0.61 and vildagliptin from 7.1 [5.3 - 9.0] to 6.5 [5.6 - 9.4] mg/kg/min (p = 0.86). The area under the C-peptide curve varied from 5.5 [1.0 - 10.9] to 14.9 [10.8 - 17.2] nmol/L/120min, p = 0.09 in group 1 and from 1.1 [0.5 - 14.1] to 13.0 [9.6 - 16.9] nmol/L/120min (p = 0.17) in group 2. LDL Cholesterol levels decreased significantly with liraglutide from 0.85 g/L [0.51 - 1.02] to 0.54 g/L [0.50 - 0.73] (p = 0.04) but not with Vildagliptin. Body weight tended to decrease in group 1 (−0.6 kg) versus modest increase in group 2 (+1.1 kg). Conclusion: Short-term metabolic effects of Liraglutide and Vildagliptin add-on therapy are comparable in sub-Saharan type 2 diabetes patients with a more favorable trend for Liraglutide on body weight, lipid profile, and insulin secretion.展开更多
Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and...Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024);non-screening for gestational diabetes (p = 0.027);history of caesarean section (p = 0.041);weight gain ≥16 kg (p 0.001);maternal HIV (p = 0.047);birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.展开更多
Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical...Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in Yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology.展开更多
Background: Adolescent pregnancy is high risk and every area should have data specific to it. We here attempted to determine the characteristics of adolescent pregnancy in Cameroon, with special reference to antenatal...Background: Adolescent pregnancy is high risk and every area should have data specific to it. We here attempted to determine the characteristics of adolescent pregnancy in Cameroon, with special reference to antenatal care (ANC). Materials and Methods: The present cross-sectional descriptive study was carried out in four secondary level hospitals in Yaounde, Cameroon from March to May 2022. Our study included adolescent pregnant females between ages 10 and 19 who received prenatal/post-partum care at these facilities. Results: We studied 101 adolescent pregnant females (pregnant or post-partum). The mean age was 17.6 ± 1.3 years. Most of them were single, Christian, had a secondary level of education, lived in a two-parent home and were from the Central region. ANC was provided by midwives for most of them but prenatal work-up was not done most of the time. Overall quality of ANC was considered poor. Conclusions: Adolescent pregnant females were mainly high-school students and lived at home with both parents. ANC quality was considered poor. These data may be important to improve reproductive health care and may be generalizable to some extent.展开更多
<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:"&qu...<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). </span><b><span style="font-family:Verdana;">Patients and Method: </span></b><span style="font-family:Verdana;">This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Main etiologies were pneumonia (44%),</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">followed by transient ta</span><span style="font-family:Verdana;">chypnea</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">(35.4).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Perinatal asphyxia</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">9.412, P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and cyanosis</span><span style="font-family:""> </span><span style="font-family:Verdana;">(O</span><span style="font-family:Verdana;">R</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">6.509;P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001)</span><span style="font-family:""> </span><span style="font-family:Verdana;">were worsening RD, while caesarian section was protective</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.412;P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.050).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Mortality rate</span><span style="font-family:""> </span><span style="font-family:Verdana;">(MR) was 10.4%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Therapeutic measures</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">briefly consisted in oxygen therapy for 98.9% of patients and probabilistic antibiotic therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Neonatal pneumonia was the preeminent etiology of RD in this population;the MR was high.</span></span>展开更多
文摘Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">Vaccination is very often delayed in premature and low birth weight infants. However, timely vaccination is even more important in this population because of their increased susceptibility to infection.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Objective</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:;" "=""> <span style="font-family:Verdana;">To assess immunization practice and factors associated with vaccine promptness</span><span style="font-family:Verdana;"> and completeness in former preterm and low-birth-weight infants.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We conducted a retrospective analytical cross-sectional study (January 2017 to February 2019).</span><b><span style="font-family:Verdana;"> Main Measurement: </span></b><span style="font-family:Verdana;">Promptness and completeness at each contact, Statistical analysis was performed using R software version 3.6.2, logistic regression was used to estimate the Odds Ratio (OR) and their 95% Confidence Interval (CI).</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"> We recruited 310 children aged 12 to 36 months born before 37 weeks with low birth weight, 163 (52.6%) of whom were female. Two hundred and fifty-three had received the vaccines at the indicated age, with</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">promptness rate of 81.6%, and 97.7% had completed routine immunization at 9 months. The mean age at vaccination initiation was 6 days ±</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">11 and the mean weight at vaccination initiation was 2233</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">g ±</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">494. High </span><span style="font-family:Verdana;">prematurity and very low birth weight were associated with a high rate of</span><span style="font-family:Verdana;"> vaccine delay: 61.5% [OR: 15.56;(CI: 3.22</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">118.52;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.002)] and 66.7% [OR: 19.19;(CI: 4.67</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">92.52;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">0.001)] respectively. Distance > 5 km with EHC [OR: 3.48;(CI: 1.68</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">7.47;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.001)] was associated with poor vaccination. </span><span style="font-family:Verdana;">Women in common-law unions had the lowest vaccine readiness rate </span><span style="font-family:Verdana;">(60.6%), (OR: 3.36;CI: 1.006</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">10.70;p</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.038). The frequency of occurrence of post </span><span style="font-family:Verdana;">immunization adverse events was 24.5%, with fever type in 94.7%.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">:</span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"> Almost all premature and/or low-birth-weight children hospitalized at Essos Hospital Center had completed routine immunization at 9 months, and the </span><span style="font-family:Verdana;">majority had received the vaccines in a timely manner. Similar</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">study</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">is</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">needed in rural area.</span>
文摘Background: We aimed to evaluate the short-term metabolic effects of a GLP-1a, (liraglutide) versus a DPP-4i, (vildagliptin) in a group of sub-Saharan type 2 diabetes patients. Methods: We conducted a randomized controlled single blinded clinical trial in 14 uncontrolled type 2 diabetes patients (HbA1c ≥ 53 mmol/mol) with mean duration of diabetes of 8 [1 - 12] years and median age of 57 [49 - 61] years. Baseline treatment consisted of metformin in monotherapy or metformin plus sulfonylureas. Participants were randomly allocated to 2 groups of add-on 1.2 mg/day subcutaneous liraglutide in group 1 or 100 mg/day of oral vildagliptin in group 2 for 2 weeks. In all participants, insulin secretion in response to mixed meal tolerance test, insulin sensitivity by 80 mU/m<sup>2</sup>/min hyperinsulinemic-euglycemic clamp, body composition, and lipid profile were measured before and after intervention. Results: At the end of intervention, insulin sensitivity remained unchanged both with liraglutide from 6.6 [4.2 - 7.9] to 6.9 [4.3 - 10.8] mg/kg/min;p = 0.61 and vildagliptin from 7.1 [5.3 - 9.0] to 6.5 [5.6 - 9.4] mg/kg/min (p = 0.86). The area under the C-peptide curve varied from 5.5 [1.0 - 10.9] to 14.9 [10.8 - 17.2] nmol/L/120min, p = 0.09 in group 1 and from 1.1 [0.5 - 14.1] to 13.0 [9.6 - 16.9] nmol/L/120min (p = 0.17) in group 2. LDL Cholesterol levels decreased significantly with liraglutide from 0.85 g/L [0.51 - 1.02] to 0.54 g/L [0.50 - 0.73] (p = 0.04) but not with Vildagliptin. Body weight tended to decrease in group 1 (−0.6 kg) versus modest increase in group 2 (+1.1 kg). Conclusion: Short-term metabolic effects of Liraglutide and Vildagliptin add-on therapy are comparable in sub-Saharan type 2 diabetes patients with a more favorable trend for Liraglutide on body weight, lipid profile, and insulin secretion.
文摘Objective: To identify risk factors of perinatal complications among macrosomic babies in a third level health care facility. Method: We conducted a case-control institutional based study. Cases (macrosomic babies and mothers with perinatal complications) and controls (pairs free of perinatal complication) of singleton live births were extracted from the maternity registry from January 2017 to December 2019. Matching was done for sex and gestational age after exclusion of genetic cause of macrosomia. The main primary outcome was the risk factors for complications. Logistic regression was used to estimate the odds ratio and the magnitude of association between the primary endpoint and the different covariates of the study. Results: Out of 362 couples included, we had 186 cases and 176 controls. The main perinatal complications were the delivery by caesarean section (26.5%) and lesions of the genital canal, 20.2%. There were no maternal deaths. Among newborns, metabolic complications (19.6%) were a leading cause of harmful outcomes before respiratory complications (12.4%), dystocic presentations (6.3%) or traumatic injuries (1.7%). The neonatal case fatality rate was 2.8%. Maternal age ≥30 years (p = 0.024);non-screening for gestational diabetes (p = 0.027);history of caesarean section (p = 0.041);weight gain ≥16 kg (p 0.001);maternal HIV (p = 0.047);birth weight ≥4500 g (p = 0.015) and birth height ≥52.7 ± 1.7 cm (p = 0.026) were risk factors for perinatal adverse outcomes. Conclusion: The delivery of a macrosomic baby remains problematic in this setting, and emphasizes the need to improve routine screening of gestational diabetes within a quality of prenatal follow-up through a multidisciplinary perinatal team involving obstetricians, endocrinologists and neonatal pediatricians.
文摘Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in Yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology.
文摘Background: Adolescent pregnancy is high risk and every area should have data specific to it. We here attempted to determine the characteristics of adolescent pregnancy in Cameroon, with special reference to antenatal care (ANC). Materials and Methods: The present cross-sectional descriptive study was carried out in four secondary level hospitals in Yaounde, Cameroon from March to May 2022. Our study included adolescent pregnant females between ages 10 and 19 who received prenatal/post-partum care at these facilities. Results: We studied 101 adolescent pregnant females (pregnant or post-partum). The mean age was 17.6 ± 1.3 years. Most of them were single, Christian, had a secondary level of education, lived in a two-parent home and were from the Central region. ANC was provided by midwives for most of them but prenatal work-up was not done most of the time. Overall quality of ANC was considered poor. Conclusions: Adolescent pregnant females were mainly high-school students and lived at home with both parents. ANC quality was considered poor. These data may be important to improve reproductive health care and may be generalizable to some extent.
文摘<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). </span><b><span style="font-family:Verdana;">Patients and Method: </span></b><span style="font-family:Verdana;">This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Main etiologies were pneumonia (44%),</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">followed by transient ta</span><span style="font-family:Verdana;">chypnea</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">(35.4).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Perinatal asphyxia</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">9.412, P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and cyanosis</span><span style="font-family:""> </span><span style="font-family:Verdana;">(O</span><span style="font-family:Verdana;">R</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">6.509;P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001)</span><span style="font-family:""> </span><span style="font-family:Verdana;">were worsening RD, while caesarian section was protective</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.412;P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.050).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Mortality rate</span><span style="font-family:""> </span><span style="font-family:Verdana;">(MR) was 10.4%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Therapeutic measures</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">briefly consisted in oxygen therapy for 98.9% of patients and probabilistic antibiotic therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Neonatal pneumonia was the preeminent etiology of RD in this population;the MR was high.</span></span>
