Background: Idiopathic nephrotic syndrome (INS) is a frequent pathology in children. There is little data on the future of NS in children in sub-Saharan Africa, particularly Cameroon. The aim of our study is to report...Background: Idiopathic nephrotic syndrome (INS) is a frequent pathology in children. There is little data on the future of NS in children in sub-Saharan Africa, particularly Cameroon. The aim of our study is to report the prognosis of children treated for nephrotic syndrome in the city of Yaoundé. Method: This was an analytical cross-sectional study with retrospective collection in 4 reference hospitals in the Cameroonian capital over a period of five years from January 1, 2018 to December 31, 2022. We included all medical records of patients treated for idiopathic INS. We excluded incomplete records and those with a history of chronic kidney disease. The sociodemographic, clinical, paraclinical, and therapeutic data, as well as the short-term evolution were collected in the files. Data was analysed using the software statistical package for social sciences version 25.0. Statistical significance was set at a p-value Results: A total of 131 children (58% boys) were included in our study over a period of 5 years. The median age was 8 [6 - 11] years. Median proteinuria was 5 g/24h [3 - 8.4], median serum protein was 39 [34 - 46] g/l and median estimated glomerular filtration rate was 130.36 [68 - 174.6] ml/min/1.73m2. During steroid therapy, 45.07% were in partial remission at 2 months, 16.9% were in complete remission at 4 and 6 months, and 37.25% had relapsed. Steroid sensitivity was reported in 28.17% of cases, steroid resistance in 64.78% of cases and steroid dependent in 7.04% of cases. The mortality rate was 12.97%. Survival time averaged 48.2 months, with an overall crude survival rate of 99.2% at 3 and 6 months and 98.4% at 1 year. Regarding renal survival, renal function was impaired in 8.33% of patients at 6 months and 9% at 12 months. Conclusion: Idiopathic nephrotic syndrome is a common disease in children. Its evolution depends on corticosteroid therapy. The long-term prognosis is dominated by the risk of progression to end-stage kidney disease or even death. Rigorous and affordable follow-up is essential to reduce the number of patients lost to follow-up and the occurrence of complications.展开更多
Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been s...Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture.展开更多
Introduction: Sickle cell disease is the most common hemoglobinopathy in the world. Sickle cells are quickly fixed and destroyed by the elements of the reticuloendothelial system mainly in the spleen. It leads to a pa...Introduction: Sickle cell disease is the most common hemoglobinopathy in the world. Sickle cells are quickly fixed and destroyed by the elements of the reticuloendothelial system mainly in the spleen. It leads to a palpable increase in the volume of the spleen called splenomegaly. Splenomegaly is the cause of multiple complications that are relatively frequent and potentially serious in sickle cell disease, such as splenic sequestration seizures, spleen rupture, hypersplenism and splenic abscesses. We aimed at determining the prevalence of splenomegaly and to study the associated factors in patients with sickle cell disease. Materials and Methods: This was an analytical cross-sectional study, conducted from 1 January to 30 April 2019, at the Mother and Child Center of the Chantal BIYA Foundation. Patients were grouped into two groups: patients with splenomegaly (PS1) and patients without splenomegaly (PS0). As soon as we obtained the informed consent of the parents, we examined the children and recorded socio-demographic data, disease history and follow-up, documented complications, and clinical findings;then we performed the Rapid Malaria Diagnostic Test. The statistical analyzes were carried out using SPSS20 (Statistical Package for Social Sciences) and Microsoft Excel 2010 software. Results: We examined 403 children with sickle cell disease and 142 had splenomegaly (35%). Almost all of the study populations were homozygous SS. The Hackett 2 stage of splenomegaly was the most frequent (56.7%). The most common physical sign among PS1 was the presence of abdominal scarring (50.7% vs. 19.4%). PS1 had significantly lower levels of Hb (6.94 ± 1.67 vs 7.62 ± 1.43 p = 0.003) and platelets (297.45 ± 146.25 vs 398.70 ± 163.73 p < 0.001) than patients without splenomegaly (PS0). However, the percentages of HbF (21.78 ± 10.48 vs 15.66 ± 9.20 p < 0.001) and malaria infection (74.6% vs 17.2% p < 0.001) were statistically higher among PS0. Logistic regression analysis determined that the factors associated with splenomegaly were: malaria, high fetal hemoglobin, low hemoglobin S, hepatomegaly, thrombocytopenia and use of non-steroidal anti-inflammatory drugs. Conclusion: Splenomegaly is a frequent physical sign of sickle cell disease in children and factors associated are malaria, high hemoglobin F, low hemoglobin S, hepatomegaly, thrombocytopenia and NSAID use.展开更多
文摘Background: Idiopathic nephrotic syndrome (INS) is a frequent pathology in children. There is little data on the future of NS in children in sub-Saharan Africa, particularly Cameroon. The aim of our study is to report the prognosis of children treated for nephrotic syndrome in the city of Yaoundé. Method: This was an analytical cross-sectional study with retrospective collection in 4 reference hospitals in the Cameroonian capital over a period of five years from January 1, 2018 to December 31, 2022. We included all medical records of patients treated for idiopathic INS. We excluded incomplete records and those with a history of chronic kidney disease. The sociodemographic, clinical, paraclinical, and therapeutic data, as well as the short-term evolution were collected in the files. Data was analysed using the software statistical package for social sciences version 25.0. Statistical significance was set at a p-value Results: A total of 131 children (58% boys) were included in our study over a period of 5 years. The median age was 8 [6 - 11] years. Median proteinuria was 5 g/24h [3 - 8.4], median serum protein was 39 [34 - 46] g/l and median estimated glomerular filtration rate was 130.36 [68 - 174.6] ml/min/1.73m2. During steroid therapy, 45.07% were in partial remission at 2 months, 16.9% were in complete remission at 4 and 6 months, and 37.25% had relapsed. Steroid sensitivity was reported in 28.17% of cases, steroid resistance in 64.78% of cases and steroid dependent in 7.04% of cases. The mortality rate was 12.97%. Survival time averaged 48.2 months, with an overall crude survival rate of 99.2% at 3 and 6 months and 98.4% at 1 year. Regarding renal survival, renal function was impaired in 8.33% of patients at 6 months and 9% at 12 months. Conclusion: Idiopathic nephrotic syndrome is a common disease in children. Its evolution depends on corticosteroid therapy. The long-term prognosis is dominated by the risk of progression to end-stage kidney disease or even death. Rigorous and affordable follow-up is essential to reduce the number of patients lost to follow-up and the occurrence of complications.
文摘Introduction: Acute pain associated with caregiving is a major cause of pain among neonates. Left untreated, it can lead to long-term neurosensory and psychoaffective consequences. In Cameroon, this subject has been scarcely explored, thus constituting an impediment to the management of care-induced pain. Objective: Assess procedural pain in neonates in Yaoundé. Material and Methods: We conducted a cross sectional study with prospective data collection over a period of eight months (October 2022 to May 2023) in three hospitals. We included neonates who were being cared for and were not crying prior to the onset of healthcare, whose parents consented to the study. Assessments were done using the DAN scale, which is specific to care-induced pain. Data was entered and analyzed using SPSS 23.0 software. Results: A total of 161 newborns were included. The hospital prevalence of care-induced pain in neonates was 85%. Neonatal sepsis was the main cause for admission (96.6%). The most common procedures were venous blood sampling (94.4%) and insertion of peripheral venous lines (93.8%). The pain intensity for these procedures was severe (83.9%). The most painful procedure was lumbar tap, followed by venous access procedures. Conclusion: Neonates in hospitals are subjected to many painful procedures. The pain experienced during these procedures is severe. The most nociceptive procedure is a lumbar puncture.
文摘Introduction: Sickle cell disease is the most common hemoglobinopathy in the world. Sickle cells are quickly fixed and destroyed by the elements of the reticuloendothelial system mainly in the spleen. It leads to a palpable increase in the volume of the spleen called splenomegaly. Splenomegaly is the cause of multiple complications that are relatively frequent and potentially serious in sickle cell disease, such as splenic sequestration seizures, spleen rupture, hypersplenism and splenic abscesses. We aimed at determining the prevalence of splenomegaly and to study the associated factors in patients with sickle cell disease. Materials and Methods: This was an analytical cross-sectional study, conducted from 1 January to 30 April 2019, at the Mother and Child Center of the Chantal BIYA Foundation. Patients were grouped into two groups: patients with splenomegaly (PS1) and patients without splenomegaly (PS0). As soon as we obtained the informed consent of the parents, we examined the children and recorded socio-demographic data, disease history and follow-up, documented complications, and clinical findings;then we performed the Rapid Malaria Diagnostic Test. The statistical analyzes were carried out using SPSS20 (Statistical Package for Social Sciences) and Microsoft Excel 2010 software. Results: We examined 403 children with sickle cell disease and 142 had splenomegaly (35%). Almost all of the study populations were homozygous SS. The Hackett 2 stage of splenomegaly was the most frequent (56.7%). The most common physical sign among PS1 was the presence of abdominal scarring (50.7% vs. 19.4%). PS1 had significantly lower levels of Hb (6.94 ± 1.67 vs 7.62 ± 1.43 p = 0.003) and platelets (297.45 ± 146.25 vs 398.70 ± 163.73 p < 0.001) than patients without splenomegaly (PS0). However, the percentages of HbF (21.78 ± 10.48 vs 15.66 ± 9.20 p < 0.001) and malaria infection (74.6% vs 17.2% p < 0.001) were statistically higher among PS0. Logistic regression analysis determined that the factors associated with splenomegaly were: malaria, high fetal hemoglobin, low hemoglobin S, hepatomegaly, thrombocytopenia and use of non-steroidal anti-inflammatory drugs. Conclusion: Splenomegaly is a frequent physical sign of sickle cell disease in children and factors associated are malaria, high hemoglobin F, low hemoglobin S, hepatomegaly, thrombocytopenia and NSAID use.
