Background: Heart failure (HF) is a rising global health problem. Patients with HF tend to use several therapies obtained via different treatment routes to relieve their symptoms. It is rampant in sub-Saharan Africa (...Background: Heart failure (HF) is a rising global health problem. Patients with HF tend to use several therapies obtained via different treatment routes to relieve their symptoms. It is rampant in sub-Saharan Africa (SSA), leading to poor health-seeking behaviours and worsened HF health outcomes. We aimed to describe the different therapeutic routes of HF patients from the onset of their first symptom until treatment in a specialised cardiology centre to identify and rebuke harmful therapeutic routes. Materials and Methods: This was a cross-sectional study at the Yaoundé Central Hospital in Cameroon between December 2018 to July 2019. Patients were recruited by consecutive convenient sampling. Adult patients aged above 18 years with confirmed HF were included using the Framingham criteria. Variables relating to socio-demographic and clinical data and the health-seeking behaviours of HF patients were studied. Results: We included 132 patients with a mean age of 62.90 years (62.88% women). Very few patients (0.90%) followed an ideal route;60.71% of subjects had a pseudo-ideal route, 19.64% accessed a specialised facility directly, and 21.42% used an erratic route. At the arrival time in a cardiology unit, 49.24% and 35.61% of our subjects were in NYHA stage III and IV HF compared to 15.15% for stage II. None of them was in Stage I. Conclusion: Most heart failure patients in Cameroon have resorted to non-specialised care, which worsens their clinical presentation. There is an urgent need for health education of HF patients in our context.展开更多
In Senegal, access to health care for rural populations and therapeutic choices remain problematic. These problems may be synonymous with insufficient financial resources, long waits, ineffective treatments, or drug s...In Senegal, access to health care for rural populations and therapeutic choices remain problematic. These problems may be synonymous with insufficient financial resources, long waits, ineffective treatments, or drug shortage in health structures, leading patients to perform various therapeutic behaviours. The aim of this present study was to identify the therapeutic routes of the patients and the determinants of the different uses of health care in the populations of Ferlo. This descriptive and analytical study was carried out as part of the medical consultation days of the 2016 summer at the university in Widou Thiengoly. All patients who met the selection criteria were enrolled. In total, the 150 participants were mainly animal breeders (63.3%) and housewives (26%), also, most were women (90.7%). The analysis of the therapeutic routes showed that the health post was used as first-line and second-line respectively in 85.3% and 59.3% of the study populations. Traditional medicine and self-medication would be used in the third intention. Therapeutic choices were independent of age (p = 0.94), marital status (p = 0.84) and occupation (p = 0.58). On the other hand, social dimensions, such as tradition, appreciation of efficiency, distance, cost, and gender, also determine the use of health care. Women used health post more frequently than men (p = 0.03) (OR: 3.89, CI95% [1.16 - 12.98]) of the order 3.89. The main reasons for self-medication practice were the treatment of headache or fever (46%) and that of fatigue (26%). The prices were more expensive for health facilities (70.9%) than for traditional healers (70% “not expensive at all”) where the waiting time was considered “not long at all” (70%).展开更多
Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squa...Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.展开更多
文摘Background: Heart failure (HF) is a rising global health problem. Patients with HF tend to use several therapies obtained via different treatment routes to relieve their symptoms. It is rampant in sub-Saharan Africa (SSA), leading to poor health-seeking behaviours and worsened HF health outcomes. We aimed to describe the different therapeutic routes of HF patients from the onset of their first symptom until treatment in a specialised cardiology centre to identify and rebuke harmful therapeutic routes. Materials and Methods: This was a cross-sectional study at the Yaoundé Central Hospital in Cameroon between December 2018 to July 2019. Patients were recruited by consecutive convenient sampling. Adult patients aged above 18 years with confirmed HF were included using the Framingham criteria. Variables relating to socio-demographic and clinical data and the health-seeking behaviours of HF patients were studied. Results: We included 132 patients with a mean age of 62.90 years (62.88% women). Very few patients (0.90%) followed an ideal route;60.71% of subjects had a pseudo-ideal route, 19.64% accessed a specialised facility directly, and 21.42% used an erratic route. At the arrival time in a cardiology unit, 49.24% and 35.61% of our subjects were in NYHA stage III and IV HF compared to 15.15% for stage II. None of them was in Stage I. Conclusion: Most heart failure patients in Cameroon have resorted to non-specialised care, which worsens their clinical presentation. There is an urgent need for health education of HF patients in our context.
文摘In Senegal, access to health care for rural populations and therapeutic choices remain problematic. These problems may be synonymous with insufficient financial resources, long waits, ineffective treatments, or drug shortage in health structures, leading patients to perform various therapeutic behaviours. The aim of this present study was to identify the therapeutic routes of the patients and the determinants of the different uses of health care in the populations of Ferlo. This descriptive and analytical study was carried out as part of the medical consultation days of the 2016 summer at the university in Widou Thiengoly. All patients who met the selection criteria were enrolled. In total, the 150 participants were mainly animal breeders (63.3%) and housewives (26%), also, most were women (90.7%). The analysis of the therapeutic routes showed that the health post was used as first-line and second-line respectively in 85.3% and 59.3% of the study populations. Traditional medicine and self-medication would be used in the third intention. Therapeutic choices were independent of age (p = 0.94), marital status (p = 0.84) and occupation (p = 0.58). On the other hand, social dimensions, such as tradition, appreciation of efficiency, distance, cost, and gender, also determine the use of health care. Women used health post more frequently than men (p = 0.03) (OR: 3.89, CI95% [1.16 - 12.98]) of the order 3.89. The main reasons for self-medication practice were the treatment of headache or fever (46%) and that of fatigue (26%). The prices were more expensive for health facilities (70.9%) than for traditional healers (70% “not expensive at all”) where the waiting time was considered “not long at all” (70%).
文摘Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa.It is usually more frequent between the fifth and sixth decades of life,and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma.It is an invasive neoplasia with a significant recurrence rate;40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis.The tumor invasion front is a characteristic of tumor growth,which can be infiltrative or noninvasive.The histopathological parameters examined include the number of mitoses,depth of the tumor,invasion pattern,degree of keratinization,and nuclear pleomorphism.For the pathologist,these parameters are routinely evaluated but are not reported to the treating physician in all cases,which we consider to be useful information when determining the therapeutic route.
