Comparison of the Clinical Profile and Severity Factors of COVID-19 during the First 4 Waves in a Paediatric Population of Yaounde

Introduction: COVID-19 is an infectious disease that has been causing a global pandemic since 2019. Although clinical forms are generally less severe in children than in adults, children nevertheless present polymorphous clinical forms and severe cases that can lead to death. Objective: To describe the clinical presentations found in the different waves of COVID-19, and to highlight the different factors of severity. Materials and Methods: We conducted a cross-sectional study with retrospective and prospective data collection which lasted 7 months (from November 2021 to June 2022) and covered a study period from 6 March 2020 to 22 June 2022, i.e. 27 months. All patients aged 0 to 18 years, suspected of having COVID-19, confirmed by real-time RT-PCR or an antigenic Rapid Diagnostic Test or antibody were included. These patients were to be managed in the Mother and Child Centre of the Chantal Biya Foundation, as well as in the Specialised Centre for the Management of COVID patients, annex number II of the Yaoundé Central Hospital. The results were analysed using IBM SPSS.23 software. Results: We included 163 patients in our study. No paediatric patients were registered during the 3rd wave. The mean age of the patients in the study population was 13 ± 5 years with extremes from 15 days to 18 years. We had a female predominance with a sex ratio of 0.83. The most common comorbidity was asthma. The first wave presented mainly with respiratory symptoms such as dry cough and signs of respiratory distress. The second wave presented mainly with digestive symptoms such as diarrhoea, abdominal pain and vomiting. The fourth wave presented with ENT signs such as sore throat, and rhinorrhea. Factors associated with severity were mainly age less than five years (OR = 17.69), vomiting (OR = 6.50), presence of comorbidities (OR = 3.39), and alteration of vital parameters such as bradypnoea (OR = 19.68), bradycardia (OR = 6.34), tachycardia (OR = 3.73), oxygen saturation Conclusion: Clinical presentations varied between waves and the main risk factor was age under 5 years. The fourth wave was less severe than the second wave, which in turn was less severe than the first. (4th nd st) which allows us to humbly recommend more screening for patients under 18 years of age with respiratory, ENT and digestive signs and special attention for those under 5 years of age.

Non-invasive diagnostic imaging of colorectal liver metastases

Colorectal cancer is one of the few malignant tumors in which synchronous or metachronous liver metastases [colorectal liver metastases(CRLMs)] may be treated with surgery. It has been demonstrated that resection of CRLMs improves the long-term prognosis. On the other hand, patients with un-resectable CRLMs may benefit from chemotherapy alone or in addition to liverdirected therapies. The choice of the most appropriate therapeutic management of CRLMs depends mostly on the diagnostic imaging. Nowadays, multiple non-invasive imaging modalities are available and those have a pivotal role in the workup of patients with CRLMs. Although extensive research has been performed with regards to the diagnostic performance of ultrasonography, computed tomography, positron emission tomography and magnetic resonance for the detection of CRLMs, the optimal imaging strategies for staging and follow up are still to be established. This largely due to the progressive technological and pharmacological advances which are constantly improving the accuracy of each imaging modality. This review describes the non-invasive imaging approaches of CRLMs reporting the technical features, the clinical indications, the advantages and the potential limitations of each modality, as well as including some information on the development of new imaging modalities, the role of new contrast media and the feasibility of using parametric image analysis as diagnostic marker of presence of CRLMs.

Innate lymphoid cells in tissue homeostasis and diseases

Innate lymphoid cells(ILCs) are the most recently discovered family of innate immune cells. They are a part of the innate immune system, but develop from the lymphoid lineage. They lack pattern-recognition receptors and rearranged receptors, and therefore cannot directly mediate antigen specific responses. The progenitors specifically associated with the ILCs lineage have been uncovered, enabling the distinction between ILCs and natural killer cells. Based on the requirement of specific transcription factors and their patterns of cytokine production, ILCs are categorized into three subsets(ILC1, ILC2 and ILC3). First observed in mucosal surfaces, these cell populations interact with hematopoietic and non-hematopoietic cells throughout the body during homeostasis and diseases, promoting immunity, commensal microbiota tolerance, tissue repair and inflammation. Over the last 8 years, ILCs came into the spotlight as an essential cell type able to integrate diverse host immune responses. Recently, it became known that ILC subsets play a key role in immune responses at barrier surfaces, interacting with the microbiota, nutrients and metabolites. Since the liver receives the venous blood directly from the intestinal vein, the intestine and liver are essential to maintain tolerance and can rapidly respond to infections or tissue damage. Therefore, in this review, we discuss recent findings regarding ILC functions in homeostasis and disease, with a focus on the intestine and liver.

Shirley Clift modified-TG小鼠基因组DNA提取方法及其在Gene-Trap中的应用

目的:介绍一种简单、快速、高效同时从数十、甚至上百个小鼠尾巴中提取基因组DNA的方法。方法Shirley Clift modified-TG小鼠Gene-Trap DNA提取法。结果使用该法从小鼠尾巴中获取的基因组DNA的数量、纯度完全适用各种实验,如在C3H/HCJ-Mgrn1md转基因小鼠杂交C57BL/6小鼠Mahogunin基因变异传代培殖实验中,应用鼠尾抽提的DNA进行Gene-trap。类推该法到小鼠其它组织如肝、肾、肌肉和心脏,也同样得到了高质量的基因组DNA。结论该技术可以连续、高效、快速、批量从小鼠组织中提取基因组DNA,为国内利用小鼠进行基因遗传疾病的研究提供了基础方法。

Aging:A mitochondrial DNA perspective,critical analysis and an update

The mitochondrial theory of aging, a mainstream theory of aging which once included accumulation of mitochondrial DNA(mt DNA) damage by reactive oxygen species(ROS) as its cornerstone, has been increasingly losing ground and is undergoing extensive revision due to its inability to explain a growing body of emerging data. Concurrently, the notion of the central role for mtDNA in the aging process is being met with increased skepticism. Our progress in understanding the processes of mtDNA maintenance, repair, damage, and degradation in response to damage has largely refuted the view of mt DNA as being particularly susceptible to ROS-mediated mutagenesis due to its lack of "protective" histones and reduced complement of available DNA repair pathways. Recent research on mitochondrial ROS production has led to the appreciation that mitochondria, even in vitro, produce much less ROS than previously thought, automatically leading to a decreased expectation of physiologically achievable levels of mtDNA damage. New evidence suggests that both experimentally induced oxidative stress and radiation therapy result in very low levels of mtDNA mutagenesis. Recent advances provide evidence against the existence of the "vicious" cycle of mtDNA damage and ROS production. Meta-studies reveal no longevity benefit of increased antioxidant defenses. Simultaneously, exciting new observations from both comparative biology and experimental systems indicate that increased ROS production and oxidative damage to cellular macromolecules, including mtDNA, can be associated with extended longevity. A novel paradigm suggests that increased ROS production in aging may be the result of adaptive signaling rather than a detrimental byproduct of normal respiration that drives aging. Here, we review issues pertaining to the role of mtDNA in aging.

Diabetic cardiomyopathy: Pathophysiology, theories and evidence to date

The prevalence of type 2 diabetes(T2D)has increased worldwide and doubled over the last two decades.It features among the top 10 causes of mortality and morbidity in the world.Cardiovascular disease is the leading cause of complications in diabetes and within this,heart failure has been shown to be the leading cause of emergency admissions in the United Kingdom.There are many hypotheses and well-evidenced mechanisms by which diabetic cardiomyopathy as an entity develops.This review aims to give an overview of these mechanisms,with particular emphasis on metabolic inflexibility.T2D is associated with inefficient substrate utilisation,an inability to increase glucose metabolism and dependence on fatty acid oxidation within the diabetic heart resulting in mitochondrial uncoupling,glucotoxicity,lipotoxicity and initially subclinical cardiac dysfunction and finally in overt heart failure.The review also gives a concise update on developments within clinical imaging,specifically cardiac magnetic resonance studies to characterise and phenotype early cardiac dysfunction in T2D.A better understanding of the pathophysiology involved provides a platform for targeted therapy in diabetes to prevent the development of early heart failure with preserved ejection fraction.

Sensibility of male rats fertility against olive oil, Nigella sativa oil and pomegranate extract

Objective:To clarify the modulatory effects of daily consumption of pomegranate extract(PE),olive oil(OO)andNagilla sativaoil(NSO)on antioxidant activity,sperm quality and pituitary-testicular axis of adult male wistar rats.Methods:Thirty-two adult male Wistar rats were dividedinto four equal groups,eight rats each.Using rat gastric tubes,1.0 mL distilled water,1.0 mL PE,0.4mL NSO and 0.4 mL OO were orally administered daily for 6 weeks in the first,second,third andfourth groups,respectively.Reproductive organs,body weight,sperm criteria,testosterone,FSH,LH,inhibin-B,lipid peroxidation,and antioxidant enzyme activities were investigated.At the endof the study protocol,analyses occurred at the same time.Data were analysed by ANOVA test and P<0.05 was considered to be a significant value.Results:In all studied groups,malondialdehydelevel was significantly decreased accompanied with an increases in glutathione peroxidase andglutathione.Rats treated with PE showed an increase in catalase activities accompanied withan increase in sperm concentration which was also observed in NSO group.In PE treated group,sperm motility was also increased accompanied with decreased abnormal sperm rate.NSO,OOand PE treated groups shows an insignificant effect on testosterone,inhibin-B,FSH and LH incomparison with control group.Conclusions:These results show that administration of PE,NSOand OO could modify sperm characteristics and antioxidant activity of adult male wistar rats.

A novel sampling method for the investigation of gut microbiota

AIM: In order to characterize the qualitative and quantitative microorganisms in different sites of the lower digestive tract (LDT) in healthy volunteers, a specific technique was developed for collecting mucous of the distal ileum, colon and rectum. METHODS: A polyethylene tube was designed to go through the colonoscope channel with a No. 8 French tube. In order to avoid internal contamination, the distal extremity was protected with a membrane of microfilm after being sterilized in ethilene oxid. To facilitate the aspiration of a precise volume, its interior was coated with silicone. One hundred microlliter (0.1 mL) sample of mucous was collected and transferred into an Eppenddorff tube containing nine hundred microlliter (0.9 mL) of VMGA-3 (viable medium of Goteborg). This procedure was repeated at each site of the LDT with a new sterilized catheter. RESULTS: All sites revealed the "non pathogenic" anaerobic bacteria Veillonella sp (average 105 colony forming units/mL-CFU/mL), allowing to conclude an environment of low oxidation-reduction potential (redox) in the LDT. It was also characterized the presence of Klebisiella sp with significant statistical predominance (SSP) in the ileum. Enterobacter sp was found with SSP in the sigmoid colon, Bacteroides sp non-pigmented (npg) and E.coli with SSP in the sigmoid colon and rectum, Enterococcus sp and Lactobacillus sp with SSP in the rectum, all in a mean concentration of 105 CFU/mL. CONCLUSION: This procedure is feasible and efficient and can point out a similar distribution of the aerobic and anaerobic bacteria with the presence of biological markers of normal microbiota in the LDT.

Neurovascular ageing:transcriptomic readout and implications on therapeutic targeting in Alzheimer’s disease

Ageing is one of the greatest risk factors for neurodegenerative diseases.How the complex biological changes in ageing increase the brain’s susceptibility to neurodegeneration remains incompletely understood.Research into neurodegenerative disorders has shifted from a neuron-centric approach,to the contributing roles of age-related neurovascular and glial cell dysfunction.

Use of Anti-Mullerian Hormone (AMH) for Testing of Ovarian Reserve: A Survey of Fifteen (15) Fertility Centres in Ghana

Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein with a molecular weight of 140 kD, encoded by a gene on the short arm of chromosome and a member of the transforming growth factor-beta (TGF-β) superfamily. The expression of AMH is markedly different in males and females, both in concentration and temporality. In males, Sertoli cells maintain a high concentration of AMH in utero which peaks shortly after birth and then drops precipitously at puberty. In females, granulosa cells produce very low levels of AMH in utero followed by a transient spike in the neonatal period. Concentrations of the hormone then rise steadily through adolescence to a peak in the mid-twenties and subsequently decline until becoming undetectable in menopause. The study aimed to understand how Clinicians and Clinical Embryologists used anti-mullerian hormone (AMH) test to assess ovarian reserve, direct patient selection and treatment regimens and guide in vitro fertilization (IVF) cycle management in all registered fertility hospitals in a West African country, Ghana. A web-based survey (questionnaire) using google forms was performed to solicit responses from all IVF hospitals that are registered with the Fertility Society of Ghana (FERSOG). This questionnaire consisted of fifteen (15) broader questions, ten (10) of which assessed the clinics’ use of AMH. Responses were screened for quality to verify that only one (1) survey was completed by each IVF centre. The study was conducted during May and June 2020 at the In Vitro Fertilization (IVF) Department of the Airport Women’s Hospital (AWH) in Accra, Ghana. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Survey responses were completed from 15 IVF centres, representing 2504 IVF cycles performed annually. A good majority (73.3%) [1835 IVF cycles] of the respondent IVF hospitals reported to use AMH as a first line test and 93.3% reported it as the best test for evaluating ovarian reserve. Another 66.7% reported that AMH results were extremely relevant to clinical practice. However, in contrast, for predicting live birth rate, 60% reported age as the best predictor in their practice. Overall, our results indicate that AMH is considered a first line test for assessing ovarian reserve and is relevant to the clinical practice of majority of Assisted Reproductive Technologies (ART) providers in Ghana.

The road towards sustainable control of schistosomiasis in the Democratic Republic of Congo:Pre-assessment of staff performance and material resources in endemic regions

Objective: To improve knowledge and practice of health staff as well as the availability of material resources for diagnosis and management of schistosomiasis in two endemic provinces of DRC(Kinshasa and Bas-Congo).Methods: Structured interviews were performed using questionnaires with staff from 35 healthcare facilities in 9 health zones(HZ) of Kinshasa and 2 HZ in Bas-Congo.Results: Schistosomiasis was reported to be present in all the included HZ.Health staff knew the most important symptoms of schistosomiasis, but advanced symptoms were more accurately reported in Bas-Congo.Knowledge of symptoms related to schistosomiasis such as anemia(P = 0.0 115) and pollakiuria(P = 0.0 260) was statistically different in both two provinces.Kato-Katz technique and urine filtration were unavailable in both provinces.Parasitological diagnosis was mostly performed using the direct smear method.PZQ was available in 70% of the health facilities, all situated in Bas-Congo.Diagnosis and treatment mostly relied on symptoms and cost more in urban area than in rural.Conclusions: Though knowledge on schistosomiasis among health staff appears sufficient, substantial efforts still must be made to improve the availability of diagnostic tools and treatment in the health facilities in DRC.

Anatomical Risk Factors for Rupture of the Anterior Cruciate Ligament:Magnetic Resonance Imaging Based Knee Joint Assessment

Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors increase the anterior translation of the knee and thus promote the stretching and rupture of the anterior cruciate ligament. Objectives: To determine the anatomical risk factors favouring ACL rupture by comparing morphometric parameters of patients with knee ACL rupture to patients without ACL rupture, as well as the intercondylar notch index and the tibial slopes of the two groups and describing the ruptured ACLs and associated signs. Materials and Methods: We conducted a case-control descriptive analytical study in imaging centres of the General Henri Mondor of Aurillac Hospital Centre in France (CHM) and the Jordan Medical Centre of Yaoundé in Cameroon (CMJ). MRI exam protocols included T1 SE, T2 SE, proton density and Fat Sat sequences, with slices in all three planes. Morphometry knee variables measured in our study were: intercondylar notch index and the tibial slopes. These measurements were obtained from images stored in DICOM format and post processing software OsiriX MD&reg;for CMJ patients and Explore&reg;for CHM patients. Results: The study included 92 individuals, 38 in the case group and 54 in the control group. The mean age was 36.6 years for both groups;35.5 years for the cases and 37.4 years for the controls. The sex ratio was 1.87 men for 1 woman in both groups;2.16 men for 1 woman for the case group. 53% of ACL ruptures are partial, with the predominant direct sign being morphologic and signal abnormalities of the ACL. The most significant indirect sign of ACL rupture was mirror-image bone contusion that was observed in 47.3% of cases. In the case group, the mean lateral tibial slope was 4.003&deg;, whereas it was 2.92&deg;in the control group. The comparison of means was estimated at approximately 0.039 (p Conclusion: The increase in the lateral tibial slope was a risk factor for anterior cruciate ligament rupture in our study population. Intercondylar notch index and medial tibial slope did not show any statistical significant difference.

Therapeutic potential of translocatorprotein ligands for age-related macular degeneration

Age-related macular degeneration:Agerelated macular degeneration(AMD)is a retinal degenerative disorder,characterized by the irreversible loss of the central vision during ageing.This chronic,progressive disease has been estimated to currently affect around 196 million people worldwide and will increase to 288 million in 2040(Wong,et al.,2014).Early AMD is defined by the presence of drusen underneath the retinal pigment epithelial(RPE)layer.Late AMD can be divided into two groups,"wet AMD"and"dry AMD",depending on the underlying clinical features.

Cancer combination therapy with carnosic acid

Carnosic acid(CA)is a natural phenolic diterpene mainly occurring in some species of the Lamiaceae family.Numerous studies described the cytotoxicity of CA towards different types of cancer both in vitro and in vivo.Particularly,the influence of CA in combination with other drugs,vitamins or natural products through affecting various targets has raised interest.Current experimental in vivo data suggested that CA may cooperate with clinically used anticancer drugs promoting their activity against cancer.From this point of view,CA gained importance,because it may alter pharmacodynamic profiles of various agents in the case of their co-administration,and thereby,act in a potentially synergistic manner,which can provide a basis for potential applications of CA in the management of cancer.In the present review,we give an overview of CA as well as CA co-treatment regimens with a special focus on cancer.In this context,the role of CA as an adjuvant treatment alternative is highlighted.

Functional Recovery of Axonal Injury Induced by Gelatin-Hydrogel Film and PRP: An Initial Study in Rats

In today’s society, axonal regeneration is considered very important because of high incidence of nerve injuries. The injury may cause vast damage of extracellular matrix leading to the condition wherein cell lost their environment to live. In this situation, new strategies by the introduction of scaffold to function as synthetic extracellular matrix are needed. In the field of tissue engineering, a large variety of carriers and matrices have been utilized as a scaffold to direct axonal growth. In this study, a new strategy by the combined application of gelatin hydrogel film and Platelet Rich Plasma (PRP) to induce functional recovery of sciatic nerve crushed injury was investigated in Wistar rat model. Assessment of motorist and sensory functions were done to evaluate the recovery processes. It was found that the application of gelatin hydrogel film with controlled release manner combined with PRP results faster axonal regeneration. Further research by different injury model and other investigation factors are needed to confirm the effectiveness of the strategy.

Adenocarcinomas after Prophylactic Surgery for Familial Adenomatous Polyposis

The incidence of familial adenomatous polyposis (FAP) is one in 7,000 to 12,000 live births. Virtually, all surgically untreated patients with FAP inevitably develop colorectal-cancer in their lifetime because they carry the adenomatous polyposis coli gene. Thus prophylactic proctocolectomy is indicated. Surgical treatment of FAP is still controversial. There are however, four surgical options: ileorectal anastomosis, restorative proctocolectomy with ileal pouch-anal anastomosis, proctocolectomy with ileostomy, and proctocolectomy with continent-ileostomy. Conventional proctocolectomy options largely lie between colectomy with ileorectal anastomosis or ileal pouch-anal anastomosis. Detractors of ileal pouch-anal anastomosis prefer ileorectal anastomosis because of better functional results and quality of life. The functional outcome of total colectomy with ileorectal anastomosis is undoubtedly far superior to that of the ileoanal pouch;however, the risk for rectal cancer is increased by 30%. Even after mucosectomy, inadvertent small mucosal residual islands remain. These residual islands carry the potential for the development of subsequent malignancy. We reviewed the literature (1975-2012) on the incidence, nature, and possible etiology of subsequent ileal-pouch and anal transit zone adenocarcinoma after prophylactic surgery procedure for FAP. To date there are 24 studies reporting 92 pouch-related cancers;15 case reports, 4 prospective and 5 retrospective studies. Twenty three of 92 cancers (25%) developed in the pouch mucosa and 69 (75%) in anal transit zone (ATZ). Current recommendation for pouch surveillance and treatment are presented. Data suggest lifetime surveillance of these patients.

Pediatric COVID-19 in Sub-Saharan Africa: A Series of Cases Report in Cameroon

Background: Infection with the new Coronavirus 2019 SARS-CoV-2, COVID-19, is a global pandemic that does not spare children. Pediatric forms of COVID-19 are increasingly described in the literature with less severe clinical forms and lower mortality as compared to adults. We do not have data on the epidemiologic characteristics of SARS-CoV-2 infection in children in sub-Saharan Africa where the pandemic is less severe. Aim: We present four cases of pediatric COVID-19 in Cameroun. Case Presentation: These cases of COVID-19 concern children aged 12 weeks to 13 years. We discuss the diagnostic difficulties and the issues of effective management in the context of a resource-constrained country. Conclusion: COVID-19 affects children in sub-Saharan Africa. There are different clinical presentations with favorable outcomes, but there is a need for greater vigilance in the pediatric population.

Cyst aspiration with gonadotropin suppression in ovarian remnant syndrome with ureteral obstruction: A case report

Background: Ovarian remnant syndrome (ORS) is characterized by functional ovarian tissue following bilateral salpingo-oophorectomy. ORS presents with pelvic pain or mass, but may also present with urinary tract symptoms resulting from enlarging residual tissue. Case: A 37 year old woman presented with pelvic pain radiating to her flank due to ureteral obstruction from an enlarging ovarian cyst in ORS. Transvaginal ultrasound guided, ovarian cyst aspiration accompanied by leuprolide acetate gonadotropin suppression resulted in acute and chronic relief of ureteral obstruction. Conclusion: This case demonstrated successful treatment of ureteral obstruction caused by an ovarian cyst in a patient with ORS via cyst aspiration and leuprolide acetate gonadotropin suppression. This treatment is a viable alternative for management of ORS, but sacrifices pathologic diagnosis when compared to traditional surgical resection.

Orthognathic Surgery for Achieving Facial Balance and Harmony in Cleft Patients

Cleft surgery requires an expert team performing ongoing treatment in order to achieve optimal outcomes. The senior author's(KES) experiences of more than 2000 patients with cleft lip and palate treated by a surgical-orthodontic protocol were introduced. The paper here will concentrate on not only correcting the occlusion as others have described,but also on what one surgeon can do to achieve optimal aesthetic balance, harmony and beauty. The results of orthognathic surgery in respect to function, stability, cosmesis, and complications are also audited.