Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartile (Q1) was 36 months (3 years). Independent factors associated with reduced survival were breast ulceration (aHR = 3.23;p = 0.002), bilateral tumor location (aHR = 9.2;p < 0.001) and clinical stage 3 (aHR = 1.72;p = 0.010) while patients classified ACR3 on imaging (aHR = 0.19;p = 0.005) had improved survival. Conclusion: Breast cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was highest in the first 40 months. Independent factors associated with reduced survival were breast ulceration, bilateral tumor location and clinical stage 3 while patients classified ACR3 on imaging had improved survival.

Asymptomatic Carriage of Salmonella and Intestinal Parasites in Pupils in Yaounde

Background: Feco-oral transmitted diseases (FOTD) remain a public health issue, particularly in developing countries. Data concerning the carriage of Salmonella and intestinal parasites in children are available worldwide but are lacking in Cameroon. This study aimed to determine the asymptomatic carriage of Salmonella and intestinal parasites in children of two primary schools in Yaoundé. Methods: A cross-sectional descriptive study was conducted from October 2017 to May 2018 in two primary schools (from rural and urban areas) in the 7th precinct of Yaoundé. Sociodemographic, clinical and paraclinical (rectal swab, direct examination of fresh stool and bacteriological culture on Hektoen medium) data were collected. Results: We included 368 (192 boys) pupils from both schools (184 in each school) with a mean age of 8.99 ± 2.21 years. None of the children was infected by Salmonella spp. Intestinal parasite prevalence was 9.80% (6.52% of children from the urban school vs 13.04% from the rural ones). The intestinal parasite prevalence tended to be higher in girls than in boys (11.98% vs. 7.39%). Among intestinal parasites, protozoa were the most widely found. Entamoeba histolytica and Giardia intestinalis were the most prevalent pathogenic intestinal protozoa (11.11% vs. 25% of all positive stool exams). The helminths, less frequent, were represented by Ascaris lumbicoides and Enterobius vermicularis. The factors associated with intestinal parasite carriage were mainly rural school location and age between 11 - 13 years. Conclusion: Among children in primary school, Salmonella infection was absent, while intestinal parasites are frequent, represented mostly by protozoa. This parasitism is in our cohort associated with the rural school location and the 11 - 13 years age group. This suggests that there is additional room for the implementation of prevention measures for intestinal parasite infections in our setting.

Septate uterus with cervical duplication and longitudinal vaginal septum:A two case series

Müllerian duct anomalies consist of a set of structural malformations resulting from abnormal development of the paramesonephric or Müllerian ducts.Failures in lateral fusion may result in uterus didelphys,bicornuate uterus or arcuate uterus while,reabsorption failure results in a uterus with a partial or complete septum.We reported a series of two cases of a woman with a septate uterus,cervical duplication and longitudinal vaginal septum undergoing an in vitro fertilization procedure.Septate uterus with double cervix and longitudinal vaginal septum is a rare anomaly.We reported its endoscopic management in two infertile women.Hysteroscopic metroplasty which is a safe and simple approach for the removal of the uterine septum can improve reproductive outcomes but in vitro fertilization can be an alternative approach for these patients.

Laparoscopic management of an ectopic pregnancy after in vitro fertilization and embryo transfer at CHRACERH:A case report

1.Introduction Initially,in vitro fertilization and embryo transfer(IVF-ET)was designed to solve tubal factors infertility(TFI)by placing the embryo(s)within the uterine cavity.However,in some cases,an ectopic implantation occurs as the embryo can enter the tube.Ectopic pregnancy(EP)is the location of the pregnancy outside the intrauterine cavity.The prevalence of EP following assisted reproductive technology(ART)ranges between 2.1%and 8.6%of all pregnancies and it can reach up to 11%inwomen with tubal factors infertility history.