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Biomedical subjects

F Binam

Publications and source records attributed to F Binam.

13 recordsLinked to original sources
PubMed2002

[Venous thromboembolism in Cameroon (report of 18 cases)].

The purpose of this report was to describe clinical and ultrasound findings associated with venous thromboembolism of the lower extremities and pulmonary embolism observed in our department with special emphasis on the utility of venous ultrasound in the diagnosis of venous thromboembolism. Between January 1, 1998 and December 31, 1999, a total of 47 venous ultrasound procedures were carried out according to the standard technique using a Logic 400 MD system (General Electric). Deep venous thrombosis was diagnosed in 18 cases (38.3%). There were 10 men and 8 women with a mean age of 46 years (range, 24 to 71 years). Thrombosis involved the internal saphenous, popliteal, or sural vein in 12 cases, the common or deep femoral vein in 4, and the external iliac vein in 2. The most common risk factors observed in our series were surgery, predisposing conditions, history of venous thrombosis and morbid obesity (66.8% of case). Prolonged periods of bed confinement and neoplasm (lower extremity Kaposi's disease) were more uncommon (22.2%). Pulmonary embolism occurred during the observation period in six cases (33.3%) including 3 (50%) that were fatal. Based on these findings it can be concluded that although its incidence is relatively low in black African patients at risk, thromboembolic disease is often fatal and requires routine preventive treatment using heparin.

Adult↗
PubMed2002

[Are health care facilities in Cameroon compatible with rational management of emergency patients?].

The aim of this month-long cross sectional study was to evaluate the preparedness of health care institutions in Cameroon to provide rational management of emergency patients. During January 2002 a survey was carried out to list all health care institutions offering emergency care services and to determine their other departments and available equipment and staff. A total of 144 institutions with emergency care facilities were found including 12 central reference hospitals and 123 district hospitals equipped to provide primary emergency care. In relation to a population of 15 million inhabitants, the ratio was one reference hospital for 104180 inhabitants and one district hospital for 100,000 inhabitants. None of the services involved in emergency management had facilities for emergency treatment on an outpatient basis. Regarding hospital-based services, an emergency ward was available at the 12 central reference hospitals for a ratio of one ward for 1,250,000 inhabitants. This ratio was 10 times higher than in France in 1994. Almost all major equipment and trained personnel for emergency care medicine were concentrated at the central reference hospitals but these resources were insufficient to organize round-the-clock services except at a single site. The findings of this survey indicate that the distribution of health care facilities in Cameroon was relatively adequate in relation to population density but that equipment and human resources were still insufficient to provide rational management of emergency patients.

Cameroon↗
PubMed2002

[Emergency medical training: the future of emergency care in Africa?].

The main goal of emergency medicine training is to teach the wide range of sciences and skills necessary to recognize and stabilize emergency situations. Emergency medicine training has proven highly effective in developed countries especially with regard to organization of survival medicine. This type of training is especially important in sub-Saharan Africa where there is a severe shortage of intensive care specialists and an almost total lack of other personnel qualified to manage life-threatening trauma and disease. Starting with the 1998 Nsam fire disaster in Yaounde, a number of situations have confirmed the seriously deficient state of resources for handling emergencies in Cameroon. In view of this situation a two-year study program in emergency medicine was proposed and introduced at the School of Medicine and Biomedical Sciences of the University of Yaounde I during the 2000/2001 academic year. The curriculum includes eight 40-hour didactic course modules and 800 hours of hands-on work in local hospitals and in France. Students undergo regular assessment of their scientific knowledge and practical competencies after each module. As additional prerequisites for the diploma, they must be certified in first aid and rescue and present a research paper. Despite the lack of faculty and teaching materials, this program is expected to increase the number of emergency medical care providers and improve access to high-quality emergency care services.

Africa↗
PubMed2001

Transfusion outcome in a resource-limited setting of Cameroon: a five-year evaluation.

OBJECTIVE: With a goal to establish strategies for improving blood safety in resource-limited conditions, the outcome of blood transfusion in a hospital setting of Cameroon was examined. METHODS: A 5-year descriptive and prospective study was conducted in which information on donor blood and recipients was obtained by direct patient observation and by examining patient notes in the various services of the hospital and records from the blood bank. RESULTS: Of 40,134 donations, 35,318 (88%) were from relatives or friends of recipients. Only 80% of all donated blood was considered safe for distribution. An average of about 20% of donated blood was rejected each year for positive human immunodeficiency virus (HIV) or hepatitis B antigen results. Other infections were not screened for. More than 50% of transfusions within the hospital were associated with an unfavorable outcome, predominantly febrile reactions and urticaria (40.1% and 19.4%, respectively). Acute intravascular hemolysis, circulatory overload, and deaths occurred in 0.01%, 0.04%, and 0.14% of cases, respectively. A case of post-transfusion HIV infection was also detected. CONCLUSIONS: Blood transfusion is still unsafe in many resource-limited communities of developing countries. However, it is possible to reduce some of these complications without sophisticated technology. Efforts to recruit more benevolent and autologous donors in the communities are essential.

Adolescent↗
PubMed1999

[Evolution of the demography of anesthesia practitioners in French speaking Sub-Saharan Africa].

OBJECTIVE: To assess the course of the demography of anaesthesia providers in French-speaking subsaharian countries. TYPE OF STUDY: Retrospective survey. PERSONS: Doctors trained in anaesthesia and nurse anaesthetists registered in West African medical societies. METHODS: Countries, hospitals, anaesthesia manpower, seniority and place of training were analysed. RESULTS: In the 13 French-speaking subsaharian countries including 97.5-M inhabitants, 122 doctors and 868 nurses were registered as anaesthetists in 1998. Mean ratios were one doctor trained in anaesthesia for 799,180 inhabitants and one nurse anaesthetist for 112,327 inhabitants. From 1980 to 1998, these figures increased by a factor 11 for doctors (+1100%) and by a factor two for nurses (+100%). Most doctors were working in the chief town, in both public and private health care institutions. CONCLUSIONS: In all French-speaking subsaharian countries, a major shortage of doctors trained in anaesthesia is existing.

Africa South of the Sahara↗
PubMed1999

[Anesthesia practices in Yaounde (Cameroon)].

This descriptive and prospective study, carried out during a 6-month period at Yaounde (Cameroon), assessed work practices relating to anaesthesia in public and private health care institutions, the incidence and causes of complications, and considers possible means for improving security of the anaesthetized patient. This study included 1,103 patients, aged 12 days to 89 years. Main surgical indications were gynaecology-obstetrics (33.3% of cases) and emergency surgery (28.6% of cases). Anaesthetic practices were characterized by an unsuitable and non systematic use of procedures which are essential parts of a safe anaesthetic. Pre-anaesthetic assessment was carried out in 71.4% of cases, premedication in 78.4% of cases and management in recovery room in 24% of cases only. Patients were anaesthetized by nurses in 78.6% of cases (40% of them had been trained on-the-job only). The anaesthesia equipment of operating room was poor in most places, especially with respect to physiological monitors. The rate of complications, 476 in 321 patients (29.1% of cases), was similar to the incidence registered in 1977 (30%). Twenty-four deaths occurred (overall mortality rate of 2.2%). Besides the shortage of equipment, this study underlines the necessity for producing and adhering to guidelines for safe practice of anaesthesia, adapted for developing countries.

Adolescent↗
PubMed1998

[Transfusion practices and quantification of blood loss in a surgical setting in Cameroon].

The purpose of this prospective study was to analyze compliance by surgical teams with new guidelines for blood transfusion. Study was focused on routine, presumably hemorrhagic procedures performed electively in adults at the Central Hospital in Yaounde, Cameroon. Overall blood loss was less than 20% of the total volume in 89% of the 303 patients included. Blood loss was between 20 and 30% in 10.6% and greater than 30% in 0.3%. Administration of replacement blood products was warranted only in the last two groups. Blood transfusion was performed in 104 patients and was unjustified in 81.7%. Seven percent of the remaining 199 patients presented indications for transfusion which was not performed and not compensated for by appropriate alternative precautions. At least one unit of whole blood had been requested and delivered to the operating room in 70% of cases with blood loss less than 20%, but was used in only 45% of cases. This study demonstrates poor compliance with new guidelines for blood transfusion in the surgical setting. Overconsumption of blood products represents the main problem. These findings underline the need for wider teaching of new blood transfusion strategies. Interest in this information is usually great in developing countries where blood banks are faced with limited facilities, qualified personnel, and supplies.

Adolescent↗
PubMed1998

[Ocular manifestations and sequelae of Lyell syndrome caused by sulfadoxine-pyrimethamine in Cameroon].

We report a Lyell syndrome secondary to anti-malarial treatment with sulfadoxine-pyrimethamine. Eye lesions predominated: symblepharon and corneal opacification. Desinsertion of conjunctival synechias was performed by ophthalmologists. There were corneal opacities and fibro-vascular veil on the two eyes. A keratoprosthesis was done on one eye. It is very likely that the incidence of this syndrome will increase mainly because of two factors. The continuous increase of plasmodii resistance to chloroquine hence the more frequent use of sulfonamides for the treatment of malaria; secondly, sulfonamides are used in the treatment and prevention of opportunistic infections in AIDS patients. It is important for ophthalmologists in tropical areas to be aware of Lyell's syndrome so that proper and early management may be undertaken.

Adult↗
PubMed1993

[The detection of gas embolisms in neurosurgery caused by joint monitoring with capnography and the Swan-Ganz probe. (Apropos of 7 patients operated on in the sitting position].

The aim of this study was to detect per-operative venous gas embolism in neurosurgery using capnography coupled to the Swan-Ganz catheter method. Using both methods, our study, carried out on seven patients operated in the sitting position, showed an occurrence of air embolism in four cases. The diagnosis of air embolism was made on a rapid and progressive drop of FECO2 with, at the same time, a rise of the pulmonary arterial pressure.

Adult↗
PubMed1991

[Failure of medical treatment with antihypertensive agents in a child with pheochromocytoma. Recovery after surgery].

Anaesthesia for removal of pheochromocytomas requires preoperative preparation of patients so as to normalize blood pressure. During operation, hypovolemia linked with the sudden fall of circulating catecholamines as well as hypertension during handling of the tumor are to be managed. A case of a 11 year child with pheochromocytoma is reported. Once the diagnosis had been established, various attempts to normalize blood pressure failed. Despite a precarious condition, the operation could be performed. During surgery, hypertension occurred and three hypotensive drugs failed to correct it. It ceased after removal of the tumor. The postoperative course was uneventful. The authors discuss the role of the type of catecholamines and their concentration in the failure of antihypertensive medication.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Filarial meningoencephalitis: discussion of a case].

Loiasis treatment by diethylcarbamazine (DEC) may be complicated by a meningoencephalitis that is often fatal. Following one case, four others have been reviewed in the literature and the therapeutic approach in resuscitation departments discussed. Until the discovery of other less-dangerous microfilaricidal or macrofilaricidal drugs, we raise the question of the opportunity to treat loiasis by DEC, while many authors consider it as a simple nuisance.

Adult↗