Background: Statistics on birth injuries in Cameroon are scarce, despite its frequency in postnatal consultations; we sort to find its prevalence and contributing factors, the different clinical presentations and treatment methods. Methodology: This was a retrospective, descriptive study. Data on maternal characteristics, neonatal factors, the place of birth and qualification of birth attendant, age at diagnosis, clinical presentation and management were considered. Results: Among the 14,284 newborns that were consulted from January 2003 to February 2014, 263 (1.84%) had birth injuries. The average age at diagnosis was 12 days. The contributing factors were: advanced maternal age, macrosomia, vaginal and instrumental delivery. Birth attendants were mostly nurses and the health center was the place of birth for 57.4% of patients. The main clinical presentations were: obstetric brachial plexus palsy (70.6%), fracture of the clavicle (22.5%) and fracture of the humerus (4.80%). Physiotherapy and orthopedic treatment were methods used with favorable outcome. Conclusion: The frequency of birth injury is relatively high in our context. The diagnosis is late, birth attendants need to be trained and systematic examination of all newborns in delivery room encouraged.

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1 st 2018 to May 31 st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother's reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in "spoiled milk" (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding involves communication, to break beliefs about spoiled milk, and strengthening mothers' knowledge for optimal breastfeeding processes in accordance with WHO's guidelines.

Objectives: Determining 24-hour urinary copper excretion (UCE) levels is useful for diagnosing Wilson's disease (WD) and for treatment monitoring. Exchangeable copper (ExC) is a novel potential marker, but its long-term changes have never been described in patients under chelation therapy. Our aim was to describe the long-term changes in ExC levels compared to UCE levels in symptomatic WD pediatric patients under chelation therapy. Methods: A retrospective, descriptive, and analytical study including all patients under 18 years of age, diagnosed between 2006 and 2020, and treated with chelation therapy was conducted at the National Reference Center for WD in Lyon. Ceruloplasmin levels, serum copper, 24 h-UCE, ExC, and liver enzymes at diagnosis and during follow-up were analyzed. Results: Our study included 36 patients, predominantly with hepatic form of WD (n = 31). The median [interquartile range (IQR)] age at diagnosis was 10.5 (8.4-13.1) years, and the median (IQR) follow-up duration was 6.3 (3.3-8.8) years. At diagnosis, the median (IQR) ExC value was 1.01 (0.60-1.52) µmol/L. There was a significant decrease during the first year of chelation treatment (P = 0.0008), then a stabilization. The median (IQR) ExC values was 0.38 (0.22-0.63) µmol/L at 12-18 months and 0.43 (0.31-0.54) µmol/L at 5 years of chelation treatment (P = 0.4057). Similarly, there was a significant decrease in 24-hour UCE (P < 0.001) during the first year of chelation treatment, then a stabilization. Conclusions: Our study showed a significant decrease in ExC and 24-hour UCE levels during the first year of follow-up; The dynamics of both biomarkers were similar along the follow-up, demonstrating their usefulness in clinical practice for monitoring WD.

The Prune-Belly syndrome (PBS) is a rare pathology predominating in male infants, classically manifesting with the triad including aplasia of the abdominal wall muscles, dilatation of the urinary tract, and testicular abnormalities. We report and discuss the case of a full-term male newborn, in whom clinical examination at birth revealed abdominal wall muscle hypoplasia, cryptorchidism, urinary tract dilatation and renal failure. The diagnosis was made based on physical assessment, abdominal ultra-sonographic imaging, and blood sampling of urea and creatinine. For such cases, the recommended surgical management usually consists in a sequential surgical intervention including urinary tract reconstruction, abdominoplasty, and orchidopexy. However, these could not be practiced in due time in our patient, who died on the seventh day of life because of kidney failure. The prognosis of infants with Prune-Belly syndrome may be improved by quality antenatal follow-up, to enable the early diagnosis and preparation for prompt surgical intervention.

Background: Quite a tricky day-to-day clinical condition which may present as the first alarming sign of a life-threatening pathology, neonatal respiratory distress (NRD) remains an emergency until its etiology is diagnosed and appropriate treated delivered to the neonate. While the prevalence, risk factors, etiologies, diagnosis and management of this potentially fatal neonatal condition has not been examined extensively, the objective of this scoping review is to synthesise contemporary studies on the prevalence, risk factors, etiologies, diagnosis and management of NRD. Methods: We searched MEDLINE and Google Scholar up to November 13, 2020 for observational and experimental studies and systematic reviews addressing NRD without language restriction. Eight investigators working in four pairs independently selected and extracted relevant data. The methodological quality of all included studies was assessed.Results: We included 81 studies eligible with a total of 511,158 neonates from 21 countries across the world. The risk of bias was low in 61 (75%), moderate in 14 (17%), and high in six (8%) studies. The prevalence of NRD ranged from 0.21 to 84.8% and the highest prevalence rates were observed in Saudi Arabia (78.5%) and Iraq (84.8%). Its highest reported case fatality rates were in Sudan (36%) and India (47.1%). Predisposing factors included prematurity, male gender, low and high birth weights, low socio-economic status, smoking, infectious anamneses, diabetes mellitus, antepartum haemorrhage, cesarean delivery, fetal distress, anesthetic drugs and meconium stained amniotic fluid. Attending four or more antenatal care visits conveyed protection against NRD. Its diagnosis was mainly clinical using the Silverman-Anderson score. Its leading etiology was neonatal infection followed by transient tachypnoea of the newborn and hyaline membrane disease. With regards to its management, it is widely recommended to start with resuscitation followed by specific management of the etiology of NRD by medical or surgical measures or both. Conclusion: The prevalence and mortality rates of NRD are alarming, particularly in low- and middle-income countries. Most of its risk factors are preventable. Neonatal infections is the leading cause of NRD. Overall, we have presented an updated overview of NRD which should serve to ameliorate its healthcare.

Background:The improvement of postnatal care has led to the increase in survival rate of preterm infants in our setting and considering their vulnerability, we set out to assess the morbidity and mortality of preterm infants 12 months after discharge from the neonatal intensive care unit (NICU). Methods: A retrospective cohort study was done from the 2008 to 2013 at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital and included children born preterm, admitted in the NICU and discharged alive during the study period. Results: Out of 816 premature infants that were discharged alive from the NICU, only 232 (28.4%) preterm infants discharged alive presented for the routine visits during the first 12 months of life. Among these, 206 (89%) had at least one complication during the neonatal hospitalization period. Postnatal complications were significantly more frequent in infants born before 34 weeks of gestation and in babies with birth weight below 1500 grams (p<0.001). Up to 72.5% of those who came for routine visits were less than 34 weeks and 86% weighed <2000 g at birth. Seventy-six (32.7%) preterm infants were readmitted within their first year of life and the causes of readmission were respiratory tract diseases in 42 (55%), late neonatal sepsis in 19 (25.0%), malaria in 9 (11.8%) and epilepsy in 6 (7.9%). Neither the gestational age nor birth weight influenced readmission (p=0.25, p=0.590 respectively). The smaller the gestational age, the longer the duration of postnatal hospitalization (p<0.001). Conclusion: Routine follow-up after discharge remains a problem in our setting due to non-respect of appointments. Infants born preterm suffer mostly from respiratory tract diseases during the first year of life.

Confinement and social distancing have been widely used in the prevention of the COVID-19 pandemic, as interventions consisting in reducing physical contact between individuals to prevent the spread of the disease. In order to demonstrate the pattern of these measures, we did a review of pertinent articles on the subject available online. We found that though confinement and social distancing significantly contributed to the mitigation of the COVID-19 infection in a number of countries worldwide, there however exist a dilemma in choosing between the expected benefits and adverse effects, especially when applied on a large scale. Thus considerations with regards to socio-anthropological and politico-economic impacts should be considered in order to protect citizens, especially the vulnerable. Besides, population information, education and communication helps to increase adherence and observation of recommendations. However, further improvements need to be implemented in other to render these measures more bearable and less restrictive while ameliorating their efficacy.