Purpose of The Study:The aim of this study was to describe sexual function disorders and investigate associated factors in women on maintenance hemodialysis in Cameroon. Methods:This was a cross-sectional study of three months duration (August-October 2014) in adult women on maintenance hemodialysis (HD) at three HD facilities in Cameroon. Patients with active psychiatric disease, infection or uncontrolled congestive heart failure were excluded. We use the Rosen questionnaire for evaluating female sexual function (FSFI), the Beck depression Inventory (BDI) and the short form (SF-36) of WHOQOL-BREF questionnaire to evaluate the quality of life (QOL). Logistic regressions were used to investigate the predictors of sexual function disorders. Results:We included 52 women with the mean age of 38±13 years (min-max: 18-69), with 31 (62%) being of child-bearing age (18-44 years). All participants had at least one sexual function abnormality including sexual dysfunction (75%), abnormalities of the menstrual cycle (83%), and sexual inactivity (30%). In women of child-bearing age, reported menstrual disorders were: irregular menses (45%), non-gravid amenorrhea (40%), oligo-menorrhea (25%), poly-menorrhea (25%), metrorrhagia (6%), and menorrhagia (3%). Ten of the 31 women had more than one menstrual disorder. Sexual dysfunction included: decreased sexual desire (56%), decreased sexual arousal (39%), decreased vaginal lubrication (49%), and failure to achieve orgasm (46%), sexual dissatisfaction (51%), and dyspareunia (36%). Advanced age (p = 0.0046), depression (p<0.0001), anemia (p=0.0005) and poor quality of life were negatively associated with sexual dysfunction. Sexual inactivity (p = 0.035) was equally associated with poor quality of life. Conclusion:Our results suggest that disorders of sexual function are common in women on maintenance hemodialysis, and are associated with depression, poor quality of life, advanced age, and anemia.
Abstract:Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the predictors of low adherence to asthma controller therapy. Methods: A cross-sectional study including asthma patients was conducted from November 1, 2012 to May 31, 2013 in 4 chest clinics in Cameroon. The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A multivariate logistic regression analysis was performed for the identification of factors associated with adherence to asthma treatment. Results: Among the 201 asthma patients included, 133 (66.2%) were female. The mean age of participants was 41.2 years. Sixty-one (30.3%) of the patients did not visit the chest physician during the last year prior to the study. Asthma was well controlled in 118 patients (58.7%). The prevalence of low adherence rate to asthma controller therapy was 44.8% and the absence of any chest specialist visit within the last 12 months was the only factor associated with the low adherence rate to asthma treatment (OR 5.57 ; 95% CI 2.84-10.93). Conclusion:The adherence rate to asthma controller therapy in Cameroon is low and it could be improved if scheduled visits are respected by patients.
IntroductionThe goal of asthma treatment is to obtain and maintain a good control of symptoms. Investigating factors associated with inadequately control asthma could help in strategies to improve asthma control. This study aimed to determine the prevalence and factors associated with inadequately controlled asthma in asthma patients under chest specialist care.MethodsA cross-sectional study was conducted from November 2012 to May 2013. Physician-diagnosed asthma patients aged 12 years and above were included. A questionnaire was used to collect demographic data, comorbidities, and medical history of asthma. Asthma control was assessed using the Asthma Control Test (ACT), with a score less than 20 for inadequately controlled asthma and a score greater or equal to 20 for controlled asthma. A multivariate analysis was used to identify factors associated with inadequately controlled asthma.ResultsOverall, 243 patients were included in this study. Asthma was controlled in 141 patients (58%) and inadequately controlled in 102 (42%). The mean duration of asthma was 8 years with an interquartile range of 4 and 18 years. Forty-three participants (17.7%) were not under any controller medication while the mean ACT score was 19.3 ± 4.6. Independent associations were found between inadequately controlled asthma and female gender (OR 1.91; 95% CI 1.06-3.47) and obesity (OR 1.81; 1.01-3.27).ConclusionAsthma remains poorly controlled in a large proportion of asthma patients under specialist care in Cameroon. Educational programs for asthma patients targeting women and based on weight loss for obese patients may help in improving the control of asthma.
Background Hypercalcemia and aplastic anemia are two uncommon presentations of non-Hodgkin lymphoma that potentially worsen the disease prognosis. Although hypercalcemia has been reported in the B-cell subtypes and some T-cell subtypes of non-Hodgkin lymphoma, it has not been described in T-cell lymphoblastic lymphoma. The same applies to aplastic anemia, which is also not described in T-type lymphomas. Case presentation We report a case of a 52-year-old Cameroonian man with acute kidney injury who presented with confusion, abdominal pain, constipation, polyuria, polydipsia, calciphylaxis, enlarged lymph nodes, tachycardia, and a blood pressure of 170/88 mmHg. Laboratory investigations revealed hypercalcemia (total/ionized 199.5/101.75 mg/L), normal serum phosphorus (40.20 mg/L), and a low intact parathyroid hormone (9.70 pg/ml). Complete blood count revealed pancytopenia. Peripheral blood smear confirmed thrombocytopenia but showed neither blasts nor flower cells. Bone marrow aspirate revealed hypocellularity with no blasts or fibrosis. Lymph node biopsy was suggestive of T-cell precursor lymphoma. T-lymphoblastic lymphoma presenting with hypercalcemic crisis and aplastic anemia was diagnosed, and the patient received the cyclophosphamide-doxorubicin-vincristine-prednisone protocol of chemotherapy together with filgrastim and whole-blood transfusion for aplastic anemia. The short-term outcome was fatal, however. Conclusions Severe hypercalcemia and aplastic anemia are potential paraneoplastic syndromes of adult T-type lymphoblastic lymphoma, with fatal short-term outcome.
Africa trails the rest of the world in COVID-19 cases and deaths. However, as the pandemic spreads through the continent, we expect increases in community infection in the months ahead. Patients with kidney infection, especially those with end-stage kidney disease and those with kidney transplants, are at high risk for acquiring the disease and dying from it. While there is limited evidence for the benefit of interventions, we have the advantage of learning from the experiences of those in China, Europe and the Americas. This document sets forth guidance for dealing with our patients who have acute and chronic kidney disease, including those on renal replacement therapy and the staff involved in their care. Emphasis is placed on preparedness and prevention strategies. As evidence and experience accumulate, it is likely that updated guidance will be needed. L’Afrique suit le reste du monde en termes de nombre de cas et de décès dus à COVID-19. Cependant, alors que la pandémie se propage à travers le continent, nous prévoyons une augmentation de l’infection communautaire dans les mois à venir. Les patients atteints d’une maladie rénale, en particulier ceux atteints d’une maladie rénale chronique en phase terminale et ceux ayant subi une transplantation rénale, courent un risque élevé de contracter la maladie et d’en mourir. Bien que les preuves d’interventions soient limitées, nous avons l’avantage de tirer des enseignements des expériences de ceux qui se trouvent en Chine, en Europe et dans les Amériques. Ce document présente des conseils pour traiter nos patients atteints d’insuffisance rénale aiguë et chronique, y compris ceux sous thérapie de suppléance rénale et le personnel impliqué dans leurs soins. L’accent est mis sur les stratégies de préparation et de prévention. Au fur et à mesure que les preuves et l’expérience s’accumulent, il est probable que des directives actualisées seront nécessaires.
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