Objective:To describe the level of satisfaction of patients with amputated lower limb wearing external prostheses in the town of Yaoundé. Methodology: A descriptive cross-sectional study was carried out at the National Center for the Rehabilitation of Persons with Disabilities-Cardinal Paul Emile Leger and the Jamot Center in Yaoundé from 7th November 2016 to 29 th March 2017. Only patients over 5 years of age were included in the study. The data collection was carried out using a data sheet derived from SAT-PRO. Results: Seventy seven patients with prostheses were recruited. Their mean age was 46.02 years and they were predominantly males. The prevalence of amputated patient with prosthesis was 39.44%. The main etiology of the amputation was traumatic and the trans-tibial amputations were the most common, followed by trans-femoral amputations. Thirty-nine percent of these patients were physically dissatisfied and 11% very dissatisfied. The rate of dissatisfaction was related to the patient's weight, displacement constraints, pain and sores generated by wearing the prosthesis, the look of the prosthesis and its cost. Psychologically, 26% of the patients were dissatisfied and 17% were very dissatisfied. Dissatisfaction here was related to low self-esteem and poor acceptance of the prosthesis. Socially, nearly 17% were dissatisfied. The prosthesis however favored a better social (family and friendly) acceptance of the handicap. This encouraged a return to routine activities, although some had marital problems and others lost their jobs. Overall, 75.3% of patients were satisfied, and up to 24.7% of patients were dissatisfied. Conclusion: The satisfaction of patients, with an amputated lower limb, with respect to their prosthesis was not optimal in the sense that some criteria like the appearance of the prosthesis, patient's weight, displacement constraints, price, and quality of the prosthesis still needed to be improved. Nevertheless, patients were mostly satisfied.

Background: Sub Saharan population are the most affected by chronic hepatitis C. The interferon-based regimen has been the only available treatment in the last decade. The announced direct acting antivirals will still be associated to the actual regimen. Reports on the safety of these protocols are so far Caucasiansbased, and data from sub Saharan populations are lacking. Aim: To describe the secondary effects of the combination of Pegylated interferon and ribavirin I the treatment of chronic hepatitis C in black Africans. Methods: it was a multicenter study in which we included chronic hepatitis C patients, over ten years, treated by the association of Pegylated interferon-Inf and ribavirin, from all the centers of treatment in the country. Patients should be naïve to this treatment, fulfill the condition of treatment according to manufacturer, namely Hoffmann La Roche. Side effects were recorded during follow up. The base line follow up biological tests included: Liver function tests; full blood count; TSH; kidney function test. Results: All the patients reported at least one adverse event, related to treatment. The clinical adverse events were dominated by asthenia; flu-like syndrome; head ache and myalgia; we registered 6 cases of depression. The most biological adverse events were of hematologic origin. Conclusion: The adverse effects related to combination therapy using Pegylated interferon alfa-2a and ribavirin in the treatment of chronic HCV in the blacks, are similar to those indicated by the manufacturer. These adverse effects tend to be in relation the duration of treatment. Some of them can become intractable, alternative treatment or psychological support from patients association can be helpful.

Background: Post-traumatic osteomyelitis is bone infection secondary to a trauma (open fracture or bone surgery). It is a painful and frustrating disease characterised by a high rates of therapeutic failures and a costly management. However, treatment is increasingly becoming difficult because of the phenomenon of antibiotic resistance. The present study was realised to determine the epidemiological and susceptibility profile of bacterial isolates in posttraumatic osteomyelitis in a tertiary hospital in the city of Yaoundé. Method: A descriptive cross-sectional study was carried out between November 2016 and May 2017. Patients admitted for post-traumatic osteomyelitis were recruited. After recoding clinical informations, deep specimens were taken during surgical debridement and were cultured in Blood, Mannitol Salt and MacConkey plates at 37 o C for 24-72hrs. Culture isolates were identified by standard biochemical reactions. Antibiotic susceptibility was performed by Kirby-Bauer method using the CASFM guidelines. Results: A total of 31 patients were recruited; the modal age range was 21-50 years (67.8%) and the sex ratio 1.8:4. The commonest bones affected were the tibia (48.5%) and femur (32.3%). Predisposing factors identified included open fractures (76%), delay surgical debridement (83.3%), presence of prosthesis (58%) and surgical wound infections (23%). Out of 31 samples, 29 yielded positive culture giving rise to 48 bacteria isolates. Fourteen samples (48%) were polybacterial. The most predominant species was Escherichia coli (29%), followed by Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae (all 22.6%). The Gram positive organisms showed good sensitivity to Imipenem, Rifampicin, Fucidine, Lincomycin, and to Vancomycin whereas the Gram negative bacilli were mostly sensitive to Imipenem (96.7%), Amikacin (82.1%) and to a lesser extend Quinolones (54%) and Piperacillin/Tazobactam and Ceftazidime (48%). Conclusion: Nosocomial bacteria dominate the bacterial flora of posttraumatic osteomyelitis in our setting and many multidrug resistant strains are emerging thus emphasizing on the importance of hygiene and targeted antibiotherapy.

Background: Fractures are more and more frequent, because of the extent of traffic road accidents and the rise of moto-taxis in Cameroon context. However, there are major public health challenges in the therapeutic response within the pyramidal care chain. Method: This was a cross-sectional study with mixed component (qualitative and quantitative) that lasted ten months (from October 2017 to July 2018). It covered a six-year period (between 2012 and 2018) and was carried in the departments of orthopedic surgery and traumatology of Yaoundé Central Hospital. Included were the medical records of patients with fractures. Results: The sample consisted of 428 patients, with a clear male predominance (sex ratio of 2.6) and a median age of 39 years. Biomedicine and ethnomedicine represented the most widely used treatment options in first (52.3%) and second-line (57%) respectively. As for self-medication, it constituted 44% of the first recourse, because of its geographical accessibility, and 40.2% of the third remedies. The orthopedic itineraries are very erratic, because of the medical pluralism observed within the health system. In addition, the therapeutic response within the pyramidal care chain has been marked by several public health challenges. They were respectively epidemiological (with extent of fractures and traffic road accidents), organizational (due to poor organization of front-line services) and financial (because of ineffectiveness of universal health coverage and socio-economic context specific to low-resource countries). Conclusion:This study will make efficient data available to stakeholders, in order to improve the supply's organization of orthopedic care according to the demand, through perspectives of resolution of epidemiological, organizational and financial challenges in the pyramidal chain of fractures management.