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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 Yaounde 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.

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 Yaounde. 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 oC 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: Postoperative infections (POIs) contribute to morbidity and mortality of surgical patients. There was no data on the prevalence and associated risk factors of POIs in the Limbe Regional Hospital (RLH). Methods: Selected patients were those who underwent a surgical procedure and were admitted into the surgical or maternity ward of the LRH between January 2009 and August 2012. Data studied included demographic variables, type of surgical procedure performed and postoperative follow-up. Data was analyzed for evidence of POIs using the Chi-square test for categorical variables and test for significance of association between POI and sex, age, procedures performed, hospitalization ward and duration of hospital stay. Results: 848 patients were selected among whom 78.8% were females. 62.1% of the patients were selected from the Obstetric and Gynaecology ward, while 37.9%were from the surgical ward. The mean age of the study subjects was 32.3±12.4 years. 175 patients met the criteria for POI giving a prevalence of 20.6%. The Obstetrics and Gynaecology ward had the highest prevalence of POI (61.7%). Prevalence of POIs was highest (64.3%) among patients in the 0 - 10 years age group. Males (26.7%) were at a higher risk of developing POIs .There was a statistically significant difference between POI and participants' age group (p

We present a case of intestinal infarctus through the vagina. This was a consequence of induced abortion done clandestinely. The main objective was to point out the surgical complications of uterine dilatation and curettage by means of this rare case.