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The ectocervix is the part of the uterus which plunges into the apex of the vagina. A stratified squamous epithelium covers it. The endocervical canal, which establishes communication between the vagina and the endometrial cavity, is paved with a mucous secreting glandular epithelium. Because of the acidity of the vagina, these two epithelia undergo metaplasia. Some oncogenic factors do ignite instead of dysplasia. CIN1, CIN2, and CIN3 correspond to the premalignant transformation of 1/3, 2/3 and 3/3 of these epithelia from the basal membrane. Invasive Cancer is when the latter is broken, and there is a penetration of the stroma by the malignant cells. Methodology:A retrospective hospital-based study was conducted to establish the prevalence of various cervical malignancies at the Buea regional hospital. The registry of the pathology department was used. The study spanned from the 8th of March 2017 to the 16th of March 2021. Results:The different cervical cancer types found were squamous cell carcinoma, small cell carcinoma, adenocarcinoma, and non-Hodgkin cervical cancer or lymphoma of the cervix. Their respective percentages were 73%, 20.7%, 5.4% and 0.9%. Conclusion:Four different types of cancers were found in this study. Their prevalence was for squamous cell carcinoma (73%), small cell carcinoma (20.7%), adenocarcinoma (5.4%), and non-Hodgkin carcinoma of the cervix (0.9%).

OBJECTIVE: This study aimed to assess the prevalence of drinking and driving on roadways in urban areas and highways in Cameroon, and to determine the associations between drinking and driving and socio-demographic factors.METHODS: A cross-sectional study of motor vehicle drivers was performed on Fridays, Saturdays, and Sundays between May and September 2020 with three driver groups: (1) random motor vehicle drivers (including riders) on major highways, (2) drivers recruited at car stations in Yaoundé, and (3) at fuel stations in Douala. Alcohol was measured using breathalyzers, and a questionnaire collected socio-demographic data.RESULTS: In total, 2402 motor vehicle drivers were asked to participate in the study and 1701 (70.8%) gave informed consent. The vast majority (98.6%) were men. Drivers aged 30-39 years constituted the largest age group on highways and in Yaoundé, whereas 18-29 years was the largest age group in Douala. The highest prevalence of alcohol was observed among drivers in Yaoundé, which included mainly clandestine taxi car drivers and motorcycle taxi riders, where about 30% had blood alcohol concentrations (BAC) above the legal limit of 0.08%. The proportion with BACs above the legal limit was about 6% among the drivers in Douala, which included mainly motorcycle taxi riders, and about 4% among drivers on highways.CONCLUSIONS: The findings indicate that drinking and driving is a major traffic safety problem on Cameroonian public roads, especially among motorcycle taxi riders and clandestine taxi drivers in towns, which represent the major mass transportation means in the country. Drinking and driving education and legislation should be better developed and enforced in order to reduce the number road traffic crashes.

This study was carried out to investigate the possible toxic effects of the water extract from Khaya grandifoliola stem bark in Wistar rats. The acute assay used 9 females distributed into 3 groups of 3 rats each. A control group received distilled water and the two test groups received by oral gavage a unique dose of the extract at 2000 mg/kg. In subacute assay, 60 rats both sexes were distributed into 6 groups of 10 rats each (5 males and 5 females) and received the extract by oral gavage for 28 days consecutively. The tests groups received extract at 250, 500 and 1000 mg/kg. The controls and satellite test groups received respectively distilled water and extract at the dose of 1000 mg/kg. Some anthropometrical, hematological and biochemical parameters were measured and histological sections of some organs were realized. LD50 was superior at 2000 mg/kg in acute assay. In subacute toxicity assay, Khaya grandifoliola stimulated the haematopoetic and immune function, showed a significant decrease of alanine transaminase, aspartate transaminase and hypocholesterolaemic effects. Histopathology showed the presence of disturbances at the dose of 1000 mg/kg especially. K. grandifoliola stem bark could possess moderate toxicity at high doses and adequate caution should be exercised in its use in ethnomedicine.

Introduction. The burden of urinary tract infection (UTI) in pregnancy has been understudied in Cameroon.Aim: to determine the prevalence and risk factors of UTI in pregnancy in a tertiary hospital in Cameroon.Materials and methods. A hospital-based matched case-control study of pregnant women with evidence of UTI and those without who underwent antenatal care and gave birth at the Douala General Hospital from January 2014 to December 2018. Demographic, reproductive health/clinical data were collected using a pre-tested questionnaire and analyzed with SPSS.Results. The prevalence of UTI in pregnancy was 4.41 %. Poor antenatal care uptake (AOR = 5.64; 95 % CI = 2.21–14.33), multiple weekly sexual intercourses (AOR = 4.64; 95 % CI = 0.22–96.94), a history of UTI (AOR = 3.01; 95 % CI = 1.12–8.04) and drying the genitals from back to front (AOR = 5.50; 95 % CI = 1.95–15.44) were associated factors.Conclusion. The prevalence of UTI in pregnancy is low amid multiple associated factors. Screening for UTI in pregnancy should be made the standard of obstetric care in Cameroon.

This study evaluated the in vivo curative and antacid effects of MY41g clay on chronic and “unhealed" gastric ulcers in rats. Chronic gastric ulcers were induced by injecting 0.05 mL of acetic acid (30%) into the stomach wall. From day 5-14 after induction of ulcers, rats were treated daily with MY41g clay (125 and 250 mg/kg). For “Unhealed" gastric ulcers, from day 5-18 rats received MY41g clay orally concomitantly with indomethacin (1 mg/kg/day) subcutaneously. The ulcer index, percentage of healing, mucus secretion, histological parameters, oxidative stress parameters and gastric acidity were assessed. Treatment with clay solution for 10 days resulted in accelerated spontaneous healing of chronic gastric ulcers (83.69-90.2%). However, indomethacin administration did not induce significant variations in the percentage of healing (89.23-91.66%) in rats. For both ulcer models performed, ulcer healing was accompanied by a significant increase (p

Background: Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and health expenditure. The burden of this condition has been understudied in Cameroon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Referral Hospital. Methods: We conducted an analytic matched case-control study of 206 pregnant women with evidence of urinary tract infection (103 cases) and those without (103 controls) who underwent antenatal care and gave birth at the DRH from January 2019 to April 2019. Socio-demographic, laboratory and maternal-fetal outcome data were collected using a pre-tested structured questionnaire and analyzed with SPSS version 23. Statistical significance was set at p Results: Escherichia coli (51.5%), Proteus mirabilis (15.5%), Staphylococcus aureus (11.7%) and Klebsiella sp. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1; 95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4; 95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6; 95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1; 95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13; 95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5; 95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. Conclusion: Escherichia coli was the main uropathogenic agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyelonephritis, preterm labor and delivery while fetal outcomes include: low-birth weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.

Aim: HBV infection is known to cause liver fibrosis as well as some extrahepatic manifestations. We aimed at assessing hematological changes and identifying possible hepatic fibrosis of Hepatitis B origin using non-invasive markers (NIMs). Study Design: A hospital-based Case-control study Place and Duration of Study: Conducted at the Buea Regional Hospital, South West Region of Cameroon from February 2016 to December 2017 Methods: We enrolled HBV infected treatment naïve patients and “healthy” controls. All participants were subjected to alanine aminotransferase (ALT) and aspartate aminotransferase (AST) measurement, Full blood count (FBC), HBsAg, anti-HBc, HIV and HCV tests. Aspartate-platelet ratio index (APRI), fibrosis based on 4 factors (FIB-4), age-platelet index (API) and AST/ALT ratio (AAR) were generated from the test results. A questionnaire was administered to collect demographic data, alcohol consumption and history of liver/kidney disease or metabolic syndrome. Results: A total of 202 cases and 202 controls were enrolled. Hematocrit (HCT) was significantly higher (p

Information collected from local traditional healers reported that Eremomastax speciosa (Hochst.) Cufod. has for a long time been used to manage gastric ulcers in many regions of Cameroon and beyond. This traditional use is supported by numerous studies. However, efficacy of this plant has never been tested in case of chronic gastric ulcers associating Helicobacter pylori infection.This study was designed to investigate curative effects of the aqueous extract of E. speciosa leaves (AEESL) against chronic gastric ulcers associated to Helicobacter pylori infection.Two experimental methods of chronic gastric ulcers, involving H. pylori infection, were performed using Wistar rats, namely: acetic acid-induced ulcers and "unhealed ulcers". E. speciosa extract was tested at three doses (100; 200; 400 mg/kg) and at the end of experiments, some in vivo antioxidant parameters were measured, bacterial load in stomach tissue calculated and histopathological examinations performed.E. speciosa reduced ulcer index at all the doses and significantly increased mucus production as well as antioxidant (mainly SOD and GSH) level. Bacterial load in stomach significantly decreased (p 0.05) in extract-treated groups (200 and 400 mg/kg) as confirmed by histopathological observations. The extract was found to be non toxic to healthy and cancerous cells (ICE. speciosa accelerated healing of gastric ulcers even in presence of indomethacin, while decreasing bacterial loads in rats' stomachs. These results provide supplementary support to the use of E. speciosa in ethnomedicine and open new perspectives regarding development of a herbal-based monotherapy able to efficiently replace/supplement standard antiulcer tri/quadritherapy.

Background Studies reporting the natural immune responses against malaria in children from different geographical settings in endemic areas are not readily available. This study was aimed at comparing the immune responses against Plasmodium falciparum MSP-119 antigen in children from five contrasting bioecological zones in Cameroon. Methods In a cross-sectional survey, children between 2 and 15 years, were enrolled from five ecological strata including the south Cameroonian equatorial forest, sudano-sahelian, high inland plateau, high western plateau, and the coastal strata. The children were screened for clinical malaria (defined by malaria parasitaemia ≥ 5000 parasites/µl plus axillary temperature ≥ 37.5 °C). Their antibody responses were measured against P. falciparum MSP-119 antigen using standard ELISA technique. Results In all, 415 children comprising 217 (52.3%) males participated. Total IgG and IgG1–IgG4 titres were observed to increase with age in all the strata except in the sudano-sahelian and high inland plateau strata. Total IgG and IgG1–IgG4 titres were significantly higher in the coastal strata and lowest in the high inland plateau (for IgG1 and IgG2) and sudano-sahelian strata (for IgG3 and IgG4). Titres of the cytophilic antibodies (IgG1 and IgG3) were significantly higher than the non-cytophilic antibodies (IgG2 and IgG4) in all the strata except in the sudano-sahelian and high inland plateau strata. Total IgG and IgG subclass titres were significantly higher in children positive for clinical malaria compared to negative children in all study sites except in the high western plateau and coastal (for IgG1 and IgG3), and the sudano-sahelian strata (for all antibodies). Furthermore, a significant positive correlation was observed between parasite density and IgG2 or IgG4 titres in all study sites except in the south Cameroonian equatorial forest and sudano-sahelian strata. Conclusions This study showed that antibody responses against MSP-119 vary considerably in children from the different bioecological strata in Cameroon and could be linked to the differential exposure to malaria in the different strata. Furthermore, the rate of antibody acquisition was not observed to increase in an age-dependent manner in low transmission settings.

Heterotopic pregnancy is the simultaneous presence of an intrauterine and ectopic pregnancy. The prevalence of the condition is unknown in Cameroon. We report a case of heterotopic pregnancy managed by laparoscopy. MS a 33-year-old G2P0010 woman was admitted to our department because of 7 2/7 weeks' amenorrhea, mild vaginal bleeding, and severe lower abdominal pain. She has a 6 years' history of secondary infertility, one induced abortion, and chlamydia infection treated with doxycycline. Furthermore, she has a history of left laparoscopic salpingotomy for tubo-ovarian abscess. She became pregnant after receiving clomiphene citrate and timed intercourse. Her beta hCG assay was 97000 mIU/mL and transvaginal sonography confirmed ruptured heterotopic pregnancy. She underwent laparoscopic left salpingectomy and the intrauterine pregnancy evolved normally and she gave birth to a healthy female that weighed 3050 g at 38 5/7 weeks gestation. The diagnosis of heterotopic pregnancy needs a high index of suspicion. Laparoscopic treatment of heterotopic pregnancy needs to become widespread in Cameroon.

Background Studies reporting the natural immune responses against malaria in children from different geographical settings in endemic areas are not readily available. This study was aimed at comparing the immune responses against Plasmodium falciparum MSP-119 antigen in children from five contrasting bioecological zones in Cameroon. Methods In a cross-sectional survey, children between 2 and 15 years, were enrolled from five ecological strata including the south Cameroonian equatorial forest, sudano-sahelian, high inland plateau, high western plateau, and the coastal strata. The children were screened for clinical malaria (defined by malaria parasitaemia ≥ 5000 parasites/µl plus axillary temperature ≥ 37.5 °C). Their antibody responses were measured against P. falciparum MSP-119 antigen using standard ELISA technique. Results In all, 415 children comprising 217 (52.3%) males participated. Total IgG and IgG1–IgG4 titres were observed to increase with age in all the strata except in the sudano-sahelian and high inland plateau strata. Total IgG and IgG1–IgG4 titres were significantly higher in the coastal strata and lowest in the high inland plateau (for IgG1 and IgG2) and sudano-sahelian strata (for IgG3 and IgG4). Titres of the cytophilic antibodies (IgG1 and IgG3) were significantly higher than the non-cytophilic antibodies (IgG2 and IgG4) in all the strata except in the sudano-sahelian and high inland plateau strata. Total IgG and IgG subclass titres were significantly higher in children positive for clinical malaria compared to negative children in all study sites except in the high western plateau and coastal (for IgG1 and IgG3), and the sudano-sahelian strata (for all antibodies). Furthermore, a significant positive correlation was observed between parasite density and IgG2 or IgG4 titres in all study sites except in the south Cameroonian equatorial forest and sudano-sahelian strata. Conclusions This study showed that antibody responses against MSP-119 vary considerably in children from the different bioecological strata in Cameroon and could be linked to the differential exposure to malaria in the different strata. Furthermore, the rate of antibody acquisition was not observed to increase in an age-dependent manner in low transmission settings. Electronic supplementary material The online version of this article (10.1186/s12936-019-2654-9) contains supplementary material, which is available to authorized users.

The aim of the study was to determine beliefs and utilization of cervical cancer screening and prevalence of low-grade squamous intraepithelial lesion/high-grade squamous intraepithelial lesion among a university-based population in the Southwest region of Cameroon.A public-private partnership was established between the University of Arizona, University of Buea, and the Cameroon Baptist Convention Health Services. A single-day screening clinic using visual inspection with acetic acid and Lugol's iodine solution (VILI) was provided at the University of Buea. Screening results were documented as negative, low-grade, high-grade, or suspicious for cancer. Thermocoagulation and loop electrosurgical excisional procedure was available for low- and high-grade lesions, respectively. A survey was conducted before screening and factors associated with screening practices were evaluated.Of 120 clinic participants, 107 (89.2%) believed that treatment of precancerous lesions helped prevent cervical cancer, but most (67.5%) had never been screened. Eighty women (66.7%) were aware of the human papillomavirus (HPV) vaccine, and only 2 had received vaccination. Among 115 patients screened, the prevalence of abnormal screening was 6.09%. Low-grade lesions were treated with thermocoagulation and high-grade lesions were treated with loop electrosurgical excisional procedure.Despite knowledge of cervical cancer screening benefits, the majority had not been screened or vaccinated. This study suggests a desire for additional screening services in this population and validates the utility of public-private partnerships in low-income regions.

Acquired immune-deficiency syndrome (AIDS) is becoming an increasing problem to the surgeon. The impact of HIV/AIDS on surgical practice include the undoubted risk to which the surgeon will expose him or herself, the atypical conditions that may be encountered and the outcome and long term benefit of the surgical treatment in view of disease progression. The two factors most associated with surgical outcome and poor wound healing were AIDS and poor performance status (ASA score). This article questions whether gastrointestinal surgical procedures can be safe and effective therapeutic measures in HIV/AIDS patients and if surgical outcome is worthy of the surgeon's ethical responsibility to treat. As HIV/AIDS patients are not a homogeneous group, with careful patient selection, emergency laparotomy for peritonitis confers worthwhile palliation. However, aggressive surgical intervention must be undertaken with caution and adequate peri-operative care is required. Symptomatic improvement of anorectal pathology may make delayed wound healing an acceptable complication. Alternatives to surgery can be contemplated for diagnosis, prophylaxis or palliation., Highlights • Atypical conditions may be encountered. • The best predictor of perioperative morbidity and mortality is the general health status. • Postponing elective operations to start antiretroviral medication should be encouraged. • Surgical intervention should be considered in life threatening surgical correctable disease. • The risk of exposure is reduced by the growing role of minimally invasive surgery.

Introduction: Cancer of the cervix is the second most common gynecologic malignancy in the world due to lack of awareness and poor uptake of cervical cancer screening services especially in low income countries. In Cameroon, though there is a national cervical cancer-screening program the service has been limited to some main cities without an appreciable impact. Aims: The objectives of this study were to determine the knowledge, attitude, practice towards Pap smear screening, thus evaluating its suitability as a screening procedure in Cameroon, through this pilot study in the Buea Health District. Methods: The study was a community-based cross-sectional descriptive survey that involved 309 women. Women from 18 years were enrolled for the study from 9th October to 20th November 2013. Results: The mean age of the participants was 32.3 years (SD = 11.7 years). Most of the women (29.5%) who had gone for the Pap test were in the 41 - 50 years age group. Only 3.6% of the study participants had “good” knowledge of cervical cancer and Pap smear screening. Approximately 20% of the women had a previous Pap smear test with 55.7% of them having the test just once. Eighty two percent of those who had secondary and tertiary levels of education had never had a Pap smear test. Awareness of risk factors for cervical cancer was low. Fear of pain, positive results after screening, non-curability of cervical cancer were some factors associated with a low Pap test uptake (p < 0.05). Conclusion: There is poor knowledge and perceived barriers by women about Pap smear screening and follow-up services. For an impact to be made in the prevention of cervical cancer, Pap smear screening is not the preferred method because of these limitations in this community.

Objective. This work investigated the healing and antisecretory effects of the aqueous extract ofEremomastax speciosaon “unhealed gastric ulcers” associated with gastric acid hypersecretion.Materials and Methods. “Unhealed gastric ulcers” were induced using indomethacin following the establishment of acetic-acid-induced chronic gastric ulcers. The extract (200 and 400 mg/kg, per os) was administered concomitantly with indomethacin (1 mg/kg, subcutaneously). The effects of the extract on both basal and histamine-stimulated gastric acid secretion were determined. Mucus secretion and oxidative stress parameters were measured, and histological assessment of ulcer healing was carried out.Results. The extract significantly promoted the healing process in rats subjected to “unhealed gastric ulcers” (82.4–88.5% healing rates). Treatment with the extract significantly reduced the basal (25.95–49.51% reduction rates) and histamine-stimulated (24.25–47.41%) acid secretions. The healing effect of the extract was associated with a significant (p<0.05) increase of mucus secretion and concentrations of antioxidant enzymes compared with the controls. The extract at the highest dose showed normalization of the mucosa, without glandular destruction and with the disappearance of fibrosis and lymphocyte infiltration.Conclusion. The abilities of the extract to increase mucus secretion, to reinforce antioxidant status, and to inhibit acid secretion would be some of the mechanisms by which this extract would accelerate the healing process in “unhealed gastric ulcers.”

Hepatocellular carcinoma (HCC) is a complex disease and a major cause of death in high endemic areas of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. HCC has gone from being a universal death sentence to a cancer that can be prevented, detected at an early stage and effectively treated. Liver resection or tumour ablation techniques may be effective bridge to liver transplantation if they fulfill the Milan criteria. The areas of progress in HCC are in the control of HBV or HCV and the development of adjuvant or neoadjuvant therapies.

We report the case of a 10 year old girl with a late diagnosis of a high grade osteosarcoma (Stage IIb) of the right femur in a low income setting. The diagnosis could clinically have been made much earlier if the observation of an enucleated congenitally blind left eye due to a probable retinoblastoma was known to be associated with osteosarcoma. Screening of at-risk families and close surveillance of affected individuals for these heritable genetic predisposition syndromes may permit earlier diagnosis and more effective treatment of osteosarcoma in these populations.

Background: Malaria and human immunodeficiency virus (HIV) account for significant morbidity and mortality in Cameroon. Studies on malaria and HIV coinfection in the Southwest Region of the country are few. The aim of this study was to determine the prevalence of malaria and HIV coinfection as well as the association between HIV and severe malaria (SM), in febrile patients attending the Regional Hospital of Buea. Materials and Methods: In this cross-sectional study, 218 febrile patients were enrolled from the Outpatient Department/Emergency Unit of the Regional Hospital of Buea. Their vital signs were collected, and the consulting physician examined them. Their HIV and malaria statuses were determined by serology and Giemsa microscopy, respectively. SM was classified according to the WHO criteria. Results: The participants' age ranged between 2 weeks and 79 years, and the majority were females (59.2%). The prevalence of malaria, HIV, and coinfection with malaria and HIV were 30.7%, 6.9%, and 2.3%, respectively. Malaria prevalence was significantly higher in children 10 years and below (P = 0.018); meanwhile, HIV prevalence was significantly higher in participants between 31 and 40 years (P = 0.005). The mean hemoglobin concentration was significantly lower while the malaria parasite density was significantly higher in malaria and HIV-coinfected group. The rate of SM was 13.8%, and this was higher in children ≤10 years (P = 0.037). The association between HIV and SM was not statistically significant (P = 0.308). Conclusion: In general, a low prevalence of coinfection with malaria and HIV was observed, and HIV infection was not found to be associated with SM in this study. Further studies in other populations from Cameroon are required to shed more light.

We evaluated the qualitative chemical composition and tested the antiulcer actions on cold/restraint stress ulcers, the healing effect on chronic acetic acid-induced gastric ulcers, and thein vivoandin vitroantioxidant capacity ofOcimum suaveextract. Triterpenes, flavonoids, sugars, phenols, sterols, and multiple bonds were among the phytochemicals detected. The extract (250–500 mg/kg) dose-dependently inhibited the formation of gastric ulcers induced by cold/restraint stress (52.30%–83.10%). The prophylactic actions were associated with significant increases in gastric mucus production. There was significant histological healing of chronic ulcers following 14-day treatment withO. suaveextract (250–500 mg/kg). We also evaluated the efficacy ofO. suaveextract in cold/restraint-induced oxidative stress in rat stomach tissue.O. suave(500 mg/kg) ameliorated the decreased levels of reduced glutathione from 0.85 (control group) to 2.08 nmol/g tissue. The levels of SOD and catalase were also improved in rats treated withO. suaveextract. The extract had a high phenol content (899.87 mg phenol/g catechin equivalent),in vitroDPPH radical scavenging activity (89.29%), and FRAP (antioxidant capacity) (212.64 mg/g catechin equivalent). The cytoprotective and ulcer healing effects of the extract are attributed to enhanced mucus production and the antioxidant properties which may likely be associated with the high presence of flavonoids and polyphenols.

A properly operated death investigation system (DIS) serves multiple stakeholders. Law enforcement, public health departments and members of the public, benefit in various ways from the information that it provides. This information must be collected systematically and efficiently. The system must also be flexible enough to respond to pressures on its resources such as occurs during mass disasters. These obligations on a DIS require an investment of public money. However even in affluent Western countries the recent world economic crisis has led to a cut in spending on public services that affect both the healthcare system and services associated with death investigation. Although pathologists and other stake holders (judiciary, police, families) would like to see death investigations conducted to international standards, the fact is that policy makers in resource limited countries face additional population health and sociopolitical pressures which generally result in very little funding for the service. The purpose of this paper is to review some of the challenges that impede the proper functioning of a death investigation system in resource limited countries in Sub-Saharan Africa and the Caribbean. Possible solutions are discussed.

Pancreatic ductal carcinoma continues to be the most lethal malignancy with rising incidence. It is the fourth most common cause of cancer death in the western world due to its low treatment success rate. In addition, because of its rapid growth and silent course, diagnosis is often only established in the advanced stages. As one of the most aggressive malignancies, the treatment of this disease is a great challenge to clinicians. This paper reviewed the natural history of pancreatic cancer, the current clinical practice and the future in pancreatic cancer management.

Background Hepatocellular carcinoma (HCC) usually affects patients aged 50–70 years but earlier onset (25–40 years) may occur in hepatitis B endemic areas. 70–90 % of HCC develop on a background of cirrhosis. However, hepatitis B virus is directly oncogenic and can cause HCC in the absence of cirrhosis. This may represent a major cause of death from late diagnosis in resource-limited areas. Case presentation We report a black African family in which clinical diagnosis of HCC was made on two male siblings in the south west region of Cameroon. Conclusions The highest risk for HCC may occur in families in which a hereditary component may be acting in concert with hepatitis B virus. In all cases of HCC, it is important to screen all first degree relatives to detect early and asymptomatic disease. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1366-7) contains supplementary material, which is available to authorized users.

Non-Hodgkin lymphomas (NHLs) are a diverse group of blood cancers derived from lymphocytes that vary significantly in their severity. Surgery is not often used as a treatment because of the efficacy of chemotherapy, biological therapy, radiotherapy and hematopoietic stem cell transplantation. We reviewed the natural history and possible role of surgery for NHL. Surgery may be useful in confirming or refuting an equivocal radiological diagnosis through biopsy, removing symptomatic limited disease from an affected organ and in splenectomy for primary splenic lymphoma. Emergency abdominal surgery for acute complications of NHL provides palliation and diagnosis. There is as yet no consensus as to the optimum treatment for symptomatic limited disease affecting an organ and timing of chemotherapy perioperatively. Prospective randomized trials are required.

Intestinal metaplasia (IM) of the stomach has been shown to increase the relative risk of gastric cancer. Endoscopic surveillance has been proposed and advocated for populations at risk. Those patients who had undergone surgery for gastric malignancy exhibited precancerous lesions such as atrophic gastritis and IM, and the possibility of anastomotic recurrence is higher than for the patients who had undergone benign gastric surgery. At present, there are no other recognized good markers of gastric dysplasia or cancer. We reviewed the literature on IM of the stomach to ascertain whether residual premalignant (type III) IM may predispose to anastomotic recurrence of gastric cancer.

More recently some patients with rectal mucosal prolapse and obstructive defaecation have been treated with the procedure for prolapse and haemorrhoids. We report a case of symptomatic chronic circumferentially prolapsed haemorrhoids that had several failed attempts at surgical repair. This was finally managed by ablation and correction of the associated rectal mucosal prolapse by a modified ‘Delorme's procedure akin to a stapled anopexy.

The HIV epidemic in Cameroon is marked by a broad genetic diversity dominated by circulating recombinant forms (CRFs). Studies performed more than a decade ago in urban settings of Southern Cameroon revealed a dominance of the CRF02_AG and clade A variants in >90% of the infected subjects; however, little is known about the evolving viral variants circulating in this region. To document circulating HIV viral diversity, four regions of the viral genome (gag, PR, reverse transcriptase, env) in 116 HIV-1 positive individuals in Limbe, Southern Cameroon, were PCR-amplified. Sequences obtained at the RT and protease regions were analyzed for mutations that conferred drug resistance using the Stanford Drug Resistance Database. The present study reveals a broad genetic diversity characterized by several unique recombinant forms (URF) accounting for 36% of infections, 48.6% of patients infected with CRF02_AG, and the emergence of CRF22_01A1 in 7.2% of patients. Three out of 15 (20%) treated patients and 13 out of 93 (13.9%) drug naive patients harbor drug resistance mutations to RT inhibitors, while 3.2% of drug naive patients harbor drug resistance mutations associated with protease inhibitors. The high proportion (13.9%) of drug resistance mutations among the drug naive patients reveals the ongoing transmission of these viruses in this region of Cameroon and highlights the need for drug resistance testing before starting treatment for patients infected with HIV-1. J. Med. Virol. 86:385–393, 2014. © 2013 The Authors. Journal of Medical Virology Published by Wiley Periodicals, Inc.

The anti-ulcerogenic potential of the leaf methanol extract of Aloe buettneri A. Berger was investigated using three methods of gastric lesion induction in experimental Wistar rats (150-200 g) and mice (20-25 g): 1. HCl/ethanol-induced gastic lesions, 2. Indomethacin-HCl/ethanol-induced gastric lesions, and 3, Pylorus ligation-induced gastric lesions. Mice were used in acute and sub acute toxicity tests. Oral administration of the extract of Aloe buettneri to the rats and mice (500-1000 mg/kg) dose-dependently prevented the formation of acute gastric lesions induced using the three experimental techniques. The dose-dependent reduction of lesion formation was accompanied by a significant increase in gastric mucus production in mice. Inhibition of lesion formation was 22 and 54 % in mice, 25 and 77% in rats for the doses of 500 and 1000 mg/kg when the HCl/ethanol mixture was given. Pre-treatment, by oral route, with indomethacin significantly reduced the ability of the extract to inhibit the formation of HCl/ethanol-induced lesions, inhibition dropping to 11% for the dose of 1000 mg/kg. When the rats were subjected to pylorus ligation, the level of lesion inhibition was 36 and 68% for the two doses of extract. Gastric acid secretion reduced to 88 and 79mEq/l compared with105 mEq/l for the controls. Acute toxicity studies did not reveal toxic effects up to the dose of 10 g/kg. However, sub acute studies revealed toxicity effects in heart (pericarditis), lung (diffuse alveolar disease) and liver (chronic active hepatitis) tissue. These results confirm the ethnomedical use of Aloe buettneri in the management of gastroduodenal ulcer disease and suggest that toxic effects may result from prolonged intake of high doses of the extract.

The gastric cytoprotective actions of the extract of Ocimum suave wild (lamiaceae) have previously been demonstrated. We have investigated here the healing effect of the leaf methanol extract of Ocimum suave against chronic gastric ulcers induced in experimental rats. Chronic gastric ulcers were induced using acetic acid and the induced ulcers treated over a period of two weeks using daily oral doses (125 – 500 mg/kg) of the extract. Possible toxic effects of the extract given in the short term were also investigated. The extract reduced ulcer indices from 50.40 in the 4-day controls to 11.8, 5.8, and 3.6, respectively, for the rats receiving 125, 250 and 500 mg/kg of the extract. The highest dose of the extract (500 mg/kg) showed a highly significant (P < 0.001) reduction of ulceration with a corresponding healing rate of 81.25 per cent. Treatment with the plant extract was also associated with a significant increase in mucus production up to 57 per cent (P < 0.01) for the 500 mg/kg dose. A similar increase in mucus production was not observed with ranitidine although it generated a healing rate of 66 per cent. No apparent toxicity signs were observed through food and fluid intakes, vital organ weights, animal behaviour, stool texture, red and white blood cell counts and histopathological evaluation. The results of the present study show that in addition to the previously demonstrated cytoprotective antiulcer actions of the leaf methanol extract of O. suave, the extract also possesses potent healing effects against chronic gastric ulcers. Enhanced mucus production appears to play a significant role in the mode of action of the extract

The incidence rate of lung cancer in Africa is low. However, there are few studies reporting clinical characteristics of lung cancer in African countries. We did a study of lung cancer at the Medical Oncology Service of the Yaounde General Hospital, Cameroon, from January 1998 to December 2007. Out of the 2,355 cancer patients seen at this hospital over a 10-year period, 48 patients (28 men and 20 women) were diagnosed with lung cancer. The average age (SD) of patients was 53 (13) years and ranged from 25 to 80 years. Seven patients were cigarette smokers. The median duration from initial symptoms to visiting doctors was 5 months (interquartile range: 3-11 months). The most common histology types were squamous cell carcinomas (31, 65%), followed by adenocarcinomas (8, 17%), large cell carcinomas (4, 8%), small cell carcinomas (4, 8%), and fibrosarcoma (1, 2%). Of the 19 patients with stage classification, 8 had stage IV and 11 had stage III disease. Only 14 patients reported having received treatment, including chemotherapy, radiotherapy, and/or surgery. In conclusion, lung cancer was uncommon in Yaounde, Cameroon, but most of patients presented with advanced stage due to long delay in seeking diagnosis. Less than half of the patients received chemotherapy, radiotherapy, or surgery.