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Controlling the COVID-19 outbreak remains a challenge for Cameroon, as it is for many other countries worldwide. The number of confirmed cases reported by health authorities in Cameroon is based on observational data, which is not nationally representative. The actual extent of the outbreak from the time when the first case was reported in the country to now remains unclear. This study aimed to estimate and model the actual trend in the number of COVID -19 new infections in Cameroon from March 05, 2020 to May 31, 2021 based on an observed disaggregated dataset. We used a large disaggregated dataset, and multilevel regression and poststratification model was applied prospectively for COVID-19 cases trend estimation in Cameroon from March 05, 2020 to May 31, 2021. Subsequently, seasonal autoregressive integrated moving average (SARIMA) modeling was used for forecasting purposes. Based on the prospective MRP modeling findings, a total of about 7450935 (30%) of COVID-19 cases was estimated from March 05, 2020 to May 31, 2021 in Cameroon. Generally, the reported number of COVID-19 infection cases in Cameroon during this period underestimated the estimated actual number by about 94 times. The forecasting indicated a succession of two waves of the outbreak in the next two years following May 31, 2021. If no action is taken, there could be many waves of the outbreak in the future. To avoid such situations which could be a threat to global health, public health authorities should effectively monitor compliance with preventive measures in the population and implement strategies to increase vaccination coverage in the population.

Earlier studies, mostly overseas, have explored the reasoning and thought processes underlying women's desires to conceive. A retrospective qualitative study was conducted to explore the motivations and anxieties of an Australian sample of women proceeding to a pregnancy and to explore their decision-making process. Twenty women over 18 years old who had one or more successful pregnancies and were recruited from a tertiary centre and private clinics, completed a questionnaire and a semi-structured interview. Thematic analysis was applied to the data. Multiple factors motivated women to proceed to a pregnancy and including influences arising from society or existing personal relationships, goals and desired experiences for parenthood and innate drives and reproductive related issues. The motivations of an urban Australian sample to proceed to a pregnancy differed little from studies elsewhere. This knowledge may assist in dealing with the concerns that underlie any pregnancy allowing for better obstetric management. [ABSTRACT FROM PUBLISHER]

A simplified method for isolating highly purified laterobasal membranes (LBM) from enterocytes is based on treatment of membranes with 8 mM CaCl2 concentration in order to aggregate intracellular membrane contaminants. The resultant LBM showed an average 15-fold enrichment and constituted 8% of the original K-stimulated phosphatase in the initial crude homogenate. It showed typical LBM migration on counter-current distribution (CCD) and was essentially free of contamination with endoplasmic reticulum and Golgi membranes. This method is highly efficient and yields sufficient purified LBM to allow comprehensive analysis of enterocyte membrane events. [ABSTRACT FROM AUTHOR]

Bioaugmentation promises benefits for agricultural production as well as for remediation and phytomining approaches. Thus, this study investigated the effect of soil inoculation with the commercially available product RhizoVital ® 42, which contains Bacillus amyloliquefaciens FZB42, on nutrient uptake and plant biomass production as well as on the phytoaccumulation of potentially toxic elements, germanium, and rare earth elements (REEs). Zea mays and Fagopyrum esculentum were selected as model plants, and after harvest, the element uptake was compared between plants grown on inoculated versus reference soil. The results indicate an enrichment of B. amyloliquefaciens in inoculated soils as well as no significant impact on the inherent bacterial community composition. For F. esculentum , inoculation increased the accumulation of most nutrients and As, Cu, Pb, Co, and REEs (significant for Ca, Cu, and Co with 40%, 2042%, and 383%, respectively), while it slightly decreased the uptake of Ge, Cr, and Fe. For Z. mays , soil inoculation decreased the accumulation of Cr, Pb, Co, Ge, and REEs (significant for Co with 57%) but showed an insignificant increased uptake of Cu, As, and nutrient elements. Summarily, the results suggest that bioaugmentation with B. amyloliquefaciens is safe and has the potential to enhance/reduce the phytoaccumulation of some elements and the effects of inoculation are plant specific.

Scaffold hopping and structure-based drug design were employed to identify substituted 4-aminoquinolines and 4-aminonaphthyridines as potent, small molecule inhibitors of tumor necrosis factor alpha (TNFα). Structure-activity relationships in both the quinoline and naphthyridine series leading to the identification of compound 42 with excellent potency and pharmacokinetic profile are discussed. X-ray co-crystal structure analysis and ultracentrifugation experiments clearly demonstrate that these inhibitors distort the TNFα trimer upon binding, leading to aberrant signaling when the trimer binds to TNF receptor 1 (TNFR1). Pharmacokinetic-pharmacodynamic activity of compound 42 in a TNF-induced IL-6 mouse model and in vivo activity in a collagen antibody-induced arthritis model, where it showed biologic-like in vivo efficacy, will be discussed.

The potent MCHR1 in vitro and in vivo antagonist activity of a series of cyclic tertiary alcohols derived from compound 2b is described. Subsequent pharmacokinetic and pharmacodynamic studies identified BMS-814580 (compound 10) as a highly efficacious antiobesity agent with a relatively clean in vitro and in vivo safety profile.

Identification of MCHR1 antagonists with a preclinical safety profile to support clinical evaluation as antiobesity agents has been a challenge. Our finding that a basic moiety is not required for MCHR1 antagonists to achieve high affinity allowed us to explore structures less prone to off-target activities such as hERG inhibition. We report the SAR evolution of hydroxylated thienopyrimidinone ethers culminating in the identification of 27 (BMS-819881), which entered obesity clinical trials as the phosphate ester prodrug 35 (BMS-830216).

Purpose: Women even with moderate to severe congenital heart disease (CHD) seek motherhood despite posing significant health risks to themselves and their infant. This study explored their motivations and perceptions and compared them to those of women with low risk CHD who conceived., Procedures: Twenty women over 18 years with CHD who had a successful pregnancy were recruited, half of whom were identified as having a high risk cardiac abnormality. They completed a questionnaire and a semi-structured interview following which a thematic analysis was employed. Their medical records and clinical status were also reviewed and their current cardiac status graded by their attending cardiologist., Findings: Women with high risk (moderate to severe) CHD (n=10) appeared to have similar motivations for conceiving as women with low-risk (mild) CHD (n=10). Their decision to conceive seemed based on their own and at times unrealistic perceptions of the consequences of their CHD., Conclusions: Women with mild or more severe CHD had similar motivations to conceive tending to down play the seriousness of their CHD. Their drive for motherhood appeared to be stronger than the drive for self care. It behoves clinicians, both obstetricians and cardiologists caring for women with high risk CHD to be knowledgeable of the effects of the CHD on the pregnancy and the impact of the pregnancy on the cardiac status., (Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)

Objective: To assess the perceptions of women with congenital heart disease (CHD) regarding the severity of their cardiac abnormality and its implications in pregnancy, and whether their motivations to conceive were similar to those of women without CHD., Methods: A retrospective descriptive study of a cohort of women with (n = 20) or without (n = 20) CHD, aged over 18 years, who had had one or more successful pregnancies. The women were surveyed using a semi-structured questionnaire and their medical records were reviewed. Data were analyzed using thematic analysis., Results: Women with CHD were concerned about the health risks associated with their CHD; however, they were not deterred from conceiving because 10 out of 20 women had a tendency to downplay the seriousness of their CHD. The women's motivations to conceive were similar in both groups., Conclusion: Although women with CHD were clinically identified as an at-risk group, with possible health complications for themselves and their infant, it was ultimately the women's inaccurate perception of the severity of their CHD and of the associated potential health risks that influenced their decision to pursue motherhood. This emphasizes the need for clinicians to have detailed knowledge of the cardiac abnormality and its implications in pregnancy., (Copyright © 2014. Published by Elsevier Ireland Ltd.)

A series of inhibitors of mammalian 15-lipoxygenase (15-LO) based on a 3,4,5-tri-substituted pyrazole scaffold is described. Replacement of a sulfonamide functionality in the lead series with a sulfamide group resulted in improved physicochemical properties generating analogs with enhanced inhibition in cell-based and whole blood assays., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Agonists of the 5-HT(2C) receptor have been shown to suppress appetite and reduce body weight in animal models as well as in humans. However, agonism of the related 5-HT(2B) receptor has been associated with valvular heart disease. Synthesis and biological evaluation of a series of novel and highly selective dihydroquinazolinone-derived 5-HT(2C) agonists with no detectable agonism of the 5-HT(2B) receptor is described. Among these, compounds (+)-2a and (+)-3c were identified as potent and highly selective agonists which exhibited weight loss in a rat model upon oral dosing., (Copyright (c) 2009 Elsevier Ltd. All rights reserved.)

3-hydroxy-3-methylglutaryl coenzyme-A reductase (HMGR) inhibitors, more commonly known as statins, represent the gold standard in treating hypercholesterolemia. Although statins are regarded as generally safe, they are known to cause myopathy and, in rare cases, rhabdomyolysis. Statin-dependent effects on plasma lipids are mediated through the inhibition of HMGR in the hepatocyte, whereas evidence suggests that myotoxicity is due to inhibition of HMGR within the myocyte. Thus, an inhibitor with increased selectivity for hepatocytes could potentially result in an improved therapeutic window. Implementation of a strategy that focused on in vitro potency, compound polarity, cell selectivity, and oral absorption, followed by extensive efficacy and safety modeling in guinea pig and rat, resulted in the identification of compound 1b (BMS-644950). Using this discovery pathway, we compared 1b to other marketed statins to demonstrate its outstanding efficacy and safety profile. With the potential to generate an excellent therapeutic window, 1b was advanced into clinical development.

A series of 2,4,5-tri-substituted imidazoles has proven to be highly potent in inhibiting mammalian 15-lipoxygenase (15-LO) with excellent selectivity over human isozymes 5- and P-12-LO. Non-symmetrical sulfamides (e.g., 21a-n) were found to be suitable replacements for the earlier arylsulfonamide-containing members of this series (e.g., 2, 14a-p). Several members of these series also demonstrated potent inhibition of human 15-LO in a cell-based assay.

A series of inhibitors of mammalian 15-lipoxygenase based on tryptamine and homotryptamine scaffolds is described. Compounds with aryl substituents at C-2 of the indole core of tryptamine and homotryptamine sulfonamides (e.g., 37a-p) proved to be potent inhibitors of the isolated enzyme. Selected compounds also demonstrated desirable inhibition selectivities over isozymes 5- and P-12-LO.

Inhibition of the sodium hydrogen exchanger isoform-1 (NHE-1) has been shown to limit damage to the myocardium under ischemic conditions in animals. While most known NHE-1 inhibitors are acylguanidines, this report describes the design and synthesis of a series of heterocyclic inhibitors of NHE-1 including aminoimidazoles with undiminished in vitro activity and oral bioavailability.

Objective: To assess echocardiographic evidence of cardiomyopathy and its association with microalbuminuria in type 2 normotensive non-proteinuric diabetic patients., Material and Methods: Forty consecutive normotensive non-proteinuric type 2 diabetic patients were studied. Body mass index, blood pressure, urinary albumin excretion, ECG at rest and after exercise, left ventricular mass, and shortening fraction using two-dimensional and M-mode echocardiography were measured in every patient., Results: Among the 40 patients studied, 17 (42.5%) presented with microalbuminuria, 16 (40.0%) with left ventricular hypertrophy, 22 (55.0%) with systolic dysfunction and 3 (7.5%) with ECG changes compatible with cardiac ischaemia. No significant difference existed between normoalbuminuric and microalbuminuric patients for age, known duration of diabetes, body mass index, systolic and diastolic blood pressure. Ventricular mass correlated to urinary albumin excretion rate (r=0.34; p=0.04) and shortening fraction to diastolic blood pressure (r = - 0.40; p=0.01)., Conclusion: Left ventricular structure and function might be altered in African type 2 diabetic patients in the absence of hypertension, and microalbuminuria may be an early biochemical marker of these abnormalities.

Aim: The aim of this study was to investigate left ventricular diastolic function in a group of homozygous Black African patients with sickle-cell disease via echocardiography-Doppler, and to describe the possible hemodynamic implications of these findings., Patients and Methods: Fifty patients with sickle-cell anemia from two hematology departments in Yaoundé volunteered to participate in the study, carried out between May-October 1995. The presence of any other associated pathology (cardiovascular disorder, acute drepanocytic anemia, pregnancy) was excluded following a clinical, hematological and echocardiographic examination. A sex- and age-matched control group consisting of 50 healthy subjects was selected after the same examination criteria had been met. Mitral flow recorded by pulsed Doppler was measured, and the amplitudes of the E and A waves of the proto- and telediastolic flow, the E/A ratio, the decrease over time (DT) for the E wave, and the left ventricular isovolumetric relaxation time were also calculated. The limits of the confidence interval for the mean DT of the control group were used as the criterion to determine the following in the patient population: i) relaxation disorder profile, with DT > 154 ms; ii) restrictive disorder profile, with DT < 137 ms., Results: The dimensions of the cardiac cavities and the left ventricular mass were higher in the patient population; 34 cases of left auricular dilatation (68%) and 33 cases of left ventricular dilatation 8 66%) were observed. In only two patients was a systolic dysfunction noted. The amplitudes of the mitral flow E and A waves were increased, and the DT was longer in the sickle-cell group. Forty patients (80%) had abnormal diastolic function, with a marked predominance of the 'relaxation disorder' profile (60%). The restrictive disorder profile was only observed in ten sickle-cell patients (20%), while ten others displayed a normal profile (20%). The means of the various clinical and echocardiographic parameters of the three categories of sickle-cell patients (based on their diastolic profile, i.e., normal, relaxation disorder, restrictive disorder) were compared. The clinical parameters could be superimposed in the 3 categories. The dimensions of the left auricle and the telesystolic diameter of the left ventricle were significantly larger in the restrictive disorder category. The latter category appeared to be more symptomatic, and included the two isolated cases of systolic dysfunction., Conclusion: Left ventricular diastolic dysfunction is commonly encountered in sickle-cell cases in the Cameroon. The restrictive disorder profile is less frequently observed, but appears to be more harmful at the hemodynamic level. The present results suggest that the study of diastolic function in patients with sickle-cell anemia could help identify hemodynamically at-risk subjects who require more specific cardiovascular care, even before a noticeable alteration in systolic function has taken place.

The optically active and fully protected gamma,gamma-di-t-butyl N-Fmoc-L-gamma-carboxyglutamate was synthesized from the relatively inexpensive D-serine. The overall yield of the synthesis was about 30%. Our studies review that, under TFA and various acidic conditions, L-Gla and its derivatives were stable with no decarboxylation. Finally, gamma,gamma-di-t-butyl N-Fmoc-L-gamma-carboxyglutamate was successfully used in peptide synthesis by Fmoc strategy on solid phase.

We undertook a prospective study of cancerous lesions of the liver in 163 patients (136 males and 27 females) considered to be on high risk. These patients were, healthy carriers of HBs Antigen (n = 70), had chronic hepatitis (n = 45) or cirrhosis (n = 48). The screening was done from two main tests: liver ultrasound and blood alphafoetoprotein. Amongst the 163 patients, malignancy was diagnosed in 29 (22 males and 7 females) giving a prevalence of 17.8 percent: 9 cancers were diagnosed in the group with chronic hepatitis (20 percent), 20 in the group with cirrhosis (41.6 percent) and none in the group of healthy carriers. These results show that in Cameroun, cirrhosis is the most frequent abnormality associated with development of hepatocarcinoma. Thus the strategy against liver cancer should be oriented towards two main objectives; vaccination of children after eliminating healthy carriers and a regular follow-up of patients at risk.

In a collection of 3,571 patient's files admitted in the University Teaching Hospital and the Yaounde General Hospital, we studied 27 patients suspected of chronic pancreatitis. 20 patients with calcified chronic pancreatitis benefited from a detailed history, physical examination and a complete paraclinical work-up. From the data collected, chronic alcoholism seemed to have been the main aetiology. Industrial beer from barley alone and/or associated with other traditional liquors was most consumed. The majority of patients were heavy alcoholics and daily consumption varied from 75 to 124 g of pure alcohol. The natural history of the disease and physical examination were identical to that observed in the western countries. Associated pathology was observed in 10% of the patients. This included peptic ulcer disease, cirrhosis and bile stones. Complications included diabetics, obstructive jaundice, and malabsorption syndrome. As a conclusion, chronic pancreatitis is a pathology whose prevalence seems to be progressing constantly.