ABSTRACT
Objective: To assess the feasibility and outcome of laparoscopic myomectomy with single or double-layer closure of myoma bed for management of myomas at a tertiary care centre in Douala, Cameroon. Materials and Methods: Thirty patients with large or moderate-size myomas were managed laparoscopically from September 1996 to September 2008. The indications for surgery included subfertility, heavy menstrual bleeding, abdominal mass and lower abdominal pain. Pre‑operative evaluation included history, clinical examination and sonographic mapping. Myomas were enucleated and retrieved laparoscopically by morcellation. Myoma beds were sutured in a single or double layer by endoscopic intra-corporeal suturing depending on the depth of the fibroids. Results: Among our patients, 14 (46.7%) presented with subfertility, 8 (26.7%) with heavy menstrual flow and 6 (20%) with abdominal mass. Two (6.7%) presented with lower abdominal pain. The average maximum diameter of myoma was about 8.5 cm. The mean duration of surgery was 123.2±90 min and blood loss was minimal. The mean post-operative stay in hospital was averagely 3.03 days. There were no intra-operative complications recorded among our series and hospital stay was uneventful. Conclusion: With proper single layer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas not more than three fibroids, and has excellent outcomes.
ABSTRACT
Background: Lactation mastitis is a painful, debilitating condition that if not well managed, can mislead women into prematurely stopping breastfeeding and by so doing deprive the child of optimal feeding. The World Health Organization (WHO) estimates that about 10% of breastfeeding mothers worldwide develop mastitis, though incidence may vary between 2.6% and 33%. Objective: The aim of this study is to determine the prevalence and risk factors of lactation mastitis among breastfeeding mothers in three hospitals in Cameroon. Patients and Methods: This was an observational, cross-sectional prospective study of 245 breastfeeding women in three hospitals in Douala and Limbe during the period January 1, 2012 to December 31, 2012. Participants who had opted for breastfeeding were recruited and invited to complete a baseline questionnaire before discharge from hospital. Cases of mastitis were either reported directly to the researchers or diagnosed clinically. Regular telephone follow-up interviews were done for women diagnosed with mastitis. Results: A total of 37 (15%) women were diagnosed with mastitis. Seventy-one percent (174/245) of them were not aware of breastfeeding techniques and did not practice standard breastfeeding habits. 42% practiced poor breastfeeding hygiene. Conclusion: Approximately one in seven women is likely to have mastitis during breastfeeding. Most of the women are not aware of breastfeeding techniques and practice substandard breastfeeding hygiene that predisposes them to mastitis and to possible premature cessation of breastfeeding. In such circumstances, the method’s nutritional, immunological and economic benefits are lost.