Laparoscopic Myomectomy in a Tertiary Care Centre in Douala, Cameroon.

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.

Bacterial reservoirs in a health care environment: case of the Douala general Hospital, Cameroon

Background:Health care acquired infections are a major cause of morbidity and mortality in hospitals. There is very little documentation of this important problem in our resource limited setting. The aim of our study was to identify bacterial reservoirs and microorganisms with the potential of nosocomial infections in our health care environment Methods:Bacteriological samples from the air; surfaces; equipment; personnel and patients from six units of the Douala General Hospital; Cameroon were collected for culture according to standardised collection; culture and germs identification techniques. of all collected samples were contaminated with pathogenic bacteria. These included 83.3 of air samples and 100; 54.1and 48.7of specimens respectively. The same bacteria found on the hands of nursing personnel were same as on both surfaces and equipment. The intensive care and neonatal units were the most contaminated with 100 positive cultures. The sterilization unit was bacteria free