ABSTRACT
OBJECTIVE: The aim of this study was to assess the effectiveness of nevirapine (NVP) in the prevention of mother-to-child transmission (MTVT) of HIV-1 in children in the Yaounde University Teaching Hospital, Cameroon. METHODS: This was a prospective and descriptive hospital-based study in which pre-counselled HIV-infected pregnant women who gave their consent were included. At the onset of labour a single dose of 200 mg oral NVP was administered to each woman. Their newborns were also given 2 mg/kg of oral NVP syrup within 72 hours of their birth. These NVP-treated babies were assessed at 6 weeks, 6 months and between 15 and 18 months for viral load levels, using a branched DNA technology. Viral load levels were classified as undetectable (< 50 copies/ml); intermediate (50-3 500 cp/ml) or high (> 3 500 cp/ml). RESULTS: Of the 350 women screened for HIV 22 (6.3 %) were positive for HIV-1, but only 18 children were duly tested until 18 months. Viral load levels were undetectable at 6 weeks in 61.1 % of the children; intermediate in 38.9 % and no child had a high VL (> 3 500 cp/ml). At 6 months 5 of 7 children with intermediate levels had dropped to undetectable levels. By 15-18 months, a total of 16 children (88.9 %) had undetectable levels while 2 children (11.1 %) with detectable levels were confirmed to be HIV positive using ELISA test and immunoblot analysis. CONCLUSIONS: We conclude that the rate of HIV-1 MTCT with NVP is about 11 % in CHU Yaounde.
Subject(s)
Anti-HIV Agents/administration & dosage , Developing Countries , HIV Infections/prevention & control , HIV-1/drug effects , Infectious Disease Transmission, Vertical/prevention & control , Nevirapine/administration & dosage , Pregnancy Complications, Infectious/drug therapy , Administration, Oral , Anti-HIV Agents/adverse effects , Cameroon , Female , Follow-Up Studies , HIV Infections/transmission , Hospitals, Teaching , Humans , Infant, Newborn , Nevirapine/adverse effects , Pregnancy , Prospective Studies , Viral LoadABSTRACT
We report a Lyell syndrome secondary to anti-malarial treatment with sulfadoxine-pyrimethamine. Eye lesions predominated: symblepharon and corneal opacification. Desinsertion of conjunctival synechias was performed by ophthalmologists. There were corneal opacities and fibro-vascular veil on the two eyes. A keratoprosthesis was done on one eye. It is very likely that the incidence of this syndrome will increase mainly because of two factors. The continuous increase of plasmodii resistance to chloroquine hence the more frequent use of sulfonamides for the treatment of malaria; secondly, sulfonamides are used in the treatment and prevention of opportunistic infections in AIDS patients. It is important for ophthalmologists in tropical areas to be aware of Lyell's syndrome so that proper and early management may be undertaken.
Subject(s)
Antimalarials/adverse effects , Blepharitis/chemically induced , Keratoconjunctivitis/chemically induced , Pyrimethamine/adverse effects , Stevens-Johnson Syndrome/diagnosis , Sulfadoxine/adverse effects , Adult , Antimalarials/administration & dosage , Blepharitis/diagnosis , Cameroon , Diagnosis, Differential , Drug Therapy, Combination , Humans , Keratoconjunctivitis/diagnosis , Male , Patient Care Team , Pyrimethamine/administration & dosage , Sulfadoxine/administration & dosageABSTRACT
La chirurgie cardiaque a ete introduite au Cameroun en 1985 au CHU de Yaounde. Six missions de chirurgie cardiaque ont ete effectuees au Cameroun de juillet 1985 a avril 1990. Nous nous sommes proposes d'evaluer cette experience initiale dans notre pays et d'essayer d'etablir la courbe de survie des patients operes cardiaques. L'etude a ete essentiellement menee au CHU de Yaounde. Au total; 83 sujets dont 42 femmes et 41 hommes ont ete operes. Leur age varie de 9 a 60 ans avec une moyenne de 29 ans. Parmi ces malades 53 pour cent des sujets etaient au stade fonctionnel III et IV de la NYHA en preoperatoire et 95;3 pour cent presentaient une insuffisance cardiaque refractaire au traitement medical. Les remplacements valvulaires sur valvulopathies post-rhumatismales representaient la principale indication (77 cas). 4 cardiopathies congenitales (1 communication interauriculaire; 1 communication interventriculaire et 2 canaux arteriels persistants); 5 pericardites (2 constrictives; 1 serofibrineuse et 1 purulente) et 1 endomyocardite fibreuse ont egalement ete repertoriees. Les resultats ont ete remarquables; car ils ont permis a une grande majorite d'operes une survie d'au moins 5 ans. Cependant; le cout de la chirurgie cardiaque reste toujours eleve quoique de loin preferable a celui d'une evacuation sanitaire a l'etranger
Subject(s)
Heart Diseases , Heart Valve Diseases , Pericarditis , Thoracic SurgeryABSTRACT
La chirurgie cardiaque a ete introduite au Cameroun en 1985 au CHU de Yaounde; sous l'egide du Ministere de la Sante Publique et grace a l'impulsion de quelques pionniers camerounais; avec la collaboration des equipes chirugicales francaises de Lyon et de Marseille. Nous nous sommes proposes d'evaluer cette experience initiale dans notre pays et d'essayer d'etablir la courbe de survie des patients operes cardiaques. Au total; 83 sujets ont ete operes. leur age varie de 9 a 60 ans avec une moyenne de 29 ans. Parmi ces malades 53 pour cent des sujets etaient au stade fonctionnel III et IV de la NYHA en preoperatoire et 95;3 pour cent presentaient une insuffisance refractaire au traitement medical. [abstract terminated]
Subject(s)
Heart Diseases , Heart Valve Diseases , International Cooperation , Pericarditis , Thoracic Surgery/mortalityABSTRACT
Loiasis treatment by diethylcarbamazine (DEC) may be complicated by a meningoencephalitis that is often fatal. Following one case, four others have been reviewed in the literature and the therapeutic approach in resuscitation departments discussed. Until the discovery of other less-dangerous microfilaricidal or macrofilaricidal drugs, we raise the question of the opportunity to treat loiasis by DEC, while many authors consider it as a simple nuisance.
Subject(s)
Diethylcarbamazine/therapeutic use , Loiasis/drug therapy , Meningoencephalitis/parasitology , Adult , Cameroon , Filariasis , Humans , Male , Meningoencephalitis/drug therapyABSTRACT
Five - Fluorouracil (5 FU) is widely used in oncology, especially in tumors of the gastrointestinal tract and in carcinoma of the breast. Its side effects (gastrointestinal, haematological, alopecia) are well known. However, its cardiac effects are not widely appreciated, despite an incidence similar to that observed with the anthracyclines (1.6% vs 2.2%) and a high mortality rate (12.5%). A new case of coronary insufficiency is reported illustrating the absence of a dose-effect relationship and the frequency of recurrence of symptoms when 5 FU is reintroduced even with coronary vasodilator therapy. The mechanism of cardiotoxicity in this case seems to be coronary spasm.
Subject(s)
Coronary Disease/chemically induced , Fluorouracil/adverse effects , Fluorouracil/therapeutic use , Humans , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Male , Middle AgedABSTRACT
We evaluated the diffusion of pefloxacin into the cerebrospinal fluid (CSF) in 15 patients with bacterial meningitis or ventriculitis, 14 of whom were treated with other antibiotics. Three doses of pefloxacin were administered at 12-h intervals to 11 patients intravenously and to 4 patients orally. Individual doses were 7.5 mg/kg in seven patients and 15 mg/kg in eight patients. Plasma and CSF levels were determined by a high-performance liquid chromatographic assay. The concentrations of pefloxacin in CSF were measured 2 h after the third intravenous dose and 4 h after the third oral dose. In patients receiving 7.5 mg/kg, peak levels in plasma ranged from 6.8 to 16 micrograms/ml, and trough levels were from 2 to 7.5 micrograms/ml. Concentrations in CSF ranged from 2.4 to 9 micrograms/ml. In patients receiving 15 mg/kg, peak levels in plasma ranged from 14 to 18.6 micrograms/ml, and trough levels were from 4 to 13.2 micrograms/ml. Concentrations in CSF ranged from 6.5 to 13 micrograms/ml. These preliminary data indicate that pefloxacin diffuses well into the CSF of patients with inflamed meninges.
