Prevalence, complications and factors associated with severely elevated blood pressure in patients with hypertension: a cross-sectional study in two hospitals in Yaoundé, Cameroon.

Introduction: severely elevated blood pressure significantly increases cardiovascular morbidity and mortality in hypertensive Black patients. The objective of this study was to determine the prevalence, complications and factors associated with severe high blood pressure in hypertensive patients in Yaoundé, Cameroon. Methods: we conducted a cross-sectional study in the outpatient and cardiology units of two teaching hospitals in Yaoundé. We included consenting hypertensive patients aged over 18 years. We first measured their blood pressure (BP), then we collected their sociodemographic data, cardiovascular risk factors, follow-up data, and ended with a complete physical examination. We performed a regression analysis to assess correlates of severe hypertension. Results: we included a total of 153 patients with 33 (21.6%) of them having severe hypertension. Among the 33 patients, 16 (48.5%) were male and 17 (51.5%) were female. Their mean age was 60.52 ± 12.83 years. Chronic kidney disease (78.8%), hypertensive retinopathy (69.7%) and left ventricular hypertrophy (48.5%) were the most common complications. On multiple logistic regression analysis, inadequate follow-up was independently associated with severe hypertension (adjusted OR=7.09; 95% CI [2.29-21.9]). Conclusion: severely elevated BP is common among hypertensive patients in our setting with important physical and economic consequences. Increased patients awareness and improving access to primary care physicians and cardiologists, through health insurance or other means, may be an effective strategy for reducing cardiovascular morbidity and mortality among hypertensive Black patients.

Pancreatic and splenic tuberculosis mimicking a pancreatic cancer with splenic metastases in an immunocompetent adolescent: a case report.

We present a case of pancreatic and splenic tuberculosis (TB) in a 15-year-old human immunodeficiency virus-negative patient who was initially misdiagnosed as suffering from a pancreatic carcinoma with splenic metastases. Pancreatic and splenic TB are extremely rare in young immunocompetent patients, with a nonspecific clinical presentation, making the diagnosis elusive.

Sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor with no previous asbestos exposure.

Sarcomatoid malignant peritoneal mesothelioma is the rarest and most lethal form of peritoneal mesothelioma. We present the case of a sarcomatoid malignant peritoneal mesothelioma presenting as a localized mesenteric tumor in a 54-year-old female with no previous asbestos exposure. This clinical presentation is extremely rare and is the first documented in Cameroon.

Gastric outlet obstruction secondary to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl: a case report.

Gastric outlet obstruction encompasses a broad spectrum of conditions characterized by complete or incomplete obstruction of the distal stomach, which interrupts gastric emptying and prevents the passage of gastric contents beyond the proximal duodenum. Idiopathic hypertrophic pyloric stenosis is the most common cause with an incidence of 1.5-3 per 1000 live births. However, it is excluded; other causes in children such as peptic ulcer disease are relatively rare. We report a case of an acquired gastric outlet obstruction due to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl. Beyond the rarity of this clinical event, this case highlights the challenges of the aetiological diagnosis of gastric outlet obstruction with subsequent therapeutic issues, and is the first documented case in Cameroon.