Iodine deficiency in children 7-19 years old in Eastern Province of Cameroon.

OBJECTIVE: To determine the prevalence of iodine deficiency in children in Eastern Province, Cameroon. METHOD: Urinary iodine (I) and thiocyanate (SCN) excretion levels were assessed in 158 children (62 boys and 96 girls) aged 7-19 years. RESULTS: Mean urinary iodine excretion was 4.49 microg/dl for girls and 4.71 microg/dl for boys, lower than the 5.0 microg/dl minimal value defined by WHO. Overall 64.42% of subjects had urinary iodine excretion below the minimum, more than three times the population percentage (20%) at which a zone is declared endemic. Mean urine SCN concentration and mean I/SCN ratios of the study population were 2.57 +/- 1.43 mg/dl and 2.21 +/- 1.35 microg/mg for boys and 2.91 +/- 1.57 mg/dl and 1.91 +/- 1.1 microg/mg for girls. CONCLUSION: Iodine deficiency remains a problem in Eastern Province of Cameroon.

Youth of West Cameroon are at High Risk of Developing IDD due to Low Dietary Iodine and High Dietary Thiocyanate

Objectives: Hypothyroidism in utero leading to mental retardation is highly prevalent and recurrent in developing countries where iodine deficiency and thiocyanate overload are combined. So; to explore and identify human population's risks for developing iodine deficiency disorders and their endemicity in Western Cameroon; with the aim to prevent this deficiency and to fight again it; urinary iodine and thiocyanate levels were determined. Methods: The district of Bamougoum in Western Cameroon was selected for closer study due to its geographic location predisposing for iodine deficiency disorders (IDD). A comprehensive sampling strategy included 24-h urine samples collected over three days from 120 school-aged children. Urinary iodine and thiocyanate levels were measured by colorimetric methods. Results: Twenty one percent of boys between the ages 3 and 19 were classified as iodine deficient. The prevalence of thiocyanate overload in the same population was found to be 20. Conclusion: Presence of endemic iodine deficiency and excessive thiocyanate in the population indicates that the region is at risk of iodine deficiency disorder. A multifactorial approach that includes improvement of diet; increasing iodine and minimizing goitrogen substances intake; soil and crop improvement and an iodine supplementation program may help alleviate IDD in the affected area studied

Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study.

To investigate intraarticular lesions producing persistent postoperative pain, we arthroscopically examined 31 ankles in 31 patients (15 women and 16 men) with lateral ligament injury. The patients ranged in age from 15 to 33 years, with a mean of 20 years. Nine patients were freshly injured, and 22 patients had chronic injuries. All of the patients underwent arthroscopic examination immediately before the ligament operation. Chondral lesions were found in 89% of the freshly injured ankles and 95% of the ankles with chronic injuries. Most of these lesions were in the medial half of the ankle joint, especially in the anteromedial edge of the tibial plafond. After followup for 1 year postoperatively, persistent pain was noted in 4 patients who had chondral lesions of greater than one-half the thickness of the articular cartilage. Pain and tenderness were localized at the anteromedial joint line, corresponding to the location of the chondral lesions. Chondral lesions of greater than one-half the thickness of the articular cartilage were found in 8 ankles in the chronic injury group, but there were none in the fresh injury group. Thus, in lateral ligament injuries of the ankle, the longer the time elapsed from the initial injury, the more severe the associated chondral lesions became. These chondral lesions appear to cause persistent pain.

Reconstruction of lateral ligaments of the ankle with allogeneic tendon grafts.

Fresh frozen allogeneic tendon was used to reconstruct the lateral ligaments in 17 ankles. Two or more years later, 13 returned for follow-up examination. The mean age at operation was 23 years (range 15 to 39); the interval between injury and operation varied from six months to 20 years. There were no infections and no immunological rejections, and according to Sefton's criteria, nine patients were excellent and four good. No patient complained of instability of the ankle and stress radiography confirmed this improvement. Allograft reconstruction of the lateral ligaments of the ankle is a new method of treatment which restores stability without sacrificing normal tendons.

The effects of intra-arterially injected adriamycin on microvascular anastomosis.

Although free tissue transfer following limb-saving wide resection has become increasingly necessary in the treatment of sarcomas of the extremities, the side effects of adjuvant chemotherapy on the microvascular structure are not yet known. There may be significant effects, especially with intra-arterial administration. In order to study the time-dependent manifestations of possible effects, experimental microvascular anastomoses in the rat femoral artery were performed at various intervals, after intra-arterial injection of Adriamycin. This drug was used because of its popularity as an adjuvant chemotherapeutic agent. Vessels were examined at varying intervals for macroscopic changes affecting patency and for histologic changes. Anastomoses done at three weeks after Adriamycin injection resulted in the worst patency rate. Histologically, thrombotic occlusion was associated with widespread and profound disruption of the internal elastic lamina, thought to be thrombogenic trauma: the vessel was presumed to have been made fragile by preoperative Adriamycin treatment. Five weeks or longer after injection, this effect was reduced, according to patency rates and histologic findings. Endothelial damage was minimal and appeared insignificant.

Epiphyseal separation of the coracoid process associated with acromioclavicular sprain. A case report and review of the literature.

A rare injury of traumatic separation of the epiphysis of the coracoid process associated with Grade I acromioclavicular sprain occurred in a nine-year-old girl. The accident occurred when she was asleep. The mechanism of injury was unknown. Tenderness and mild swelling around the coracoid process were seen. The anteroposterior radiograph of the shoulder with the arm abducted 150 degrees (abduction view) clearly demonstrated the epiphyseal separation with subtle displacement at the base of the coracoid process. She was treated by simple immobilization and recovered fully with normal shoulder arm function.