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Introduction: Nosocomial infections (NI) are common conditions among hospitalized patients. This study aimed to evaluate healthcare workers' knowledge and practices regarding infection prevention measures in intensive care units. Method: This was a descriptive, cross-sectional study conducted from April 13to June 10, 2022, among 45 healthcare workers in three university teaching hospitals of Abidjan. The parameters studied were: the theoretical and practical knowledge of healthcare workers regarding the prevention of nosocomial infections. Results: 45 healthcare workers participated. 74.7% knew the definition of a nosocomial infection and 43% identified the main risk factors for its occurrence. Sixty-five percent identified staff hands as the main mode of cross-transmission of germs between patients. Sixty-four percent of staff reported using non-sterile gloves during urinary catheter insertion. Compliance with hand hygiene before patient contact was low (31.8%) while gloves changes between patients were observed in 87.2% of cases. Deficiencies were noted in adherence to aseptic techniques before performing invasive procedures. Non-compliance was mainly attributed to shortages of supplies and personnel, and insufficient knowledge of preventive measures. Conclusion: healthcare workers’ knowledge and adherence to hygiene practices in intensive care units were insufficient.

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Background: Transverse colon surgery is technically demanding because of the anatomical mobility of the colon and its complex vascular supply. In sub-Saharan Africa, late presentation and emergency conditions remain frequent, but dedicated data on transverse colon surgery are scarce. Objective: To describe the indications, surgical procedures and postoperative outcomes of transverse colon surgery in four referral hospitals of Douala, Cameroon. Methods: We conducted a retrospective multicenter descriptive study over a 10-year period (January 2012–December 2021). All patients who underwent surgery involving the transverse colon were included. Sociodemographic characteristics, operative indications, surgical procedures and in-hospital postoperative outcomes were analyzed descriptively. Results: A total of 103 patients were included. Mean age was 44.68 ± 27.63 years (range: 7 months–83 years), with male predominance (sex ratio 2.4). Emergency surgery accounted for the majority of cases. Acute generalized peritonitis was the leading indication (33.0%), followed by intestinal obstruction (22.2%) and abdominal trauma (17.4%). Right hemicolectomy (41.4%) and transverse colectomy (35.9%) were the most frequently performed procedures. Postoperative complications occurred in 18.4% of patients, dominated by surgical site infections (13.6%). In-hospital postoperative mortality was 3.9%. Conclusion: Transverse colon surgery in Douala is predominantly performed in emergency settings and is associated with a substantial burden of postoperative infectious morbidity. Improving early diagnosis and perioperative care is essential to improve outcomes.

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Introduction: Enhanced recovery after cesarean (ERAC) delivery is a multimodal approach aimed at reducing surgical stress and accelerating maternal recovery after cesarean. Its application remains limited in many African contexts. This study evaluated the application and results of an ERAC protocol in an hospital of sub-Saharan Africa. Patients and Methods: this is a prospective, descriptive and analytical study conducted over 5 months. Fifty patients who underwent a caesarean section under spinal anesthesia and met the inclusion criteria were analyzed. The data was collected from obstetric records, anesthesia registers and interviews with patients. The variables included demographic, per and postoperative clinical parameters as well as maternal feeling and satisfaction. The analyses were performed with STATA with a significance threshold p<0.05. Results: The average age of patients was 27.2 years. The majority of caesarean sections were scheduled (82%) and performed for scarring of the uterus (44%) or fetal and adnexal pathologies (30%). All patients benefited from effective multimodal analgesia, an early mobilization and feeding protocol. Immediate skin-to-skin contact was established in 96% of patients. Postoperative pain was well controlled with a VAS < 3 at rest in 84% of patients. Overall maternal satisfaction was high in 92% of parturients. The most common adverse events were postoperative nausea vomiting (34.6%) but did not compromise the benefits of the protocol. The average length of stay was 57 hours. Conclusion: The implementation of the ERAC protocol in sub-Saharan Africa is feasible and well accepted by patients. It promotes rapid recovery, pain control and strong maternal satisfaction. Enhanced staff training could optimize the application of the protocol.

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Introduction: Hemorrhagic stroke is a major cause of death and disability in low-resource settings. The objective of this study was to describe the epidemiological, clinical, therapeutic, and prognostic features of hemorrhagic stroke patients managed in the Emergency Department (ED). Methods: We conducted a prospective descriptive and analytical study in the ED of CHU Gabriel Touré over a 12-month period. We included all patients presenting with a focal neurological deficit without head trauma and with CT-confirmed hemorrhagic stroke. Data were collected using a standardized form and analyzed with SPSS version 22. Categorical variables were compared using the chi-square test or Fisher’s exact test as appropriate, and relative risks were calculated. Statistical significance was set at p < 0.05. Results: Among 751 stroke cases, 224 hemorrhagic strokes were recorded, accounting for 29.8% of all strokes. The mean age was 53.7 years, with a male predominance (62%). Hypertension was the main risk factor (77.4%). The most frequent reasons for admission were motor deficit (79.3%) and altered level of consciousness (73%), with abrupt onset in 91.1% of cases and admission within 6 hours in 65.2%. CT imaging showed intracerebral (intraparenchymal) hemorrhage in 60.7% of patients. Intensive supportive care was common (intubation 45.5%, oxygen therapy 78.1%), and 18.8% underwent neurosurgical management. The leading complications were aspiration pneumonia (76.9%) and intracranial hypertension (50.8%). In-hospital mortality was 44.6% and was significantly associated with severe prognostic scores (ICH ≥ 3), impaired consciousness, intracranial hypertension, ventilator-associated pneumonia, and malaria. Conclusion: Hemorrhagic stroke affected predominantly relatively young adults and was associated with high in-hospital mortality. Strengthening hypertension prevention and control, reducing pre-hospital delays, and improving access to intensive and neurovascular care are essential t

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Background: The interplay between right ventricular dysfunction (RVD) and respiratory failure in septic shock is a critical determinant of outcome. Data on this interaction, particularly from resource-limited settings in sub-Saharan Africa, are scarce. This study aimed to determine the respiratory profile, management strategies, and prognosis of patients with septic shock and concomitant RVD. Methods: We conducted a single-center, prospective, observational cohort study in the intensive care unit (ICU) of Douala General Hospital, Cameroon, from December 2020 to August 2021. We included patients aged ≥21 years with septic shock. Data on demographics, clinical features, respiratory parameters (respiratory rate, SpO2, PaO2/FiO2), ventilator settings, and outcomes were collected. Patients were stratified by the presence of RVD. Results: Of 75 patients screened, 53 were included (mean age 53±16 years, sex ratio 1:1). Pulmonary involvement was present in 96.7% of patients with RVD. Acute Respiratory Distress Syndrome (ARDS) was diagnosed in 30.2% of the cohort. The mean respiratory rate was 29±22 breaths/min, and the mean PaO2/FiO2 ratio was 279±181. Invasive mechanical ventilation (IMV) was required in 50% of patients with RVD, and non-invasive ventilation (NIV) in 46.6%. Mortality for patients on IMV for over two days was catastrophically high at 92.9%. In contrast, the survival rate for patients managed with spontaneous breathing was 23.3% (p<0.005). The most common pathogens were Klebsiella pneumoniae (17.0%) and Staphylococcus aureus (15.0%). Conclusion: In patients with septic shock and RVD in our resource-limited setting, the development of respiratory failure is nearly universal and portends a dismal prognosis. The requirement for invasive mechanical ventilation is associated with extremely high mortality. These findings highlight the lethality of this clinical syndrome and underscore the urgent need for management strategies that protect the right ventricle and a

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Background: The American Society of Anesthesiologists (ASA) Physical Status classification is a critical preoperative risk assessment tool. Its predictive utility for outcomes in the high-acuity, resource-constrained environment of an emergency surgical setting, such as for emergency Cesarean Section (CS) in Sub-Saharan Africa (SSA), requires validation. This study aimed to evaluate the correlation between the ASA status score and the therapeutic outcomes (maternal and neonatal) of patients undergoing emergency CS at Douala General Hospital (DGH). Methods: This was a single-center, prospective, descriptive cohort study conducted on 36 consecutive patients who underwent emergency CS at DGH from January 2024 to July 2025. Patients were stratified into ASA physical status categories I to III based on preoperative assessment. Data collected included demographics, CS indications, intraoperative complications (e.g., hemorrhage, hemodynamic instability), postoperative maternal outcomes (ICU admission, length of stay), and neonatal outcomes (Apgar scores, resuscitation needs). Statistical analysis used ANOVA and Chi-square tests, with p<0.05 considered significant. Results: The mean age was 28.5±5.2 years. The cohort comprised 13.9% ASA I, 61.1% ASA II, and 25.0% ASA III patients. Fetal distress (41.7%) was the leading indication, followed by severe pre-eclampsia/eclampsia (22.2%), which heavily drove the ASA III classification. A higher ASA score significantly correlated with worse outcomes. ASA III patients had a significantly longer mean hospital stay (8.5±2.8 days vs. 6.5±2.0 days for ASA II, p<0.05), higher incidence of hemodynamic instability (55.6% vs. 13.6% for ASA II, p<0.01), and were the only group requiring postoperative ICU admission (22.2%, p=0.03). Neonates of ASA III mothers had significantly lower 5-minute Apgar scores (6.8±1.6, p<0.01) and higher NICU admission rates (55.6%, p<0.01). Conclusion: The ASA physical status classification is a robust, practical

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Introduction: Accidental intrathecal injection of tranexamic acid (TXA) is a rare but potentially fatal medication error responsible for severe neurotoxicity. It most often results from drug ampoule confusion during spinal anesthesia. Case Presentation: We report the case of a 40-year-old ASA II woman admitted for semi-urgent cesarean section under spinal anesthesia. Due to a medication error, 150 mg of tranexamic acid was inadvertently injected intrathecally after confusion with hyperbaric bupivacaine. General anesthesia was immediately induced to allow fetal extraction. Approximately forty-five minutes after the accidental injection, the patient developed generalized tonic–clonic seizures refractory to midazolam. Management consisted of a combination of thiopental, midazolam, a volatile anesthetic agent, and cerebrospinal fluid lavage–drainage. The clinical outcome was favorable, with a normal neurological examination one month later. Conclusion: This case highlights the severity of accidental intrathecal tranexamic acid injection and emphasizes the need for strict preventive measures to avoid medication errors in anesthesia.