ABSTRACT
Recent data confirms breast cancer to be the leading cancer amongst women in sub-Saharan Africa and the second cause of cancer-related deaths. Screening and early diagnosis are the main pillars in the management of breast cancer in resource-limited settings. This study explored mammography utilization and challenges in a peripheral referral hospital in Cameroon. To achieve this aim, a hospital-based sequential explanatory mixed-methods study was conducted. Quantitative data was extracted from the mammography registry over a five-year period, after which in-depth interviews were conducted for some clients randomly selected from the registry. A total of 392 clients had a mammogram during the study period and all were females. The median age was 47 years (range: 20 to 73 years). There were 126 screening mammograms (32.14%; 95% confidence interval: 27.54 – 37.02%). The fear of a diagnosis of breast cancer was reported to be an important factor in getting a mammogram, but also deterred some who did not consider themselves able to afford for care in the event of such a diagnosis. Other important factors associated with obtaining a mammogram were the death of a relative, friend, colleague or acquaintance attributed to breast cancer. Many respondents did not know about mammography and its availability in the local reference hospital. These findings indicate low levels of awareness and under-utilization of mammography. Campaigns to educate and raise public awareness about breast cancer screening may be important to improve mammography uptake and increase the proportion of screening studies.

ABSTRACT
Close to three-quarters (70%) of all cases of cervical cancer occur in countries with a low human development index where the burden of infections with human papilloma virus is high and screening uptake is low. The aim of this study was to assess the burden of metastatic disease from cervical cancer and the pattern of spread in a sub-Saharan African population. We extracted data from reports of computed tomography scans of the thorax, abdomen and pelvis (CT-TAP) of patients with histologically proven cervical cancer from a prospectively collected cancer imaging database from July 2022 to February 2024. Independent statistical associations were performed using Fisher’s exact test whilst metastatic disease patterns were illustrated with a Sankey diagram. Data was extracted from 113 CT-TAP reports of patients. The mean age was 59.9 ± 12.21 (range: 38 to 84 years). There was reported local, regional or distant spread in 53 out of 103 (46.39%) patients. Four out of 8 (50.00%) baseline scans for staging reported tumor spread, against 49 out of 105 (46.67%) follow-up scans (p=0.570). Cancer spread was mostly local invasion than distant (59% vs. 41%). Parametrial invasion was reported in 41 cases (35.04%), followed by nodal tumor disease (32 cases; 27.35%) of which 75% was pelvic. Common sites for distant metastatic disease were the peritoneum (16 cases; 13.68%), spleen (12 cases; 10.26%) and pleurae (12 cases; 10.26%). Age-related trends in the occurrence of metastatic disease was significant with a peak at 40 to 49 years (p=0.001). The high burden of cervical cancer spread suggests the need to intensify primordial, primary and secondary prevention strategies.

ABSTRACT
Background: Brain infections are serious conditions that can lead to neurological complications and functional sequelae. Brain magnetic resonance imaging (MRI) is a diagnostic tool of choice for brain infections, as it allows to visualize the lesions with high spatial resolution and good tissue sensitivity. In Cameroon, data on brain infections are scarce and fragmented. Objective: To determine the frequency and characteristics of brain infections in patients who underwent brain MRI in three hospitals in Cameroon. To compare the MRI diagnosis with the biological diagnosis when available. Methods: We conducted a cross-sectional and descriptive study in three hospitals in Cameroon equipped with an operational MRI: the General Hospital of Douala, the Regional Military Hospital of Yaoundé and the Cathedral Medical Center of Yaoundé. Our study population consisted of patients of any age and sex who underwent brain MRI with the indication of a suspected or confirmed brain infection. We collected epidemiological and clinical data of the patients, as well as the results of brain MRI and biological tests. We calculated sums, frequencies and distributions. Results: Out of 351 patients who underwent brain MRI, 43 had a brain infection on MRI. The frequency of brain infections in our series can therefore be estimated at 12.25% of brain MRIs performed. The most affected age group by brain infections in our series was 41 to 50 years old with 13 cases, or 30.2%. Men accounted for 53.49% of patients, with a sex ratio of 1.15/1 in favor of men. Most of our patients lived in the city of Yaoundé (46.51%) and were of urban origin (79.07%). The main indications were altered state of consciousness (14%) followed by altered general condition (11.6%), subacute encephalitis (11.6%) and cerebellar syndrome (9.3%). Out of 43 cases of brain infections, 21 cases were HIV positive, or 48.84%. The most common brain infection was cerebral toxoplasmosis with 10 cases, or 23.3%. The most common ...

ABSTRACT
The concern about ionizing radiation exposure of women of childbearing age or pregnant women is still relevant and CT scanning alone is a subject of interest as it is responsible for 58% of radiation exposure from medical x-rays. The objective of our survey was to evaluate the knowledge and practices of radiation protection of CT scan users in women of childbearing age in the city of Douala in Cameroun. This was a descriptive and cross-sectional study that was conducted over a period from October to December 2019, in two referral hospitals in the city of Douala. We interviewed 30 women of childbearing age, 15 medical imaging technicians, and 45 referring physicians. The majority of patients were relatively young with an average age of 33.3±9.6 years. The majority of the medical imaging technicians and the requesting physicians were young people (24 to 30 years old) with 40% and 44.4% respectively. The applicant physicians were mostly general practitioners (40%), and the average years of experience were 2.1±1.1 years. The level of knowledge of radiation protection of women of childbearing age, radiology technicians and requesting physicians was unsatisfactory with a rate of 25.5%, 48.1% and 48.6% respectively without influence of the level of education. At the end of our study, continuing education in radiation protection and the routine use of the guide to the proper use of imaging examinations were recommended.

ABSTRACT
The benchmark for noninvasive anatomic examination for the coronary arteries is now Coronary computed tomography angiography (CCTA). CCTA has a strong positive predictive value and an even greater negative predictive value, making it possible to quickly determine whether coronary plaque is present in a patient and to prioritize which patients require more invasive testing and treatment. From the standpoint of an interventional cardiologist, CCTA is useful in establishing whether invasive therapy is necessary, more so than stress testing. The anatomic evaluation from CCTA more closely resembles the anatomical assessment of a coronary angiography when combined with functional assessments than any other noninvasive evaluation.

ABSTRACT
Aim: To study Pelvic sonographic findings, their relationship with microorganisms detected on endocervical swabs and factors associated with sonographic PID among women at Gynaecology clinic of Mbarara Regional Referral Hospital. Methods: 144 women aged 15-49 years with clinical diagnosis of PID at gynaecology clinic of MRRH were interviewed with structured questionnaires about socio-demographic, behavioural and gynaecological factors. Pelvic sonographic examination via transvaginal and transabdominal methods was performed. Analysis of sonographic PID findings, association with factors above and testing for gonorrhea and chlamydia by nucleic acid amplification test (NAAT), a DNA-PCR test was done. Data was entered using EPI info, exported to excel and analysed using STATA© 15.0 software (College Station, Texas, USA). Categorical variables were summarized as frequencies, percentages, Chi-square test followed by logistic regression. Continuous variables were summarized as mean and standard deviation. A factor was considered associated if p≤ 0.05. Results: Sonographic PID was diagnosed in 41.66% (60/144) of patients. Most presented with uterine findings 9.72% (14), free fluid in posterior cul-de-sac 6.94% (10). Few had fallopian tubal and ovarian findings each at 3.47% (5) respectively. However, most patients presented with mixed structural findings 18.05% (26). The rest of the patients 58.35% (84) had normal findings. Women with history of STIs [AOR = 2.8 (95% CI: 1.00–7.57), p=0.05] or had adnexal mass [AOR = 7.1 (95% CI: 1.58–31.90), p=0.01] were statistically more likely to have sonographic PID. Of the 144 women, 29.17% (42) were diagnosed with microorganisms, 22.92% (33) positive for Neisseria, 4.86% (7) positive for chlamydia and 1.39% (2) for both. However, at 5% level of significance diagnosis with Neisseria gonorrhoeae was associated with a higher likelihood of sonographic PID compared to absence of microorganisms (p<0.05). Conclusion: A high proportion ...

ABSTRACT
This article presents the case of a 14-year-old male who experienced acute torsion of an undescended testis located in the right inguinal canal. The patient presented with severe right inguinal pain. Imaging studies, including CT and MRI, revealed the underlying pathology. Intraoperative findings confirmed testicular necrosis, necessitating an orchiectomy. This report aims to highlight the clinical presentation, radiological findings, and surgical management of this condition, supplemented with relevant images.