ABSTRACT
Introduction: Currently, infertility constitutes a real public health problem due to its prevalence, distribution, and the difficulties related to its management. The general objective of this study was to contribute to the study of male infertility in its epidemiological, clinical, and therapeutic aspects at the Urology-Andrology department of Ignace Deen National Hospital. Methodology: This was a retrospective descriptive study lasting five (5) years, from January 1, 2020, to December 31, 2024. All patient records admitted for male infertility, having clinical observation and at least two sperm analyses during the study period, were included in this study. Results: We collected 272 records during our study over a period of five (5) years. The average age of patients was 36.50 years (ranging from 20 to 68 years). The 30-39 age group was most represented, accounting for 44.85% (n=122). Risk factors were dominated by smoking and heat exposure, with 30.51% (n=83) and 22.06% (n=60), respectively. Infertility was primary in 74.63% (n=203) of patients and secondary in 25.37% (n=69) of cases. On examination, 68% (n=185) of patients had varicocele. Regarding quantity, the spermogram was abnormal in 95.2%. From a therapeutic perspective, varicocelectomy was performed in 185 patients, representing 68% of cases, compared to 32% of cases (n=87) where spermatogenesis induction and/or dietary supplements were provided for azoospermic patients or those with oligo-astheno-teratospermia (OATS). Conclusion: The prevalence of male infertility in our study was remarkable. Over a period of 5 years, 272 records were collected in our department. This represents a real public health problem. The sperm profile was dominated by oligoasthenoteratozoospermia.

ABSTRACT
Background: Acute pain is a leading cause of presentation to emergency departments (EDs) worldwide, yet robust data from sub Saharan Africa remain limited. Understanding its epidemiology is essential to optimise triage, analgesic strategies, and patient outcomes. Objective: To characterise the epidemiological profile of acute pain and identify independent determinants of severe pain among patients presenting to the ED of Essos Hospital Center. Methods: We conducted a prospective observational study over three months. Consecutive adult patients (≥18 years) presenting with acute pain were enrolled. Pain intensity was assessed at triage using a 10 point visual analogue scale (VAS). Etiologies were categorised as trauma-related, abdominal, obstetric/gynecological, or other medical. Multivariable logistic regression identified independent predictors of severe pain (VAS ≥7). Results: Among 220 patients (mean age 36 ± 12 years; 54% female; sex ratio 0.85), trauma-related pain accounted for 38% of presentations, abdominal 31%, obstetric/gynecological 18%, and other medical 13%. Severe pain was reported in 64% of patients. Independent predictors of severe pain were female sex (OR 1.7; 95% CI 1.1–2.7), trauma-related etiology (OR 2.3; 95% CI 1.4–3.8), and delayed presentation >2 hours (OR 1.9; 95% CI 1.2–3.1). Conclusion: Trauma, abdominal, and obstetric/gynecological conditions are the predominant causes of acute pain. Early, structured, context-adapted analgesia protocols are essential to reduce oligoanalgesia and improve emergency care quality in resource-limited settings.

ABSTRACT
Introduction: Fitz-Hugh-Curtis Syndrome (FHCS) is a rare complication of pelvic inflammatory disease (PID) characterized by inflammation of the liver capsule and peritoneum, often resulting from chlamydial or gonococcal infections. Although it typically presents with right upper quadrant (RUQ) pain, its diagnosis can be challenging due to its similarity to other gastrointestinal or hepatic disorders. Understanding FHCS and its associated risk factors is crucial for timely diagnosis and management. Case 1: A 38-year-old female presented with episodic RUQ and epigastric pain over several months, unresponsive to medical treatment. Ultrasound showed gallstones, during laparoscopic cholecystectomy revealed violin-like adhesions on the liver, suggestive of FHCS. The patient had a history of multiple chlamydial infections and post surgery she became symptom free. Case 2: A 32-year-old woman with persistent RUQ pain, worsened by cold weather, underwent diagnostic laparoscopy revealing violin-like adhesions over the liver confirming FHCS. She underwent adhesiolysis and improved without further complications. Case 3: A 30-year-old female with symptomatic cholelithiasis and recurrent RUQ pain underwent laparoscopic cholecystectomy. During surgery, violin-like adhesions were noted, suggestive of FHCS. She underwent adhesiolysis and cholecystectomy with complete symptom resolution. Clinical Discussion: Fitz-Hugh-Curtis Syndrome is often underdiagnosed and can mimic other conditions like gallbladder disease or gastrointestinal disorders. Early diagnosis through imaging and laparoscopic evaluation is essential. Treatment may involve involves surgical intervention via adhesiolysis. Conclusion: FHCS should be considered in women with unexplained RUQ pain and a history of PID or sexually transmitted infections. Early surgical intervention led to successful outcomes with symptom resolution.

ABSTRACT
Intrauterine fetal death (IUFD) remains a public health concern worldwide, particularly in low- and middle-income countries. Adolescents constitute a vulnerable population because pregnancy during this period is frequently associated with biological immaturity, limited reproductive health knowledge, and suboptimal use of antenatal care services. This study aimed to identify factors associated with IUFD and maternal outcomes among adolescents managed in referral hospitals in Yaoundé, Cameroon. A case–control study was conducted in three tertiary hospitals between January 2021 and December 2023. Cases were adolescents admitted with IUFD at ≥22 weeks of gestation or birth weight ≥500 g, while controls were adolescents who delivered live fetuses. Cases and controls were matched in a 1:2 ratio. Data were analyzed using SPSS version 23.0 with univariate analysis followed by multivariate logistic regression. A total of 180 adolescents were included (60 cases and 120 controls). Sociodemographic characteristics did not differ significantly between groups. IUFD cases occurred more at earlier gestational ages and were strongly associated with low birth weight (<2500 g) and placental anomalies. A history of induced abortion, maternal pathology during pregnancy and threatened preterm delivery were significantly associated with IUFD. Multivariate analysis identified maternal pathology, fetal anomaly, and low birth weight as independent factors associated with outcome. Vaginal delivery was predominant. Maternal complications included endometritis, postpartum hemorrhage, disseminated intravascular coagulation, acute psychosis, and maternal death. Strengthening antenatal surveillance and early management of maternal and fetal complications among adolescents may help reduce IUFD in this setting.

ABSTRACT
Ovarian cysts are common gynecological conditions that affect women of reproductive age and vary widely in types, laterality, hormonal profile, and associated demographic factors. This study investigated the distribution(location), hormonal profile, and histological patterns of ovarian cysts among 414 female patients of reproductive age visiting secondary and primary hospitals in Ogoni ethnic groups and Port Harcourt city, as well as their association with age and ethnicity. Data were obtained through ultrasonographic and hormonal analyses, including serum levels of Follicle stimulating hormones (FSH), Luteinizing hormone (LH), estradiol, progesterone, and prolactin, and analyzed using ANOVA and Chi-square tests. The majority of participants were aged 27–36 years, with cysts occurring more frequently in the right ovary (46.1%) than the left (35.7%), while 18.1% were bilateral. Ethnic group was significantly associated with cyst type (p < 0.001) but not with cyst location, and age group also showed a significant association with cyst type (p = 0.008). No significant variations were found in hormonal levels across cyst types or ethnic groups (p > 0.05). The relatively higher incidence of malignant cysts observed underscores the need for early detection, regular screening, and timely intervention to prevent complications and improve reproductive health outcomes.

ABSTRACT
Adenocarcinoma of the pancreas (AP) accounts for 90% of pancreatic tumours and is expected to become the second leading cause of cancer deaths in Europe and the United States by 2030. Its incidence has been increasing significantly for several years. The curative treatment of adenocarcinoma of the pancreas until recently relied mainly on surgery, which is only feasible in a limited number of cases due to the high frequency of loco-regional (lymph node and vascular) and metastatic extension, particularly hepatic. Chemotherapy has both curative and palliative indications. In recent years, systemic induction treatment has become the reference for borderline classified tumors. The results of the first prospective randomized phase II studies confirm the interest of a systematic induction treatment. We report the case of a 57-year-old woman, diagnosed with an adenocarcinoma of the head of the pancreas classified as borderline. Induction chemotherapy was performed, followed by reassessment and cephalic duodenal-pancreatectomy surgery. The aim of this work is to present the diagnostic and therapeutic approach adopted for a borderline tumor of the pancreas head.

ABSTRACT
Pancreatic surgery remains associated with significant mortality and morbidity. Efforts are generally focused on reducing postoperative complications, but early detection of patients at risk could be another effective strategy. Cephalic duodenopancreatectomy (DPC) is the treatment of choice for pancreatic head adenocarcinomas and Vater ampullomes. In the multicenter series of the French Association of Surgery published in 2010, DPC had a hospital mortality of 4% and a morbidity of 54%, about half of which corresponded to severe complications. In Algeria, in recent years, there has been a reduction in post-DPC mortality, especially in high-volume operating centres. We report the case of a patient operated for an adenocarcinoma of the head of the pancreas, in whom a DPC was performed with a favorable initial evolution. Three weeks after his discharge, he returned for abdominal pain accompanied by an infectious syndrome. The scan showed a tubular formation of 5 cm intra-abdominal. The surgical revision confirmed the presence of an intra-abdominal drain fragment responsible for a digestive wound in the small intestine. The purpose of this article is to draw attention to this exceptional, but possible complication in order to make surgeons aware of the need for particular vigilance when managing postoperative drains.