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Background: Neonatal sepsis is among the leading causes of neonatal mortality. Due to limited laboratory services, the diagnosis is mainly based on clinical presentation. Signs and symptoms of neonatal sepsis are multiple and nonspecific. Blood culture is the gold standard for the diagnosis of neonatal sepsis. The demographic and obstetric factors associated with neonatal sepsis vary in facilities and locations. Therefore, we conceptualized the study to determine the factors that can independently predict the occurrence of neonatal sepsis. Methodology: A prospective cross-sectional study was conducted by recruiting neonates admitted to the neonatal ward with signs and symptoms of sepsis. The blood sample was collected for culture, and isolates were identified using conventional methods. Descriptive analysis was presented as frequencies and proportions. Univariate logistic regression analysis was used to analyze the factors associated with laboratory-confirmed neonatal sepsis. Multivariable logistic regression was performed to determine the independent predictors of neonatal sepsis. A p-value of less than 0.05 was considered statistically significant. Results. Two hundred seventy-nine neonates were recruited; 161(57.7%) were aged less than four days. Fever was the most common complaint in 72.4% of neonates among the 13 clinical features used to determine the clinical diagnosis of neonatal sepsis. Of 279 blood cultures performed, 198(71.0%) were culture-positive. In bivariate analysis, birth asphyxia, vaginal delivery, and foul-smelling liquor had increased odds of neonatal sepsis. However, neonatal sepsis was independently associated vaginal delivery. Neonates born through vaginal delivery had 2.57 times the adjusted odds of getting neonatal sepsis than those born by cesarean section (aOR = 2.57, 95% CI = 1.3–28.2, p= 0.021) Conclusion: Vaginal delivery was the only factor independently associated with laboratory-confirmed neonatal sepsis. There is a need for evalua

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Introduction: Abdominal trauma is a shock of any kind exerted on the abdomen. It is quite frequent in childhood and is of type: abdominal bruises, and abdominal wounds. This study aimed to assess the epidemio-clinical and evolutionary aspects of abdominal trauma in childhood. Materials and Methods: The results, from a retrospective study covering children aged 0 to 15 years, treated in the Pediatric Surgery Service of Fousseyni Daou Hospital in Kayes from January 2021 to December 2023 for abdominal trauma. Results: Over a period of 2 years we collected 20, 16 boys and 4 girls cases, being a hospitalization frequency of 5.71%. The age bracket of 11 to 15 years was majority being 60% with a male predominance of 80%. Pupils were the majority with 60%. The predominant functional sign was abdominal pain in 100% of cases and one case of terminal hematuria, associated with a minimal pelvic fracture secondary to a seizure. Ultrasound imaging was performed in 80% of our patients. A laparotomy was performed in 35% (7). In our operated patients we recorded 1 case of parietal suppuration. Evolution was favorable in all our patients and one was reoperated for occlusion on flange. After a median retraction of 6 months, the mortality rate was 0%.

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Abstract: Since 2012, Mali has been experiencing a security crisis, characterized by armed attacks against civilians and soldiers; in the form of terrorist attacks or ambushes using various vulnerable agents. The injuries observed are often multiple and serious and can affect all organs to varying degrees. The penis is rarely hit by firearms due to its position, its volume relative to the rest of the body, and its mobility. We report a case of penile urethral section by firearm, initially treated in a primary structure, then referred to our structure for better management. The patient was a 13-year-old boy with no known medical or surgical history. He was traveling to their field with his older brother in a cart. Along the way, they were attacked by unidentified armed individuals. They were immediately rescued and taken back to their health facility, where the older brother succumbed to his injuries. There, he underwent an open cystostomy and a penile bandage, as he had no other associated injuries. A week later, he was referred to our facility for better care. On admission, he was hemodynamically stable and had a well-draining cystostomy catheter. Lateroventral penile degeneration was present, along with a section of the penile urethra over an infected wound. There were no lesions of the corpora cavernosa. Otherwise, there were no other unusual features. We initially initiated treatment with antibiotics, anti-inflammatories, and a daily dressing. He also received antitetanus serum. Three months later, we scheduled and performed an end-to-end urethroplasty of the penile urethra under a CH14 catheter. The postoperative course was uneventful.

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Abstract: Background: Stillbirths, particularly macerated stillbirths linked to delayed antenatal care (ANC) and chronic placental insufficiency, remain a critical public health challenge in low-resource settings. In Tanzania, 34% of women initiate ANC after 16 weeks, exacerbating risks of undetected maternalfetal complications. This study investigated the association between delayed ANC attendance and macerated stillbirths at Mwananyamala Regional Referral Hospital in Dar es Salaam, Tanzania. Methods: A retrospective cross-sectional study analyzed medical records of women with stillbirths (≥28 weeks) from January- December 2024. Data on ANC timing, maternal demographics, comorbidities, and pregnancy outcomes were collected. Logistic regression and ANOVA were used to assess associations, adjusting for confounders (e.g., age, parity, HIV). Results: Among 199 participants (57.6% response rate), 73.9% initiated ANC after 12 weeks and 94.5% attended fewer than the recommended 8 visits. Macerated stillbirths accounted for 74.9% of cases, with 42.2% of women reporting prior stillbirths. Late ANC initiation independently increased macerated stillbirth risk (AOR=3.46, 95% CI:0.182-0.742). Grand multiparity (≥5 births) was strongly associated with fresh stillbirths (OR=164.5, 95% CI:13.1-206.7), while multiparity (2-4 births) predicted macerated stillbirths (AOR=2.69, P=0.008). Hypertensive disorders (41.2% prevalence), particularly preeclampsia (OR=2.78, P=0.017), and HIV (43.2% prevalence) were linked to adverse outcomes. Higher education showed a protective trend (OR=0.39, P=0.089). Conclusion: Delayed ANC initiation, multiparity, and hypertensive disorders are critical, modifiable risk factors for macerated stillbirths in urban Tanzania. Community-driven ANC promotion and targeted prenatal monitoring for high-parity women are urgently needed to reduce preventable stillbirths.

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Objectives: This retrospective study seeks to delineate the epidemiological, clinical, and radiological profiles of patients admitted to the intensive care unit (ICU) for stroke at the Essos Hospital Center, a tertiary care facility in Cameroon. Methods: We conducted a comprehensive analysis of the clinical records of all patients diagnosed with stroke and admitted to the ICU between January 2019 and December 2024. Data on demographics (age, sex, risk factors), clinical characteristics (stroke subtype, Glasgow Coma Scale score at admission, clinical manifestations), and radiological findings (stroke type based on neuroimaging, lesion localisation) were systematically collected and subjected to descriptive statistical analysis. Results: Of the 100 patients included, the mean age was 63 years, with a predominance of male patients (70%). Ischaemic strokes represented 65% of cases, while haemorrhagic strokes accounted for 35%. Hypertension (75%), diabetes mellitus (30%), and smoking (25%) were the predominant risk factors. Neuroimaging, particularly computed tomography (CT), identified cerebral infarctions in 60% of cases and intracerebral haemorrhages in 30%. The overall ICU mortality rate was 40%, with key prognostic factors including advanced age, low Glasgow Coma Scale score at admission, and the specific localisation of cerebral lesions. Conclusions: This study underscores the high prevalence of ischaemic strokes and the significant role of modifiable risk factors in the aetiology of stroke. Strokes remain a leading cause of mortality in the ICU in Cameroon. Early intervention and optimised management of modifiable risk factors hold potential for improving clinical outcomes in this patient population.

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Introduction: Extrahepatic cholangiocarcinoma is a rare and severe cancer, representing less than 3% of malignant digestive neoplasms and is the second most common primary liver cancer after hepatocellular carcinoma (HCC). Its frequency is often underestimated. The resectability rate depends on the tumor's location (5-30% in hilar forms). Objective: Evaluate the surgical treatment outcomes of extrahepatic cholangiocarcinoma. Patients and Methods: This retrospective, single-center, and analytical study spanned from January 1, 2018, to September 30, 2023, involving 20 patients (excluding Klatskin tumors). The mean patient age was 65 years (range: 55-74), with a male-to-female ratio of 2.3. Most patients were classified as ASA I and II (American Society of Anesthesiologists). Results: Clinically, jaundice was observed in 100% of cases. Nine patients exhibited general health deterioration. The diagnostic delay averaged 9 months (range: 9-18 months). Histologically, adenocarcinoma was identified in 100% of surgical specimens. Surgery was performed in 40% of patients, while palliative care was applied in 45%. Post-resection morbidity was 35%, and mortality was 37.5%. Conclusion: Surgical resection remains the only treatment offering prolonged survival, though five-year survival rates are low, even after curative procedures.

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Introduction: The global progression of diabetes mellitus (DM) pandemic is a real public health problem. This growth, more remarkable in low- and middle-income countries is linked to risk factors (RF) and urbanization. This study contributes to the updating of epidemiological data on diabetes and its RF in rural and urban areas in Congo. Aim of the Study: To describe epidemiological and diagnostic aspects of DM and its RF in rural and urban areas in Congo. Patients and Method: A cross-sectional, retrospective and multicenter study, including patients in 20 centers (urban/rural) from October 2010 to 2017.Studied parameters were: socio-demographic profile, duration of diabetes, anthropometric measurements, RF, types of DM and glycaemia. Data were analyzed by Epi info 7.2.1.0, using Chi-2 and Student, with a significance threshold of 0.05. Results: A total of 4758 patients were received, including 4116 patients (86.51%) in urban areas and 642 patients (13.49%) in rural areas. Among them, 2460 men (51.70%) and 2298 women (48.30%), M/F ratio of 1.07. The mean age was 51.67±15.45 years [range 2 to 95 years].3021 patients (63.5%) were known to be diabetic, with a mean duration of 5.97 years and 1737 patients (36.5%) were newly diagnosed. The annual incidence was 248 new cases/year. The socio-professional status was dominated by the unemployed (33.80%), employees (26.2%), students/pupils (12.9%) and retirees (11.9%). T2D (84.72%) and T1D (8.53%) were more represented. RF: Hypertension (39.34%), affects 90.60% of patients in urban areas and 9.40% in rural areas (p = 0.000). Overweight (37.89%) and obesity (27.77%), predominantly urban, female and in T2D (p = 0.000)). Metabolic syndrome of urban predominance was found in 17.12% of patients. The mean glycaemia was 283 ± 14 mg /dl. Conclusion: Our study shows that DM and its RFs are common in Congo, with a strong predominance in urban areas, requiring specific strategies to reduce the impact of urbanization.