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High-degree atrioventricular (AV) block is a life-threatening emergency that may reveal an underlying infectious cause, such as a septal interventricular abscess. We report a case of a 22-year-old male admitted with recurrent syncopal episodes. Clinical evaluation revealed irregular bradycardia (42 bpm) and a grade 3/6 diastolic murmur at the aortic area. Electrocardiography confirmed high-degree AV block, necessitating temporary pacing. Multimodal imaging including transthoracic, transesophageal echocardiography and cardiac Computed Tomography identified an abscess-like collection within the interventricular septum, originating from the aortic valve. Laboratory findings supported systemic infection. Due to limited surgical capacity, the patient was managed conservatively with antibiotic therapy. He demonstrated clinical improvement, with regression of the abscess and resolution of conduction abnormalities to first-degree AV block, allowing removal of the temporary pacemaker. This case highlights the severity of infectious AV block and illustrates the diagnostic and therapeutic challenges faced in resource-limited settings.

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Background: Vaginal bleeding is the most common reason for consultation in early pregnancy and its effects on pregnancies that survive are still unclear. Objective: Our aim was to study the relationship between bleeding in the first half of pregnancy (BFHP) and foetal outcome (birth weight, gestational age at delivery, and 5th minute Apgar score) in a resource-limited setting. Methods: We conducted a retrospective cohort study in two hospitals in Yaoundé, Cameroon. Medical records of pregnant women who gave birth between January 2020 and May 2023 were reviewed. Participants were categorized into exposed (had vaginal bleeding <20 weeks of gestation) and unexposed groups. Foetal outcome (birth weight, gestational age at delivery, and Apgar score) was the primary outcome. Linear regression analysis was used to examine the contributions of variables to changes in foetal outcome. Results: Of the 200 women included, 35 (17.5%) experienced BFHP. The mean birth weight was significantly lower among women who bled compared to those who did not (2,813 ± 1,008g versus 3,276 ± 566 g; p <0.001). Similarly, the mean gestational age at delivery was smaller in the exposed group (36.3 ± 4.1 weeks versus 38.7 ± 2.4 weeks; p <0.001). The risk of low birth weight was nearly fivefold higher among women with BFHP (RR = 4.7; 95% CI: 2.4–9.3; p <0.001). Among women with BFHP, neither the duration (<1 day or >1 day) nor the gestational age at onset (<10 weeks or >10 weeks) influenced birth weight or gestational age at delivery. While regression analysis suggested a potential decrease in birth weight by 116 grams in the exposed group, this association was not statistically significant (p = 0.326). Conclusion: This study’s findings suggest significant contribution of BFHP, and a history of BFHP in a previous pregnancy, to low birth weight and prematurity. However, further research, with larger samples or a prospective approach, is needed to better elucidate this relationship and the need to an

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Introduction: The objective was to present the results of the management of traumatic pelvic fractures in children in the department. Materials and Methods: This is a prospective 16-month study from January 2024 to July 2025 on patients admitted, hospitalised and treated for traumatic pelvic fractures. The parameters studied were epidemiological, clinical, radiological, therapeutic and evolutionary. Results: Thirty patients were registered, corresponding to 35 cases of lower limb fractures. The average age was 11.7 years (7 to 15 years). There were 13 (43.33%) boys and 17 (56.67%) girls, with a sex ratio of 0.76. The majority of patients were schoolchildren (28, or 93.33%). Only five (16.66%) patients were transported by ambulance. Road traffic accidents accounted for 25 cases (83.33%). Pain associated with functional impairment was found in all cases. The fracture was closed in 21 cases (70%). Overlap was the most commonly observed displacement in 14 cases (40%). ECMES was performed in 16 cases (45; 71%). The average length of hospitalisation was 17.46 days (1 to 140 days). The outcome was favourable in 25 patients (80.33%). The minimum follow-up period was 6 months. Conclusion: Traumatic fractures of the lower limb are common in our setting, with schoolchildren being the most affected. Only prevention can help reduce the frequency of these accidents.

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Background: Sigmoid surgery is a major component of digestive surgery in sub‑Saharan Africa, where emergency abdominal conditions remain frequent. Multicenter local evidence is limited. Objective: To describe indications, operative procedures, and postoperative outcomes of sigmoid surgery in four referral hospitals in Douala, Cameroon. Methods: Retrospective descriptive multicenter study over a 10‑year period. Patients aged ≥15 years undergoing surgery involving the sigmoid colon were included. Sociodemographic variables, indications, procedures, morbidity and mortality were analyzed using IBM SPSS v25. Results: A total of 116 patients were included; 68.1% were male. Mean age was 47.6 ± 15.6 years. Main indications were sigmoid volvulus (19.8%), rectosigmoid junction cancer (19%), sigmoid cancer (12.9%) and rectal cancer (12%). Sigmoid colostomy was the most frequent procedure (56.9%). Laparotomy was the predominant approach. Overall morbidity was 11.2% and mortality 5.1%. Conclusion: Sigmoid surgery in Douala is dominated by emergency indications, particularly volvulus and complicated colorectal cancers. Strengthening early diagnosis and gradual implementation of minimally invasive surgery may improve postoperative outcomes.

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Background: Right colon surgery is a substantial component of digestive surgery in sub-Saharan Africa, where late presentation and emergency conditions remain frequent, and multicenter data are scarce. Objective: To describe the indications, surgical procedures and postoperative outcomes of right colon surgery in four referral hospitals of Douala, Cameroon. Methods: We conducted a retrospective descriptive multicenter study over 10 years (January 2012–December 2021). All patients aged ≥15 years who underwent right colon surgery were eligible. Sociodemographic, operative and postoperative variables were extracted from medical records and analyzed descriptively. Results: A total of 145 patients were included. Mean age was 46.16 ± 18.06 years (16–87), with male predominance (64.1%; sex ratio 1.78). Emergency surgery accounted for 67.58% of cases. Obstructive right colon cancer was the leading indication (25.51%). Right hemicolectomy was the most frequent procedure (57.24%). Overall postoperative morbidity was 65.51%, dominated by surgical site infections (35.06%) and enterocutaneous fistulas (25.97%). In-hospital mortality was 6.89% (n=10). Conclusion: Right colon surgery in Douala is mainly performed in emergency settings for advanced colorectal cancer and is associated with high morbidity. Strengthening early diagnosis and perioperative quality improvement is essential to improve outcomes.

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Background: Rectal surgery is technically demanding and associated with significant morbidity. In sub-Saharan Africa, delayed presentation frequently leads to advanced disease and emergency surgery. Objective: To describe indications, operative procedures and postoperative outcomes of rectal surgery in three referral hospitals of Douala, Cameroon. Methods: Retrospective descriptive multicenter study conducted from January 2018 to December 2023, including patients aged ≥15 years who underwent rectal surgery. Sociodemographic data, operative indications, surgical procedures, postoperative morbidity and in-hospital mortality were analyzed. Results: Ninety-one patients were included. Mean age was 54.6 ± 13.4 years with a male predominance (sex ratio 1.2). Rectal cancer was the main indication (68.1%). Abdominoperineal resection was the most frequent procedure (46.2%). Overall morbidity was 9.6% and mortality 6.5%. Conclusion: Rectal surgery in Douala is dominated by advanced malignant disease with a high rate of radical procedures.