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Unlabelled: We analysing 8 cases of diabetes secondary to primary hemochromatosis in a group of black diabetic patients in Yaoundé. Diagnosis of primary hemochromatosis is based on clinical and biological arguments. Central hypogonadism is associated to diabetes in 75%, dilated cardiomyopathy existed in 37.5%, arthropathy in 75%. Diabetes is mostly type II., Conclusion: Secondary diabetes to primary hemochromatosis does exist in Black Africa. Diagnosis should be in the mind of clinician when in a diabetic patients are associated: central hypogonadism, dilated cardiomyopathy and chronic arthropathy. In the future diagnosis of hemochromatosis will be easier by genetic because of recent discovery of the gene of the disease.

We have undertaken an epidemiological and the treatment modality of diabetic foot in Yaounde Diabetic Center. 5315 patients have included in the study 1275, 23.98% have lesions of the diabetic foot. Neuropathy lesions are more frequent. Gangrenous lesion represent 4.39% with high level of total amputation. Patients are young, with short history of diabetes. Infection is present in 89% of cases. Health education is the only modality to be undertaken to prevent diabetic foot more frequent in our environment.

Despite the fact that essential facial neuralgia is a well known clinical entity as relates to its evolution and treatment, its physiopathology is still a controversial issue. The form with bilateral evolution that we observed and that we are reporting here is extremely rare and its physiopathology is even more controversial. The case of our patient is all the more complicated in that, the pain topography is limited to the right to a sensitive region of the trigeminal nerve (superior maxillary) and to the left to the region of the mandible (inferior maxillary) A similar disease evolution is not described so far in the present literature of the disease. We have therefore seized this opportunity to out line the possible causes of faulty diagnosis in order that essential facial neuralgia should not be labelled as facial pain of tumoral, vascular or other origin.

We analysed the epidemiological, clinical, biological, morphological and therapeutic characteristics of 36 cases of pituitary prolactinomas in Yaoundé, Cameroun. Diagnosis was made on the basis of neuro-ophthalmological, gynaecological and sexual symptoms associated with quantity determinations of prolactinemia, total testosterone and blood oestrogen, folliculo stimulating hormone and luteining hormone. Expected levels of prolactinemia are above 150 micrograms/l. Cerebral tomodensitometry and, where possible, magnetic resonance imaging were used. Among the 24 patients on whom a tomodensitometry was performed, 4 male patients presented macroprolactinomas; the remaining 20 patients--mostly female--had microprolactinomas. Macroprolactinomas were found in male patients only, leading to an acute ophthalmological emergency for 2 of them who were operated in Paris-France. All the patients were put on bromocriptine; this molecule has antisecretory and antiproliferative properties, which are very useful in Africa, since surgery is very expensive. Cases of resistance to the molecule exist and new dopaminergic agonists are not yet being used in Cameroon.

In this study, we investigated the disturbances of glucose metabolism in 61 Cameroonian children aged 1 to 15 years old, infected with cerebral malaria and severe malaria cases admitted in hospitals in Yaoundé. Parasitaemia in the two groups was respectively 8.10 +/- 0.35% in cerebral malaria group and 4.47 +/- 0.84% in those admitted for severe malaria. The majority of our patients (n = 42) had normal glycaemia, while 15 cases were hyperglycemic and only 4 subjects all belonging to the cerebral malaria group were hypoglycemic. No case of hyperinsulinaemia was recorded. The level of lactate was higher in 74% of patients (19 over 26) admitted for cerebral malaria virsus 37% patients (13 over 35) admitted for severe cases. We found a positive correlation between the level of parasite and that of lactate (P < 0.01 r = 0.47). Whereas no positive correlation was found in one hand between the level of parasite and glycaemia, the level of parasites and insulin, and in the other hand between glycaemia and the level of lactate, glycaemia and insulin.

This work studies the relationship between a common genetic marker in our population, sickle-cell trait, and atherogenic risk factors. One hundred and twenty-two healthy subjects were studied. Forty-six subjects had normal haemoglobin (HB-AA) while 76 had sickle-cell trait Hb-AS. Mean cholesterol level was higher in subjects with sickle-cell trait (2.82 +/- 0.21 g/I) than in subjects with normal haemoglobin (2.08 +/- 0.40 g/I) used as controls. The difference was statistically significant (p < 0.05). HDL cholesterol levels remained in the normal range in controls (Hb-AA) (0.560 +/- 0.10 g/I) while subjects with Hb-AS had high HDL-c levels (0.618 +/- 0.30 g/I). Mean LDL cholesterol levels in Hb-AS subjects were about 57% higher than those in controls (1.84 +/- 0.10 g/I and 1.17 +/- 0.30 g/I, respectively) (p < 0.05). Apolipoprotein A1 levels of Hb-AS subjects were lower (1.37 +/- 0.10 g) than those of Hb-AA subjects (1.98 +/- 0.15 g/I), (p < 0.05) while apolipoprotein B concentrations of Hb-AS subjects were higher (1.70 +/- 0.27 g/I) than in controls (1.30 +/- 0.10 g/I) (p < 0.05). The atherogenicity index given by the Apo-B/Apo-AI ratio was higher in Hb-AS subjects (1.24) than in those with normal haemoglobin (0.65). We conclude that Hb-AS subjects are at high atherogenic risk if subsequent diet management is not undertaken.

Anhaptoglobinemia in the tropics has long been considered as a genetic phenomenon (Allison et al 1968; Sulton et al 1959). However, between 1963 and 1968, several other workers found a close relationship between anhaptoglobinemia and hemolytic diseases, thus bringing to question the genetic hypothesis which had earlier existed. The object of our study was to verify the following in a area that was endemic both for malaria and sickle cell disease: if anhaptoglobinemia was present in both populations, if it was proportional to the parasite load or the amount of hemolysis, if anhaptoglobinemia could be used either as a marker for malaria studies or for diagnosis of intravascular hemolysis. Anhaptoglobinemia turned out not to be present in all patients suffering from malaria, but was proportional to the parasite load and hemolysis. In patients with malaria, it was undetected after malarial prophylaxis but reappeared one month after cessation of treatment, while, in sickle cells patients, it disappeared at the end of their crisis. This was evidence of high reticulocyte regeneration. These findings highlight the problem of the existence of the HpO phenotype.

Total serum cholesterol and lipoproteins levels were determined in a selected group of healthy and Plasmodium falciparum infected Cameroonians. There was a significant difference (P less than 0.05) in the level of the cholesterol between normal individuals (1.61 +/- 0.60 g1-1) and patients (1.23 +/- 0.37 g1-1). The mean values +/- SD of HDL cholesterol were (0.62 +/- 0.25 g1-1) and (0.46 +/- 0.36 g1-1) for controls and malaria infected subjects respectively. The LDL cholesterol concentration was (0.77 +/- 0.85 g1-1) in patients compared to (0.99 +/- 0.33 g1-1) for controls. There was a significant difference between the apolipoprotein B concentration in the sera of non infected (1.03 +/- 0.50 g1-1) and infected subjects (1.64 +/- 0.50 g1-1) (P less than 0.05). A decrease of apolipoprotein A was observed in the sera of patients (1.36 +/- 0.60 g1-1) compared to controls (1.70 +/- 0.34 g1-1). These results suggest a possible atherogenic risk during persistent malaria infection.