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Payment for dental services is one of the key determinants of treatment options, access to health care, and treatment decisions. The ability to pay for services directly affects the quality of life of an individual and also their accessibility to oral health services. The aim of the present study was to identify the different methods of payment used to obtain oral health care in Yaoundé, Cameroon This was a cross-sectional descriptive study carried out in selected dental clinics in Yaoundé using convenient sampling between January 2021 and June 2021. Data was collected using a structured questionnaire. A total of 377 patients aged 8 to 83 years made up of 194 (51.46%) females and 183 (48.54%) males participated in the study. There is no government-assisted package for oral health care in Cameroon and more than two-thirds (66.84%) made direct payments or paid out of pocket without a refund from any insurance company. More than half 147 (58.33%) of the study population did not complete the planned dental care due to insufficient funds. Direct payments covered treatments such as scaling, restorations, root canal therapy, and dental extractions while prostheses (dentures, crowns, bridges, and implants) were only afforded by very few patients. The reasons for the inability to pay for dental services included financial difficulties 107 (72.97%) and lack of time 36 (24.49%). Only half 36 (50%) of the participants employed in the formal sector had access to health insurance and treatments like scaling, dental prosthesis, orthodontics, and dental implants were rarely provided by an insurance company. These procedures were considered to be very expensive with fluctuating prices and were viewed as being for aesthetic purposes. The majority 67 (93.06%) of payments through insurance reported being reimbursed aftercare. Two-thirds of 48 (71.64%) of the insured participants said it was difficult to get reimbursed due to the administrative bottlenecks and as such some preferred to pay out of pocket despite being insured. Late consultations encountered led to caries complications with 105 (52.24%) pulpitis. In general, financial difficulty was reported by 97 (48.26%) as the main reason for not being able to afford dental care. Oral diseases present a huge burden for children and adults due to the high cost of treatment limiting their accessibility and treatment options. There is a need to create compulsory health insurance to enhance greater access to oral health services to encourage the population to seek dental care timeously.

Abstract Background In recent years, natural orifice specimen extraction surgery (NOSES) has become a field of special interest for colorectal surgeons. Some researchers have reported transanal specimen extraction in the laparoscopic anterior rectal resection, including intersphincteric resection (ISR) and rectal eversion-resection. However, these surgical procedures have certain limitations. Based on the proven expertise in laparoscopic surgery, our center has developed a modified technique of transanal specimen extraction. The aim of this study was to investigate the safety and feasibility of a modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection. Methods From January 2011 to January 2014, the patients with upper rectal or lower sigmoid colon cancer who had undergone laparoscopic anterior rectal resection with specimen extraction by a modified transanal technique were enrolled in the observation group, and the patients who had undergone laparoscopic anterior rectal resection with specimen extraction via an abdominal incision by the same surgeons during the same period were enrolled in the control group. Results A total of 36 patients were included in the observation group and 128 patients were included in the control group. There were no significant differences (P > 0.05) between the two groups in terms of the mean operative time [144 ± 10 min vs. 141 ± 11 min], mean intraoperative blood loss [63 ± 6 ml vs. 61 ± 7 ml], and the mean time to anal exhaust [67 ± 7 h vs. 65 ± 8 h]. However, there were significant differences (P 0.05) between the two groups in terms of the 3- or 5-year overall survival. Conclusions The modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection fulfilled the principle of no-neoplasm touch technique, with advantages, such as minimal trauma, rapid recovery, and fewer complications. Long-term follow-up results also showed satisfactory oncological outcomes.

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Objective: The current study examined the effects of the methylene chloride/methanol extract of root bark of Ceiba pentandra (L) in normal and streptozotocin-induced diabetic rats. Materials and Methods: Diabetes was induced by intravenous streptozotocin (55 mg/kg) in adult male albino Wistar rats. Single and multiple dose studies were carried out. Blood glucose levels were determined after oral administration of graded doses of C. pentandra (40, 75, 150 and 300 mg/kg) in fasting normal and diabetic groups for the single dose study; and before and at the end of day 3 of the treatment period for the multiple dose study. Results: In both the groups, the extract (40 and 75 mg/kg) significantly reduced the blood glucose 5 hours after administration, in a consistent and time-dependent manner. C. pentandra at the lower dose (40 mg/kg) produced 40% and 48.9% lowering of blood glucose in normal and diabetic rats, respectively compared to the initial values. In the multiple dose studies, the diabetic rats were treated orally by gavage, twice a day for three days. On day 3, C. pentandra (40 and 75 mg/kg) significantly decreased blood and urine glucose, compared to initial values. With 40 and 75 mg/kg of drug, the 14 h fasting blood glucose concentration was reduced by 59.8% and 42.8% with corresponding reductions of urine glucose levels by 95.7% and 63.6%, respectively. Conclusion: These results indicate that C. pentandra possesses a hypoglycaemic effect. The plant extract is capable of ameliorating hyperglycaemia in streptozotocin-induced diabetic rats and is a potential source for isolation of new orally active agent(s) for diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: The present study was designed to evaluate the effects of the aqueous extract obtained from the mixture of fresh leaf of Persea americana, stems and fresh leaf of Cymbopogon citratus, fruits of Citrus medica and honey on ethanol and sucrose induced hypertension in rats., Methods: Rats were divided into eight groups of 6 rats each and daily treated for 5 weeks. The control group received distilled water (1 mL/kg) while rats of groups 2, 3 and 4 received ethanol 40 degrees (3 g/kg/day), 10% sucrose as drinking water and the two substances respectively. The remaining groups received in addition to sucrose and ethanol, the aqueous extract (50, 100 and 150 mg/kg) or nifedipine (10 mg/kg) respectively. Many parameters including hemodynamic, biochemical and histopathological were assessed at the end of the study., Results: The concomitant consumption of ethanol and sucrose significantly (p < 0.001) increased the blood pressure and the heart rate compared to distilled water treated-rats. The levels of total cholesterol, LDL-cholesterol, triglycerides, atherogenic index, glucose, proteins, AST, ALT, creatinin, potassium, sodium and albumin increased while the HDL-cholesterol decreased under ethanol and sucrose feeding. Chronic ethanol and sucrose intake significantly decreased the activities of superoxide dismutase (SOD) and catalase (CAT) as well as the contents of reduced glutathione (GSH) and nitrites whereas elevated the malondialdehyde (MDA) levels. Histological analysis revealed among other vascular congestion, inflammation, tubular clarification and thickening of the vessel wall in rats treated with alcohol and sucrose. Administration of the aqueous extract or nifedipine prevented the hemodynamic, biochemical, oxidative and histological impairments induced chronic ethanol and sucrose consumption., Conclusion: Current results suggest that the aqueous extract used in this study possess antihypertensive activity against ethanol and sucrose induced hypertension in rats by the improvement of biochemical and oxidative status, and by protecting liver, kidney and vascular endothelium against damages induced by chronic consumption of ethanol and sucrose.

These studies focus on the toxicity leaf hexane extract of A. occidentale L (Anacardiaceae) used in Cameroon traditional medicine for the treatment of diabetes and hypertension. Previous findings on antidiabetic and anti-inflammatory have given support to the ethnopharmacological applications of the plant. After acute oral administration, it was found that doses of the extract less than 6 g/kg are not toxic. Signs of toxicity at high doses were asthenia, anorexia, diarrhoea, and syncope. The LD(50) of the extract, determined in mice of both sexes after oral administration was 16 g/kg. In the subchronic study, mice received A. occidentale at doses of 6, 10 and 14 g/kg (by oral route) for 56 days. At doses of 2, 6 and 10 g/kg of extract, repeated oral administration to mice produced a reduction in food intake, weight gain, and behavioural effects. Liver or the kidney function tests were assessed by determining serum parameters like, creatinine, transaminases, and urea. All these parameters were significantly (p<0.01) abnormal. Histopathological studies revealed evidence of microscopic lesions either in the liver or in the kidney which may be correlated with biochemical disturbances. We conclude that toxic effects of A. occidentale L hexane leaf extract occurred at higher doses than those used in Cameroon folk medicine.

The aim of this work was to investigate the effect of daily oral administration of root bark methylene chloride/methanol extract of Ceiba pentandra (Linn) in streptozotocin-induced type-2 diabetic rats, and the effect of this treatment on the physiological and metabolic parameters that are related in diabetic animals. The diabetic rats were separated into four groups and each given the following samples by gavage, daily for 28 days: vehicle (diabetic control), Ceiba pentandra extract at the dose of 40 mg/kg, Ceiba pentandra extract at the dose of 75 mg/kg and glibenclamide (5 mg/kg). All the parameters were also determined in healthy (non diabetic) rats for comparison. The methylene chloride/methanol extract of Ceiba pentandra treatment significantly reduced the intake of both food and water as well as the levels of blood glucose, serum cholesterol, triglyceride, creatinine and urea, in comparison with diabetic controls. The treatment also improves impaired glucose tolerance but no effect was observed in the level of hepatic glycogen. The effect of Ceiba pentandra (40 mg/kg) was more prominent when compared to glibenclamide in lowering blood glucose, with the added benefit of considerably reducing serum cholesterol and triglyceride concentrations. The results of this experimental animal study indicated that Ceiba pentandra possesses antidiabetic activity; and thus is capable of ameliorating hyperglycaemia in streptozotocin-induced type-2 diabetic rats and is a potential source for isolation of new orally active agent(s) for anti-diabetic therapy.