Lawrence U. Ogbonnaya, Cosmas K. Onah, Benedict N. Azuogu, Christian O. Akpa, Kingsley C. Okeke, Violet N. Nwachukwu, Adaeze Stephen-Emeya, Irene U. Asaga, Chukwuma D. Umeokonkwo
{"title":"Adverse drug reactions, adherence, and virologic outcomes in adult patients on dolutegravir- based antiretroviral therapy at a tertiary hospital, southeast Nigeria","authors":"Lawrence U. Ogbonnaya, Cosmas K. Onah, Benedict N. Azuogu, Christian O. Akpa, Kingsley C. Okeke, Violet N. Nwachukwu, Adaeze Stephen-Emeya, Irene U. Asaga, Chukwuma D. Umeokonkwo","doi":"10.4314/gmj.v58i1.14","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.14","url":null,"abstract":"Objective: To assess the adherence, adverse drug reactions (ADR), and virologic outcomes of dolutegravir-based antiretroviral therapy.Design: This was a retrospective chart review.Setting: A tertiary health facility-based study in Abakaliki, Nigeria.Participants: Five hundred and fifteen (515) adult patients on dolutegravir were selected using a Random Number Generator. Demographic and clinical data were extracted from patients’ case notes and analysed with IBM-SPSS version-25.Main outcome measures: Adherence to dolutegravir, ADRs, virologic outcome, and change in Body Mass Index (BMI) were estimated.Results: The mean age of the patients was 45.5±10.8 years; 68.2% of them were females; 97.1% of them had good self-reported adherence. The majority (82.9%) of them reported no ADRs and among those (17.1%) that did, headache (9.7%), body-itching (3.1%), and skin rash (2.7%) dominated. Most achieved viral suppression (94.4%) and did not have detectable viral particles (57.4%). There was a significant increase in the BMI of the patients with a mean weight increase of 0.9kg, a mean BMI increase of 0.3 kg/m2, and a 2.6% increase in the prevalence of overweight and obesity.Conclusions: Patients on dolutegravir reported low ADRs, good self-reported adherence, and a high viral suppression rate. However, dolutegravir is associated with weight gain. We recommend widespread use and more population-wide studies to elucidate the dolutegravir-associated weight gain.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140381101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ademuyiwa Adetona, Olusegun E. Elegbede, Olusola O. Odu, Kabir A. Durowade, Tope M. Ipinnimo, David S. Ekpo, Taofeek A. Sanni
{"title":"Comparative assessment of birth preparedness and complication readiness among couples in rural and urban communities of Ekiti State, Southwestern Nigeria","authors":"Ademuyiwa Adetona, Olusegun E. Elegbede, Olusola O. Odu, Kabir A. Durowade, Tope M. Ipinnimo, David S. Ekpo, Taofeek A. Sanni","doi":"10.4314/gmj.v58i1.6","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.6","url":null,"abstract":"Objectives: To assess and compare the level of Birth Preparedness and Complications Readiness (BPCR) and determine the predicting effect of socio-demographic factors on it among couples in rural and urban communities of Ekiti State.Design: A community-based comparative cross-sectional study.Setting: The study was conducted in twelve rural and twelve urban communities in Ekiti State.Participants: Couples from rural and urban communities. Female partners were women of reproductive age group (15-49 years) who gave birth within twelve months before the survey.Main outcome measures: Proportion of couples that were well prepared for birth and obstetric emergencies, and its socio-demographic determinants.Results: The proportion of couples that were well prepared for birth and its complications was significantly higher in urban (60.5%) than rural (48.4%) communities. The study also revealed that living above poverty line (95% CI=1.01– 3.79), parity and spousal age difference less than five years (95% CI=1.09 – 2.40) were positive predictors of BPCR among respondents.Conclusions: Urban residents were better prepared than their rural counterparts. Living above poverty line, parity, and spousal age difference less than five years were positive predictors of BPCR. There is a need to emphasize on educating couples on the importance of identifying blood donors as a vital component of BPCR.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140385305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ernest Oyeh, Josephine Nsaful, A. Bediako-Bowan, H. Gbadamosi, Yaw Boateng Mensah, Nii A. Adu-Aryee, Veneranda Nyarko
{"title":"Mucocoele of the appendix","authors":"Ernest Oyeh, Josephine Nsaful, A. Bediako-Bowan, H. Gbadamosi, Yaw Boateng Mensah, Nii A. Adu-Aryee, Veneranda Nyarko","doi":"10.4314/gmj.v58i1.15","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.15","url":null,"abstract":"Introduction: Mucocoele of the appendix occurs in 0.2-0.7% of people in the world without any well-defined clinical symptoms. It occurs when there is an accumulation of mucous in the lumen of the appendix.Case Presentation: We present three cases: a 48-year-old male admitted to the emergency room with a one-day history of right iliac fossa pain. Abdominal examination was suggestive of acute appendicitis. The initial abdominal computerised tomography scan was reported as being unremarkable. At surgery, a firm tumour of the appendix was found, and a limited right hemicolectomy was done. Histopathology confirmed a mucocoele of the appendix with borderline mucinous histology.The second case is a 63-year-old man who presented with a one-year history of abdominal distension and weight loss. Previous abdominal ultrasound was suggestive of liver cirrhosis with significant ascitic fluid. Abdominal magnetic resonance imaging found an appendix mucocoele with infiltration of the omentum and scalloping of the liver surface suggestive of pseudomyxoma peritonei. A percutaneous biopsy of the omental mass confirmed metastatic mucinous adenocarcinoma of the appendix.The third case is a 68-year-old man who, during an annual medical check-up, had an incidental finding of a cystic right iliac fossa mass on ultrasound, confirmed on abdominopelvic computerised tomography scan to be an appendix mucocele. He had laparoscopic appendicectomy. The histopathological diagnosis confirmed a mucinous cystadenoma of the appendix.Conclusion: Preoperative diagnosis of appendiceal mucocoele is difficult and commonly discovered intraoperatively. The prognosis is good for the histologically benign type, but it is poor when malignant or peritoneal lesions are present.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140382789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ifeakachukwu D. Agadaga, Peter N. Ebeigbe, Babatunde Oyefara
{"title":"Cervical ripening with vaginal Misoprostol plus Hyoscine-N-Butylbromide versus vaginal Misoprostol alone among pregnant women: a double-blind randomised controlled trial","authors":"Ifeakachukwu D. Agadaga, Peter N. Ebeigbe, Babatunde Oyefara","doi":"10.4314/gmj.v58i1.7","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.7","url":null,"abstract":"Objective: To compare cervical ripening time with the use of vaginal Misoprostol plus Hyoscine-N-Butylbromide, with vaginal Misoprostol alone.Design: A double-blind randomized controlled trial with Pan-African Clinical Trials Registry (PACTR) approval number PACTR202112821475292Setting: Federal Medical Centre, Asaba, Nigeria.Participants: A total of 126 eligible antenatal patients for cervical ripening were enrolled.Interventions: Participants in Group A had 25μg of vaginal misoprostol with 1ml of intramuscular placebo, and those in Group B had 25μg of vaginal misoprostol with 20mg of Intramuscular Hyoscine (1 ml). Oxytocin infusion was used when indicated, and the labour was supervised as per departmental protocol.Main outcome measure: Cervical ripening timeResults: The mean cervical ripening time was statistically significantly shorter in the hyoscine group (8.48±4.36 hours) than in the placebo group (11.40±7.33 hours); p-value 0.02, 95% CI 0.80-5.05. There was no statistically significant difference in the mean induction-delivery interval in Group A (7.38±5.28 hours) compared to Group B (7.75±5.04 hours), with a value of 0.54. The mode of delivery was comparable. However, women in Group B (53, 84.1%) achieved more vaginal deliveries than women in Group A (50, 79.4%); p-value 0.49. Thirteen women in Group A (20.6%) had a caesarean section, while ten women (15.9%) in Group B had a caesarean section (p-value 0.49, RR 0.94, CI 0.80-1.11). Adverse maternal and neonatal outcomes were not statistically significant between the two groups.Conclusion: Intramuscular hyoscine was effective in reducing cervical ripening time when used as an adjunct to vaginal Misoprostol, with no significant adverse maternal or neonatal outcome.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reviewers for 2023","authors":"Editor-in-Chief","doi":"10.4314/gmj.v58i1.2","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.2","url":null,"abstract":"Reviewers of manuscripts for our journal contribute immensely to the standard and quality of the papers we publish. The Ghana Medical Journal is grateful for the voluntary service provided by the following reviewers for the year 2023.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoganathan Chidambaram, Clement J. Dhas, Juhi R, Velammal Petchiappan, Sujithkumar S
{"title":"Tracking the shift in enteric fever trends and evolving antibiotic sensitivity patterns","authors":"Yoganathan Chidambaram, Clement J. Dhas, Juhi R, Velammal Petchiappan, Sujithkumar S","doi":"10.4314/gmj.v58i1.12","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.12","url":null,"abstract":"Objective: This study aims to examine the frequency of Salmonella Paratyphi found in blood cultures and evaluate the antibiotic susceptibility pattern of Salmonella isolates to different antibiotics. Additionally, the study aims to assess the paradigm shift in the trend of enteric fever caused by Salmonella Typhi (S. Typhi) to Salmonella Paratyphi(S. Paratyphi) .Study Design: Retrospective studyParticipant: The study enrolled patients aged 12 years and above diagnosed with enteric fever (positive blood culture) and admitted to Peelamedu Samanaidu Govindasamy Naidu (PSG) Hospital.Interventions: The study analyzed demographic and antibiotic susceptibility profiles of Salmonella isolates collected from 106 enteric fever patients in the hospital between 2010 and 2022. The susceptibility profiles of Salmonella isolates to multiple antibiotics were assessed.Results: There were 106 participants, and 95 (89.62%) of them had enteric fever linked to Salmonella Typhi, while only 11 (10.38%) had enteric fever linked to Salmonella Paratyphi A. From 2010 to 2022, the study discovered a general decline in the prevalence of enteric fever caused by Salmonella species. But between 2014 and 2022, the incidence of enteric fever linked to S. Typhi rapidly increased. Azithromycin (100% , n = 106) and ceftriaxone (99%, n = 105) were highly effective against the Salmonella isolates, whereas nalidixic acid was resisted by 3 isolates (4.72%, n = 3).Conclusion: The study observed a higher incidence of Salmonella Typhi in comparison to Paratyphi A and a greater susceptibility of males to enteric fever.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140385152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adesola C. Odole, A. Okafor, Olufemi O. Oyewole, E. Ekediegwu
{"title":"Knowledge, attitude and utilisation of evidence-based therapeutic exercises in knee osteoarthritis management in Nigeria","authors":"Adesola C. Odole, A. Okafor, Olufemi O. Oyewole, E. Ekediegwu","doi":"10.4314/gmj.v58i1.13","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.13","url":null,"abstract":"Background: In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and beliefs of physiotherapists could influence this.Objective: To investigate Nigerian physiotherapists’ knowledge, attitude, and utilisation of evidence-based therapeutic exercisesDesign: A mixed-method of cross-sectional survey and focus group discussion.Setting: Secondary and tertiary health institutions in NigeriaParticipants: Physiotherapists consecutively sampled from the selected institutions.Main outcome measures: Participants’ knowledge, attitude and utilisation of evidence-based therapeutic exercises for the management of knee OAResults: This study revealed that 81% of physiotherapists in Nigeria had a fair knowledge of evidence-based practice and the efficacy of therapeutic exercises in managing knee OA. Despite this fair knowledge, 95.3% had a poor attitude. The important emerging categories/themes are treatment preference, clinical experience, and strength of evidence.Conclusion: Physiotherapists in Nigeria have a fair knowledge of evidence-based therapeutic exercises in managing patients with knee OA, although there is a poor attitude and disparity between the use and current recommendations.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140382738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Basil Bruno, Myke-Mbata K. Blessing, Mba N. Izuchukwu, Gbaa T. Terry, Dogoh Faeren
{"title":"Sex hormone-binding globulin is a valuable diagnostic indicator of gestational diabetes mellitus","authors":"Basil Bruno, Myke-Mbata K. Blessing, Mba N. Izuchukwu, Gbaa T. Terry, Dogoh Faeren","doi":"10.4314/gmj.v58i1.8","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.8","url":null,"abstract":"Objective: To assess the performance of the Sex Hormone-Binding Globulin (SHBG) assay as a diagnostic indicator of Gestational Diabetes Mellitus (GDM) in the study population.Design: Analytical cross-sectional studySetting: Hospital-based, Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria.Participants: Women with singleton pregnancies at 24 to 28 weeks gestational age attending Antenatal care at BSUTH, Makurdi.Intervention: Serum SHBG levels were assayed by ELISA during a diagnostic 75-gram Oral Glucose Tolerance Test (OGTT) for assessment of GDM in the cohort of consecutively selected participants who met the inclusion criteria.Main Outcome Measures: Serum levels of SHBG and presence of GDM in the participants.Result: Serum SHBG was significantly negatively correlated (rpb = - 0.534, p-value < 0.001) with the presence of GDM. It had an area under the ROC curve of 0.897 (95% Confidence Interval = 0.858–0.935; p-value < 0.001). A cut-off value of 452.0 nmol/L indicative of GDM had a diagnostic odds ratio of 21.4 in the study population.Conclusion: SHBG is a valuable diagnostic indicator for GDM in the study population.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caradee Y Wright, Margaret Lartey, Kenza Khomsi, Frederico Peres, Daniel Yilma, James W M Kigera, Annette Flanagin, Ahia Gbakima, D. Ofori-Adjei, Sumaili Kiswaya Ernest, Siaka Sidibé, Adégné Togo, Adamson S. Muula
{"title":"The African Journal Partnership Program’s guidance on the use of AI in scholarly publishing","authors":"Caradee Y Wright, Margaret Lartey, Kenza Khomsi, Frederico Peres, Daniel Yilma, James W M Kigera, Annette Flanagin, Ahia Gbakima, D. Ofori-Adjei, Sumaili Kiswaya Ernest, Siaka Sidibé, Adégné Togo, Adamson S. Muula","doi":"10.4314/gmj.v58i1.1","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.1","url":null,"abstract":"The rapid introduction and evolution of artificial intelligence (AI), machine learning (ML), natural language processing (NLP), and large language models (LLMs) combined with the emergence of text-generating chatbots have ushered in a transformative era in scholarly publishing.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Theresa Barnes, Gordon Abakah-Nkrumah, Oboshie Oboshie Anim-Boamah, Promise E. Sefogah
{"title":"Legal and ethical challenges in assisted reproductive technology practice in Ghana","authors":"Theresa Barnes, Gordon Abakah-Nkrumah, Oboshie Oboshie Anim-Boamah, Promise E. Sefogah","doi":"10.4314/gmj.v58i1.11","DOIUrl":"https://doi.org/10.4314/gmj.v58i1.11","url":null,"abstract":"Objective: Infertility remains a global challenge, with assisted reproductive technology (ART) progressively gaining relevance in developing countries, including Ghana. However, associated ethico-legal challenges have not received the needed policy attention. This study explored the legal and ethical challenges of ART practice in Ghana.Design: The study employed an exploratory phenomenological approach to examine ART in Ghana, focusing on ethics and law governing this practice.Participants: Respondents were ART practitioners, managers, facility owners, representatives of surrogacy/gamete donor agencies, and regulatory body representatives.Methods: A semi-structured interview guide was used to collect data. The in-depth interviews were audiotaped, and responses transcribed for analysis through coding, followed by generation of themes and sub-themes, supported with direct quotes.Results: It emerged that there are no ethical and legal frameworks for ART practice in Ghana, and this adversely affects ART practice. Ethical challenges identified border on informed consent, clients’ privacy and clinical data protection, gamete donation issues, multiple gestations, single parenting, and social and religious issues. The legal challenges identified include the non-existence of a legal regime for regulating ART practice and the absence of a professional body with clear-cut guidelines on ART practice. In the absence of legal and ethical frameworks in Ghana, practitioners intimated they do comply with internationally accepted principles and general ethics in medical practice.Conclusion: There are no regulations on ART in Ghana. Legal and ethical guidelines are essential to the provision ofsafe and successful ART practices to protect providers and users. Governmental efforts to regulate Ghana need to beprioritized.","PeriodicalId":35509,"journal":{"name":"Ghana Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}