Ghana medical journal最新文献

{"title":"Rectal screening for carbapenemase-producing Enterobacteriaceae in an intensive care unit in India","authors":"Arun Sachu, Sanjo Sunny, Philip Mathew, Ajeesh Kumar, Alice David","doi":"10.4314/gmj.v58i2.7","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.7","url":null,"abstract":"Objectives: To determine the proportion of patients admitted to ICU who are colonised with carbapenem-resistant Enterobacteriaceae (CRE) and to estimate the agreement between colonised patients and patients who developed an infection with CRE.Design: Prospective surveillance studySetting: The ICU of a tertiary care hospital in Kerala, IndiaParticipants: All patients above 18 were admitted to the ICU during the study period.Outcome measures: Patients colonised with CRE and systemic infection with the colonised organismResults: CRE colonisation was found in 20(8.7%) samples. Among the 20 patients in the study who were colonised with CRE, 5(25%) developed systemic infection due to CRE. History of antibiotic usage and admission to other hospitals in the last 90 days were independent predictors of CRE colonisation.Conclusion: Five of the 20 patients colonised with CRE developed an infection. Hospital admission and antibiotic usage were the main risk factors associated with CRE colonisation. Antibiotic escalation was suggested for two colonised patients based on their clinical worsening, but they succumbed to the illness. This study led us to modify our infection control practices, which led to isolating patients colonised with CRE.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687675","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":"Prognostic significance of morphology markers of chromosomal instability in acute leukaemia and myelodysplastic syndrome","authors":"Anju Khairwa, M. Kotru, Pooja Dewan, Shiva Narang","doi":"10.4314/gmj.v58i2.6","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.6","url":null,"abstract":"Objective: This study aimed to assess the prognostic significance of various morphological markers of chromosomal instability (CI).Design: This is a cross-sectional analytical study.Setting: Single centre study from the Department of Pathology of a tertiary care centre in India.Participants: The study included samples of bone marrow aspirates (BMA) and biopsies of patients with acute leukaemia (AL) and myelodysplastic syndrome (MDS) performed between June 2019 and June 2021. Inadequate samples were excluded. We included 178 samples from 80 cases.Interventions: BMA and biopsies slides examined for CI markers like chromatin bridges, multipolar mitosis, nuclear budding, micronuclei, laggards, chromatin string (CS) and nuclear heterogeneity (NH). CI markers were correlated with the type, severity and prognosis of acute leukaemia and MDS.Main outcome measures: Evaluation of CI markers as prognostic markers in AL and MDS.Results: We included B-cell ALL (35), AML (11), MDS (04), relapse of AL (12), and remission of AL (116). All CI markers were significantly increased in AL and MDS compared to the remission group. All CI markers were significantly higher in non-responders to therapy than in responders. In regression analysis, the median (IQR) values of CS and NH were significantly higher among non-survivors than survivors.Conclusion: CI markers of morphology are significantly associated with poor prognosis, including Non-survival of the disease. These markers are easy to identify and cost-effective. We recommend incorporating morphological markers of CI in routine reporting of haematological malignancies to assist in prognostication before reports from sophisticated techniques are available.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"19 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685028","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":"Correlation of sonographically-determined residual urine volume with lower urinary tract symptoms in adult males at a tertiary hospital","authors":"Linda Nketiah, K. Dzefi-Tettey, Raphael N. Mayeden, Ambrose Agborli, Benard Ohene- Botwe, Yaw B. Mensah","doi":"10.4314/gmj.v58i2.4","DOIUrl":"https://doi.org/10.4314/gmj.v58i2.4","url":null,"abstract":"Objective: To determine the correlation between the severity of LUTS as measured by the International Prostate Symptom Score (IPSS) and PVR urine volume measured by transabdominal ultrasound in patients with LUTS, and to determine the correlation between ‘feeling of incomplete bladder emptying and sonographically measured PVR urine volume.Design: Correlational cross-sectional studySetting: Ultrasound Unit of the Radiology Department and Urology Clinic of Korle Bu Teaching HospitalParticipants: Male patients (n=256) aged 40 years or older who presented to the urology department of Korle Bu Teaching Hospital with LUTS and gave their written consent were enrolled. The presence and severity of LUTS were evaluated using the IPSS. The PVR urine was measured using a real-time transabdominal ultrasound scan.Main outcome measure: Severity of LUTS and Residual urine volumeResults: The mean PVR urine volume was 84.5ml. Most respondents (57.3%, n=146) had PVR urine volume below 50ml, with 27% (70 patients) having PVR urine volume above 100ml. PVR urine volume and total IPSS showed no statistically significant correlation. All age groups of respondents scored above 4 for Quality of life (QoL). ‘Intermittency’ is the IPSS symptom, which showed a statistically significant correlation with PVR urine volume. PVR urine volume did not correlate statistically with the ‘feeling of incomplete emptying’.Conclusions: There was no statistically significant correlation between the total IPSS and PVR urine volume. Thus, residual urine volume does not correlate with the severity of LUTS. The ‘feeling of incomplete emptying’ does not correlate with PVR urine volume.","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688503","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":"Angiographic severity of coronary artery disease and the influence of major cardiovascular risk factors.","authors":"Nehemiah J Dung, Mark M Tettey, Martin Tamatey, Lawrence A Sereboe, Alfred Doku, Martin Adu-Adadey, Francis Agyekum","doi":"10.4314/gmj.v57i4.2","DOIUrl":"10.4314/gmj.v57i4.2","url":null,"abstract":"<p><strong>Objective: </strong>To determine the angiographic severity of coronary artery disease (CAD) and assess the influence of major cardiovascular risk factors (CVRF).</p><p><strong>Study design: </strong>a cross-sectional, hospital-based study.</p><p><strong>Setting: </strong>the catheterisation laboratory of the National Cardiothoracic Centre, Accra, Ghana.</p><p><strong>Participants: </strong>for 12 months, consecutive patients admitted for coronary angiography were assessed for the presence of CVRFs. Those with significant CAD after angiography were recruited into the study.</p><p><strong>Intervention: </strong>The patient's angiograms were analysed, and the CAD severity was obtained using the SYNTAX scoring criteria.</p><p><strong>Main outcome measure: </strong>The lesion overall severity (SYNTAX) score and the relationship with CVRFs present.</p><p><strong>Results: </strong>out of the 169 patients that had coronary angiography, 78 had significant CAD. The mean SYNTAX score was 20.18 (SD= 10.68), with a significantly higher value in dyslipidaemic patients (p < 0.001). Pearson's correlation between the score and BMI was weak (r= 0.256, p= 0.034). The occurrence of high SYNTAX score lesions in about 18% of the population was significantly associated with hypertension (OR= 1.304, 95% CI [1.13-1.50]; p= 0.017) dyslipidaemia (OR= 5.636, 95% CI [1.17-27.23]; p= 0.019), and obesity (OR= 3.960, 95% CI [1.18-13.34]; p= 0.021). However, after adjusting for confounding factors, only dyslipidaemia significantly influenced its occurrence (aOR= 5.256, 95% CI [1.03-26.96]; p= 0.047).</p><p><strong>Conclusion: </strong>Even though the most severe form of CAD was found in about one-fifth of the study population, its occurrence was strongly influenced by the presence of dyslipidaemia.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"262-269"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic parietal bone thinning mimicking a bone lesion.","authors":"Thomas Saliba, Alessandro De Leucio, Paolo Simoni","doi":"10.4314/gmj.v57i4.10","DOIUrl":"10.4314/gmj.v57i4.10","url":null,"abstract":"<p><p>Idiopathic focal unilateral skull thinning is a rare finding. An explanation, such as trauma or disease, can often be found. However, in some cases, no explanation is forthcoming, and thus, we must look further into their history for a possible cause. The case of a nine-year-old boy with a crescent-shaped unilateral parietal bone thinning and a history of ventouse-assisted birth is presented. The lesion matches a ventouse's typical location, shape, and size. Thus, with the support of one other reported similar case, we hypothesise this may be the origin. We present the case of a crescent-shaped lesion matching the imprint of a ventouse in a child with a concordant history. This finding is put in the context of similar reports in the literature, and we believe that this report provides further evidence of this obscure phenomenon.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"321-323"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of COVID-19 vaccine knowledge and acceptability among healthcare workers in a Nigerian tertiary hospital.","authors":"Iriagbonse I Osaigbovo, Esohe O Ogboghodo, Otaniyenuwa E Obarisiagbon, Darlington E Obaseki","doi":"10.4314/gmj.v57i4.5","DOIUrl":"10.4314/gmj.v57i4.5","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the knowledge and acceptability of COVID-19 vaccines among HCWs.</p><p><strong>Design: </strong>A descriptive cross-sectional study was conducted in March 2021 among eligible HCWs using a self-administered questionnaire.</p><p><strong>Setting: </strong>The study was conducted in a southern Nigerian tertiary hospital.</p><p><strong>Participants: </strong>All HCWs not on annual or study leave were eligible to participate. The number of HCWs in each occupational category was determined by proportional allocation. HCWs were selected by stratified sampling technique.</p><p><strong>Main outcome measures: </strong>Knowledge of COVID-19 vaccines was assessed using 25 questions. The minimum and maximum scores were 0 and 25, respectively. Scores were converted to percentages. Scores of 50% and above were rated as good knowledge. Participants were also asked if they were willing to receive the vaccine.</p><p><strong>Results: </strong>The mean age of 512 participating HCWs was 33.4±7.8 with an M:F ratio of 1:1.1. Overall, 399 (76.6%) had good knowledge. Occupation and exposure to COVID-19 were predictors of knowledge. Three hundred and twenty-eight respondents (63.0%) were willing to take the vaccine. Predictors of willingness to accept vaccination were age, sex, number of years in employment and knowledge about the vaccines (p< 0.05).</p><p><strong>Conclusions: </strong>Most HCWs had good knowledge and were disposed to accepting the COVID-19 vaccine. Educational interventions are necessary to improve HCWs knowledge as they may provide vaccine-related information to the general public.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"284-292"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of clinical characteristics of COVID-19 among vaccinated and unvaccinated patients in a major treatment facility in Ghana.","authors":"Benedict Nl Calys-Tagoe, Joseph Oliver-Commey, Georgia Nk Ghartey, Abdul G Mohammed, Delia Bandoh, Christian Owoo, Ernest Kenu","doi":"10.4314/gmj.v57i4.6","DOIUrl":"10.4314/gmj.v57i4.6","url":null,"abstract":"<p><strong>Objectives: </strong>To compare clinical characteristics of COVID-19 among vaccinated and unvaccinated patients in a major treatment facility in Ghana.</p><p><strong>Design: </strong>A retrospective study drawing on data from COVID-19 patients' records visiting the facility from March 2021 to December 2021.</p><p><strong>Setting: </strong>Ghana Infectious Disease Centre, Ga East Municipality, Greater Accra Region, Ghana.</p><p><strong>Participants: </strong>In-patients and outpatients who reported to the facility from 1st March 2021 to December 2021 were included in the study, and patients with missing data on vaccination were excluded.</p><p><strong>Outcome measures: </strong>underlying conditions, symptoms, case management information, hospital service rendered (OPD, HDU or ICU), length of hospital stay, treatment outcome.</p><p><strong>Results: </strong>The study included 775 patient records comprising 615 OPD and 160 hospitalised cases. Less than one-third (26.25%; 42) of the patients hospitalised were vaccinated compared to almost 40.0% (39.02%; 240) of the patients seen at the OPD. Vaccinated individuals were nearly three times (aOR = 2.72, 95%CI:1.74-4.25) more likely to be managed on an outpatient basis as compared to the unvaccinated. The death rate among the vaccinated group and the unvaccinated were (0.71%; 2) and (3.45%; 17), respectively, with a significant reduction in the risk of dying among the vaccinated compared to the unvaccinated (aOR = 0.13, 95%CI: 0.028 0.554).</p><p><strong>Conclusions: </strong>Less than half of the in-patient and OPD patients were vaccinated. Mild infections, fewer days of hospitalisation, outpatient treatment and higher chances of survival were associated with being vaccinated against SARS-CoV-2. Prudent measures should be implemented to encourage the general public to take up SARS-CoV-2 vaccines.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"293-299"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gustatory dysfunction in euthyroid primary hypothyroidism.","authors":"Afshan Z Hasan, B L Preethi, Pramila Kalra","doi":"10.4314/gmj.v57i4.3","DOIUrl":"10.4314/gmj.v57i4.3","url":null,"abstract":"<p><strong>Objectives: </strong>The study assessed gustatory functions in patients with primary hypothyroidism who are euthyroid on supplemental hormone therapy with levothyroxine over six months' duration and to evaluate the association of gustatory dysfunction, if any, with the serum TSH levels.</p><p><strong>Design: </strong>This analytical community-based cross-sectional study was conducted in April 2021, following participants' ethical approval and written informed consent.</p><p><strong>Setting: </strong>The study was conducted in a tertiary health care centre in Bangalore, Karnataka, India.</p><p><strong>Participants: </strong>Sixty-eight subjects participated in this study: 34 primary hypothyroid patients and an equal number of healthy controls.</p><p><strong>Interventions: </strong>Gustatory sensations were assessed by the triple drop test, and scores were given depending on the identification of the tastants (sweet, sour, salty, and bitter). The taste scores were compared, and the association between TSH levels and gustatory parameters were evaluated.</p><p><strong>Results: </strong>Overall taste scores were lesser in hypothyroid patients. This finding depicted that their taste thresholds were increased and were statistically significant (p < 0.001), though the association between the degree of hypogeusia and TSH levels was not statistically significant.</p><p><strong>Conclusion: </strong>Patients with primary hypothyroidism can suffer from hypogeusia, which may revert to normal once they achieve euthyroid status with levothyroxine supplementation. However, this has not been conclusively shown in studies. Our study concluded that hypogeusia was present in primary hypothyroidism despite patients being euthyroid on hormone supplementation, and it was not dependent on the serum TSH levels.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"270-274"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski","doi":"10.4314/gmj.v57i4.1","DOIUrl":"10.4314/gmj.v57i4.1","url":null,"abstract":"","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"258-261"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological distress of Ghanaian couples after unsuccessful treatment for infertility.","authors":"Stephen M Arhin, Kwesi B Mensah, Evans K Agbeno, Felix Yirdong, Kwame Opoku-Agyeman, Charles Ansah","doi":"10.4314/gmj.v57i4.4","DOIUrl":"10.4314/gmj.v57i4.4","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of the study was to assess psychological distress and to identify any gender specific differences in the psychological distress among infertile couples after one year of unsuccessful pharmacotherapy.</p><p><strong>Design: </strong>A descriptive cross-sectional study.</p><p><strong>Setting: </strong>The study was conducted in four fertility clinics in the Cape Coast Metropolis.</p><p><strong>Participants: </strong>One hundred and twenty respondents (71 women and 49 men) were recruited by simple random sampling.</p><p><strong>Statistical analysis: </strong>Statistical analysis was done using SPSS (v. 25). Psychological distress scores were presented as Mean±SD and were analysed using One-way ANOVA, followed by Bonferroni's post hoc test. Associations between exposures and outcomes were measured using relative risk.</p><p><strong>Outcome measure: </strong>The main outcome measure was the level of depression, anxiety, and stress among infertile couples after unsuccessful pharmacotherapy.</p><p><strong>Results: </strong>Anxiety was the predominant psychological distress experienced by respondents (60.8%), followed by depression (43.3%) and stress (37.5%). Generally, psychological distress scores increased with age among female respondents but decreased with age for male respondents. The duration of infertility only significantly affected anxiety (<i>p</i>=0.01) but not depression (<i>p</i>=0.51) and stress (<i>p</i>=0.06) levels. Approximately 31.7% of respondents reported experiencing extremely severe anxiety. Male respondents reported higher degree of depressive symptoms than females (46.9 vs. 40.8%).</p><p><strong>Conclusion: </strong>Unsuccessful pharmacotherapy of infertility is associated with varied degrees of psychological distress among Ghanaian infertile couples, which can be affected by age, duration of infertility and gender.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"57 4","pages":"275-283"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}