Ghana medical journal最新文献

{"title":"Outcome of pregnancy in patients with systemic lupus erythematosis at Korle-bu Teaching Hospital.","authors":"Ida Dzifa Dey,&nbsp;Jerry Coleman,&nbsp;Harriet Kwarko,&nbsp;Michael Mate-Kole","doi":"10.4314/gmj.v50i2.4","DOIUrl":"https://doi.org/10.4314/gmj.v50i2.4","url":null,"abstract":"<p><strong>Objective: </strong>To study maternal and fetal outcomes in Ghanaian women with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Retrospective study of pregnancies in women with SLE in a single centre in Ghana.</p><p><strong>Results: </strong>The mean age was 30.1 years and all were nulliparous. Two out of the seven pregnancies were in disease remission at the time of booking. Nephritis without renal impairment was present in 7 pregnancies (6 women). One woman developed intrapartum eclampsia. Two women had secondary antiphospholipid syndrome (APS). Two suffered early fetal losses and one late fetal loss at 32 weeks. All three who lost their fetus had uncontrolled hypertension. Six had mild flares mainly joint pains during pregnancy. There was no maternal mortality. The median gestational age at delivery was 38 weeks (range, 16 to 40 weeks) and the mean birth weight was 3017 g; the median Apgar scores were 8 and 9 at 1 and 5 minutes of life, respectively. There were no cases of intrauterine growth restriction (IUGR). There were no cases of congenital heart block or neonatal lupus.</p><p><strong>Conclusion: </strong>Good pregnancy outcomes are possible in women with SLE even in resource poor settings. . All pregnancies should still be considered high risk and be managed jointly between the obstetricians, the perinatologists and the rheumatologists, in particular, those with renal involvement and hypertension. Long term follow up of a larger cohort is needed.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"50 2","pages":"72-7"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/gmj.v50i2.4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71435072","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":"Do diabetes-specialty clinics differ in management approach and outcome? A cross-sectional assessment of ambulatory type 2 diabetes patients in two teaching hospitals in Nigeria.","authors":"Rasaq Adisa,&nbsp;Titilayo O Fakeye","doi":"10.4314/gmj.v50i2.7","DOIUrl":"https://doi.org/10.4314/gmj.v50i2.7","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes-specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about diabetes were also explored.</p><p><strong>Design: </strong>A cross-sectional prospective study using semi-structured interview among consented patients for eightweek, and a review of participants' case notes at 3-month post-interactive contact for details of diabetes-specific parameters and antidiabetes medications.</p><p><strong>Settings: </strong>The University College Hospital (UCH) and Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in southwestern Nigeria.</p><p><strong>Participants: </strong>Adult patients with type 2 diabetes, on therapies for >3-month and who had average fasting blood glucose (FBG)>6.0mmol/L were enrolled. All patients with type 1 diabetes, and type 2 diabetes who decline participation were excluded. Out of 185 participants who were approached, 176(95.1%) consented and completed the study including 113(64.2%) from UCH and 63(35.8%) in OAUTHC.</p><p><strong>Results: </strong>Mean FBG for patients were 9.6mmol/L in UCH and 11.0mmol/L in OAUTHC (p=0.03). Medication adherence among patients was 47(46.5%) in UCH and 31(52.5%) in OAUTHC (p=0.46). Prescribed antidiabetes medications between the clinics significantly differ. Practice of self-monitoring of blood glucose among participants was 26(23.0%) in UCH and 13(20.6%) in OAUTHC (p=0.72). Thirty-two participants (29.4%) in UCH and 33(43.4%) from OAUTHC (p=0.02) mentioned complications as perceived fear about type 2 diabetes.</p><p><strong>Conclusion: </strong>There are differences and similarities between the diabetes-specialty clinics with respect to diabetes management and outcome. This underscores the necessity for a protocol-driven treatment approach in ensuring improved diabetes care and outcome.</p><p><strong>Funding: </strong>None declared.</p>","PeriodicalId":94319,"journal":{"name":"Ghana medical journal","volume":"50 2","pages":"90-102"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/gmj.v50i2.7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71435071","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}