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Tumours and tumour like lesions of the lower face at Korle Bu Teaching Hospital, Ghana – an eight year study

Tumours and tumour like lesions of the lower face at Korle Bu Teaching Hospital, Ghana – an eight year study

Thorough knowledge of regional anatomy is essential to understand the behaviour of both malignant and benign lesions of this region and the pattern of spread of tumours to the lymph nodes. Management of these tumours present a challenge due to their sizes at presentation in the West African region. There have been International reports on tumours of the jaws in the West African sub region, mainly from Nigeria, as well as other parts of the continent, but none from Ghana. The studies from Nigeria [8,9] show that odontogenic tumours have a pre- dilection for the lower face while one study from Jordan found more non-odontogenic tumours in the mandible [10]. The Maxillofacial Surgery Department of the Korle Bu Teaching Hospital in Accra, the capital of Ghana, is the main referral hospital in the country and receives patients from the whole country as well as from the neighbouring countries of Ivory Coast, Burkina Faso and Togo, but pre- dominantly from Southern Ghana. The aim of this study is to find the tumours and tumour-like lesions predomi- nant in the lower face, their clinical and sites of presenta- tion in all age groups. It is envisaged that results presented here will add to the depth of information on facial tumours in this region and in Africa at large.

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Unrecognized human immunodeficiency virus infection and risk factors among elderly medical patients at the Korle Bu teaching hospital, Accra, Ghana

Unrecognized human immunodeficiency virus infection and risk factors among elderly medical patients at the Korle Bu teaching hospital, Accra, Ghana

Anecdotal reports from the Department of Medicine and Therapeutics, Korle Bu Teaching Hospital (KBTH), Accra, Ghana, indicate a rise of older people (>50 years old) on admission at both the Surgical/Medical Emer- gency (SME) Ward and the Medical Wards, Department of Medicine and Therapeutics, KBTH; and that, age- re- lated illnesses were the leading cause of death among the elderly (>60 years old) on admission. Although sev- eral studies have indicated that older patients with HIV infection present with non-specific problems or signs and symptoms that mimic age-related illnesses [18], the testing and diagnosis of HIV-related immune-suppression were not done, unrecognized or overlooked among the patients on admission in both wards. Consequently, the sero-prevalence of HIV and/or HIV/AIDS-related death among the elderly patients was not included in the report.

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The Role of Human Herpesvirus Type 6 (HHV 6) in Convulsions Seen in Children at Korle Bu Teaching Hospital, Accra

The Role of Human Herpesvirus Type 6 (HHV 6) in Convulsions Seen in Children at Korle Bu Teaching Hospital, Accra

Since 2004, cases of convulsion of unknown causative agent have been reported at the Child Health Depart- ment of the Korle-Bu Teaching Hospital (KBTH). Up to date, the actual etiological agent is unknown. Children between the ages of one month and ten years are usually faced with this condition with clinical presentations of fever, convulsion and with or without rash. Approximately fifteen cases are recorded every month. Since the actual causative agent that will give an idea of the appropriate drug to be used is unknown, only the symptoms are clinically managed leading to misuse of antibiotics and anti-malarial drugs. Parasitological and bacteriologi- cal investigations conducted on samples were usually negative, however, since HHV-6 has been associated with convulsions, it will be important to investigate its role in the convulsions seen in these Ghanaian children.

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Soluble Human Leukocyte Antigen G Expression in Pregnancy Success and Early Pregnancy Loss in Korle Bu Teaching Hospital

Soluble Human Leukocyte Antigen G Expression in Pregnancy Success and Early Pregnancy Loss in Korle Bu Teaching Hospital

The study participants include women undergoing spontaneous abortion recruited from the Gynecology Unit KBTH and non-pregnant women and healthy men recruited from the staff of College of Health Sciences. An archive sample of women who had normal vaginal deliveries without any complications and any history of ma- laria infection from gestation to delivery was obtained from Noguchi Memorial Institute for Medical Research Ghana. KBTH situated in the nation’s capital, Accra, Ghana, is the leading tertiary hospital and the major refer- ral center in the country. It also serves as the teaching hospital of the University of Ghana College of Health Sciences, in Accra. Participants with history of immunodeficiencies, malignancies, and immunosuppressive and immune stimulant therapies were excluded from the study.

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Benign Proliferative Breast Disease: A Histopathological Review of Cases at Korle Bu Teaching Hospital

Benign Proliferative Breast Disease: A Histopathological Review of Cases at Korle Bu Teaching Hospital

With the increasing education on breast cancer, most women are reporting to the hospital with breast lumps most of which are benign breast lesions. [1,2] Benign breast diseases constitute a heterogeneous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferation and neoplasms. These may present with a wide range of symptoms or may be detected as incidental microscopic findings, [3] examples include fibroadenomas, hyperplasia, cysts, intraductal papilloma, sclerosing adenosis, radial scars, fat necrosis and cysts, mastitis, granular cell tumour, duct ectasia, lobular carcinoma in situ, amidst others [4].

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Molecular investigations of viral meningitis among HIV infected adults in Accra, Ghana

Molecular investigations of viral meningitis among HIV infected adults in Accra, Ghana

This study was conducted at the Fevers’ Unit (FU) of the Korle Bu Teaching Hospital (KBTH) in Korle Bu, Accra from August 2014 to January 2016. Korle Bu Teach- ing Hospital is a referral hospital with a 2000 patient bed capacity and 17 clinical and diagnostic departments and the largest tertiary health facility in Accra which is the capital city of Ghana. In all, eighty (80) patients who had been tested and confirmed to be HIV positive and with clinical symptoms consistent with meningi- tis were recruited for this study. All patients were adults (≥ 18  years). As meningitis may present with diverse clinical symptoms such as headache, fever, stiff neck, neurologic symptoms, abnormal behaviour, seizure, nau- sea, tachycardia, photophobia and others, it was expedi- ent to have a clear definition for cases. Trained health staff screened and enrolled patients who met the stand- ard case definition of meningeal symptoms of stiff-neck, fever and headache as well as cerebrospinal fluid pleocy- tosis, with no laboratory evidence of bacterial or fungal organisms. .

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Prevalence of congenital malaria in high risk Ghanaian newborns: a cross sectional study

Prevalence of congenital malaria in high risk Ghanaian newborns: a cross sectional study

This study shows that patent malaria parasitaemia was uncommon in untreated high-risk newborns referred to Korle Bu Teaching hospital in southern Ghana during the peak seasons for malaria in 2008, and 2010. The 2.2% congenital malaria prevalence by microscopy in the 2008 cohort was lower than rates from longitudinal studies from neighbouring countries, 5.1% in Nigeria and 4.7% in Ivory Coast [8,9]. The data also suggests that congenital malaria is mostly asymptomatic with no pathognomic clinical features and that affected new- borns have low parasitaemia; these findings are similar to work reported by others [21,22].

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An Assessment of Health Worker’s view on the Current
Single Spine Pay Policy. A Case Study on Doctors and
Nurses in Greater Accra Region, Ghana

An Assessment of Health Worker’s view on the Current Single Spine Pay Policy. A Case Study on Doctors and Nurses in Greater Accra Region, Ghana

The study used a mixed method made up of quantitative and qualitative survey through the use of questionnaires and interviews as well as focus group discussions (FDG). The researcher chose this approach because findings from both methods complemented each other and adequately achieve the research objectives. The outcome of the quantitative methods assisted in making generalizations about the study population, while that of interviews and FGDs elicited in-depth explanations on motivation and retention of doctors and nurses in the public health sector in Ghana. The case study location was the public health sector in the Greater Accra Region. Respondents were from the various level of health facilities in Greater Accra. These are the major Tertiary, Secondary and Primary healthcare facilities in Greater Accra. Respondents were from Korle Bu Teaching Hospital (Tertiary health facility), Greater Accra Regional Hospital (formally Ridge Hospital (secondary health facility), Tema General Hospital (secondary Health facility), Dangbe East District Hospital, Ada, (District Hospital), Pentecost Hospital (Primary Healthcare facility). According to the Ministry of Health (2015), doctors and professional nurses (state registered nurses) in the Greater Accra Region are five thousand, four hundred and twenty-six (5426) (Figure 1).

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Epidemiology of injuries presenting to the accident centre of Korle-Bu Teaching Hospital, Ghana

Epidemiology of injuries presenting to the accident centre of Korle-Bu Teaching Hospital, Ghana

The Korle Bu Teaching Hospital is the largest health facility, and premier teaching hospital in Ghana. With a bed capacity of over 2000, it serves as the main referral center for the entire southern Ghana and beyond. It also serves as a training center for medical doctors, nurses and other health professionals. The hospital has 17 clin- ical and diagnostic departments/units which includes the Accident and emergency department (housing the Accident center), where this study took place. It is the point of entry into the hospital for victims of road crashes, burns, bites, and foreign body ingestion. The centre attends to ‘walk-in’ and referred trauma patients of all ages, from primary care, primary hospitals and secondary hospitals in the southern part of Ghana and beyond. It, therefore, has a wide catchment area with an ill-defined population.

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Genetic characterization of TEM-type ESBL-associated antibacterial resistance in Enterobacteriaceae in a tertiary hospital in Ghana

Genetic characterization of TEM-type ESBL-associated antibacterial resistance in Enterobacteriaceae in a tertiary hospital in Ghana

ESBL-producing bacterial isolates have been reported across Africa, even in isolated remote communities [11– 16]. Beyond detection, data on specific identification of ESBLs are needed for deciding local therapy options, control strategies and recognition of unusual cases. In Ghana, investigations into mechanisms of β-lactam resistance have often been limited to phenotypic charac- terizations. This study reports the presence of TEM-type β-lactamase genes, their location(s) and their transfer- ability by conjugation in clinical enterobacteria isolates collected at the Korle-Bu Teaching Hospital (KBTH).

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Psychosocial Factors Influencing the Perception and Choice of Nursing as a Profession: A Study at Korle - Bu Nurses’ Training College

Psychosocial Factors Influencing the Perception and Choice of Nursing as a Profession: A Study at Korle - Bu Nurses’ Training College

This favourable perception exhibited by the participants in this study reflects the Ghanaian public perceptions of the nursing profession. The Ghanaian public are mostly of the opinion that the nursing profession is an area of ready job availability and paid allowances during training periods that gives relief to low income parents. Furthermore, the trainee nurses were overwhelmingly satisfied with their decision to become nurses but they were very clear about the future prospects of the profession. They also have plans to travel abroad after graduation. This finding confirms that of Kersten, Bakewell & Meyer (2003), Larsen, McGill & Palmer ( 2003) and Benner, Tanner, & Chesla (2009) who found that the most frequent reported reasons for choosing nursing include love to care for others, past experience in hospital, employment opportunities and job security.

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Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

Review of Gynaecological Diagnoses and Surgeries Performed at a Tertiary Health Facility in Niger-Delta of Nigeria from 2012-2017: Implications for Healthcare Planning and Budgeting

The female reproductive system is vulnerable to dysfunction or disease from infancy to old age. Gynaecological disorders are a particularly common cause of morbidity and mortality among women of reproductive age groups, and a common cause of hospital presentation and admission in both developing and developed countries of the world [1,2]. They can be acute or chronic depending on the time of presentation and urgency of the need for medical intervention. Infertility is a worldwide problem, affecting 8.0% - 15.0% of couples in their reproductive age [3,4]. However, there is a worldwide variation in its incidence, being highest in the so-called infertility belt of Africa, which includes Nigeria [5]. This has been attributed to high rate of sexually transmitted infections (STIs), complications of unsafe abortions and pelvic inflammatory disease (PID) [6]. Institutional-based studies in some parts of Nigeria have reported the incidence of infertility as 15.4% [4], 15.7% [7], 23.9% [8], 32.0% [9] and 48.1% [10].

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The IAEA/WHO TLD Audit Program. The results of the TLD postal dosimetry audits in the National Centre for Radiotherapy and Nuclear Medicine Department, Korle-Bu, Accra (1998 to 2012)

The IAEA/WHO TLD Audit Program. The results of the TLD postal dosimetry audits in the National Centre for Radiotherapy and Nuclear Medicine Department, Korle-Bu, Accra (1998 to 2012)

Several radiotherapy accidents which could have been prevented, have been given on overexposure of patients. Notably among these is the Costa Rica incidence which occurred in 1996 (IAEA, 1998). In such incident, the absorbed dose rate of the new source was underestimated, resulting in treatment times being overestimated by 66%, and leading overexposures involving 115 patients. Another radiotherapy accident which occurred at the National Oncology Institute (Instituto Oncológico Nacional, ION), Panama (Borrás, 2006), is also reported. The incident involved the overexposure of 28 radiation therapy patients at the ION in late 2000 and early 2001. Also, at another hospital clinic located in Zaragoza, Spain, between the dates of December 10 and December 20, 1990, at least 27 patients who were receiving radiotherapy for cancer were accidentally exposed to high levels of radiation, which resulted in the deaths of 11 patients, and severe injuries to the others (IAEA/WHO, 1997). With these and other reported cases of unintended exposures, The IAEA/WHO TLD postal audit program has been an important tool in reducing radiotherapy accidents.

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In-process modification yields improved teaching outcomes for international emergency medicine

In-process modification yields improved teaching outcomes for international emergency medicine

The establishment of international medical teaching pro- grams and academic affiliations has become increasingly popular [1 – 3]. While several processes, models and frame- works exist to investigate differences in belief and practice in a medical community, there has not been a process developed that examines how efficiently international programs are run to maximize the transfer of knowledge, technology and practices among international medical communities [4]. This process can be further complicated when two medical communities are not familiar with each other’s principle medical needs or cultural beliefs.

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Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

strongly suggest a poor ADRs monitoring system in Nigeria. Therefore more awareness on ADRs reporting and surveillance needs to be created among doctors in Nigeria. Reference to drug formularies for prescribing information has been reported as an important step to preventing ADRs [35]. It is highly commendable that this was prac- tised by a majority of the respondents. However, making a little reference to the Nigerian national drug formulary/ essential drug lists is of great concern. The implication of this is that the respondents are likely to prescribe drugs that are more expensive and unavailable locally at all time; this totally negates the WHO's guidelines for rational prescribing [36]. Deficiencies in the knowledge and basic skills of prescribing, as well as deficiency in tak- ing a good drug history, are responsible for a significant number of medication errors [37,38]. These topics were however given a low priority in undergraduate CPT teach- ing by a majority of the respondents, which further shows, that complacency of the respondents towards achieving appropriate prescribing skills, may be very difficult to change. It is also surprising that alternatives to teaching improvement of CPT were not suggested by any of the respondents. The use of a prescribing checklist as an aide- memoire has been suggested by Jackson et al [39] as a means of improving prescribing practice. This can be developed for medical students for their familiarisation and use during internship.

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Maternal mortality in baghdad teaching hospital

Maternal mortality in baghdad teaching hospital

For the other 5 cases who were multiparaus, 4 of them had repeated cesarean section,3 of them had presented with vaginal bleeding, diagnosed to have placenta previa by emergency ultrasound, the 3rd one who had previous 4 cesarean section presented with labor pain and full dilatation of cervix, all of these cases admitted to emergency C ̸ S, all of them had emergency hysterectomy, and complicated with bleeding and admitted to the RCU all of them died there. The fourth case who had previous C ̸ S, presented with full term pregnancy intrauterine fetal death, with history of pregnancy induced hypertension and diabetes mellitus with uterine contractions, in the operating theatre decision for spinal anesthesia done, during which the patient collapsed and passed. The last case was multiparaus women referred from AL- Zahraa hospital as a case of primary postpartum hemorrhage, after delivery at midwife home, the patient arrived in a shock state, resuscitation started hand by hand with examination to detect the possible cause of hemorrhage, as the bleeding continued decision for emergency life saving hysterectomy done, during which she developed ventricular fibrillation as stated by the anesthetist and cardiac physician called to assist in her resuscitation but, unfortunately the patient passed. Unfortunately, in this study half of the died women were less and equal to 20 years of age that represented a disastrous event for them and their families and this proportion is higher than that reported in other developing countries as in Nigeria (2010) study by Agan TU, et al. the proportion of younger age was approximately 20%. The residence of died women was 62% rural and this might be attributed to difference in socioeconomic conditions (22).

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A ten year review of Jadelle contraceptive use at Rivers State University Teaching Hospital, south south Nigeria

A ten year review of Jadelle contraceptive use at Rivers State University Teaching Hospital, south south Nigeria

Norplant-2 (Jadelle) is an effective long acting hormonal contraceptive method. It is highly acceptable and safe with efficacy equivalent to sterilization. To determine the uptake rate, socio-demographic characteristics of the acceptors of Jadelle contraceptive method and its pattern of use at the RSUTH. This is a retrospective observational study in which patients’ records in family planning clinic at the Rivers State University Teaching Hospital (RSUTH) over a period of ten years were reviewed; data extracted, coded and analyzed in statistical package for social sciences (SPSS) IBM version 25.0 (Armonk NY). The prevalence rate of Jadelle contraceptive among contraceptive acceptors at the RSUTH is 13.4 %. The mean age and range of the acceptors of jadelle contraceptive were 33.43 SD 4.9 years and 19-49 years respectively. The modal age group was 30-34 years. Majority of the clients had secondary level of education 185 (73.1 %) followed by tertiary education 44 (17.4%) while 7 (2.8%) had no formal education. Of the 253 acceptors of jadelle, greater than two third 176 (69.5%) were multipara. Most of the clients were married 248 (98%) and of Christian religion 238 (94%). The uptake of Jadelle over the study period was low. Adequate counseling and public enlightenment are needed for an improvement in its uptake in our environment .

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Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana

Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana

However, empirical data on the overall and HPV geno- type specific prevalence in cases of cervical cancers in Ghana were very few at the time of this study. Addition- ally, and in order to evaluate the potential benefits of an introduction of HPV vaccination in Ghana, this study was designed to detect, genotype and determine the extent of multiple HPV infection using archival formalin- fixed paraffin-embedded cervical tumour specimen collected from the Pathology Department of Korle-Bu Teaching Hospital during the years 2004–2006. For the detection of HPV, a nested-multiplex PCR method that had been shown to be very sensitive and specific, with de- tection rates of between 91.8 % for cervical intraepithelial neoplasia (CIN I) and 99.3 % for CIN III was used [12].

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Prevalence of psychological symptoms among adults with sickle cell disease in Korle-Bu Teaching Hospital, Ghana

Prevalence of psychological symptoms among adults with sickle cell disease in Korle-Bu Teaching Hospital, Ghana

After ethical clearance was obtained from the Noguchi Memorial Institute for Medical Research Institutional Review Board, permission was obtained from the Director of the Institute of Clinical Genetics, Korle-Bu Teaching Hospital to collect survey data from the sickle cell clinic in Korle-Bu Teaching Hospital. Written informed consent was obtained from potential participants and the principal researcher and his assistants handed the questionnaires to SCD participants who awaited their turn to see their doc- tor. The questionnaires were completed and collected same day before participants left the clinic. About nine potential participants refused to give consent and 19 did not return the questionnaires, or filled them poorly or returned uncompleted questionnaires. Return rate was 91 %, that is, 201 questionnaires were retrieved out of 220.

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Neonatal near-misses in Ghana: a prospective, observational, multi-center study

Neonatal near-misses in Ghana: a prospective, observational, multi-center study

Study sites included the maternal and neonatal units of Komfo Anokye Teaching hospital (KATH) in Kumasi and Cape Coast Teaching Hospital (CCTH) in Cape Coast. KATH is the teaching hospital affiliated with the Kwame Nkrumah University of Science and Technology School of Medical Sciences (KNUST-SMS) and serves as the referral center for most of central Ghana. Each year approximately 11,000 women give birth at KATH. CCTH is the teaching hospital of the University of Cape Coast, School of Med- ical Sciences (UCC-SMS) and serves as the main referral hospital for much of the rural central and parts of western regions of Ghana. The hospital oversees about 2800 births per year. At the time of this research, each hospital pro- vided specialty care for sick newborns, with capacity to provide bag and mask ventilation, oxygen and incubator care with radiant warmers (although often shared), and phototherapy. Routine laboratory tests, such as complete blood counts (CBC), serum bilirubin and electrolytes, were available, but delays in processing sometimes limited the utility and utilization of such tests.

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