Audit of the appropriateness of the indication for obstetric sonography in a tertiary facility in Ghana

Introduction: the use of ultrasound is one of the most vital tools in the management of pregnancies and contributes significantly in improving maternal and child health. Certain indications in pregnancy, guide the obstetrician as to which obstetric scan deems appropriate. The full realization of the benefits of ultrasound depends on whether it is being used appropriately or not, and hence this study aimed at auditing for the appropriate indications for obstetric ultrasound. Methods: a review of all request forms for obstetric scan between June 2019 and July 2020 was performed to assess the appropriateness of requests for obstetric ultrasound at the Cape Coast Teaching Hospital. The data obtained was analyzed using SPSS (SPSS Inc. Chicago, IL version 20.0). A Chi-squared test of independence was used to check for statistically significant differences between variables at p ≤ 0.05. Results: three hundred and fourteen (314) out of the 527 request forms had clinical indications stated. 174 (81.7%) of requests from Cape Coast Teaching Hospital and 39 (18.3%) from other health centers did not indicate patients clinical history/indication on the request forms. Majority 76 (68.5%) of scans in the first trimester were done without indications/history. Only 29 of requests with clinical history were inappropriate. Conclusion: practitioners should be mindful of adequately completing request forms for obstetric investigations since e a large number of practitioners do not state the history/indications for the scans. There should be continuous medical education on the importance of appropriate indication for obstetric ultrasound

Pattern of chest computerized tomography scan findings in symptomatic RT-PCR positive Covid-19 patients at the Korle Bu Teaching Hospital, Ghana

Background: Chest Computerized Tomography (CT) features of Corona Virus Disease 2019 (COVID-19) pneumonia are nonspecific, variable and sensitive in detecting early lung disease. Hence its usefulness in triaging in resource-limited regions. Objectives: To assess the pattern of chest CT scan findings of symptomatic COVID-19 patients confirmed by a positive RTPCR in Ghana. Methods: This study retrospectively reviewed chest CT images of 145 symptomatic RT-PCR positive COVID-19 patients examined at the Radiology Department of the Korle Bu Teaching Hospital (KBTH) from 8th April to 30th November 2020. Chi-Squared test was used to determine associations among variables. Statistical significance was specified at p≤0.05. Results: Males represent 73(50.3%). The mean age was 54.15±18.09 years. The age range was 5 months-90 years. Consolidation 88(60.7%), ground glass opacities (GGO) 78(53.8%) and crazy paving 43(29.7%) were the most predominant features. These features were most frequent in the elderly (≥65years). Posterobasal, peripheral and multilobe disease were found bilaterally. The most common comorbidities were hypertension 72(49.7%) and diabetes mellitus 42(29.2%) which had significant association with lobar involvement above 50%. Conclusion: The most predominant Chest CT scan features of COVID-19 pneumonia were GGO, consolidation with air bronchograms, crazy paving, and bilateral multilobe lung disease in peripheral and posterior basal distribution. Keywords: Computerized Tomography Scan; COVID-19 Pneumonia; Ghana

Computed tomography features of spontaneous acute intracranial hemorrhages in a tertiary hospital in Southern Ghana

Introduction: spontaneous acute intracranial hemorrhage (SICH) accounts for approximately 10-15% of all stroke cases. Early detection by computed tomography (CT) and early treatment are key. Hence this study to examine the CT features of SICH. Methods: this retrospective cohort study reviewed all 435 patients diagnosed with SICH from 1st March, 2017 to 1st January, 2021 in a tertiary facility in Southern Ghana. Data collected (age, sex, SICH type and the CT scan features) were organized and analyzed using GNU PSPP and Libre Office Calc. Statistical significance level was pegged at p≤0.05. Results: the SICH types were acute intracerebral hemorrhage (97.93%), acute subarachnoid/intraventricular hemorrhage (1.15%), acute epidural hemorrhage (0.46%) and acute subdural hemorrhage (0.46%). Acute intracerebral hemorrhage was more common in those >60 years (57.75%, p<0.001). The commonest CT feature for acute intracerebral hemorrhage was hyperdense lesion with perilesional edema (40.98%), with smoking (OR=2.24, 95% CI: 1.14-4.41, p=0.019) and anticoagulants intake (OR=2.56, 95% CI: 1.15-5.72, p=0.022) as the predictive factors; followed by hyperdense lesion extending to the edge of the brain (25.03%), also predictable by smoking (OR=0.23, 95% CI: 0.11-0.47, p<0.001); and hyperdense lesion with mass effects (22.70%) was not predictive with any risk factor. Type 2 diabetes mellitus (60.00%, p<0.001) and smoking (97.83%, p<0.001) were more common in males. Conclusion: hyperdense lesion with perilesional edema was the most frequent CT feature for acute intracerebral hemorrhage and was predictable by smoking and anticoagulants intake. Smoking was a predictive factor to the development of most of the features of acute intracerebral hemorrhage