MRI features in the non-traumatic spinal cord injury patients presenting at the Korle Bu Teaching Hospital, Accra

Background: Neurological limb deficit due to non-traumatic myelopathy is a disabling and distressing neurological condition.  In recent time Magnetic Resonance Imaging (MRI) has proven to be the ultimate imaging modality for evaluating pathologies of the spinal cord.Objective: To describe the Magnetic Resonance Imaging (MRI) features of patients with Non-Traumatic Spinal Cord Injury evaluated at the Korle Bu Teaching Hospital.Methods: A descriptive cross-sectional study was carried out at the Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Results: Out of a total of 141 MRI’s evaluated 60.3% were males and 39.7% female. The majority of the respondents 85.1% had paraparesis/paraplegia,13.5% had quadriparesis/quadriplegia, 1.4% had weakness in one upper limb and both lower limbs. The commonest MRI features of NTSCI recorded was due to degenerative disease of the spine 75.9%, spinal metastases 5.7%, Pott's/pyogenic spondylitis 3.5%, demyelinating disease 2.8% and primary spinal tumours 2.8%.Conclusion: The commonest MRI findings in the study population were due to degenerative disease of the spine, followed by spinal metastases and infective spondylitis. Funding: Not declaredKeywords: paraparesis, paraplegia, tetraparesis, tetraplegia, Magnetic Resonance Imagin

Magnetic Resonance Imaging (MRI) Utilization in a Ghanaian Teaching Hospital: Trend and Policy Implications

Background: The use of Magnetic Resonance Imaging (MRI) is new in Ghana compared with some Western countries.A number of studies have observed increased MRI utilization due to increased sensitivity to diagnosis, and the paradigm shift to modalities that do not use radiation. Challenges with MRI use include high cost of the examination and inappropriate requests by referring clinicians. Objective: To determine the MRI utilisation trend in Korle Bu Teaching Hospital (KBTH), Ghana and its policy implications. Materials and Methods: A retrospective study undertaken in the Radiology Department, KBTH, from February to March, 2017. Eight hundred and forty request forms for MRI studies between January, 2013 and December 2016 were reviewed. Information on patient’s age and sex, number of MRI studies done, body parts and clinical conditions evaluated, appropriateness of clinical requests and existing policies on MRI in Ghana was gathered. Measures of central tendency and spread were obtained. Chi square, Pearson’s correlation and linear regression analysis were also used in the analysis. Results: The top three body parts requested were Spine (55 %), Brain (19%) and Joints (6 %); degenerative disease was the most common clinical condition evaluated.Significant association and correlation were obtained between of the number of body parts evaluated and examination year as well as the variety of clinical conditions requested and examination year. Conclusion: A progressive increase was noted in MRI utilisation both in number and diversity but no policy guiding MRI use in Ghana exists

Bleomycin-induced pneumonitis in a young Ghanaian male with Hodgkin’s Lymphoma

We report a case of a young Ghanaian male who developed Bleomycin Induced Pneumonitis (BIP) after being treated for Hodgkin’s Lymphoma. Pulmonary toxicity is the most feared complication of bleomycin therapy despite its effectiveness in achieving cure in patients with Hodgkin’s lymphoma and germ cell tumors. BIP has a significant mortality rate if detected late and a high index of suspicion is required in all patients on bleomycin-based therapies with sudden onset of respiratory symptoms

A rare mimic of adult‐onset asthma: Case report and review of the literature

Abstract Adult‐onset asthma is extremely variable in its phenotypic presentation and has gained notoriety for the overall poorer treatment outcomes even on standard asthma therapy. Tracheal tumours are rare but when present, exhibit asthma‐like phenomenon in adult patients posing great diagnostic challenges. We report two adult patients with tracheal adenoid cystic tumours who were initially treated for adult‐onset asthma. Patient 1, a 45‐year‐old man was diagnosed and managed for adult‐onset asthma over a 12 months period without satisfactory control of his symptoms. Following a late episode of hemoptysis, a chest Computed Tomography (CT) scan done revealed an occluding tracheal tumour. Patient 2 is a 28‐year‐old female who was diagnosed with adult‐onset asthma for over 2 years with poor symptom control despite optimal asthma therapy. She developed cough‐induced subcutaneous emphysema for which a chest CT scan revealed a tracheal mass. The patient had surgery with incomplete resection of tumour and adjuvant radiotherapy

Importance of <i>Aspergillus</i>-Specific Antibody Screening for Diagnosis of Chronic Pulmonary Aspergillosis after Tuberculosis Treatment: A Prospective Follow-Up Study in Ghana

Chronic pulmonary aspergillosis (CPA) often occurs in patients that have been previously treated for pulmonary tuberculosis (PTB). A limited number of studies have looked at the development of CPA at different times following the completion of a PTB treatment course. This prospective longitudinal study aimed to determine the incidence of CPA at two timepoints, at the end of the PTB treatment (T1) and six months post-treatment (T2). Patients with confirmed PTB from a previous study who were placed on anti-TB medication were followed up and screened for CPA at T1 and T2 by assessing their symptoms, evaluating their quality of life, and screening them for Aspergillus infection by performing antibody testing and cultures. CPA was defined by the Global Action for Fungal Infections (GAFFI) diagnostic algorithm. Forty-one patients were enrolled, of whom thirty-three patients (80%) and twenty-eight patients (68%) were resurveyed at T1 and T2, respectively. The rate of new CPA was 3.3% (1/33) and 7.4% (2/27) at T1 and T2, respectively, with an overall incidence of 10.7% (3/28) among the patients at both T1 and T2. A positive Aspergillus-specific antibody test was an indicator for CPA in all three patients. Aspergillus-specific antibody screening during and after the end of an anti-TB treatment regimen may be important for early detection of CPA in high-PTB-burden settings

Chronic Pulmonary Aspergillosis is Common among Patients with Presumed Tuberculosis Relapse in Ghana

Chronic pulmonary aspergillosis (CPA) may mimic pulmonary tuberculosis (PTB). The two diseases are clinically indistinguishable and may result in CPA misdiagnosed as PTB or vice versa. Although PTB is largely recognised as a differential diagnosis of CPA and often ruled out prior to CPA diagnosis, the reverse is uncommon. The aim of this study was to determine the proportion of CPA cases among patients being assessed for PTB. A cross-sectional survey was conducted among consecutive patients referred for GeneXpert Mycobacterium tuberculosis test for the diagnosis of PTB at the Korle-Bu Teaching Hospital, Accra, Ghana. Patients’ demographics, clinical and socioeconomic details were obtained using a structured questionnaire. Blood was collected for Aspergillus and HIV serology, and sputum samples obtained for Aspergillus culture. Chest radiograph was obtained, and computed tomography scan was also done for patients with positive Aspergillus serology or cavitation. CPA was defined using an algorithm developed by the Global Action for Fungal Infections (GAFFI) international expert panel. A total of 154 patients were included in the analysis, of whom 134 (87%) did not have a prior PTB diagnosis. There were 41 (26.6%) GeneXpert positive cases. CPA prevalence was 9.7% overall, but 50% in patients with a prior history of PTB and 3.7% in those without previous PTB. Although CPA is rarely considered as a differential diagnosis of PTB in Ghana, our findings show that CPA may affect half of patients being assessed for PTB relapse. Efforts to diagnose CPA should be prioritised in this patient group