Factors associated with gastro-duodenal disease in patients undergoing upper GI endoscopy at the Korle-Bu Teaching Hospital, Accra, Ghana.

Background: There is a high prevalence of gastro-duodenal disease in sub-Saharan Africa. Peptic ulcer disease in dyspeptic patients, 24.5%, was comparable to prevalence of gastro-duodenal disease among symptomatic individuals in developed countries (12 \u2013 25%). Limited data exists regarding its associated risk factors despite accumulating evidence indicating that gastroduodenal disease is common in Ghana. Objectives: This study investigates risk factors associated with gastro-duodenal disease at the Korle-Bu Teaching Hospital, Accra, Ghana. Methods: This study utilized a cross-sectional design to consecutively recruit patients referred with upper gastro-intestinal symptoms for endoscopy. The study questionnaire was administered to study participants. Helicobacter pylori infection was confirmed by rapid-urease examination at endoscopy. Results: Of 242 patients sampled; 64 had duodenal ulcer, 66 gastric ulcer, 27gastric cancer and 64 non-ulcer dyspepsia. Nineteen (19) had duodenal and gastric ulcer while 2 had gastric ulcer and cancer. A third (32.6%) of patients had history of NSAIDuse. H. pylori was associated with gastric ulcer (p=0.033) and duodenal ulcer (p=0.001). There was an increased prevalence of duodenal ulcer in H. pylori-infected patients taking NSAIDs, P=0.003. Conclusion: H. pylori was a major risk factor for peptic ulcer disease. However, NSAID-related gastro-duodenal injury has been shown to be common in H. pylori infected patients. It highlights the need for awareness of the adverse gastro-intestinal effects in a H. pylori endemic area

HUMAN IMMUNODEFICIENCY VIRUS, HEPATITIS B VIRUS AND SYPHILIS INFECTIONS AMONG LONGDISTANCE TRUCK DRIVERS IN, A PORT CITY IN GHANA

Background: Although the high prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis infections among longdistance truck drivers has been well documented globally, such data are sparse from Africa, and there has been no such data from Ghana. This study carried out between the months of January and June 2013 sought to determine the sero-prevalence and risk factors of HIV, HBV and syphilis infections among long distance truck drivers at the Tema sea port, Ghana. Materials and Methods: Of a total of 800 eligible drivers, 106 (13.25%) drivers consented to take part in the study. Subjects voluntarily completed a risk factor questionnaire and provided blood specimen for testing for HIV, syphilis and the surface antigen of HBV (HBsAg). Results: The mean age of the drivers was 40.56 ± 11.56 years. The sero-prevalence of HIV was 0.94%, 14.2% had HBsAg and reactive syphilis serology was 3.8%. On multivariate analysis, the main determinants of HBV infection were; multiple sexual partnership (OR, 6.36; 95% CI: 1.35– 29.79), patronage of commercial sex workers (OR, 6.85; 95% CI: 0.88 – 52.89), cross-border travelers (OR: 6.89-fold, 95% CI: 0.86 - 55.55) and prolonged duration of trips for more than two weeks (OR: 4.76; 95% CI: 0.59 – 38.02). The main determinant of syphilis infection on multivariate analysis was being a Muslim (OR, 2.19; 95% CI: 0.22 – 21.74). Conclusion: The data indicate a lower sero-prevalence of HIV but a higher sero-prevalence of syphilis. However, the sero-prevalence of HBV infection is comparable to that of the general population

Strategies for grass establishment to control erosion on Roma flood levee batters

Gyasi-Agyei, Y ORCiD: 0000-0002-2671-1180; Koech, RK ORCiD: 0000-0002-0563-6687An earthen levee was constructed to protect areas of Roma township, Australia, against periodic floods. This paper presents strategies used to establish grasses to control erosion on the levee bat-ters. As a result of water scarcity in the semi-arid environment, precision irrigation involving the use of drip laterals was an integral part of the strategies implemented. However, the water source was alkaline, saline and sodic. The water pH of nearly 9 was adjusted by mixing 85% phosphoric acid with the irrigation water, the right amount added determined by titration tests carried out in a laboratory. The sodicity of the water was improved by mixing liquid gypsum with the water. Buffel and Rhodes grasses were seeded as they are popular for permanent pasture. The treatments imposed on the batters have worked very well with over 80% grass cover at all sections on the levee batters achieved during the first 6 months

Ovarian Cancer in Ghana, a 10 Year Histopathological Review of Cases at Korle Bu Teaching Hospital

To determine the histopathological types, age distribution, presenting signs and symptoms of ovarian cancers diagnosed at the Korle-Bu Teaching Hospital, Ghana. All histopathology slides and request cards of ovarian cancers diagnosed over a ten-year period (2001 to 2010) were reviewed and the cancers classified according to the World Health Organization 1999 classification. Biographical and clinical data of the patients were collected and results entered into Epi-info to determine the frequency, age distribution and clinical presentation of the various types of ovarian cancer. There were 192(27.2%) ovarian cancers out of 706 ovarian tumours. Epithelial cancers were the most common: 100 (52.1%), followed by sex cord stromal cancers 66 (34.4%). Majority of epithelial cancers were serous adenocarcinomas (71/100) while most sex cord stromal cancers were adult granulosa cell tumours 46 (69.7%). The mean age of patients with adenocarcinoma was 49 years while that of the 46 adult granulosa cell tumours was 46.5years. Patients present with varying combinations of symptoms and signs and ovarian cancers present at an earlier age compared to other populations, with the age of presentation being slightly lower for sex cord stromal cancers compared to adenocarcinomas. There are no specific symptoms or signs associated with ovarian cancer at presentation, to assist with diagnosis.Keywords: Ovary, Cancer, Histopathology, Demographics, Clinical features, Ghan

Nephrectomy in adults: Experience at the Korle Bu Teaching Hospital, Accra, Ghana

The objective of this study was to analyze nephrectomies performed in adults over a 12-year period at the Korle Bu Teaching Hospital, Accra and to compare our findings with reports from other institutions. In this retrospective study, medical records of 97 consecutive adult patients who underwent nephrectomy from January 2000 to December 2011 were reviewed. The parameters extracted included the patients′ age, gender, indication for nephrectomy and the side of nephrectomy. Also considered were the histology of the nephrectomy specimen and the peri-operative mortality. The data were analyzed using the Statistical Package for Social Sciences for Windows (Version 19.0). Of the 97 nephrectomies performed, 62 were performed for suspected malignant renal tumors and 35 were performed for clinically benign renal conditions. Malignancy was confirmed in 85.5% (53/62) of the suspected cases. The mean age of this group was 52.2 ± 15.5 years and the male to female ratio was 1:0.9. Thirty-two tumors (60.4%) were in the right kidney and 21 (39.6%) tumors were in the left kidney; the mean tumor size was 16.8 ± 4.0 cm. The predominant presenting complaints included flank pain (67.9%), flank mass (50.9%) and hematuria (24.5%). In one case (1.9%), the renal mass was found incidentally. Among patients who had benign disease, non-functioning kidney due to renal cystic disease was the most common lesion (11/44; 25.0%). A peri-operative mortality rate of 3.1% was recorded. Our study suggests that malignant renal tumors constitute the main indication for nephrectomy in our institution. Non-functioning kidney due to renal cystic disease was the most common benign renal indication for nephrectomy

Serum 25‐hydroxyvitamin D and hyaluronic acid levels as markers of fibrosis in patients with chronic liver disease at the main tertiary referral hospital in Ghana: A case‐control study design

Abstract Background and Aims Liver fibrosis leading to chronic liver disease (CLD) is a major cause of morbidity, mortality and health‐care expenditure worldwide. The “gold standard” for diagnosis and staging of liver fibrosis is histological analysis of liver tissue obtained by liver biopsy, an invasive procedure. Therefore, there is the need to identify noninvasive and inexpensive markers for diagnosis and staging of liver fibrosis. This study aimed at evaluating the correlation of hyaluronic acid (HA) and 25‐hydroxyvitamin D (25‐OH vitamin D) serum levels as markers of fibrosis with histologically staged and graded liver biopsies obtained from CLD patients. Methods This was a case‐control study involving 40 CLD patients requiring liver biopsies and 40 controls. Liver biopsies were staged to determine the degree of fibrosis. Serum levels of 25‐OH vitamin D and HA were determined using ELISA. Statistical analyses were performed to determine differences in HA and 25‐OH vitamin D levels between controls and patients as well as to correlate the biomarkers with the stages of fibrosis. Results CLD patients showed significant (p < 0.001) increase in the levels of AST, ALT, GGT, compared to the controls. Patients also had significantly (p < 0.001) lower serum 25‐OH vitamin D and higher HA (p < 0.001) levels compared to the controls. Additionally, 25‐OH vitamin D levels of the CLD patients were significantly different across the stages of liver fibrosis likewise serum HA levels. Furthermore, 25‐OH vitamin D levels inversely correlated with the severity of liver fibrosis. A significant negative correlation (r = −0.33, p < 0.05) between CLD patients' HA and 25‐OH vitamin D were found. Conclusion CLD patients had significantly reduced serum 25‐OH vitamin D and higher HA. Both markers correlated with the degree of liver fibrosis. These findings have major clinical translatable implication in the use of vitamin D supplementation in the management of CLD in Ghana

Helicobacter pylori cagA and vacA genes in dyspeptic Ghanaian patients

BACKGROUND: Helicobacter pylori infection is prevalent in Ghana. The development of gastro-duodenal disease is dependent on virulence of the infecting strain, host susceptibility and environmental factors. Helicobacter pylori cagA and vacA strains induce more inflammation, ulceration and oncogenesis. Here, for the first time we present data on H. pylori cagA and vacA genes and their association with gastro-duodenal disease in Ghana. A total of 159 patients with dyspepsia at Korle-Bu Teaching Hospital, Accra, were investigated for H. pylori with urease-CLO, of which 113 (71.1%) were positive. Genomic DNA was extracted from antral biopsies using QIAGEN DNeasy kit. Detection of H. pylori vacA and cagA genes were determined by PCR as previously described. RESULTS: In total, 110 (69.2%) vacAs1, 71 (44.7%) vacAm1, 35 (22.0%) vacAm2, 77 (48.4%) cagA-(hydrophilic region) and 109 (68.6%) cagA-(internal duplication region) were detected. In multivariate analysis, duodenal ulcer was more likely than other diagnoses to have detectable cagA-(hydrophilic region) (OR 3.1 CI 1.2-7.9) or vacAs1m1 (OR 6.5 CI 1.2-34.0). CONCLUSIONS: Majority of biopsies were colonized with H. pylori harboring both cagA and vacA. H. pylori cagA-(internal duplication region) was more prevalent than cagA-(hydrophilic region). Duodenal ulcer was more likely than other diagnoses to have detectable cagA-(hydrophilic region) or vacAs1m1