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

Comparing radiological presentations of first and second strains of COVID-19 infections in a low-resource country

INTRODUCTION: The novel corona virus popularly referred to as COVID-19 disease and SARS-CoV-2 was first detected in Wuhan, China in December 2019. It was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. In Ghana, the first two cases of COVID-19 infection were recorded on March 13, 2020 with a strain imported from Europe. In December 2020, a new strain from South Africa was detected in Ghana which was associated with higher transmission rates, severity of the disease, and higher number of recorded deaths. Our study aimed to record notable differences and similarities between infections due to the initial, and second strains of COVID-19 infections detected in Ghana during the last 12-months. METHOD: This was a retrospective study involving 50 patients infected with the first strain, and another 50 patients infected with the second strain of the SARS-CoV-2 virus. Microsoft Excel-2013 was the analytical tool. RESULTS: The data analysis supported publications suggesting that the new strain of the virus caused more severe infections, which were manifested on high resolution CT (HRCT) scans as more widespread alveolar disease, most commonly presenting as large areas of consolidation. CONCLUSION: Despite numerous similarities in terms of the manifestation of COVID-19 infection on HRCT scans, notable difference supporting the notion of increased virulence and severity of disease were also recorded. The study findings demonstrate the need for heightened and sustained preventive measures needed to reduce, and eventually curb COVID-19 infection and mortality rates associated with the introduction of new virulent strains

Informed Consent under the Ghana Health Service Patients Charter: Practice and Awareness

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A Predictive Maintenance Cost Model for CNC SMEs in the Era of Industry 4.0

Within the subject area of maintenance and maintenance management, authors identified a deficiency in studies focussing on the expected value from adopting predictive maintenance (PdM) techniques for machine tools (MTs). Authors identified no studies focussing on presenting a PdM value analysis or cost model specifically for small-medium enterprises (SMEs) operating computer numerically controlled (CNC) MTs. This paper’s novelty is addressing SMEs’ minimal representation in literature by explanatorily collecting data from SMEs within the focal area via surveys, modelling and analysing datasets, then proposes a cost-effective PdM system architecture for SME CNC machine shops that predicts cost savings ranging from £22,804 to £48,585 over a range of 1–50 CNC MTs maintained on a distributed numerically controlled (DNC) network. It affirms PdM’s tangible value creation for SME CNC machine shops with predicted positive impacts on their MT cost and performance drivers. These exploratory research findings corroborate SMEs pooling together to optimise their CNC MT maintenance cost through the recommended system architecture. Finally, it introduces opportunities for further PdM research taking into account SMEs’ perspective. The paper’s industrial application is confirmed from the surveyed SMEs that demonstrated their current utility of PdM; then anonymous positive feedback on the online dashboard, shared with participant companies, confirmed the research results supported SMEs in considering exploring the path to adapting PdM. It is anticipated that beneficiaries of this research will be maintenance managers, business executives and researchers who seek to understand the expected financial and performance impact of adopting PdM for a MT’s overall life cycle costs

Identification of the pore-forming and binding domains of the Sneathia vaginalis cytopathogenic toxin A.

The association between Sneathia vaginalis and preterm birth is emerging. The Gram-negative anaerobe produces a large exotoxin, the cytopathogenic toxin A (CptA), that forms pores in human epithelial cells and red blood cells. The structure of the toxin has not been determined, but in silico analysis predicts that a large amino-terminal region of the protein is globular and separated from the carboxy-terminal tandem repeats by a disordered region. We found that a recombinant protein consisting of the predicted structured amino-terminal portion of CptA and devoid of the repeat region was sufficient to permeabilize epithelial cells and red blood cells. The repeat region was capable of binding to epithelial cells but did not permeabilize them or lyse red blood cells. CptA is the only S. vaginalis virulence factor that has been examined mechanistically to date, and this analysis sets the foundation for an understanding of how this novel pore-forming toxin exerts its activity