Aesthetic outcome and the need for revision of unilateral cleft lip repair at Komfo Anokye Teaching Hospital

Background: The Millard method of unilateral cleft lip repair has been  associated with a short lip and a flattened nose on the cleft side. The aim of this study was to determine the need for revision surgery followingrepair of unilateral cleft lip repair at the Komfo Anokye Teaching HospitalMethod: Satisfaction with facial appearance (upper lip, nose and general facial appearance) was assessed quantitatively by means of a Visual Analogue Scale (VAS), where 0cm indicates totally unsatisfied or “highly unattractive” and 10cm indicates totally satisfied or “highly attractive”. Three assessors - parents, surgeon and layperson - were purposively selected to score their level of satisfaction with repair of complete and incomplete unilateral cleft lip. The assessors also indicated the need for any revision.Results: The total sample size was 120, of which 40.0% were male and 60.0% were female. There were 79 cases of repaired complete unilateral cleft lip and 41 incomplete unilateral cleft lip. Average scores of satisfactionof parents were 6.6, 6.8 and 7.2 for nose, lip and general facial  appearance (GFA) respectively. Satisfaction scores for surgeon were  6.1(nose), 6.0(lip) and 6.5(GFA), while those of the lay-assessor were5.2(nose), 5.4 (lip) and 6.0(GFA). Concerning the need for revision, parents indicated 30.2% as needing revision, surgeon 33%; and  lay-assessor 40%. Of the cases that needed revision, 33.3% were complete cleft lip and 0.1% were incomplete cleft lip.Conclusion: Parents were more satisfied with unilateral cleft lip repair using the Millard procedure than either the surgeon or lay assessor. Those who needed revision were mostly children who presented with complete unilateral cleft lip

Lipid and Lipoprotein Levels in Type 2 Diabetes Patients Attending the Central Regional Hospital in the Cape Coast Metropolis of Ghana

Purpose: To ascertain the prevalence of dyslipidaemia in diabetics in Cape Coast.Methods: This preliminary outpatient-based cross-sectional study was conducted in 79 diabetic patients (22 males and 57 females) receiving treatment at the Central Regional Hospital (CRH) in the Cape Coast Metropolis. Serum lipid profiles of the fasting diabetic patients were determined between September, 2008 and May, 2009. In addition, demographic information, height and weight were measured and BMI was computed.Results: BMI was significantly (P = 0.001) higher in females than in males, but the mean values of all the remaining measured parameters were comparable (P>0.05) between the sexes. No significant (P>0.05) correlation was observed between age or BMI and cholesterol levels. Percentage dyslipidaemia ranged from 7.60% to 55.70% in the studysample. A significantly (P<0.05) higher proportion of females than males in the entire sample were overweight/obese, had higher levels of total cholesterol (TCHOL) and TRG. No significant difference (P>0.05) was observed between proportions of individuals in both sexes who exhibited higher LDL-c but lower levels of HDL-c..Conclusion: Lipid profile should be a routine test for all diabetics receiving treatment at the CRH to identify those at increased cardiovascular risk for immediate attention.Keywords: Dyslipidaemia, Cardiovascular, Cholesterol, Body mass inde

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

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Novel <i>GREM1 </i>Variations in Sub-Saharan African Patients With Cleft Lip and/or Cleft Palate

Objective: Cleft lip and/or cleft palate (CL/P) are congenital anomalies of the face and have multifactorial etiology, with both environmental and genetic risk factors playing crucial roles. Though at least 40 loci have attained genomewide significant association with nonsyndromic CL/P, these loci largely reside in noncoding regions of the human genome, and subsequent resequencing studies of neighboring candidate genes have revealed only a limited number of etiologic coding variants. The present study was conducted to identify etiologic coding variants in GREM1, a locus that has been shown to be largely associated with cleft of both lip and soft palate. Patients and Method: We resequenced DNA from 397 sub-Saharan Africans with CL/P and 192 controls using Sanger sequencing. Following analyses of the sequence data, we observed 2 novel coding variants in GREM1. These variants were not found in the 192 African controls and have never been previously reported in any public genetic variant database that includes more than 5000 combined African and African American controls or from the CL/P literature. Results: The novel variants include p.Pro164Ser in an individual with soft palate cleft only and p.Gly61Asp in an individual with bilateral cleft lip and palate. The proband with the p.Gly61Asp GREM1 variant is a van der Woude (VWS) case who also has an etiologic variant in IRF6 gene. Conclusion: Our study demonstrated that there is low number of etiologic coding variants in GREM1, confirming earlier suggestions that variants in regulatory elements may largely account for the association between this locus and CL/P. </jats:sec

Congenital infiltrating lipomatosis of the face with hyperplastic mandibular, maxillary and pterygoid bones: case report and a review of literature

George Asafu Adjaye Frimpong,1,2 Evans Aboagye,2,3 Mansa Amamoo,4 Solomon Obiri-Yeboah,5 Jonathan Tettey Olesu6 1Department of Radiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 2Spectra Health Imaging and Interventional Radiology, Kumasi, Ghana; 3Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 4Department of Radiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana; 5Department of Oral and Maxillofacial Sciences, Kwame Nkrumah University of Science and Technology Dental School, Kumasi, Ghana; 6Department of Oral and Maxillofacial Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana Abstract: Congenital infiltrating lipomatosis of the face (CILF) is a rare lipomatous lesion, commonly seen in childhood, and it is characterized by collections of mature, unencapsulated adipose tissues that infiltrate facial soft and hard tissues. The lesion is seen as an overgrowth of bone and soft tissue and is generally present clinically as slow-growing painless masses. In this case report, we described one case of CILF, which is one of the first cases reported in Ghana and Africa as a whole, along with a literature review on the diagnosis and current treatment strategies. Keywords: congenital infiltrating lipomatosis of face, facial asymmetry analysis, hemifacial hyperplasia, macrodontis

Prevalence and associations of depression, anxiety, and stress among people living with HIV: A hospital-based analytical cross-sectional study

Background and Aims An important but much less researched burden of human immunodeficiency virus (HIV) in Sub-Saharan Africa includes the associated mental health outcomes of living with the virus. This study aimed to estimate the prevalence of depression, anxiety, and stress, and describe some of the socio-demographic associations among people living with HIV (PLHIV) in Ghana. Methods A cross-sectional study was conducted at the Cape Coast Teaching Hospital, Ghana. Simple random sampling was used to recruit 395 PLHIV who access HIV-related services at the antiretroviral therapy clinic. The Depression, Anxiety, and Stress Scale-21 was used to assess prevalence of depression, anxiety, and stress. Frequencies and percentages were used to estimate the prevalence and multivariable logistic regression was used to evaluate sociodemographic factors associated with depression, anxiety, and stress. Results The prevalence estimates of depression, anxiety, and stress among PLHIV were 28.6% (95% confidence interval [CI] 24.4–33.3), 40.8% (95% CI = 36.0–45.8), and 10.6% (95% CI = 7.9–14.1), respectively. Females reported higher prevalence of depression (32.2%; 95% CI = 27.2–37.7), anxiety (44.0%; 95% CI = 38.4–49.6), and stress (12.6%; 95% CI = 9.4–17.0) compared to depression (17.5%; 95% CI = 11.1–26.4), anxiety (30.9%; 95% CI = 22.5–40.7), and stress (4.1%; 95% CI = 1.2–10.4) among males. PLHIV without a regular partner were about 0.63 increased odds of experiencing anxiety compared to those with a regular partner (AOR = 0.63, 95% CI = 0.40–1.00: p = 0.049). PLHIV without formal education were about 0.49 and 0.44 increased odds to experience anxiety and stress, respectively compared to those with tertiary education. Conclusions Generally, the levels of stress, anxiety, and depression are high among PLHIV, but disproportionately higher among females. Mental health assessment and management should be integrated into the HIV care services. There should be capacity building for health care workers to offer differentiated service delivery based on mental health care needs of PLHIV