Subcutaneous basidiobolomycosis: A Case Report

Basidiobolomycosis is an uncommon chronic deep fungal infection in which gradually enlarging granulomas form, usually in the subcutaneous fat tissues of the limbs, chest or trunk of immunocompetent hosts, primarily children and young adults. It is caused by the fungus Basidiobolus ranarum. Definitive diagnosis is by microscopy and histopathology.Effective treatments include ketoconazole, itraconazole, potassium iodide and co-trimoxazole.A 3 year old girl presented with ulcerations on the right thigh for one month, and painful swelling of the right leg and right buttock for six months. The right lower limb and vulva were swollen, tender and hard with hyperpigmentation and inguinal lymphadenopathy.She had severe anaemia, eosinophilia and negative serology for HIV I and II. Histopathological examination showed a dermal chronic granulomatous infiltrate with fungal hyphae and yeast forms suggestive of Basidiobolus ranarum.There was marked reduction in right leg size and inguinal lymphadenopathy after several weeks of oral itraconazole, and complete healing of ulcers after 10 weeks.The purpose of this report is to increase awareness of this disfiguring condition which is treatable but, if not correctly diagnosed, could result in inappropriate interventions such as amputation and anti-coagulant therapy.Funding: None declaredKeywords: Deep fungal infection, basidiobolomycosis, itraconazole, chronic ulcer, leg swellin

The Effect of Leadership Styles on Learners’ Performance. The Case of Asonomaso Nkwanta in the Kwabre District Assembly of Ashanti Region in Ghana

The purpose of this study was to explore the effect of leadership styles on academic performance in Junior High Schools (JHS) in Asonomaso Nkwanta in the Kwabre District Assembly of Ashanti Region in Ghana. The design for the study was a mixed study using both the qualitative and quantitative analyzes. It was a correlation survey designed to establish the relationship between leadership styles and academic performance in schools in Asonomaso Nkwanta in the Kwabre District Assembly. Data collected on the leadership styles of the school leaders were the independent variables and the academic performance as dependent variables. The data were analyzed using Statistical Package for Social Science (SPSS) version 22 and Epi-Info, a data capturing and analysis software. The study noted that unless the headmasters are well equipped with knowledge and skills in leadership they would not know if they have any influence on their schools and on academic work. The study also established that even though respondents agreed that a leadership style can affect academic performance, the headmasters do not gain the confidence of the stakeholders enough in order to build terms that can enhance quality of teaching and learning. Based on these establishments, it was recommended that teacher training institutions should incorporate in their curriculum, training in the art and science of leadership in order to groom leaders’ right from school. Again, it is recommended that compulsory continuous professional development in leadership should be institutionalized in Ghana Education Service (GES) for headmasters. Keywords: Leadership, Learners’ performance, Education, schoo

Effect of Thermotherapy in the Elimination of Viruses on Four (4) Mosaic Diseased Cassava Cultivars

In Ghana, cassava is the most favoured among all the root crops and indeed all food crops by consumers. Its per capita consumption (PCC) index is as high as 148kg/year followed by that of plantain (83kg/year: Annor-Frempong, 1991). Cassava mosaic disease (CMD) is considered the most important biotic constraint as it greatly reduces yields (Calvert and Thresh, 2002) significantly. Application of meristem culture combined with thermotherapy is reported to increase the survival rate of in vitro explants (Manganaris et al., 2003). It is against this background that this study was undertaken to ascertain the effectiveness of thermotherapy to generate large numbers of virus-free plants. The study assessed the effect of thermotherapy in the regeneration rate and eradication of cassava mosaic virus disease in four (4) local cassava cultivars. The cuttings of the four cassava accessions showed varying degrees of foliar symptom severity typical of the cassava mosaic disease. Shoots that were subjected to pre-culture thermotherapy at 35-37°C appeared to be disease-free of the cassava mosaic symptoms after three to four weeks of treatment. Thermotherapy treated meristem showed better survival rate in larger explant size than smaller ones in the cassava accessions studied indicating that virus-free planting materials could be produced using thermotherapy. Keywords: Thermotherapy, cassava mosaic, meristem tip, tissue culture

Maternal demographic and placental risk factors in term low birth weight in Ghana

Background: Several studies report on factors that associate preterm birth and intrauterine growth restriction with low birth weight (LBW). However, few studies discuss risk factors that associate with LBW for full-term births. No such studies exist that involve a population from Ghana. Method: We used a nested case-control study approach to examine maternal socio-demographic and placental factors that contribute significantly to term LBW in Ghana. We assessed also the incidence of LBW in general at a major teaching hospital facility in Ghana. Results: Univariate and multivariate logistic regression analysis were used to investigate maternal sociodemographic and placental factors that associate with LBW. Following the preliminary univariate analysis, a stepwise logistic regression analysis showed that unstable income source, single motherhood, combined effect of pre-eclampsia and anaemia; ORs of 5.366 (95% CI: 1.986 to 14.497), 21.390 (95% CI: 3.610 to 126.734) and 3.246 (95% CI: 1.074 to 9.814), respectively, and placental weight and irregular insertion of the umbilical cord (variables scaled by a factor of 10-2 to aid interpretation) ORs 0.28 (95% CI: 0.115 to 0.683), 0.010 (95% CI: 0.001 to 0.173 respectively) on the chorionic plate, were risk factors for LBW. The socio-demographic and placental factors reveal a core role of maternal and infant nutritional deficiencies in term LBW in Ghana. The general prevalence of LBW in the Hospital facility was 6.2%. Conclusion: We conclude that poor maternal and infant nutrient supply is key factors in term LBW in Ghana. These factors are amenable to appropriate nutritional and educational interventions. a, Tettey Yaob, Gyasi Richard, Obed Samuel, Farnell Damian Joseph John, Quaye Isaac Kweku

Detection of Human Papillomavirus Genotypes and Epstein-Barr Virus in Nasopharyngeal Carcinomas at the Korle-Bu Teaching Hospital, Ghana

Nasopharyngeal carcinomas (NPC) are endemic in Far East Asia and commonly harbour Epstein-Barr virus (EBV) which is known to serve as a key oncogenic promoter. Human papillomavirus (HPV) is known to contribute to the pathogenesis of NPC. However, in Ghana these two viruses have not been linked to NPC prevalence. This study was designed to determine the HPV genotypes and EBV involved in NPC tissue biopsies. A retrospective study design involving 72 formalin-fixed paraffin-embedded tissue (FFPET) samples of NPC from 2006 to 2012 were retrieved from the Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences. Sections were taken for histological analysis and for DNA lysate preparation. The DNA lysates were subjected to polymerase chain reaction (PCR) analysis to determine the presence of HPV genotypes and EBV. HPV specific primers were used to type for fourteen HPV genotypes (HPV-16, 18, 6/11, 31, 33, 35, 44, 42, 43, 45, 56, 52, 58, and 59). Out of the 72 NPC biopsies analyzed by PCR, EBV DNA was present in 18 (25%) cases and HPV DNA in 14 (19.23%). High risk HPV (HR-HPV) genotypes 18 and 31 were associated with the NPC. There were 3 (4.2%) cases of coinfection by both viruses. The EBV DNA present in the undifferentiated variant of the NPC and the histopathology of the NPC in Ghana is similar to the type described in endemic areas

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

Clinically Relevant Insulin Degludec and its Interaction with Polysaccharides: A Biophysical Examination.

Protein polysaccharide complexes have been widely studied for multiple industrial applications and are popular due to their biocompatibility. Insulin degludec, an analogue of human insulin, exists as di-hexamer in pharmaceutical formulations and has the potential to form long multi-hexamers in physiological environment, which dissociate into monomers to bind with receptors on the cell membrane. This study involved complexation of two negatively charged bio-polymers xanthan and alginate with clinically-relevant insulin degludec (PIC). The polymeric complexations and interactions were investigated using biophysical methods. Intrinsic viscosity [η] and particle size distribution (PSD) of PIC increased significantly with an increase in temperature, contrary to the individual components indicating possible interactions. [η] trend was X > XA > PIC > A > IDeg. PSD trend was X>A>IDeg>XA>PIC. Zeta (ζ)- potential (with general trend of IDeg < A < XA < X ≈ PIC) revealed stable interaction at lower temperature which gradually changed with an increase in temperature. Likewise, sedimentation velocity indicated stable complexation at lower temperature. With an increase in time and temperature, changes in the number of peaks and area under curve were observed for PIC. Conclusively, stable complexation occurred among the three polymers at 4 °C and 18 °C and the complex dissociated at 37 °C. Therefore, the complex has the potential to be used as a drug delivery vehicle

Non-malaria fevers in a high malaria endemic area of Ghana.

BACKGROUND: The importance of fevers not due to malaria [non-malaria fevers, NMFs] in children in sub-Saharan Africa is increasingly being recognised. We have investigated the influence of exposure-related factors and placental malaria on the risk of non-malaria fevers among children in Kintampo, an area of Ghana with high malaria transmission. METHODS: Between 2008 and 2011, a cohort of 1855 newborns was enrolled and followed for at least 12 months. Episodes of illness were detected by passive case detection. The primary analysis covered the period from birth up to 12 months of age, with an exploratory analysis of a sub-group of children followed for up to 24 months. RESULTS: The incidence of all episodes of NMF in the first year of life (first and subsequent) was 1.60 per child-year (95 % CI 1.54, 1.66). The incidence of NMF was higher among infants with low birth weight [adjusted hazard ratio (aHR) 1.22 (95 % CI 1.04-1.42) p = 0.012], infants from households of poor socio-economic status [aHR 1.22 (95 % CI 1.02-1.46) p = 0.027] and infants living furthest from a health facility [aHR 1.20 (95 % CI 1.01-1.43) p = 0.037]. The incidence of all episodes of NMF was similar among infants born to mothers with or without placental malaria [aHR 0.97 (0.87, 1.08; p = 0.584)]. CONCLUSION: The incidence of NMF in infancy is high in the study area. The incidence of NMF is associated with low birth weight and poor socioeconomic status but not with placental malaria

HER-2 Protein Overexpression in Patients with Gastric and Oesophageal Adenocarcinoma at a Tertiary Care Facility in Ghana

The prognosis of gastric and oesophageal adenocarcinoma remains generally poor. However, mounting evidence suggests a positive role of human epidermal growth factor receptor-2 (HER-2) expression in the prognosis of patients with these cancers. In this work, the patterns of HER-2 protein expression were determined in patients with gastric or oesophageal adenocarcinoma. Retrospectively, we reviewed records of gastric and oesophageal biopsies received from 2008 to 2012 and their corresponding archived formalin-fixed paraffin-embedded tissue blocks selected for immunohistochemical analysis. The prevalence of gastric and oesophageal adenocarcinomas and their association with HER-2 protein overexpression were evaluated. Gastric adenocarcinoma made up 18.79% of the gastric biopsies reviewed, and majority of these cancers occurred in males. Regarding the tumour type, HER-2 overexpression was common in the intestinal subtype compared to the diffuse type. Although squamous cell carcinoma was observed to be the commonest (31%) tumour type in the oesophagus compared to adenocarcinoma (8.79%), HER-2 was overexpressed in 42.9% of oesophageal adenocarcinomas, like gastric adenocarcinoma (41.4%). There is a high prevalence of gastric and oesophageal adenocarcinoma, with significant overexpression of HER-2 in these tumours, a window of hope for the management of patients with these cancers

Psychological impact of COVID-19 on diabetes mellitus patients in Cape Coast, Ghana: a cross-sectional study

Introduction:&nbsp;COVID-19 pandemic has had a greater psychological impact on patients with chronic ailments such as diabetes mellitus, tuberculosis, and HIV/AIDS compared to those without chronic conditions. We explored the psychological impacts of COVID-19 among people living with diabetes mellitus in Ghana. Methods:&nbsp;this study employed a hospital-based cross-sectional design involving 157 diabetes mellitus patients aged 20 years and above. We assessed diabetes distress by the seventeen-item diabetes stress (DDS17) scale and COVID-19 worries by 3 specific benchmarks: “worry about overly affected due to diabetes if infected with COVID-19”, “worry about people with diabetes characterized as a risk group” and “worry about not able to manage diabetes if infected with COVID-19”. A close-ended questionnaire was used in data collection. Results:&nbsp;of 157 diabetic patients interviewed, the majority had type 2 diabetes mellitus with known complications and only 42.7% were managing COVID-19 symptoms. The participants showed moderate to high level of COVID-19 specific worry, moderate fear of isolation, and low level of diabetes-associated distress. About 33.8% of the study population expressed a sense of worry towards the pandemic. The logistic regression showed that age, employment status, and presence of other chronic diseases were significantly associated with worries about being overly affected if infected with COVID-19 due to their diabetes status. Age and sex were associated with worries about people with diabetes being characterized as a risk group and age, sex and employment status were associated with participants who were worried about not being able to manage diabetes if infected with COVID-19. Conclusion:&nbsp;the general trend indicates a sense of worry among diabetes patients during the COVID-19 pandemic which is associated with poorer psychological health. Clients' education and counseling on COVID-19 are necessary to address some of their concerns to minimize the level of anxiety and emotional stress in these individuals