Aetiological Agents of Ear Discharge: A Two year Review in a Teaching Hospital in Ghana

Background: The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treatment of ear infections, and also form a basis for further research.Methodology: This was a retrospective review of laboratory records of all ear swabs submitted for culture over a two year period in the Korle Bu Teaching Hospital Accra, Ghana. Data was obtained on demographic characteristics of patients, clinical diagnosis, isolated organisms and antibiotic susceptibility patterns of the isolated organisms. Data was analyzed by simple descriptive statistics.Results: A total of 351 ear swabs were received by the laboratory for processing over the two year period. Of these 277(78.9%) had microorganisms isolated. A significant number127 (47%) was obtained from children under five years. Pseudomonas spp was the commonly isolated organism 121(46%) followed by Staphylococcus aureus 33(12.5%) and Proteus spp 32(12.2%). Candida was the commonest isolated fungi  9 (69.2%). Susceptibility of Pseudomonas spp to commonly used ototopics (ciprofloxacin & gentamicin) was 93% and 74% respectively.Conclusions: Most cases of the discharging ear were found in children under the age of five years. The most common bacteriologic cause of the discharging ear was Pseudomonas spp followed by Staphylococcus aureus. Candida species was the commonest fungal cause of ear discharge. Ciprofloxacin and gentamicin are effective ototopic antimicrobial agents for empirical treatment of the discharging ear.Key words: Ear discharge, antimicrobial agents, susceptibility, ototopics, Korle-Bu teaching hospita

Effects of Harvest Time and Storage Form on Insect Population and Damage of Maize

The aim of this study was to determine the effects of harvest time and storage form on population levels of insect pests and their damage on stored maize. Maize was cultivated on a total land area of 19 x 23m2 during the major season (April to August 2020) and minor season (September to December 2020). Maize was harvested at three stages; early harvest, mid harvest and late harvest. Harvested maize was stored in three ways; husked, de-husked and shelled. Analysis of variance (ANOVA) was applied to the data through Sisvar version 5.6. Insect pests that were sampled during the study were Sitophilus zeamais, Cathartus quadricollis, Carpophilus dimidiatus and Tribolium castaneum. Carpophilus dimidiatus were sampled from treatments during the major season whereas Tribolium castaneum was sampled during the minor season. Sitophilus zeamais and Cathartus quadricollis were sampled in both seasons.  In the major season, late harvest shelled maize (LHS) recorded 689% more S. zeamais numbers as compared to early harvest husked maize (EHH). Mid-harvest husked maize (MHH) had 307% less number of S. zeamais compared to LHS in the minor season. Late-harvest shelled maize (LHS) had the highest percentage insect damaged kernels (86.94%) in the major season

Physicochemical and biological properties of different Cocoa Pod Husk-based composts

The objective was to evaluate the properties of cocoa pod husk-based composts for potential application as soil amendments for crop production. The physicochemical and biological properties of the compost types were analysed. Four compost types were prepared by mixing cocoa pod husk, poultry manure and Panicum maximum in different proportions. A phytotoxicity test was carried out using maize (Zea mays L.) to test whether the compost types contain substances that inhibit seed germination or growth of the radicle. Bulk densities of the compost types were higher than 0.160 Mg m-3, an indication that the compost types as soil amendment will restrict root growth thereby inhibiting plant growth. The average pH of the compost types falls within the optimum range of 6.5 to 8.5 and thus, the composts are stabilized. The compost types had high nitrogen content, so when utilized as a soil amendment would improve the nitrogen content of soils. Copper concentrations in the compost types were far below the WHO/FAO permissible limit of 100 mg kg-1, therefore can be applied at high rates without any problem of copper accumulation in soil. Phytophthora palmivora and Phytophthora megakarya were not detected from the compost types, therefore the compost types could be used without Phytophthora disease infection. Germination percentage and germination index showed that the analyzed compost types achieved high percentages of the germinating capacity of maize seeds and had no phytotoxic substances. The cocoa pod husk-based composts showed substantially varied physicochemical and biological properties suitable to support plant growth. The results clearly showed that, CPHcomp3 made from CPH residues, poultry manure and Panicum maximum at the ratio 6: 1: 2 mixture is recommended for use as a soil amendment for crop production

Callus induction and plant regeneration via leaf segments of three accessions of African rice (Oryza glaberrimaStued.)

A study conducted with the aim of developing a protocol for callus induction and plantlet regeneration in vitro from leaf segments of three accessions of African rice (O. glaberrimaSteud.) indigenous to Ghana. Leaf segments of the accessions namely, Guame, N/4 and SARI 1 were assessed for callus induction and plantlet regeneration ability on different concentrations of plant growth regulators, incorporated into Murashige and Skoog, (1962) (MS) basal medium. Frequency of callus induction which was achieved on MS medium supplemented with (0-10) mg/l 2,4-D differed significantly (p≤0.05) among the accessions, as well as among the levels of 2,4-dichlorophenoxyacetic acid (2,4-D) tested. Highest callus induction frequency was exhibited at a concentration of 6 mg/l 2,4-D for all three accessions.Sub-culturing of callus on regeneration medium, which consisted of MS supplemented with (1:0-5) mg/l NAA:BAP resulted in no plantlet regeneration in all tested accessions. Instead, prolific root formation was observed

A review on a deep learning perspective in brain cancer classification

AWorld Health Organization (WHO) Feb 2018 report has recently shown that mortality rate due to brain or central nervous system (CNS) cancer is the highest in the Asian continent. It is of critical importance that cancer be detected earlier so that many of these lives can be saved. Cancer grading is an important aspect for targeted therapy. As cancer diagnosis is highly invasive, time consuming and expensive, there is an immediate requirement to develop a non-invasive, cost-effective and efficient tools for brain cancer characterization and grade estimation. Brain scans using magnetic resonance imaging (MRI), computed tomography (CT), as well as other imaging modalities, are fast and safer methods for tumor detection. In this paper, we tried to summarize the pathophysiology of brain cancer, imaging modalities of brain cancer and automatic computer assisted methods for brain cancer characterization in a machine and deep learning paradigm. Another objective of this paper is to find the current issues in existing engineering methods and also project a future paradigm. Further, we have highlighted the relationship between brain cancer and other brain disorders like stroke, Alzheimer’s, Parkinson’s, andWilson’s disease, leukoriaosis, and other neurological disorders in the context of machine learning and the deep learning paradigm

Altered immunoglobulins (A and G) in Ghanaian patients with type 2 diabetes.

Elevated immunoglobulin levels have been strongly linked to the development and progression of inflammatory disorders such as type 2 diabetes and obesity. This study aimed to evaluate circulating immunoglobulin levels and to identify other metabolic factors that influence humoral immune response among Ghanaian subjects with type 2 diabetes. A comparative cross-sectional study conducted at the National Diabetes Management and Research Center, Accra. Eighty persons with type 2 diabetes were age-matched with 78 controls. Immunoglobulin A, immunoglobulin G and immunoglobulin M; interleukin 6; fasting blood glucose; glycated hemoglobin; and lipid parameter concentrations were measured. Blood pressure, anthropometry and body composition indices were also assessed. Median immunoglobulin A and immunoglobulin G (g/L) levels were higher in the case group compared with controls (0.89 vs 0.74, p = 0.043; 7.58 vs 7.29, p < 0.001). Immunoglobulin G, immunoglobulin A and interleukin 6 levels in the case cohort, respectively, associated weakly with fasting blood glucose (r = 0.252, p = 0.001; r = 0.170, p = 0.031; r = 0.296, p = 0.001). There were positive correlations within the control group for immunoglobulin A versus interleukin 6 (r = 0.366, p = 0.001) and within the case group for glycated hemoglobin versus interleukin 6 (r = 0.190, p = 0.020). Our data suggest that humoral immune response is altered in subjects with type 2 diabetes and that serum immunoglobulin levels could serve as useful biomarkers in the investigation and management of diabetes mellitus

Genotypic and phenotypic diversity of Mycobacterium tuberculosis complex genotypes prevalent in West Africa

Findings from previous comparative genomics studies of the Mycobacterium tuberculosis complex (MTBC) suggest genomic variation among the genotypes may have phenotypic implications. We investigated the diversity in the phenotypic profiles of the main prevalent MTBC genotypes in West Africa. Thirty-six whole genome sequenced drug susceptible MTBC isolates belonging to lineages 4, 5 and 6 were included in this study. The isolates were phenotypically characterized for urease activity, tween hydrolysis, Thiophen-2-Carboxylic Acid Hydrazide (TCH) susceptibility, nitric oxide production, and growth rate in both liquid (7H9) and solid media (7H11 and Lowenstein-Jensen (L-J)). Lineage 4 isolates showed the highest growth rate in both liquid (p = 0.0003) and on solid (L-J) media supplemented with glycerol (p<0.001) or pyruvate (p = 0.005). L6 isolates optimally utilized pyruvate compared to glycerol (p<0.001), whereas L5 isolates grew similarly on both media (p = 0.05). Lineage 4 isolates showed the lowest average time to positivity (TTP) (p = 0.01; Average TTP: L4 = 15days, L5 = 16.7days, L6 = 29.7days) and the highest logCFU/mL (p = 0.04; average logCFU/mL L4 = 5.9, L5 = 5.0, L6 = 4.4) on 7H11 supplemented with glycerol, but there was no significant difference in growth on 7H11 supplemented with pyruvate (p = 0.23). The highest release of nitrite was recorded for L5 isolates, followed by L4 and L6 isolates. However, the reverse was observed in the urease activity for the lineages. All isolates tested were resistant to TCH except for one L6 isolate. Comparative genomic analyses revealed several mutations that might explain the diverse phenotypic profiles of these isolates. Our findings showed significant phenotypic diversity among the MTBC lineages used for this study

Evaluation of the fluorescent-thin layer chromatography (f-TLC) for the diagnosis of Buruli ulcer disease in Ghana

BACKGROUND: Buruli ulcer is a tissue necrosis infection caused by an environmental mycobacterium called Mycobacterium ulcerans (MU). The disease is most prevalent in rural areas with the highest rates in West and Central African countries. The bacterium produces a toxin called mycolactone which can lead to the destruction of the skin, resulting in incapacitating deformities with an enormous economic and social burden on patients and their caregivers. Even though there is an effective antibiotic treatment for BU, the control and management rely on early case detection and rapid diagnosis to avert morbidities. The diagnosis of Mycobacterium ulcerans relies on smear microscopy, culture histopathology, and PCR. Unfortunately, all the current laboratory diagnostics have various limitations and are not available in endemic communities. Consequently, there is a need for a rapid diagnostic tool for use at the community health centre level to enable diagnosis and confirmation of suspected cases for early treatment. The present study corroborated the diagnostic performance and utility of fluorescent-thin layer chromatography (f-TLC) for the diagnosis of Buruli ulcer. METHODOLOGY/PRINCIPAL FINDINGS: The f-TLC method was evaluated for the diagnosis of Buruli ulcer in larger clinical samples than previously reported in an earlier preliminary study Wadagni et al. (2015). A total of 449 patients suspected of BU were included in the final data analysis out of which 122 (27.2%) were positive by f-TLC and 128 (28.5%) by PCR. Using a composite reference method generated from the two diagnostic methods, 85 (18.9%) patients were found to be truly infected with M. ulcerans, 284 (63.3%) were uninfected, while 80 (17.8%) were misidentified as infected or noninfected by the two methods. The data obtained was used to determine the discriminatory accuracy of the f-TLC against the gold standard IS2404 PCR through the analysis of its sensitivity, specificity, positive (+LR), and negative (–LR) likelihood ratio. The positive (PPV) and negative (NPV) predictive values, area under the receiver operating characteristic curve Azevedo et al. (2014), and diagnostic odds ratio were used to assess the predictive accuracy of the f-TLC method. The sensitivity of f-TLC was 66.4% (85/128), specificity was 88.5% (284/321), while the diagnostic accuracy was 82.2% (369/449). The AUC stood at 0.774 while the PPV, NPV, +LR, and–LR were 69.7% (85/122), 86.9% (284/327), 5.76, and 0.38, respectively. The use of the rule-of-thumb interpretation of diagnostic tests suggests that the method is good for use as a diagnostic tool. CONCLUSIONS/SIGNIFICANCE: Larger clinical samples than previously reported had been used to evaluate the f-TLC method for the diagnosis of Buruli ulcer. A sensitivity of 66.4%, a specificity of 88.5%, and diagnostic accuracy of 82.2% were obtained. The method is good for diagnosis and will help in making early clinical decisions about the patients as well as patient management and facilitating treatment decisions. However, it requires a slight modification to address the challenge of background interference and lack of automatic readout to become an excellent diagnostic tool