Childhood deaths from malignant Neoplasms in accra

Background: Malignant neoplasms are set to become a leading cause of childhood death in sub- Saharan Africa as immunization programmes reduce deaths due to infectious diseases. Knowledge of the pattern of deaths from these neoplasms is therefore desirable. Objective: To describe the pattern of deaths from paediatric malignancies, compare this to morbidity figures and provide baseline data for planningchild care services. Methods: A 10 year retrospective survey of autopsy cases of paediatric malignancies at the Korle-Bu Teaching Hospital Mortuary was carried out based on autopsy files form January 1, 1990 to December 31, 1999 Results: A total of 252 cases of childhood malignant tumours were retrieved, 139 males and 113females with a male to female ratio of 1.2:1. The most common malignancy was lymphoma forming 54% of cases and almost all of Non-Hodgkin’s type. Non-Burkitts type (29%) was the commonestfollowed by Burkitts (24%) and Hodgkin’s disease only one percent. The lymphomas were followed by central nervous system (CNS) tumours (13%), nephroblastomas(10.3%) leukemias (6.7%) hepatictumours (4%) and sarcomas (2.6%). Less common tumours were Neuroblastomas (2.4%) and retinoblastomas (2%). Conclusion: Overall the pattern of deaths from paediatric malignancies followed the pattern of relative incidence in morbidity figures from Ghana and the subregion except for a relatively higher proportion of deaths from CNS tumours and a lower proportion from sarcomas. The pattern ofcancer deaths seen in this study is similar to that seen in advanced countries except that lymphomas replace leukemia as the commonest cause of deat

Cervical human papillomavirus infection in accra, Ghana

Background: This study was aimed at estimating the human papillomavirus (HPV) prevalence and its determinants among a sample of Ghanaian women.Design: Cross-sectional observational study.Setting: Gynaecology outpatient clinic of the Korle-Bu Teaching Hospital, Accra, Ghana; the largest tertiary care gynaecology outpatient clinic in Ghana.Participants: Convenient sample of 75 consentingwomen visiting the clinic.Methods: Information was obtained through personal interviews using structured questionnaire, Pap smears obtained, and laboratory testing of cervical exfoliated cells was performed. HPV DNA was detected using aGP5+/6+ polymerase chain reaction assay. These data were analyzed using both univariate and bivariate techniques.Results: The mean age of participants was 33.3 years (standard deviation, 9.2) and the percentage of lifetime monogamy was 21.3%. The crude HPV DNA prevalence was 10.7%. Unlike most populations studied sofar, HPV prevalence was high not only among young women, but also in middle and old age. Independent HPV determinants were being illiterate (prevalence odds ratio [POR], 13.9; 95% confidence interval[95%CI], 1.9-100) and reporting more than three lifetime sexual partners (POR, 4.6; 95% CI, 1.0-22.2).Conclusions: The study indicates a high crude prevalence of HPV in a largely polygamous Ghanaian population with a high crude prevalence in older age groups, which may be a distinctive feature of polygamouspopulations where HPV transmission continues into middle age and cervical cancer incidence is very high

energy and carbon balance of materials used in a building envelope renovation

Construction and demolition waste (CDW) are a priority waste stream in EU's polices, accounting for about 30% of all waste generated. At the same time, according to the EU energy-efficiency directi ..

Surgically correctable adrenal-dependent hypertension: a report of five cases

Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patientsinclude young individuals, those with difficult- to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratoryparameters well-known to be associated with Cushing’s syndrome, Conn’s syndrome or phaeochromocytoma. This paper reports on 5 patients identified over a 2-year period with various hormonally-activeadrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients’ histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigationsand management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenalrelated hypertension is good and can result in significantcost savings in the long term

Correlation of sonographically-determined residual urine volume with lower urinary tract symptoms in adult males at a tertiary hospital

Objective: To determine the correlation between the severity of LUTS as measured by the International Prostate Symptom Score (IPSS) and PVR urine volume measured by transabdominal ultrasound in patients with LUTS, and to determine the correlation between ‘feeling of incomplete bladder emptying and sonographically measured PVR urine volume. Design: Correlational cross-sectional study Setting: Ultrasound Unit of the Radiology Department and Urology Clinic of Korle Bu Teaching Hospital Participants: Male patients (n=256) aged 40 years or more and who presented to the urology department of Korle Bu Teaching Hospital with LUTS and gave their written consent were enrolled. The presence and severity of LUTS were evaluated using the IPSS. The PVR urine was measured using real-time transabdominal ultrasound scan. Main outcome measure: Severity of LUTS and Residual urine volume Results: The mean PVR urine volume was 84.5ml. Majority of respondents (57.3%, n=146) had PVR urine volume below 50ml with 27% (70 patients) having PVR urine volume above 100ml. PVR urine volume and total IPSS showed no statistically significant correlation. All age groups of respondents scored above 4 for quality of life (QoL). ‘Intermittency’ is the IPSS symptom which showed statistically significant correlation with PVR urine volume. PVR urine volume did not show a statistically significant correlation with the ‘feeling of incomplete emptying’. Conclusions: There was no statistically significant correlation between the total IPSS and PVR urine volume, thus residual urine volume does not correlate with severity of LUTS. The ‘feeling of incomplete emptying’ does not correlate with PVR urine volume

Unexpected elevated alanine aminotransferase, asparte aminotransferase levels and hepatitis E virus infection among persons who work with pigs in accra, ghana

<p>Abstract</p> <p>Background</p> <p>Several studies have suggested that elevated serum alanine aminotransferase (ALT) and asparte aminotransferase (AST) may be markers of hepatitis E virus (HEV) infection. Thus, individuals with elevated ALT and AST may have ongoing subclinical infection of HEV. We estimated the prevalence of anti-HEV antibodies and serum ALT and AST levels among persons who work with pigs in Accra, Ghana.</p> <p>Results</p> <p>Three hundred and fifty- persons who work with pigs provided blood samples for unlinked anonymous testing for the presence of antibodies to HEV, ALT and AST levels. The median age of participants was 32.85 ± 11.38 years (range 15-70 years). HEV seroprevelance was 34.84%. Anti-HEV IgG was detected in 19.26% while anti-HEV IgM was detected in 15.58% of the persons who tested positive. On multivariate analysis, the independent determinants of HEV infection were, being employed on the farm for less than six months [odds ratio (OR) 8.96; 95% confidence interval (95% CI) 5.43-14.80], having piped water in the household and/or on the farm (OR 13.33; 95% CI 5.23-33.93) and consumption of alcohol (OR 4.91: 95% CI 2.65-9.10). Levels >3× the expected maximum were found for both ALT and AST among individuals who tested positive for anti-HEV IgG (ALT, 210.17 ± 11.64 U/L; AST, 127.18 ± 11.12 U/L) and anti-HEV IgM (ALT, 200.97 ± 10.76 U/L; AST, 120.00 ± 15.96 U/L).</p> <p>Conclusion</p> <p>Consistent with similar studies worldwide, the results of our studies revealed a high prevalence of HEV infection, ALT and AST values in pig handlers.</p

Overall and abdominal obesity and prostate cancer risk in a West African population: An analysis of the Ghana Prostate Study

Obesity has been associated with an increased risk of advanced prostate cancer. However, most studies have been conducted among North American and European populations. Prostate cancer mortality appears elevated in West Africa, yet risk factors for prostate cancer in this region are unknown. We thus examined the relationship between obesity and prostate cancer using a case-control study conducted in Accra, Ghana in 2004 to 2012. Cases and controls were drawn from a population-based sample of 1037 men screened for prostate cancer, yielding 73 cases and 964 controls. An additional 493 incident cases were recruited from the Korle-Bu Teaching Hospital. Anthropometric measurements were taken at enrollment. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and prostate cancer, adjusting for potential confounders. The mean BMI was 25.1 kg/m2 for cases and 24.3 kg/m2 for controls. After adjustment, men with BMI ≥ 30 kg/m2 had an increased risk of prostate cancer relative to men with BMI &lt; 25 kg/m2 (OR 1.86, 95% CI 1.11-3.13). Elevated WC (OR 1.76, 95% CI 1.24-2.51) and WHR (OR 1.46, 95% CI 0.99-2.16) were also associated with prostate cancer. Associations were not modified by smoking status and were evident for low- and high-grade disease. These findings indicate that overall and abdominal obesity are positively associated with prostate cancer among men in Ghana, implicating obesity as a potentially modifiable risk factor for prostate cancer in this region