Prevalence of neural tube defect and hydrocephalus in Northern Ghana

Neural tube defects (NTDs) are congenital anomalies of the central nervous system (CNS) which affects approximately one in every thousand pregnancies. The estimates, however, varies from country to country with countries implementing national programmes on folic acid fortification recording lower estimates. Neural tube defects are a common cause of morbidity and mortality especially in low-middle income countries such as Ghana. The study was conducted to determine the prevalence of neural tube defect and hydrocephalus in the only tertiary hospital in northern Ghana. This was a 4-year retrospective study from January 2010 to December 2014. Data regarding the age, sex, clinical diagnosis, and treatment outcomes were all retrieved from the registry of medical records using a simple data form designed for this study. During the study period, there were 35,426 deliveries at the facility with 57 cases of neural tube defects, thus giving a prevalence of 1.6 per 1000 births. They were more males than females with a male: female ratio of 2.4:1. All cases were diagnosed at birth. All the cases reported in this study were open neural tube defect (NTD). The most common defect was hydrocephalus occurring in 33 patients representing 57.9%, with spinal bifida occurring in 21 patients representing 38.6%. Encephalocele or cranium bifida occurred in only 5.3% (3 patients). Among the spinal bifida cases, myelomeningocele occurred in 13 patients (59.1%), with meningocele occurring in 8 patients (40.9%). Case fatality was about 15% of diagnosed cases. The prevalence of NTDs in this study is relatively high compared to earlier studies but, is consistent with other findings in the subregion. Prenatal screening and diagnosis are highly recommended since most women undergo routine ultrasonography as part of antenatal service.Journal of Medical and Biomedical Sciences (2017) 6(1), 18-23Keywords: neural tube defect, prevalence, spinal bifida, Northern Ghana

Incidence of Traumatic Brain Injury in a Ghanaian Tertiary Hospital

Traumatic brain injury (TBI) is considered as one of the most silent epidemics and its incidence is rising worldwide due to injuries associated with the increased use of motor vehicles and bad road network, particularly in middle-income and low-income countries including Ghana. The aim of this study was to assess the incidence of TBI, cause of injury as well as outcomes of patient’s care in the Tamale Teaching Hospital in Ghana. This retrospective study was carried out at the Tamale Teaching Hospital, the only Tertiary referral hospital in the whole of the savanna ecological zone of Ghana over 43 months from January 2009 to July 2012. All patients admitted into the hospital and diagnosed as having TBI were included in the study. The medical records of a total of 671 patients who were diagnosed with TBI were reviewed. Information regarding the age, sex, occupation and initial external cause of injury was retrieved. Data regarding length of hospital stay and treatment outcome were also retrieved. External cause of injury was classified according to International Classification of Diseases (ICD) guidelines as Road Traffic Accidents (RTA) (irrespective of type), fall from height, assault, gunshot, game or sport related accident and other causes. Road traffic accident accounts for relatively high incidence of hospitalized TBI. Majority of the patients were male within the 21-30 year age group. The high number of Intensive Care Unit (ICU) fatalities may indicate that more resources and facilities (intensive care nurses and equipment to monitor intracranial pressure) are needed to help in the management of cases particularly head injuries. Journal of Medical and Biomedical Sciences (2016) 5(2), 5-12

Prevalence of male sexual dysfunction among Ghanaian populace: myth or reality?

This study was designed to investigate the prevalence and type of sexual dysfunction (SD) in healthy sexually active Ghanaian men of fertile age. Sexual functioning was determined in 300 healthy Ghanaian men with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire leaving in Kumasi metropolis, between December 2009 and April 2010. All men had a steady heterosexual relationship for at least 2 years before enrollment in the study. Of the 300 men selected, 255 (85%) completed the survey; the overall prevalence of SD in these subjects was 66%. The most prevalent areas of difficulty were infrequency (70.2%), premature ejaculation (64.7%), dissatisfaction with sexual acts (61.2%), impotency (59.6%), nonsensuality (59.2%), noncommunication (56.9%) and avoidance (49.0%). There were positive correlation between SD, impotence, dissatisfaction and age. The prevalence rate of SD in Ghanaian men is high and related to age.

Prevalence of Theileria equi and Babesia caballi infections in horses belonging to resource-poor farmers in the north-eastern Free State Province, South Africa

The prevalence of Theileria equi and Babesia caballi infections in the north-eastern Free State Province of South Africa was determined by examination of thin and thick Giemsa-stained blood smears, IFAT and PCR. No parasites were detected by microscopy from any blood samples collected at five study sites, Qwaqwa, Kestell, Harrismith, Vrede and Warden. Of the tested serum samples, 28/29 (96.5%), 20/21 (95.2%) and 42/42 (100%) were positive by IFAT for T. equi infections in Harrismith, Kestell and Qwaqwa, respectively, and 5/29 (17.2%), 13/21 (61.9%) and 30/42 (71.4%) were sero-positive for B. caballi infections in Harrismith, Kestell and Qwaqwa, respectively. All DNA samples from the study sites were negative for B. caballi infections by PCR, but five samples, two from each of Kestell and Warden and one from Vrede, were PCR positive for T. equi infections. The high prevalence of antibodies against T. equi and B. caballi in the sampled horses indicates that the animals had been exposed to T. equi and B. caballi infections but the absence of parasitaemia and very low number of positive PCR samples, however, imply that T. equi and B. caballi are endemically stable in the north-eastern Free State Province.

Comparison of polymerase chain reaction methods for the detection of Theileria equi infection using whole blood compared with pre-extracted DNA samples as PCR templates

Rapid, efficient, and reproducible procedures for isolating DNA before PCR gene amplification are essential for the diagnosis of piroplasms. In this study, we evaluated the ease and reliability of detecting Theileria equi by PCR using pre-extracted DNA samples (by QIAamp DNA Mini Kit and phenol-chloroform methods) compared with blood spotted on FTA cards as PCR templates. Although minimal variations in limit of detection were observed among the methods compared, overall, the use of pre-extracted DNA samples and blood spotted on FTA cards had comparable detection limits. These results indicate that T. equi infection can be efficiently detected directly from FTA cards by PCR without the need for pre-extraction of DNA from blood samples.

Safety of gadolinium-DTPA: extended clinical experience

This review reports data on the general and renal tolerance of the paramagnetic contrast agent Gd-DTPA after intravenous administration. Gd-DTPA was administered usually at a dose level of 0.1-0.2 mmol/kg body wt (range: 0.005-0.25 mmol/kg body wt) in cranial, spinal and body MR indications. In phase I-IIIa studies a total of 2154 healthy volunteers and patients were investigated, usually at a dose of 0.1 mmol/kg body wt. From the obtained results it was concluded that adverse events (AEs) may be expected in the order of magnitude of 1%. In phase IIIb-IV studies 13,439 patients were investigated at 0.1 or 0.2 mmol/kg body wt. Tolerance data were collected according to a standardized protocol and metaanalysis of obtained data was performed. AEs, irrespective of their drug relationship, were observed in 1.15% of the patients. The observed AEs were comparable to those after intravenous administration of iodinated nonionic X-ray contrast media. There was no correlation between patient age and the incidence of AEs. In patients with a known history of allergy the incidence of AEs increased to 2.6%. In pediatric use no added risk was observed in a total of 826 neonates, children, and adolescents up to 18 years of age. Gd-DTPA showed good renal tolerance in patients with and without preexisting impairment of renal function. A prospective open safety and pharmacokinetic study was conducted in patients with hemodialysis. Gd-DTPA was shown to be eliminated completely by hemodialysis. Fast bolus injections were tolerated without added risk. Presented data from postmarketing surveillance (up to March 31, 1991) cover an estimated total of more than 2,000,000 applications.(ABSTRACT TRUNCATED AT 250 WORDS)

Tolerance data of Gd-DTPA: a review

Gd-DTPA is the first paramagnetic contrast agent approved for clinical use in cranial and spinal MRI in the F.R.G., U.S.A., Japan and several other countries. After submission 13,439 patients were enrolled in standardized protocolled clinical trials. The observed adverse drug reactions (ADRs) after i.v. injection of Gd-DTPA were comparable to those after administration of iodinated non-ionic roentgen contrast media (CM). However, the overall incidence of ADRs after intravenous injection of 0.1 or 0.2 mmol/kg body weight Gd-DTPA was found to be even lower. Adverse events were observed in only 1.46% of the patients - or 1.14% if localized warmth is excluded. None of them was critical. There was no correlation between patient age and the incidence of ADRs. In patients with a known history of allergy the incidence of ADRs was increased by a factor 3-4, which is still lower than the incidence reported after intravenous administration of iodinated non-ionic roentgen CM to patients without known allergy. Good renal tolerance was seen in all patients, irrespective of pre-existing renal impairment. Fast bolus injections of Gd-DTPA were tolerated without added risk. The favorable safety profile is also reflected in the post marketing surveillance reports since Gd-DTPA became available as a commercial drug.

[Histological findings in the skin of animals after percutaneous damage by hydrofluoric and hexafluorosilicic acid ]

Morphological changes in the skin of animals were studied after application of concentrated hydrofluoric and hexafluorosilicic acid. The intact skin was not generally affected by these acids. Areas injured before application of the acid showed, however, a continuous spreading of necrosis in the deeper regions. The first histological changes were noticed 1 h after the application. Such early histological findings could be seen long before any macroscopic reaction. The main characteristic findings were the hypocellular necrosis and edema reaching as far as the subcutis. The necrosis showed sharp leukocyte demarcations.