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Acute Gastric Necrosis in a Teenager
(Hindawi, 2020) Yorke, Joseph; Gyamfi, Frank Enoch; Awoonor-Williams, Ronald; Osei-Akoto, Ebenezer; Acheampong, Emmanuel; Acheampong, Emmanuella Nsenbah; Adinku, Michael Ofoe; Yamoah, Francis Akwaw; 0000-0002-5229-0340
Gastric infarction is a rare condition often associated with high mortality due to a delay in diagnosis. The stomach which has a rich supply of blood is a rare site for such a condition. Gastric infarction has a long list of etiological factors. We report a case of a patient who was managed successfully following gastric infarction from gastric dilatation. An 18-year-old female student presented with a three-day history of abdominal pain associated with abdominal distension of two days. The abdomen was distended with generalized tenderness, rebound tenderness, and guarding. Bowel sounds were absent. Digital rectal examination was unremarkable, and a pregnancy test was negative. Biochemical tests were all normal. Intraoperatively, two litres of serosanguinous fluid was suctioned from the abdomen. About 300 mL of pus was suctioned from the pelvis. The gangrenous portion was resected, and repair was done in two layers using Conell and Lambert suture techniques. Acute gastric necrosis is a rare surgical condition that requires a high index of suspicion and prompts aggressive resuscitation and surgical intervention to obviate the high mortality rate associated with the condition.
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The Prevalence and Risk Factors of Hepatitis B Virus Infection Among Dwellers in A Peri-Urban District of Ghana: A Cross Sectional Study
(UDS PUBLISHING LIMITED, 2018) Opare-Asamoah, Kwame; Majeed, Saeed F; Osei Owusu, Alexander; Keelson, Kofi Okyere; Owusu, Emmanuel Abem; Wondoh, Paul M.; Kunfah, Sheba M. P.; Fosu, Samuel E.; Yorke, Joseph; Yakong, Vida Nyagre; 0000-0002-5229-0340
Hepatitis B virus (HBV) infection is a significant health issue affecting about 296 million people worldwide. The disease is of great public health concern in Ghana as the country is within the endemic region of HBV infection. This study sought to determine the prevalence of HBV infection and associated risk factors among dwellers in a peri-urban district of Ghana. This cross-sectional descriptive study was conducted in the Sunyani West District of the Bono Region of Ghana. Respondents aged ≥18 years were purposively recruited from the four major towns in the District with health centres. A questionnaire was used to collect data from participants, and a rapid diagnostic test for the sero-presence or otherwise of hepatitis B infection was conducted. A total of 992 respondents took part in the study, with the prevalence of HBV infection using HBsAg as a marker among all the study participants being 2.9% (male 4.0% (12/298), female 2.5% (17/694)). Females aged between 20-29 years had a comparatively higher prevalence of hepatitis B infection than their corresponding males. The intake of alcohol (RR=4.23; 95% CI:2.05-8.74, p <0.000), previously diagnosed of having a sexually transmitted disease (RR= 2.43; 95% CI: 1.03-5.71, p = .04) and having multiple sexual partners (RR= 2.27; 95% CI: 1.11-4.65, p = .02) were the significant risk factors for HBV infection among the study participants. The study showed a low prevalence of HBV infection in the Sunyani West District of Ghana using HBsAg as a serum marker to diagnose the infection.
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Association of genetic variants with prostate cancer in Africa: a concise review
(Springer Open, 2021) Acheampong, Emmanuel; Asamoah Adu, Evans; Obirikorang, Christian; Amoah, George; Afriyie, Osei Owusu; Yorke, Joseph; Odame Anto, Enoch; Adu Gyamfi, Michael; 0000-0002-5229-0340
Background: Prostate cancer (PCa) has one of the highest heritability of all major cancers, where the genetic contribution has been documented, and knowledge about the molecular genetics of the disease is increasing. However, the extent and aspects to which genetic variants explain PCa heritability in Africa are limited. Main body: In this review, we summarize studies that highlight how identified genetic variants explain differences in PCa incidence and presentation across ethnic groups. We also present the knowledge gaps in PCa genetics in Africa and why Africa represents an untapped potential ground for genetic studies on PCa. A significant number of genome-wide association studies, linkage, and fine-mapping analyses have been conducted globally, and that explains 30–33% of PCa heritability. The African ancestry has a significant mention in PCa incidence and presentation. To date, the candidate gene approach has replicated 23 polymorphisms including dinucleotide and trinucleotide repeats in 16 genes. CYP17-rs743572, CYP3A4-rs2740574, CYP3A5-rs776746, CYP3A43-rs501275, and haplotype blocks, containing these variants, are significantly associated with PCa among some population groups but not others. With the few existing studies, the extent of genetic diversity in Africa suggests that genetic associations of PCa to African ancestry go beyond nucleotide sequence polymorphisms, to a level of environmental adaptation, which may interpret genetic risk profiles. Also, the shreds of evidence suggest that evolutionary history contributes to the high rates of PCa relative to African ancestry, and genetic associations do not always replicate across populations. Conclusion: The genetic architecture of PCa in Africa provides important contributions to the global understanding of PCa specifically the African-ancestry hypothesis. There is a need for more prostate cancer consortiums to justify the heritable certainties of PCa among Africans, and emphasis should be placed on the genetic epidemiological model of PCa in Africa.
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Urethroplasty among Elderly Men, Surgical Techniques and Outcomes
(Scientific Research Publishing, 2024) Arhin Appiah, Kwaku Addai; Amoah, , George; Opoku Manu Maison, Patrick; Azorliade, Roland; Otu-Boateng, Kwaku; Arthur, Douglas; Annor Mintah, Dominic; Yorke, Joseph; 0000-0002-5229-0340
Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy post operatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bul bar urethral strictures. The repair methods employed were anastomotic ureth roplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethrop lasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Com plications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.
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Momordica charantia L. for hyperlipidaemia: A randomised controlled assessment of the Ghanaian herbal medicinal product MCP-1
(Elsevier, 2021) Kwesi Prah, Thomford; Ama Kyeraa, Thomford; Yorke, Joseph; Yeboah, Ronald; Appiah, Alfred Ampomah; 0000-0002-5229-0340
Cardiovascular diseases are a public health burden for developing countries like Ghana. Scientifically validated herbal medicines are viable options in the prevention and treatment of such conditions. In this study, a rand omised controlled trial involving 15 healthy subjects identified with hyperlipidaemia was undertaken. Treatment comprised a traditional Ghanaian herbal formulation prepared from the leaves and twines of Momordica char antia (MCP-1) with a standard dietary guideline. A control group was managed using a standard dietary guideline alone. In all, 15 subjects completed the study: MCP-1 had 10 subjects and 5 subjects in the control group. At the termination of the trial after 8 weeks, reduction in lipoprotein values were recorded for all participants. In the MCP-1 group, triglycerides reduced by 3.46 % compared to 3.37 % for the control while total cholesterol was also reduced by 9.78 % and 9.43 % in the MCP-1 and control groups respectively. High density lipoproteins (HDL) levels increased by 6.92 % for MCP-1 and 3.92 % for the control group. However, these changes were not statistically significant except in the instance of the low-density lipoproteins (LDL-c; CI: -41.24 to -19.76) and very low-density lipoproteins (VLDL-c; CI: -26.87 to -8.192). Changes to other disease indices such as blood pressure (BP), fasting blood sugar (FBS) and body mass index (BMI) were also not different between the 2 groups. MCP-1 was well tolerated among the subjects and was shown to be safe from the biochemical and haematological indicators. The product, MCP-1 has therefore been shown to be a safe and prospective anti-lipidaemic agent.
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Investigation of serum level relationship of pro-inflammatory and anti-inflammatory cytokines with vitamin D among healthy Ghanaian population
(BMC Publisher, 2024) Antwi, Maxwell Hubert; Sakyi, Samuel Asamoah; Appiah, Seth Christopher Yaw; Buckman, Tonnies Abeku; 0000-0002-5229-0340
Background The interplay between vitamin D status and inflammatory cytokines in a supposedly sufficient sunshine environment has not well been evaluated. The study sought to determine their association. Methods This cross-sectional study involved 500 healthy adult blood donors from some selected hospitals in Ghana enrolled from June to November 2016. Venous blood samples were obtained from participants, 25(OH)D, TNF-alpha, IFN-gamma, and IL 10 were measured using enzyme linked immunosorbent assay (ELISA) technique. Serum levels of 25(OH)D<20ng/ml were classified as being deficient or low. Results The average age of the participants was 27.97 years. No statistically significant association was established between 25(OH) D status, mean age (p=0.1693), and gender (p=0.5461) of study participants. Similarly, the median 25(OH) D (p=0.8392), IL-10 (p=0.5355), TNF-alpha (p=0.9740), and IFN-gamma (p=0.6908) were not significantly different across gender. There was a significantly increased levels of TNF-alpha (p<0.0001) and IFN-gamma (p<0.0001) among participants with 25(OH) D deficiency compared to those without deficiency. Concurrently, participants with 25(OH)D deficiency had a significantly reduced levels of IL-10 (p<0.0001) compared to those without 25 (OH) D deficiency. The most accurate biochemical markers for identifying 25 (OH) D deficiency were IFN gamma (AUC=0.879; p<0.0001) followed by TNF-gamma (AUC=0.849; p<0.0001) and IL-10 (AUC=0.707; p<0.0001). Conclusion There was a significant association between vitamin D levels and pro-inflammatory cytokines (TNF alpha, IFN-gamma) and anti-inflammatory cytokine (IL 10) among healthy Ghanaian populace.
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Giant primary scrotal lipoma in a low-resource setting: challenges with diagnosis and review of literature
(JSCR, 2021) Seidu, Anwar Sadat; Yorke, Joseph; Danso, Patrick; Sukenibe, Seidu Suhewie; 0000-0002-5229-0340
Lipoma is the commonest benign mesenchymal tumor composed of matured adipocytes. A literature search revealed few reported cases of giant scrotal lipoma. This article aims to report a giant scrotal lipoma weighing 1100 g and illustrate our challenges with the diagnostic process in a low-resource setting. A 28-year-old male presented with a huge right scrotal mass. Examination revealed the mass had no cough impulse. It was firm, non-tender and lobulated, with definite edges. Scrotal sonography was suspicious of lipoma. Intraoperatively, there was an encapsulated scrotal wall mass and an incidental inguinoscrotal hernia, content being the omentum. The scrotal mass was excised, hernia sac was ligated, and excised and the posterior wall was repaired. Histology confirmed the scrotal mass as a lipoma. Primary scrotal lipomas are rare but should be considered in the differential diagnosis of unusual scrotal masses. Ultrasonography is a useful diagnostic tool in resource limited setting