Evaluation of the ultrasound findings of thyroid gland enlargement in Cape Coast Teaching Hospital, Ghana: A retrospective cross-sectional study.

Background and Aim: Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana. Method: The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05. Results: A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study. Conclusion: The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.

Hysterosalpingographic Findings Among Ghanaian Women with Infertility: A Five-year Trend Analysis.

Objectives: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period. Methods: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed. Results: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman's syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%). Conclusions: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.

Situs inversus totalis in a 34-year-old diabetic woman. A case report.

Incidentally diagnosed situs inversus totalis is a rare condition that is compatible with life when not associated with pathologies like primary ciliary dyskinesia. The etiology is not known but may be associated with certain cardiopulmonary conditions. Diagnosis is usually made when patient presents with other medical concerns as in this case report. Patients diagnosed with this condition must be counseled and reassured that they can live a normal life and be ready to divulge their anatomical variation to physicians when necessary. Clinicians must be on a lookout for this condition during their surgical work-up.

Lumbar facet joint arthrosis on magnetic resonance imaging and its association with low back pain in a selected Ghanaian population.

Objectives: Facet joint arthrosis is a common radiologic finding but remains controversial as a source of low back pain. We conducted a study to evaluate some of the potential risk factors contributing to the development of facet joint arthrosis, such as age, gender, and body mass index (BMI). The study aimed at establishing an association between these factors and facet joint arthrosis in the Ghanaian population, as a foundation for further research on low back pain. Materials and Methods: This was a retrospective study done at the Department of Radiology, Korle Bu Teaching Hospital from January 2019 to December 2021. The study population included all cases referred to our department with complaints of low back pain. Patients below 18 years and those with a history of congenital lesions, trauma, infection, and malignancies were excluded. A total of 1017 cases were identified with facet joint arthrosis. The mean difference in age and BMI between males and females was compared using an independent sample t-test. Statistical association was done using Pearson's Chi-square test. P ≤ 0.05 was used as statistical significance. Results: Majority of the study subjects were overweight with a mean BMI of 27.31 ± 5.37 kg/m2. The mean age was 53.61 ± 16.22 years, and majority were within the age of 51-60 years. Age was significantly associated with the prevalence of facet joint arthrosis. Conclusion: The prevalence of facet joint arthrosis is significantly associated with increasing age but not with the BMI. Lumbar facet joint arthrosis is more prevalent in women than in men, which may be due to the sensitivity of cartilage to female sex hormones.

Assessment of the Clinical Presentations and Ultrasonographic Features of Uterine Fibroids in Adult Africans: A Retrospective Study.

Objectives: We sought to determine the clinical presentations and ultrasonographic features of uterine fibroids in adult Ghanaians. Methods: Between 1 January 2018 and 31 December 2021, 4279 ultrasound-confirmed cases of uterine fibroids were retrieved. The data obtained, which included age, clinical presentations, and sonographic features were analyzed. A chi-squared test was done to assess for possible associations between the clinical indications, age distribution, and ultrasonographic features of uterine fibroids. Results: The mean age of the patients diagnosed with uterine fibroids was 37.1±11.5 years (range = 16-69 years). Routine checkup (n = 1310, 28.1%), menorrhagia (n = 1104, 23.7%), and lower abdominal mass (n = 801, 17.2%) were the leading clinical indications. Dysmenorrhea, amenorrhea, menorrhagia, and routine checkup were significantly noted in the younger patients (p ≤ 0.001). The majority of the fibroid nodules had smooth regular outline (n = 4125, 96.4%) and were mostly heterogeneous (n = 3282, 76.7%). The echo pattern of the nodules was predominantly hypoechoic (n = 3358, 51.1%) followed by hyperechoic nodules (n = 2554, 38.9%). Degenerative changes accounted for less than one-third of the total fibroid nodules, with the least recorded degenerative change being nodules with cystic areas (n = 55, 5.4%) and the most observed degenerative feature being nodules with rim of calcification and areas of calcified degeneration (n = 965, 94.6%). Almost all the sonographic features were significantly seen in the 30-44 years age category. Conclusions: Sonographically, uterine fibroids were mostly hypoechoic heterogeneous nodules with a smooth regular outline with a predominant occurrence within women in the fourth to fifth decade of life.

Unilateral congenital proximal radioulnar synostosis in a 4-year-old boy: A case report.

Congenital radioulnar synostosis is a rare musculoskeletal disorder of the elbow, occurring as a result of variable degree and length of the congenital fusion of the proximal radioulnar joint. Patients presents early to the hospital depending on the severity of the synostosis and its effect on elbow function. It may have psychosocial effects on the affected individuals as they grow older especially when the deformity is dramatic. Treatment may be conservative, surgical (which may have a variable degree of success) and psychotherapy.

Age of first diagnosis and incidence rate of uterine fibroids in Ghana. A retrospective cohort study.

BACKGROUND: Uterine fibroids are benign tumors that grow in or on the uterus of women. Globally, they occur in more than 80% of women of African ancestry and 70% in white women. Uterine fibroid requires much attention because of its high incidence rate among women of all races and ages. This study sought to document the age of first diagnosis and incidence rates of uterine fibroids in our urban setting. METHODS: This study reviewed and analyzed the ages and year of diagnosis of all 2,469 patients with the first diagnosis of uterine fibroids from 1st January 2018 to 31st December 2021 in South-Central Ghana. The obtained data were analyzed using GNU PSPP, Python on Jupyter Notebook and Libre Office Calc with statistical significance level set at p≤0.05. RESULTS: The overall average age was 36.29±8.08 years, with age range 17-61 years and the age groups with the highest frequencies were 35-39 years (n = 642, 26.00%), 30-34 years (n = 563, 22.80%) and 40-44 years (n = 381, 15.43%). The mean ages of the patients in 2018, 2019, 2020 and 2021 were 36.70±8.00 years (95%CI = 35.97-37.43), 37.07±7.66 years (95%CI = 36.45-37.70), 35.92±7.87 years (95%CI = 35.30-36.53) and 35.78±8.54 years (95%CI = 35.19-36.38) respectively. The incidence rate (per 100,000) of uterine fibroids in 2018, 2019, 2020 and 2021 were 66.77 (95% CI = 60.63-72.90), 81.86 (95%CI = 75.19-88.58), 85.60 (95%CI = 78.85-92.35) and 92.40 (95%CI = 85.88-98.92) respectively, with 35-39 age group recording the highest in all years. CONCLUSION: The incidence rate of uterine fibroids increased as the years progressed and it is mostly high in 35-39 years age category, with a decreasing annual mean age trend indicative of early diagnosis.

Perspectives of radiologists in Ghana about the emerging role of artificial intelligence in radiology.

Background: The integration of Artificial Intelligence (AI)-based technologies in medicine is advancing rapidly especially in the field of radiology. This however, is at a slow pace in Africa, hence, this study to evaluate the perspectives of Ghanaian radiologists. Methods: Data for this cross-sectional prospective study was collected between September and November 2021 through an online survey and entered into SPSS for analysis. A Mann-Whitney U test assisted in checking for possible gender differences in the mean Likert scale responses on the radiologists' perspectives about AI in radiology. Statistical significance was set at P ≤ 0.05. Results: The study comprised 77 radiologists, with more males (71.4%). 97.4% were aware of the concept of AI, with their initial exposure via conferences (42.9%). The majority of the respondents had average awareness (36.4%) and below average expertise (44.2%) in radiological AI usage. Most of the participants (54.5%) stated, they do not use AI in their practices. The respondents disagreed that AI will ultimately replace radiologists in the near future (average Likert score = 3.49, SD = 1.096) and that AI should be an integral part of the training of radiologists (average Likert score = 1.91, SD = 0.830). Conclusion: Although the radiologists had positive opinions about the capabilities of AI, they exhibited an average awareness of and below average expertise in the usage of AI applications in radiology. They agreed on the potential life changing impact of AI and were of the view that AI will not replace radiologists but serve as a complement. There was inadequate radiological AI infrastructure in Ghana.

Evaluation of the anatomical locations and sizes of uterine fibroids from ultrasound examination in Ghana.

Background: Uterine fibroids locations and sizes, have significant influences on the quality of life of women especially pregnant women and on live birth rate. Objectives: To determine the anatomical locations and sizes of uterine fibroids and assess any possible associations with age groups. Methods: This retrospective study reviewed the locations and sizes of a total of 3,542 patients who were ultrasonographically diagnosed with uterine fibroids from January 2019 to December 2021. The obtained data were analysed using GNU PSPP, and Python on Jupyter Notebook with statistical significance level set at p≤0.05. Results: The overall average diameter of uterine myoma was 5.50±2.60cm (95%CI=5.41-5.58, range=1.00cm-19.10cm) and the respective mean diameter of intramural, subserosal and submucosal fibroids were 5.53±2.60cm (95%CI=5.44-5.62), 5.50±2.27cm (95%CI=5.27-5.74) and 5.82±2.77cm (95%CI=5.49-6.14). Most of the fibroid nodules were small (48.36%, n=1713) and only 5.84% (n=207) were large (>10cm). Posterofundal fibroids and lower anterior myomas were mostly seen in the 35-44 years age class. Conclusion: The majority of the uterine fibroids were intramural and were mostly at the anterior uterine wall. The submucosal fibroids, even though the rarest, were averagely larger than the other types of uterine myomas. The diameter of uterine fibroids increased with age.

Pattern of chest computerized tomography scan findings in symptomatic RT-PCR positive Covid-19 patients at the Korle Bu Teaching Hospital, Ghana.

Background: Chest Computerized Tomography (CT) features of Corona Virus Disease 2019 (COVID-19) pneumonia are nonspecific, variable and sensitive in detecting early lung disease. Hence its usefulness in triaging in resource-limited regions. Objectives: To assess the pattern of chest CT scan findings of symptomatic COVID-19 patients confirmed by a positive RT-PCR in Ghana. Methods: This study retrospectively reviewed chest CT images of 145 symptomatic RT-PCR positive COVID-19 patients examined at the Radiology Department of the Korle Bu Teaching Hospital (KBTH) from 8th April to 30th November 2020. Chi-Squared test was used to determine associations among variables. Statistical significance was specified at p≤0.05. Results: Males represent 73(50.3%). The mean age was 54.15±18.09 years. The age range was 5 months-90 years. Consolidation 88(60.7%), ground glass opacities (GGO) 78(53.8%) and crazy paving 43(29.7%) were the most predominant features. These features were most frequent in the elderly (≥65years). Posterobasal, peripheral and multilobe disease were found bilaterally. The most common comorbidities were hypertension 72(49.7%) and diabetes mellitus 42(29.2%) which had significant association with lobar involvement above 50%. Conclusion: The most predominant Chest CT scan features of COVID-19 pneumonia were GGO, consolidation with air bronchograms, crazy paving, and bilateral multilobe lung disease in peripheral and posterior basal distribution.

Career in radiology; the ghanaian clinical medical Student's perception.

Background: The importance of radiology in this era of evidence-based medicine cannot be disputed. This has resulted in the increase in demand for radiologists. Thus, the issue of whether there would be sufficient numbers of medical students to meet this growing demand needs further probing. Purpose: To assess Ghanaian clinical medical students' perceptions about a career in radiology. Materials and methods: This was an online questionnaire-based survey of 575 clinical medical students in five public medical schools in Ghana from September 2020 to February 2021. Student's t-test and one way analysis of variance was used to compare means. For the Likert scale questions, differences in the mean Likert scale responses were assessed among various clinical year groups and across gender using Kruskal-Wallis test and Mann-Whitney U tests. A logistic regression was used to determine the significant predictors of the choice of radiology as a career. Results: Most 340 (59.1%) of the participants were males. The average age of participants was 24.64 ± 3.084 years. Students agreed that, radiology is relevant in this era of evidence-based medicine (mean Likert score = 4.62, SD = 0.819), which yielded significant responses in the third clinical year (p = 0.004). Nearly 30% of respondents stated they did not receive enough didactic lectures or tutorials in radiology, citing insufficient lectures (89.9%), a lack of lecturers (9.5%), and trouble grasping ideas (0.7%) as their main concerns. 133 (23.1%) stated they would choose radiology as a specialty, with flexible working schedule (61.9%) and high income (68.3%) as their topmost reasons. Less patient contact (8.0%) was the least observed reason. A flexible working schedule increased the choice of radiology as a specialty by 2.319 folds (95% CI: 1.413-3.805, P = 0.001). Teleradiology significantly contributed to the choice of radiology as a career (p = 0.001). Conclusion: Generally, the clinical students had varied but positive perceptions on radiology as a specialty.

Asymptomatic Familial Multiple Cerebral Cavernous Malformation in a 73-Year-Old Woman.

Cerebral cavernous malformations (CCMs) are dilated blood vessels which can develop sporadically or in familial form and are the commonest malformations of blood vessels in the spinal cord and brain. The familial form is an autosomal dominant gene mutation disorder. This condition can be diagnosed with magnetic resonance imaging (MRI) and computed tomography (CT) scan, but the modality of choice is MRI because of its high sensitivity. We report a case of a 73-year-old woman with an asymptomatic multiple familial cerebral cavernous malformation (FCCM) which was previously misdiagnosed as multiple cerebral metastases on CT scan. A brain MRI performed correctly diagnosed her condition as FCCM based on the typical MRI appearances. In order not to misdiagnose brain lesions like CCM on CT scan, for cerebral metastases in resource-poor settings, radiologists must recommend advanced imaging modalities like MRI for further evaluation, thereby avoiding unnecessary invasive surgical biopsies.

Evans index among adult Ghanaians on normal head computerized tomography scan.

INTRODUCTION: Normal-Pressure Hydrocephalus (NPH) is a neurological condition which is made up of a clinical triad of gait disturbance, dementia and urinary incontinence and can be reversed by ventricular shunting. Currently, some guidelines suggest the use of Evans' index (EI) for diagnosis of hydrocephalus radiologically. Most of the studies are based on the Western population data. None of these studies have been performed in the Ghanaian population setting yet. The aim of this study was to quantitatively establish normal borderline value for Evans Index in the Ghanaian adult population with respect to age and sex. METHODS: This study was retrospectively conducted on normal enhanced head CT scan images of 266 males and 241 females. EI was calculated as the linear ratio of Maximum Anterior Horn Width (MAHW) of the frontal horns of the lateral ventricles at the level of foramina of Monroe and the Maximum Intracranial Diameter (MICD) of the inner skull. Student T-test, ANOVA and Pearson's correlation were used to analyze the data. A test for a relationship was performed with a scatter plot and a linear regression was performed based on age, sex and different EI of ventricular size. RESULTS: The mean and median value of EI was 0.24 ± 0.02. There was no statistically significant difference in the EI values between males and females, (p-value = 0.61). A steady increase in EI with age was observed. There was a strong correlation coefficient r = 0.89 of EI and age, which suggested a strong linear relationship between EI and Age. The overall linear relationship model was EI = 0.1879 + 0.0011∗Age. CONCLUSIONS: The mean EI of 0.24 ± 0.02 in our study agrees with adapted international guidelines cut-off value for normal adult patients of (<0.30) and can be a useful tool in determining ventricular enlargement particularly in resource limited settings.

Craniolacunia in A neonate; A clinical and CT scan illustrative case report.

Neural tube defects can be accurately diagnosed prenatally. Every effort must be made to get this and its associations with Craniolacunia right, especially in low-resource settings. This case highlights the importance of three-dimensional CT in diagnosing neonatal skull abnormalities.

Evaluation of the Clinical and Imaging Findings of Breast Examinations in a Tertiary Facility in Ghana.

Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05. 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer (p value = 0.007). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.

Audit of the appropriateness of the indication for obstetric sonography in a tertiary facility in Ghana.

INTRODUCTION: the use of ultrasound is one of the most vital tools in the management of pregnancies and contributes significantly in improving maternal and child health. Certain indications in pregnancy, guide the obstetrician as to which obstetric scan deems appropriate. The full realization of the benefits of ultrasound depends on whether it is being used appropriately or not, and hence this study aimed at auditing for the appropriate indications for obstetric ultrasound. METHODS: a review of all request forms for obstetric scan between June 2019 and July 2020 was performed to assess the appropriateness of requests for obstetric ultrasound at the Cape Coast Teaching Hospital. The data obtained was analyzed using SPSS (SPSS Inc. Chicago, IL version 20.0). A Chi-squared test of independence was used to check for statistically significant differences between variables at p ≤ 0.05. RESULTS: three hundred and fourteen (314) out of the 527 request forms had clinical indications stated. 174 (81.7%) of requests from Cape Coast Teaching Hospital and 39 (18.3%) from other health centers did not indicate patients clinical history/indication on the request forms. Majority 76 (68.5%) of scans in the first trimester were done without indications/history. Only 29 of requests with clinical history were inappropriate. CONCLUSION: practitioners should be mindful of adequately completing request forms for obstetric investigations since a large number of practitioners do not state the history/indications for the scans. There should be continuous medical education on the importance of appropriate indication for obstetric ultrasound.

Incidence rate and age of onset of first stroke from CT scan examinations in Cape Coast metropolis.

INTRODUCTION: The trends in the incidence and age of onset of first stroke is lacking in Ghana and with an increasing elderly population, such trends are projected to increase in developing countries. Through the review of Computed Tomography (CT) scan examinations and patients' records; we assessed the incidence rate and age of onset of first stroke in Cape Coast Metropolis. METHODS: This study retrospectively reviewed all imaging records and clinical data of all stroke patients referred for CT scans in the radiology department of the Cape Coast Teaching Hospital (CCTH) between January 2017 and December 2019. All CT confirmed cases of stroke were classified as either hemorrhagic stroke or ischemic stroke. Age adjusted annual incidence rate with 95% Confidence Intervals (CIs) were calculated assuming a Poisson distribution. Mean difference were tested using one way Analysis of Variance (ANOVA). RESULTS: 840 patients with first onset of stroke were identified, comprising 417 (49.6%) males and 423 (50.4%) females. There was a statistically significant difference in the mean age of onset of first stroke in males (61.47 ± 13.36 years) and in females (63.41 ± 15.41 years), p = 0.049. The incidence of first stroke for the entire age categories were higher in males compared to the same age categories in females, except for patients aged 35-44 years in 2017, 25-34 years in 2018, 15-24 years and 75 years or older age groups in 2019. Males had hemorrhagic stroke at an older age (64.41 ± 15.31 years) compared to ischemic stroke (60.40 ± 12.42 years) in this study. This difference was statistically significant (p = 0.014). There was no significant difference in the mean age of onset of first stroke for the respective years under study: F (3, 836) = 0.693, P = 0.500. CONCLUSION: The findings of this study imply that the incidence rate of stroke is higher in males than in females and increases with age. The majority of the strokes were ischemic.

Computed tomography features of spontaneous acute intracranial hemorrhages in a tertiary hospital in Southern Ghana.

INTRODUCTION: spontaneous acute intracranial hemorrhage (SICH) accounts for approximately 10-15% of all stroke cases. Early detection by computed tomography (CT) and early treatment are key. Hence this study to examine the CT features of SICH. METHODS: this retrospective cohort study reviewed all 435 patients diagnosed with SICH from 1st March, 2017 to 1st January, 2021 in a tertiary facility in Southern Ghana. Data collected (age, sex, SICH type and the CT scan features) were organized and analyzed using GNU PSPP and Libre Office Calc. Statistical significance level was pegged at p≤0.05. RESULTS: the SICH types were acute intracerebral hemorrhage (97.93%), acute subarachnoid/intraventricular hemorrhage (1.15%), acute epidural hemorrhage (0.46%) and acute subdural hemorrhage (0.46%). Acute intracerebral hemorrhage was more common in those >60 years (57.75%, p<0.001). The commonest CT feature for acute intracerebral hemorrhage was hyperdense lesion with perilesional edema (40.98%), with smoking (OR=2.24, 95% CI: 1.14-4.41, p=0.019) and anticoagulants intake (OR=2.56, 95% CI: 1.15-5.72, p=0.022) as the predictive factors; followed by hyperdense lesion extending to the edge of the brain (25.03%), also predictable by smoking (OR=0.23, 95% CI: 0.11-0.47, p<0.001); and hyperdense lesion with mass effects (22.70%) was not predictive with any risk factor. Type 2 diabetes mellitus (60.00%, p<0.001) and smoking (97.83%, p<0.001) were more common in males. CONCLUSION: hyperdense lesion with perilesional edema was the most frequent CT feature for acute intracerebral hemorrhage and was predictable by smoking and anticoagulants intake. Smoking was a predictive factor to the development of most of the features of acute intracerebral hemorrhage.

Perception of Ghanaian Primigravidas Undergoing Their First Antenatal Ultrasonography in Cape Coast.

Ultrasound scans have become an essential requirement of pregnancy care in countries with developed health services and increasingly being used in medical practice in Ghana as well. The aim of this study was to find out the perception of primigravidas experiencing antenatal ultrasonography for the first time in Cape Coast. This was a descriptive, prospective study which employed the use of a questionnaire to obtain data from 384 consented respondents, who were primigravidas experiencing antenatal ultrasonography for the first time in three selected public health facilities in Cape Coast Metropolis over a six-month period. Sociodemographic data, reasons for undergoing antenatal ultrasound, their expectations, knowledge in fetal abnormalities, and suggestions to help improve their future experiences were collected. The data were analyzed using SPSS software, version 20.0 (SPSS Inc., Chicago, IL, USA). Out of a total number of 384 respondents, 87.8% of them knew about what ultrasound is used for. 87.5% scanned because a doctor or midwife requested for the scan whilst 53.9% scanned to check for fetal abnormalities. 98.4% indicated that ultrasound scanning has positive effects on pregnancy outcome. An expensive service was stated as a negative reason that would influence the decision to undergo the examination next time; nonetheless, 90.4% would recommend it to other women and suggested showing the fetus on monitor while scanning and providing accurate findings would make their future experiences better. The perception of the primigravidas was largely positive. Checking for fetal abnormalities was a major reason for the scans, although their knowledge in specific fetal abnormalities was low. They expected to know the fetal sex, but that was not a major reason for scanning. Showing them the monitor was the most frequent suggestion to make future experience better.