Assessment of the integrity of structural shielding of four computed tomography facilities in the greater Accra region of Ghana.

The structural shielding thicknesses of the walls of four computed tomography (CT) facilities in Ghana were re-evaluated to verify the shielding integrity using the new shielding design methods recommended by the National Council on Radiological Protection and Measurements (NCRP). The shielding thickness obtained ranged from 120 to 155 mm using default DLP values proposed by the European Commission and 110 to 168 mm using derived DLP values from the four CT manufacturers. These values are within the accepted standard concrete wall thickness ranging from 102 to 152 mm prescribed by the NCRP. The ultrasonic pulse testing of all walls indicated that these are of good quality and free of voids since pulse velocities estimated were within the range of 3.496±0.005 km s(-1). An average dose equivalent rate estimated for supervised areas is 3.4±0.27 µSv week(-1) and that for the controlled area is 18.0±0.15 µSv week(-1), which are within acceptable values.

Profile of breast diseases at a self-referral clinic in Ghana.

BACKGROUND: Breast cancer is a common malignancy in Ghana, and many patients are referred with advanced disease and long duration of symptoms. OBJECTIVE: To determine the spectrum of breast disease diagnosed through patient self-referral in Ghana. METHODS: A breast clinic, where patients could walk in without referral, was started in the Korle Bu Teaching Hospital in 2001. A team of surgeons, radiation oncologists, oncology nurses, a clinical psychologist and a clinical pharmacist sat in conference once a week to see and discuss self-referred patients. RESULTS: Seven hundred and forty eight patients, mean age 38.6 (range 8-85) years, were seen during a four-year period. There were 741 females and seven males. The main complaints were pain 450 (50.2%), lump 257 (28.7%) and nipple discharge 62 (8.3%). Fifty (5.6%) came for check-up; 139 (18.6%) had more than one complaint. The mean (S.D.) duration of symptoms was; for nipple discharge 14.1 (10.5) months, lump 11.9 (7.7) months, and pain 11.3 (8.9) months. The main diagnoses were: Normal breasts 192 (27.7%), mastalgia 135 (18.1%), fibroadenosis 114 (15.2%), fibroadenomas 84 (11.2%), breast cancer 58 (7.8%), suspected breast cancer 25 (3.3%), galactorrhea 9 (1.2%), mastitis 8 (1.1%), musculoskeletal pain 8 (1.1%), duct ectasia 8 (1.1%), mondor's disease 7 (0.94%) and recurrent breast cancer 6 (0.8%). In patients with breast cancer, 42 (66%) had advanced disease, 6 (9.4%) had recurrent disease and 4 (63%) had metastatic disease. CONCLUSION: The number of self-referrals, detected breast cancers and duration of symptoms justify the need for self-referral clinics in Ghana.