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1.
Heliyon ; 10(5): e27401, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38463799

RESUMO

For several years, fish smoking has been the widely adopted processing method among artisanal fish smokers located along the coastal zones in many parts of West Africa including Ghana. However, several issues pertaining to biochemical and microbiological contaminants still remain, mainly because of the suboptimal, unhygienic fish handling during the processing. To help curtail the problem, we developed and implemented a simple good manufacturing practice (GMP) system for experimentation at two local fish smoking facilities (Facility A, FA; Facility B, FB) to assess the effectiveness for improving the quality of smoked fish. The implementation of GMP did not affect the physical properties of the smoked fish but improved the peroxide value, total volatile base nitrogen, polyaromantic hydrocarbons and histamine levels. The total aerobic counts decreased from 3.96 ± 0.12 cfu/g to 1.52 ± 0.28 cfu/g (FA) or from 4.10 ± 0.2 cfu/g to 1.85 ± 0.85 cfu/g, (FB). The coliforms and Escherichia coli decreased respectively from 1.69 ± 0.12 cfu/g and 1.15 ± 0.21 cfu/g (FA) and from 1.74 ± 0.37 cfu/g and 1.24 ± 0.37 cfu/g, (FB) to below detection (no observed colony) after introducing the single use of potable water, use of smoking oven and fish core temperature of 108.1 ± 7.5 °C and 82.5 ± 3.9 °C, respectively for 2 h, wearing of safety apparels, drying and cooling of smoked fish under nets, and the use of waste disposal bins. The results show that sensitization and training of fish smokers in GMP may be relevant for improving the microbial and overall quality of smoked fish.

2.
BMC Res Notes ; 16(1): 318, 2023 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-37932827

RESUMO

BACKGROUND: Gastrointestinal Stromal Tumour is a rare but potentially curable tumour of the gastrointestinal tract accounting for up to 1% of all gastrointestinal tumours. The discovery of Imatinib mesylate, a novel tyrosine kinase inhibitor has improved the chances even for unresectable, recurrent, or metastatic diseases. METHODS: This study sought to document the clinical and pathological characteristics of GISTs from two tertiary hospitals in Ghana that have undergone immunohistochemistry confirmation between 2014 and 2021. RESULTS: The median age of the subjects was 50 years with most of them (28.0%) being above 61 years. There were more females than males (64.0% vs. 36.0%). Abdominal mass and abdominal pain made up the majority of the clinical presentations. The majority of the subjects had partial gastrectomy (32.0%) which was followed by wedge resection (28.0%). Appendectomy and sleeve gastrectomy were the least performed procedures (8% each). Four of the 25 patients (16.0%) had resections of involved contiguous organs done with splenectomy being the most common procedure. The majority of GISTs were found in the stomach (68.0%) followed by the appendix (12.0%) and small bowel (12.0%). Gastrointestinal bleeding (55.8%) and abdominal pain (38.5%) were the most reported symptoms. Free resection margins were observed in 84.0% of the subjects and only 3/25 (12.0%) experienced tumour recurrence. CONCLUSION: GIST is a potentially curable tumour that once was obscure but currently gaining popularity. Surgical resection offers the hope of a cure for localized disease while targeted therapies is a viable option for recurrent, metastatic, or unresectable tumours.


Assuntos
Antineoplásicos , Neoplasias Gastrointestinais , Tumores do Estroma Gastrointestinal , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Tumores do Estroma Gastrointestinal/patologia , Antineoplásicos/uso terapêutico , Gana , Recidiva Local de Neoplasia , Neoplasias Gastrointestinais/terapia , Dor Abdominal
3.
BMC Nephrol ; 23(1): 343, 2022 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-36289495

RESUMO

BACKGROUND: The incidence of end stage kidney disease (ESKD) is increasing in Ghana as with the rest of the world. This study compared the sociodemographic, diagnostic characteristics (clinical, biochemical and imaging) and clinical outcomes of ESKD patients who chose either renal replacement therapy (RRT) or conservative therapy as well as the factors that influenced their choice. METHODS: We retrospectively reviewed the records of 382 ESKD patient from 2006 to 2018. The data was collected from the Nephrology Clinic at the Komfo Anokye Teaching Hospital (KATH). Sociodemographic, diagnostic (clinical, biochemical and imaging) and therapeutic data were obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). RESULTS: Of the 382 patients, 321 had conservative therapy whiles 61 had renal replacement therapy. The mean age of participants was 47.71 ± 16.10 years. Bipedal swelling (16.8%), fatigue (10.4%) and facial swelling (9.2%) were the major clinical features. Chronic glomerulonephritis (31.4%), hypertension (30.3%) and diabetes mellitus nephropathy (28.2%) were the most frequent predisposing conditions. Nifedipine (82.0%), bisoprolol (32.8%), aspirin (19.7%), ranitidine (26.2%), metformin (13.1%) and lasix (78.7%) were commonly used by the RRT patients than their conservative therapy counterparts. Compared to their RRT counterparts, patients on conservative therapy were more on irbesartan/lisinopril (57.9%) and sodium hydro carbonate (NaHCO3) (52.0%). Diastolic blood pressure (DBP) (p = 0.047), uremic gastritis (p = 0.007), anaemia, uraemia, haematuria and hyperkalaemia (p < 0.001) were more common in conservative therapy patients than RRT patients with RRT patients showing better corticomedullary differentiation (38.1% vs. 27.7%, p < 0.001) and normal echotexture (15.0% vs. 11.6%, p = 0.005). Age, gender, occupation and duration of illness were significantly associated with the decision to opt for conservative therapy. CONCLUSION: Patients on conservative therapy have worse clinical outcomes than their RRT counterparts. Early referrals to nephrologist as well as subsidized RRT should be targeted.


Assuntos
Falência Renal Crônica , Metformina , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Tratamento Conservador , Furosemida , Irbesartana , Lisinopril , Bisoprolol , Gana/epidemiologia , Nifedipino , Ranitidina , Terapia de Substituição Renal/métodos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Aspirina , Sódio
4.
J Surg Case Rep ; 2022(4): rjac085, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35382139

RESUMO

Pulmonary sequestration occurs when a portion of lung tissue receives its blood supply from an anomalous systemic artery. Three main presentations, intralobar, extralobar and communicating bronchopulmonary foregut malformations, have been described. It is the second most common congenital lung anomaly. The intralobar variant is the most common type seen in 75% of cases, especially in late childhood. Imaging of choice for diagnosis are computed tomography scan and magnetic resonance imaging. Management involves surgical resection with ligation of the aberrant blood supply via thoracotomy or thoracoscopy. Endovascular therapy with coil embolization of the aberrant anomalous systemic artery as a standard therapy or as a hybrid therapy is an option. We present our successful surgical management of an infant diagnosed prenatally with congenital lung abnormality and confirmed postnatally as intralobar pulmonary sequestration.

5.
Kardiochir Torakochirurgia Pol ; 19(1): 28-35, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35414817

RESUMO

Introduction: Diaphragmatic injuries may be associated with thoracoabdominal blunt or penetrating traumas. The diagnosis is often delayed, despite the availability of several medical imaging modalities. The surgical management remains controversial, in terms of the choice of surgical approach and the surgical repair technique. Aim: To evaluate the surgical management experience of traumatic diaphragmatic rupture in our institution over a ten-year period in the local setting of a tertiary hospital in Ghana. Material and methods: A retrospective review of the medical records of patients who had undergone surgery for traumatic diaphragmatic rupture. Results: A total of 35 cases of diaphragmatic rupture were seen from thoracoabdominal injuries. There were 29 (82.86%) males. The mean age was 36.25 ±12.98 years with a range of 16-65 years. There were 3 cases of right diaphragmatic rupture and 32 cases of left diaphragmatic rupture. Penetrating chest injury caused 18 (51%) of the ruptures. The leading cause of injury was road traffic accident, which constituted 48.57%, closely followed by stab (25.71%), gunshot injuries (14.29%) and impalement injury (11.48%). Seventeen (49%) patients had their diaphragmatic ruptures repaired via laparotomy and the remaining 18 (51%) via thoracotomy. The commonest herniated organ was the stomach. One patient died in theatre from cardiac arrest after failed intubation. Conclusions: Surgery is the treatment of choice in traumatic diaphragmatic rupture and it is repaired via laparotomy or thoracotomy based on the presence or absence of concomitant abdominal injury and the presence or absence of a cardiothoracic surgeon.

6.
Clin Med Insights Case Rep ; 15: 11795476221087910, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35342320

RESUMO

Current practice for chemotherapy in most oncology departments is the use of dedicated venous access for the continuous and frequent delivery of drugs, fluids and blood products, and the monitoring of the effects of treatment. The frequent venipuncture of peripheral veins is associated with various complications and discomfort to the patients. Permanent central venous access is therefore very important. Totally Implantable Vascular Access Device (TIVAD) is a type of central venous access that utilizes the central veins; the internal jugular vein, the subclavian or the femoral veins. It is a kind of permanent central venous access where a central venous catheter is connected to a subcutaneously buried port or septum which can be accessed at any time and has the ability to stay for almost 5 years. They are therefore the preferred form of long-term central venous access in patients treated by oncology departments. We share our initial experience of 5 patients in our institution. There were 4 females and one young boy who had been diagnosed with Hemophilia. Three of the patients had new implantation, one had removal of her 5-year-old TIVAD that had been implanted in another country and one had the TIVAD accessed when she had been referred to our hospital for breast surgery after neoadjuvant chemotherapy.

7.
Kardiochir Torakochirurgia Pol ; 18(3): 165-172, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34703474

RESUMO

INTRODUCTION: Constrictive pericarditis is the endpoint of the natural history of acute pericarditis of different aetiologies where a chronic inflammatory process results in a thickened, fibrotic and inelastic pericardium with consequent impairment of diastolic function and systemic congestion. AIM: To evaluate the clinical features, diagnosis, surgical management and outcome of patients with constrictive pericarditis as managed in a local setting of a tertiary hospital in Ghana. MATERIAL AND METHODS: A retrospective review of the medical records of patients who had undergone pericardiectomy for constrictive pericarditis at a teaching hospital. RESULTS: Ten patients underwent pericardiectomy for the period of study. There were 8 (80%) males and 2 (20%) females. The mean age was 20.4 ±17.2 years. Six of the patients 6 (60%) were in NYHA class III. Preoperative diagnostics included chest X-ray, echocardiography, and computed tomography scan. The surgical approach for the pericardiectomy was median sternotomy. The mean operative time was 159.9 ±43.0 min. The mean postoperative days spent before being discharged was 6.9 ±2.3 days. Nine (90%) of the patients were in NYHA class I after a mean follow-up of 19.3 ±16.7 months. One patient died 6 weeks after surgery with heart failure and one patient was lost to follow-up. CONCLUSIONS: Surgical pericardiectomy via median sternotomy is still the standard modality of treatment for constrictive pericarditis with excellent results even in resource constraint settings.

9.
BMC Nephrol ; 22(1): 156, 2021 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-33910506

RESUMO

BACKGROUND: Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the commonest of the hereditary kidney diseases and mostly ensues in utero with signs delayed until after several decades. This study assessed the demographic, diagnostic (clinical and biochemical features) and therapeutic patterns among ADPKD patients who attended the nephrology unit of Komfo Anokye Teaching Hospital (KATH) from 2007 to 2018. METHODS: This cross-sectional retrospective analysis of ADPKD patient records was conducted at the nephrology unit of KATH in October 2020. The records of 82 ADPKD was used for this study. Demographic, clinical, biochemical, ultrasonographic and therapeutic data was obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). RESULTS: ADPKD was most prevalent in people within the ages of 31-40 years (25.6 %), with a male (52.4 %) preponderance. The most common clinical features presented were flank pain (30.5 %) and bipedal swelling (18.3 %). Hypertension (42.7 %), urinary tract infections (UTIs) (19.5 %), and anemia (13.4 %) were the most common complications reported. Average level of HDL-c was higher in females (1.7) than in males (1.2) (p = 0.001). Hematuria (34 %) and proteinuria (66 %) were among the biochemical derangements presented. About 81.7 % had CKD at diagnosis with the majority in stages 1 (27.0 %), 3(23.2 %) and 5 (20.3 %). Poor corticomedullary differentiation was observed in 90.2 % of participants and increased echogenicity was observed in 89.0 % of the participants. Estimated GFR (eGFR) correlated positively with echotexture (r = 0.320, p = 0.005) and negatively with CMD (r= -0.303, p = 0.008). About 95.1 % of patients were on conservative therapy including: 73.2 %, 52.4 %, 22.0 %, 13.4 %, 8.5 % on Irebesartan/Lisinopril, Nifecard XL, Hydralazine, Methyldopa and Bisoprolol respectively for hypertension; 26.8 and 3.7 % on Gliclazide and Metformin respectively for Type 2 diabetes mellitus; 25.6 %, 24.4 and 18.3 % on CaCO3, fersolate and folic acid respectively as nutrient supplements with 4.9 % of participants on renal replacement therapy (RRT). CONCLUSIONS: ADPKD occurs in people aged ≥ 31 years with a higher male preponderance. Clinical features include flank and abdominal pain, bipedal swelling, headache, amongst others. Uremia, hematuria, proteinuria, decreased eGFR, were the common biochemical derangements reported with higher severity detected in men. The therapeutic interventions mostly involved conservative therapy to manage symptoms and other comorbid conditions and rarely renal replacement therapy (RRT).


Assuntos
Rim Policístico Autossômico Dominante/diagnóstico , Rim Policístico Autossômico Dominante/epidemiologia , Adolescente , Adulto , Idade de Início , Biomarcadores/sangue , Biomarcadores/urina , Tratamento Conservador , Estudos Transversais , Feminino , Gana/epidemiologia , Taxa de Filtração Glomerular , Humanos , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Rim Policístico Autossômico Dominante/complicações , Rim Policístico Autossômico Dominante/terapia , Estudos Retrospectivos , Fatores Sociodemográficos , Ultrassonografia , Adulto Jovem
10.
J Fish Biol ; 99(2): 411-417, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33733481

RESUMO

Aside from ornamental uses, there is growing interest in using killifishes for a multiplicity of purposes including baitfish and mosquito biocontrol. This experiment explored the spawning habits and embryonic development of the banded lampeye, Aplocheilichthys spilauchen in ex situ freshwater (0.04‰) and brackish water (5.01‰) to ascertain the captive breeding prospects for mosquito control in areas where they occur. Significantly higher number of eggs were laid in the brackish water than the freshwater (X2  = 1613.0, P < 0.05), and black mop was the most preferred spawning substrate, followed by green, blue and white mops. Microscopic monitoring of embryos revealed that cleavage occurred within the first 30 min after fertilization, organogenesis commenced on average in the 25th hour and hatching in approximately 230 h. Although freshwater eggs were relatively bigger than brackish water eggs and certain embryonic developmental stages occurred faster in the freshwater than brackish water, these differences were overall not significant and had no effects on the development and hatching. The observed outcome that A. spilauchen can be optimally propagated with black mops in brackish water offers a significant step in its use for the mosquito biocontrol programme, as well as other potential uses not yet explored.


Assuntos
Fundulidae , Peixes Listrados , Animais , Desenvolvimento Embrionário , Hábitos , Águas Salinas
11.
Environ Chall (Amst) ; 4: 100164, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37522148

RESUMO

The emergence of the SARS-CoV-2 has affected several production services including the water production and delivery processes. This study considered sachet water quality during the advent of the SARS-CoV-2 pandemic using multivariate statistics and Water Quality Index, Water Pollution Index and, hygienic and sanitation practices of sixty-two (62) sachet water vendors using a panel assessment approach. The findings showed that vendors did not adhere to proper hygienic practices as ninety-four (94%) of them did not have health clearance, ninety (90%) did not frequently wash their receptacles for selling daily, and most of them stored and sold in unhygienic environments. Majority of the producers violated Food and Drugs Authority Regulations. The Empirical Orthogonal Function analysis showed that total iron, Total Heterotrophic Bacteria, Salmonella, Cl-, E. coli, and fecal and total coliforms were the controlling elements in the water. All the brands were below threshold limits based on the physical water assessment. However, enteric bacteria were observed in all the brands. Water Quality and Water Pollution Indices (WQI and WPI) described all the sachet water brands (vendors and production sites) as excellent for drinking. The WQI computations for samples from the production and vending sites respectively ranged from 0.12 to 0.36 and 0.27-0.42 whereas WPI presented 0.22-0.31 and 0.23-0.32. Comparatively, samples from vendors had elevated elemental concentrations and loads. This suggests that besides sachet water contamination during production and transportation, vendors significantly impacted the quality of sachet water. Sensitization on proper hygienic practices for sachet water production and vending and routine assessment of the quality of sachet water produced or sold is recommended.

12.
Sci Rep ; 10(1): 22407, 2020 12 29.
Artigo em Inglês | MEDLINE | ID: mdl-33376254

RESUMO

The novel coronavirus is predicted to have dire implications on global food systems including fisheries value chains due to restrictions imposed on human movements in many countries. In Ghana, food production, both agriculture and fisheries, is exempted from restrictions as an essential service. The enforcement of COVID-19 prevention protocols, particularly social distancing, has been widely reported in Ghana's agricultural markets whereas casual observations and media reports on fish landing sites suggest no such enforcements are in place. This study aimed to provide sound scientific evidence as a basis for informed policy direction and intervention for the artisanal fishing sector in these challenging times. We employed an unmanned aerial vehicle in assessing the risk of artisanal fishers to the pandemic using physical distancing as a proxy. From analysis of cumulative distribution function (G-function) of the nearest-neighbour distances, this study underscored crowding at all surveyed fish landing beaches, and identified potential "hotspots" for disease transmission. Aerial measurements taken at times of peak landing beach activity indicated that the highest proportion of people, representing 56%, 48%, 39% and 78% in Elmina, Winneba, Apam and Mumford respectively, were located at distances of less than one metre from their nearest neighbour. Risk of crowding was independent of the population at the landing beaches, suggesting that all categories of fish landing sites along the coast would require equal urgency and measured attention towards preventing and mitigating the spread of the disease.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Pesqueiros/estatística & dados numéricos , Distanciamento Físico , COVID-19/transmissão , Aglomeração , Sistemas de Informação Geográfica , Gana/epidemiologia , Humanos , Tecnologia de Sensoriamento Remoto , Risco , SARS-CoV-2
13.
Int J Nephrol ; 2020: 8967258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328308

RESUMO

BACKGROUND: Renal diseases over the years have become one of the leading causes of morbidity and mortality worldwide. In this study, we assessed the spectrum and clinical characteristics of Ghanaians with renal diseases at the nephrology unit of Komfo Anokye Teaching Hospital (KATH), Kumasi. METHODS: This was a retrospective hospital-based study conducted at Komfo Anokye Teaching Hospital (KATH) from the years 2005 to 2017. A non-randomized sampling approach was used to include 1426 participants who were diagnosed with AKI, CKD, ESRD, and nephrotic syndrome at the nephrology unit of KATH during the years under review. All the 1426 patients were eligible for the study. Demographic characteristics as well as clinical data such as the kind of renal disease presentation, causes of the renal disease, and the treatment options were also obtained from their records. RESULTS: Overall, 1009 of the total participants had CKD (70.76%), 295 participants had ESRD (20.69%), 72 participants had AKI (5.05%), and 50 participants had nephrotic syndrome (3.51%). Furthermore, 69 (23.4%) participants with ESRD were on dialysis whiles 6 (8.3) and 17 (1.7) participants with only AKI and CKD superimposed AKI, respectively, were on dialysis. 226 (76.6%) participants with ESRD were on conservative therapy. Hypertension emerged as the major cause of renal disease presentation (53.93%) with bilateral leg edema (13.46%) being the major complaint. There was a significant association between CKD and age (p ≤ 0.001). Nephrotic syndrome also showed a significant association with age (p ≤ 0.001). CONCLUSION: This study revealed that patients at the nephrology unit of KATH, Ghana, are mainly adults between ages 46-55. The clinical pattern of renal diseases is dominated by CKD and ESRD. We conclude that hypertension, chronic glomerulonephritis, diabetic nephropathy, and sepsis are the most common causes of renal diseases. The commonest clinical presentations are bilateral leg edema, palpitations, headache, breathlessness, dizziness, and vomiting. Early diagnosis and management of these conditions may prevent or delay the progress to end-stage renal disease.

14.
Pan Afr Med J ; 33: 236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692655

RESUMO

INTRODUCTION: Acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors. METHODS: An observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI. RESULTS: Mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively. CONCLUSION: The study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery.


Assuntos
Injúria Renal Aguda/fisiopatologia , Edema/epidemiologia , Febre/epidemiologia , Edema Pulmonar/epidemiologia , Injúria Renal Aguda/diagnóstico , Adulto , Edema/etiologia , Feminino , Febre/etiologia , Gana , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Edema Pulmonar/etiologia , Recuperação de Função Fisiológica , Sódio/sangue , Centros de Atenção Terciária , Adulto Jovem
15.
Pan Afr Med J ; 33: 259, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692836

RESUMO

Central venous catheter placement especially the femoral venous catheter is a common practice in critically ill patients. Awareness of potential complications of the guidewire such as guidewire migration is of utmost importance. Though potentially retrievable by a vascular surgeon or interventional radiologist if it occurs, close supervision by a senior person during passage by a junior or inexperienced person, the use of ultrasound before and after placement of catheter, and use of a checklist may help to identify and prevent its occurrence. We present a very rare complication of central venous cannulation of a guidewire migration in our institution. A 12-year-old girl presented to the Paediatric Emergency Unit (PEU) with status epilepticus and aspiration pneumonia and subsequently transferred to the Paediatric Intensive Care Unit (PICU) for ventilatory support. She had accidental guidewire migration to the left internal jugular vein following a right transfemoral central venous catheterization. She underwent successful guidewire retrieval via a right groin incision.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Migração de Corpo Estranho/diagnóstico , Veias Jugulares , Criança , Feminino , Veia Femoral , Humanos , Unidades de Terapia Intensiva Pediátrica
16.
Pan Afr Med J ; 33: 256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692849

RESUMO

A rare case series of traumatic right diaphragmatic rupture with hepatothorax in Ghana is reported. The first case involved a middle-aged man who sustained a penetrating chest injury following an unprovoked attack by a wild bull. The second case was a young woman who sustained a blunt chest injury after being knocked down by a moving vehicle whiles crossing the road. Both presented with ruptured right diaphgramatic rupture and had to undergo repair through thoracotomy after stabilization and the two had been well one year after surgery without any complications or sequelae.


Assuntos
Diafragma/lesões , Fígado/patologia , Ferimentos não Penetrantes/complicações , Ferimentos Penetrantes/complicações , Adulto , Diafragma/cirurgia , Feminino , Gana , Hérnia Diafragmática Traumática/etiologia , Hérnia Diafragmática Traumática/cirurgia , Humanos , Masculino , Ruptura , Traumatismos Torácicos/complicações , Traumatismos Torácicos/cirurgia , Toracotomia/métodos , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia
17.
Pan Afr Med J ; 33: 287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692942

RESUMO

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occurring within 72 hours before or after onset of menstruation. Etiology is unknown but could be linked to endometriosis. Pleural ablation via thoracoscopy and hormonal therapy are mainstay treatment options to avoid recurrence. We present a case of a young adult female who experienced gradual painless abdominal distention that resolved spontaneously after each menses twelve years post menarche. She was first seen at a peripheral facility where laparotomy undertaken was negative for suspected ectopic pregnancy. However, a bleeding omental mass was noticed and a biopsy taken. Histopathology reported it as an endometriotic tissue. The patient subsequently had recurrent cyclical chest pains and breathlessness leading to the diagnosis of catamenial pneumothorax. She had chemical pleurodesis done with sterile talc after chest tube drainage and has been well over two years now.


Assuntos
Endometriose/diagnóstico , Pleurodese/métodos , Pneumotórax/diagnóstico , Adulto , Dor no Peito/etiologia , Drenagem/métodos , Feminino , Gana , Humanos , Menstruação/fisiologia , Pneumotórax/terapia
18.
Ghana Med J ; 53(2): 181-183, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31481815

RESUMO

The inferior vena cava is the most commonly injured abdominal vessel and accounts for about 25% of abdominal vascular injuries. Despite improved preoperative care and operative techniques, the mortality rates for the inferior vena cava injuries are still high due to delayed presentation, inadequate or delayed fluid resuscitation, difficulty of diagnosis and technical problems in repair. A case of the inferior vena cava injury encountered after abdominal stab injury with about 4cm vertical tear of infrarenal vena cava, survived due to immediate transportation, appropriate and successful perioperative fluid and blood resuscitation, prompt surgical management with a team approach and critical post-operative surgical management.


Assuntos
Hematoma/cirurgia , Lacerações/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Veia Cava Inferior/lesões , Ferimentos Perfurantes/cirurgia , Duodeno/lesões , Humanos , Perfuração Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Espaço Retroperitoneal , Técnicas de Sutura , Ultrassonografia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/cirurgia
19.
Ghana Med J ; 53(4): 308-311, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32116344

RESUMO

There are few reports on lower extremity revascularization because of its high risks of general and local complications as well as poor functional prognosis. However, revascularization of the traumatically amputated lower extremity is a technically feasible surgical undertaking if there can be effective collaboration between the orthopaedic surgeon and the vascular surgeon. Successful outcome is usually judged by functional achievements of the patient toward returning to the preinjury level. Appropriate patient selection significantly increases the potential for obtaining a satisfactory outcome. We report the successful revascularization of a near amputation of the right leg of a young man who was knocked down accidentally by a speeding taxi leading to mangled and near amputation of his right leg. He underwent successful revascularization and currently doing well, one year after the surgery. Successful revascularization is possible if indicated in less resource countries especially if there is an experienced team of vascular and orthopaedic surgeons. FUNDING: None.


Assuntos
Amputação Traumática/cirurgia , Artérias/cirurgia , Isquemia/cirurgia , Traumatismos da Perna/cirurgia , Salvamento de Membro , Amputação Traumática/complicações , Pé/irrigação sanguínea , Humanos , Isquemia/etiologia , Perna (Membro)/irrigação sanguínea , Masculino , Procedimentos Cirúrgicos Vasculares , Adulto Jovem
20.
Artigo em Inglês | AIM (África) | ID: biblio-1268564

RESUMO

Introduction: acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors.Methods: an observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI.Results: mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively.Conclusion: the study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery


Assuntos
Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Gana , Estudos Prospectivos
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