Cervical human papillomavirus infection in accra, ghana.

BACKGROUND: This study was aimed at estimating the human papillomavirus (HPV) prevalence and its determinants among a sample of Ghanaian women. DESIGN: Cross-sectional observational study. SETTING: Gynaecology outpatient clinic of the Korle-Bu Teaching Hospital, Accra, Ghana; the largest tertiary care gynaecology outpatient clinic in Ghana. PARTICIPANTS: Convenient sample of 75 consenting women visiting the clinic. METHODS: Information was obtained through personal interviews using structured questionnaire, Pap smears obtained, and laboratory testing of cervical exfoliated cells was performed. HPV DNA was detected using a GP5+/6+ polymerase chain reaction assay. These data were analyzed using both univariate and bivariate techniques. RESULTS: The mean age of participants was 33.3 years (standard deviation, 9.2) and the percentage of lifetime monogamy was 21.3%. The crude HPV DNA prevalence was 10.7%. Unlike most populations studied so far, HPV prevalence was high not only among young women, but also in middle and old age. Independent HPV determinants were being illiterate (prevalence odds ratio [POR], 13.9; 95% confidence interval [95%CI], 1.9-100) and reporting more than three lifetime sexual partners (POR, 4.6; 95% CI, 1.0-22.2). CONCLUSIONS: The study indicates a high crude prevalence of HPV in a largely polygamous Ghanaian population with a high crude prevalence in older age groups, which may be a distinctive feature of polygamous populations where HPV transmission continues into middle age and cervical cancer incidence is very high.

Surgically correctable adrenal-dependent hypertension: a report of five cases.

SummaryAlthough endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patients include young individuals, those with difficult-to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratory parameters well-known to be associated with Cushing's syndrome, Conn's syndrome or phaeochromocytoma.This paper reports on 5 patients identified over a 2-year period with various hormonally-active adrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients' histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigations and management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenal-related hypertension is good and can result in significant cost savings in the long term.

Childhood deaths from malignant neoplasms in accra.

SUMMARY BACKGROUND: Malignant neoplasms are set to become a leading cause of childhood death in sub-Saharan Africa as immunization programmes reduce deaths due to infectious diseases. Knowledge of the pattern of deaths from these neoplasms is therefore desirable. OBJECTIVE: To describe the pattern of deaths from paediatric malignancies, compare this to morbidity figures and provide baseline data for planning child care services. METHODS: A 10 year retrospective survey of autopsy cases of paediatric malignancies at the Korle-Bu Teaching Hospital Mortuary was carried out based on autopsy files form January 1, 1990 to December 31, 1999 RESULTS: A total of 252 cases of childhood malignant tumours were retrieved, 139 males and 113 females with a male to female ratio of 1.2:1. The most common malignancy was lymphoma forming 54% of cases and almost all of Non-Hodgkin's type. Non-Burkitts type (29%) was the commonest followed by Burkitts (24%) and Hodgkin's disease only one percent. The lymphomas were followed by central nervous system (CNS) tumours (13%), nephroblastomas(10.3%) leukemias (6.7%) hepatic tumours (4%) and sarcomas (2.6%). Less common tumours were Neuroblastomas (2.4%) and retinoblastomas (2%). CONCLUSION: Overall the pattern of deaths from paediatric malignancies followed the pattern of relative incidence in morbidity figures from Ghana and the subregion except for a relatively higher proportion of deaths from CNS tumours and a lower proportion from sarcomas. The pattern of cancer deaths seen in this study is similar to that seen in advanced countries except that lymphomas replace leukemia as the commonest cause of death.

Laryngeal cancer at the korle bu teaching hospital accra ghana.

SUMMARY INTRODUCTION: Laryngeal cancer is the commonest Head and Neck cancer seen at the Ear Nose and Throat (ENT) Unit Korle-Bu Teaching Hospital. The aim of this study was to determine the number of cases of laryngeal cancer seen at the Korle Bu Teaching Hospital, establish epidemiological parameters of the disease and to outline preventive measures. METHOD: One hundred and fifteen (115) patients who were managed for laryngeal cancer from 1(st) January 1998 to 31(st) December 2003 were studied retrospectively with respect to age, sex, duration of symptoms at presentation, risk factors, symptoms complex, histopathology, stage of tumor, details of treatment offered and follow up. RESULTS: The age range was 17-85 years with a mean of 55.5 years (SD10.7). Majority of the patients (90.4%) were above 40 years. The commonest symptom at presentation was dysphonia. A significant proportion of cases (37.3%) presented with locally advanced disease. The commonest histological type of laryngeal tumour seen was squamous cell carcinoma. The treatment offered consisted of radiotherapy for 83 (79.8%) patients and total laryngectomy with neck dissection when necessary for 17 (16.3%) patients who also had postoperative radiotherapy. Only 58 (69.9%) patients completed radiotherapy treatment and in all 32 (24.3 %) patients did not report for any treatment. Majority of patients failed to report for post treatment follow up. CONCLUSIONS: We conclude that significant number of patients with laryngeal cancer presented with locally advanced disease and dysphonia was the commonest symptom.

Disseminated invasive aspergillosis.

SummaryWe present a case of disseminated invasive aspergillosis in a young male adult with progressive complex gastrointestinal, non-specific peripheral neural and respiratory symptoms and subsequent acute haemorrhagic conjunctivitis and generalized dermatitis.The case emphasizes the difficulty in diagnosing systemic mycosis and a high index of suspicion is recommended particularly in patients on prolonged antibiotics and systemic steroids.

Hypoglycaemia in an infant of a mother with fasting hyperglycaemia - a case report.

SummaryWe report a case of perinatal death from hypoglycaemia in an infant of a mother who had fasting hyperglycaemia diagnosed at 31 weeks of gestation and managed with diet alone. Blood glucose values were not conclusive of gestational impaired glucose tolerance by WHO and American Diabetes Association standards, yet autopsy histological findings in the pancreas were similar to that described in neonates of a diabetic mother. We therefore emphasize that all pregnant women with inconclusive glucose values for diagnosis of full blown gestational diabetes mellitus should be fully investigated and closely monitored during antenatal care. The infants of such mothers may be at a higher risk of hypoglycemia in the immediate post natal period and would require similar monitoring and aggressive management.