Upper gastrointestinal endoscopy at the korle bu teaching hospital, accra, ghana.

SUMMARY OBJECTIVES: To study the indications for endoscopy, the endoscopic diagnosis and other lessons learnt. METHODS: A retrospective and prospective audit of all upper gastrointestinal endoscopies performed in the Endoscopy Unit of the Korle-Bu Teaching Hospital from January 1995 to December 2002 was performed. RESULTS: A total of 6977 patients, 3777 males and 3200 females with age range 1 year 8 months to 93 years were endoscoped. The mean age of males was 43.5 +/- 0.5 and females 43.7 +/- 0.6 years. Epigastric pain (42.5%), dyspepsia (32.8%) and haematemesis and melaena (14.2%) were the commonest reasons for endoscopy. Chronic duodenal ulcer (19.6%), acute gastritis (12.7%), duodenitis (10.2%), oesophagitis (7.5%) were the commonest diagnoses. Normal endoscopy was reported in 41.1% patients, and was higher in the younger age group compared to the older (R = 0.973, P<0.001). Nine hundred and ninety (14.2%) patients were endoscoped for haematemesis and melaena of which chronic duodenal ulcer (32.1%), gastritis/gastric erosions (12.8%), oesophageal varices (9.8%), carcinoma of the stomach (6.4%), and duodenitis (4.2%), were the commonest causes. No lesion was found in 20.6% of these patients. Urease test was positive in 75% of all biopsy specimen and 85% in chronic duodenal ulcer, gastritis and duodenitis. CONCLUSION: The normal endoscopy rate is high and needs to be reduced in order to help prolong the lives of the endoscopes. Chronic duodenal ulcer is usually associated with H. pylori infection and is the commonest cause of upper gastrointestinal bleeding.

Knowledge, attitude and practice universal basic precautions by medical personnel in a teaching hospital.

SUMMARY BACKGROUND: Universal Basic Precautions (UBP) are not well understood nor implemented by health professionals, though crucial in HIV/AIDS prevention. As defined by Garner, UBP refers to "the prevention of transmission of blood borne pathogens like HIV through strict respect by health workers of rules concerning care and nursing" OBJECTIVES: To find out knowledge and attitudes of medical personnel doctors in the Department of Surgery of the Korle Bu Teaching Hospital to HIV transmission and to find out their current practices of UBP in surgery. METHODS: The study was carried out using a structured questionnaire which was self administered to fifty medical personnel after preliminary introduction at a plenary session. RESULTS: Results showed that alleged knowledge did not match actual tested knowledge (92% verses 71%). Knowledge of all the forms of HIV transmission was rather limited among medical personnel. Practice of UBP was also not universal as 44% preferred to rely on pre-op HIV testing of patients and knowledge of their status whilst 36% of respondents admitted reluctance to perform an invasive procedure on an HIV positive patient. CONCLUSION: This study shows the need for the Ministry of Health, the Ghana Health Service and its institutions to develop and implement specific policies on the practice of UBP, training of health care providers and ensuring the consistent supply of protective materials.

Intestinal obstruction caused by retained surgical sponge: two case reports.

SummaryWe present two cases of intestinal obstruction from retained laparotomy packs and their management. Attention to detail in theatre procedure should reduce such occurrence.