Hypertension and obesity comorbidities increases coronary risk, affects domains of sexual function and sexual quality of life.

About 25% of the world's adult population suffers from arterial hypertension with about 1.5 billion estimated to develop hypertension by 2025. Hypertensive patients have been reported to have a higher risk of developing diabetes and sexual dysfunction. Hypertension have been linked with lubricative and orgasmic difficulties in females, as wel as ED and vascular disease in men. Obesity has also been linked to ED in diabetic males as well as several aspects of female sexuality. Hypertension and obesity are closely related, each occurring in greater frequency with the other, it is only logical to think that comorbidities of obesity and hypertension could increase the risk of cardiovascular disease and SD. This research looks at the relationship between hypertension and obesity comorbidities and its association with sexual function in type II diabetics. Diabetic patients who were at least 18 years old and were engaged in a stable heterosexual relationships for at least 1 year were recruited for this study. Participants were categorized into the -HYP/-OB, +HYP/-OB and the +HYP/+OB groups. Sexual function was assessed using the GRISS-M and GRIS-F for the diabetic males and females respectively. Early morning fasting blood samples was used in lipid profile as well as FBG assay. The Coronary risk was estimated as Total/HDL Cholesterol. Triglyceride levels and coronary risk were highest in the +HYP/+OBES group, followed by the +HYP/-OBES group, with the -HYP/-OBES group recording the lowest levels. PE and infrequency recorded the highest score among the +HYP/+OBES group with the +HYP/-OBES group recording the lowest scores. SQoL was highest amongst the -HYP/-OBES group, with the +HYP/+OBES group recording the lowest scores. Anorgasmia and avoidance increased along the shades of HYP/OBES groups. Comorbidities of hypertension and obesity increases the risk of coronary disease, affects some domains of sexual function and decreases the SQoL of diabetics.

Sexual dysfunction among diabetics and its impact on the SQoL of their partners.

Sexual dysfunction (SD) has long been known to affect a significant number of people worldwide with serious implications and limitations on sexual expression and fulfillment. This may affect the sexual quality of life (SQoL) of individuals and their partners. A cross-sectional study was conducted among diabetic patients and their partners who visited the Tema General Hospital. A total of 130 and 116 diabetic males and females and their partners were interviewed. Male and female diabetic participants and partners were evaluated using the Golombuk Rust Inventory for Sexual Satisfaction-Male (GRISS-M)/SQoL-M and GRISS-Female/SQoL-F, respectively. For the diabetic males, the mean age and duration of diabetes (DOD) was 63.04±10.85 and 8.38±6.53 years, respectively, and that of the diabetic females was 56.98±9.42 and 6.11±5.31 years, respectively. Diabetic male participants with SD were significantly older and had a longer duration of diabetes. The mean SQoL and SQoL-Partner (SQoL-P) recorded for the diabetic males and their partners was 42.29±30.88 and 52.86±15.26, respectively. The mean SQoL and SQoL-P recorded for the diabetic females and their partners was 57.73±14.91 and 64.97±19.68, respectively. Diabetic males who had impotence had female partners with significantly lower SQoL-P scores, and similar results were recorded for those who had premature ejaculation, nonsensuality, avoidance and dissatisfaction problems. Female diabetics who had nonsensuality, avoidance and infrequency had male partners who recorded significantly lower SQoL-P scores. Female diabetics with higher perceptions of what an adequate intravaginal ejaculatory latency time (IELT) should be had male partners with significantly lower SQoL-P scores. Ageing and DOD are more likely to affect the sexual functioning of diabetic males than females. SD in diabetics with problems of impotence/vaginismus, premature ejaculation/anorgasmia, nonsensuality and avoidance has an adverse effect on the SQoL-P of their partners. Male partners of diabetic females who have a higher perception of IELT had a reduced SQoL. Ageing and longer DOD in diabetics are associated with a reduced SQoL-P of their partners.

The inter-relational effect of metabolic syndrome and sexual dysfunction on hypogonadism in type II diabetic men.

We sought to establish the interplay of metabolic syndrome (MetS) and/or sexual dysfunction (SD) on hypogonadism. Sexual functioning was assessed using Golombok Rust Inventory of Sexual Satisfaction in 274 consecutive diabetic men visiting the diabetic clinic of the Tema General Hospital between November 2010 and March 2011. MetS was assessed employing the criteria of World Health Organization, International Diabetic Federation and the National Cholesterol Education Program Adult Treatment Panel III while testosterone levels were estimated. The mean ages and duration of diabetes from this study were 59.9±11.3 and 6.8±5.9 years, respectively. The prevalence of hypogonadism was 7.3%, with the -SD/+MetS subjects showing the highest prevalence of hypogonadism, irrespective of the criteria used. Additionally, subjects with MetS and its components had a significantly lower level of testosterone compared with those without MetS and its components. Using standard nine-point scale, it was observed that subjects who avoided sexual act had significantly (P=0.0410) lower testosterone values (5.8±2.3 ng ml-1) than subjects who did not avoid sexual act (6.4±2.6 ng ml-1). MetS alone impacted more on hypogonadism than SD alone or both conditions altogether.

Golombok Rust Inventory of Sexual Satisfaction for the presence of sexual dysfunction within a Ghanaian urological population.

Sexual dysfunction (SD) is devastating to a man's ego and its presence could defeat his purpose of masculinity. A number of studies have explored and reported on existing comorbidities between SD and medical conditions for which urological problems are no exception. However, in Ghana there is paucity of data exploring the epidemiological, etiological and health associations of medical conditions with SD. This study was therefore conducted to determine the prevalence, types and determinants of SD in a sample of Ghanaian men with urological conditions. This descriptive cross-sectional study was carried out between December 2012 and April 2013 at the Urology clinic of the Tamale Teaching Hospital in the Northern Region of Ghana. A total of 200 participants were enrolled in the study. All participants were evaluated by using a semistructured questionnaire and the Golombok Rust Inventory of Sexual Satisfaction questionnaire. An overall response rate of 47.5% was estimated after 69 patients refused to partake in the study; 6 patients found the questionnaire too sensitive and refused to participate and 30 participants returned incomplete questionnaire. The mean age of the participants was 36.5±13.8 years and ranged from 18 to 70 years. The estimated prevalence of SD was 71.6%. The prevalence of the various SD domains was as follows: non-sensuality (71.6%), premature ejaculation (70.5%), non-communication (69.5%), impotence and infrequency (68.4%), dissatisfaction (61.1%) and avoidance (57.9%). Participants who were married, consumed alcoholic beverages, smoked cigarettes and aging males who had children were at a greater risk of developing SD. Urologic patients have a high prevalence of SD that is dependent on marital status, alcohol consumption, smoking status and aged patients with children.

Renal insufficiency in Ghanaian HIV infected patients: need for dose adjustment.

BACKGROUND: Antiretrovirals (ARVs) could lead to clinically significant nephrotoxicity and as such will require dose adjustments in the presence of renal insufficiency. OBJECTIVE: To explore renal function estimating equations as alternatives for glomerular filtration rate (GFR) measurement in a stable cohort of HIV-infected patients. METHOD: In estimating renal insufficiency in Ghanaian HIV-infected patients, GFR for 276 HAART-naïve patients and 166 patients on HAART was estimated with the Cockcroft-Gault, 4v-MDRD and CKD-EPI estimating equations. RESULTS: Females outnumbered males by 3 to 1 in the HAART-naïve group and 4 to 1 in subjects on HAART. The prevalence of renal insufficiency calculated with the Cockcroft-Gault, 4v-MDRD and CKD-EPI equations was 8.7%, 9.1% and 8.7% in HAART-naïve patients; 14.5%, 12.6% and 12.6% in patients on HAART; 7.7%, 11.5% and 11.5% in HAART-naïve males; 10.8%, 8.1% and 8.1% in males on HAART; 9.1%, 8.0% and 7.5% in HAART-naïve females and 15.5%, 14.0% and 14.0% in females on HAART. The CKD-EPI equation yielded lower bias when compared to the Cockcroft-Gault and 4v-MDRD equations. CONCLUSION: Renal insufficiency is not uncommon among HIV infected Ghanaian patients. A significant proportion (10 to 11%) will require ARV dose adjustment at the time of initiating therapy or sometime during on-going therapy.

Prevalence of anaemia and immunological markers among ghanaian HAART-naïve HIV-patients and those on HAART.

BACKGROUND: Highly active antiretroviral therapy (HAART) for people living with HIV/AIDS (PLWHA) has been generally accepted as the gold standard for the management of HIV patients but conflicting reports about the ability of HAART to improve upon the quality of life of HIV patients has cast doubts over the efficacy and the need for therapy. OBJECTIVE: This study was conducted to assess the efficacy and ability of HAART to resolve immunological and haematological abnormalities in HIV infected patients, existent sex variations in immunological and haematological parameters and CD4 predictive ability of the study parameters. METHODS: A total of 442 PLWHA consisting of 166 patients on HAART (28 males and 138 females) and 276 HAART-naïve patients (76 males and 200 females) were recruited for this study. Complete haemogram, immunological analysis (CD4 & CD3) and weight were measured for all the patients. RESULTS: HAART patients were older and heavier than their naïve counterparts. The incidence of anaemia (Hb less or equal to 10.5 (63%) and PCV < 30% (37.6%)) and lymphopoenia (16.7%) in HAART-naïve patients was significantly higher compared to their counterparts on HAART (46%, 15.2% and 5.3%) respectively. 70% of HAART-naïve females had anaemia in comparison to 44% in HAART-naïve males (P = 0.0001). The likelihood of developing microcytic hypochromic anaemia in HAART-naïve patients was 5 times more compared to those on HAART (P = 0.0002). Total lymphocyte count, haemoglobin, lymphocyte count and weight were significant predictors of CD4 counts and TLC values between 1.0 - 2.0 k µL(-1) was a significant predictor of CD4 <200 cells mm(-3). CONCLUSION: HAART has the capability of reducing the incidence of anaemia and lymphopoenia which are associated with disease progression and death in HIV infected patients. Total lymphocyte count, haemoglobin and weight could also serve as useful predictive tools in the management and monitoring of HIV infected patients in resource limited settings.

Prevalence of male sexual dysfunction among Ghanaian populace: myth or reality?

This study was designed to investigate the prevalence and type of sexual dysfunction (SD) in healthy sexually active Ghanaian men of fertile age. Sexual functioning was determined in 300 healthy Ghanaian men with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire leaving in Kumasi metropolis, between December 2009 and April 2010. All men had a steady heterosexual relationship for at least 2 years before enrollment in the study. Of the 300 men selected, 255 (85%) completed the survey; the overall prevalence of SD in these subjects was 66%. The most prevalent areas of difficulty were infrequency (70.2%), premature ejaculation (64.7%), dissatisfaction with sexual acts (61.2%), impotency (59.6%), nonsensuality (59.2%), noncommunication (56.9%) and avoidance (49.0%). There were positive correlation between SD, impotence, dissatisfaction and age. The prevalence rate of SD in Ghanaian men is high and related to age.

The impact of blood glucose and cholesterol levels on the manifestation of psychiatric disorders.

This study examined possible association of fasting glucose and lipid abnormalities in psychiatric patients on conventional antipsychotic medications. A total of 305 subjects were used for the study, comprising 203 clinically diagnosed psychiatric patients and 102 non-psychiatric subjects used as control at the psychiatric clinic at Komfo Anokye Teaching Hospital (KATH). Questionnaires were administered, blood pressure and anthropometric measurements undertaken. Fasting blood samples were taken for glucose and total cholesterol. The patients included those treated with conventional antipsychotic agents. It was noted, that there were higher rates of diabetes (22.17%) and lipid abnormalities (42.43%) with lower rate of hypertension (5.91%) and obesity (5.91%) across the sample as compared to control. This finding suggests that the high prevalence of diabetes and lipid abnormalities, in a young, psychiatrically ill population makes the case for aggressive screening.

Serum lipid profile of breast cancer patients.

The purpose of this study was to carry out a comparative study to investigate the effect of lipid profile, oestradiol and obesity on the risk of a woman developing breast cancer. This study was carried out at the Komfo Anokye Teaching Hospital (KATH), Peace and Love Hospital, Oduom, Kumasi and Redeemed Clinic, Nima, Accra between May 2002 and March 2003. In this study, 200 consented women comprising 100 breast cancer patients (43 pre- and 57 post-menopausal) and 100 controls (45 pre- and 55 post-menopausal) with similar age range (25 to 80 years) were assessed for lipid profile, oestradiol and BMI. There was a significant increase in Body Mass Index (BMI) (p = 0.011), Total Cholesterol (TC) (p < 0.001), triglyceride (p = 0.026) and low density lipoprotein (LDL-cholesterol) (p = 0.001) of the breast cancer patients compared to the controls. With the exception of oestradiol (EST) that decreased, the lipid profile generally increased with age in both subjects and controls with the subjects having a much higher value than the corresponding control. There was also a significant positive correlation between BMI and TC (r2 = 0.022; p = 0.002) and also between BMI and LDL-cholesterol (r2 = 0.031; p = 0.0003). Apart from EST and LDL-cholesterol that were increased significantly only in the postmenopausal phase in comparison to the controls, BMI, TC and TG were increased in both pre-menopausal and post menopausal phases with HDL-cholesterol remaining unchanged. This study confirms the association between dyslipidaemia, BMI and increased breast cancer risk.

Bacterial contamination of donor blood at the Tamale Teaching Hospital, Ghana.

BACKGROUND: Transfusion of bacterially contaminated blood can result in sepsis and will constitute a substantial health burden to the patient. OBJECTIVE: To assess the level of transfusion related sepsis and the bacterial types responsible for the contamination at the Tamale Teaching Hospital in Ghana. METHOD: We sampled 80 refrigerated donor blood at the blood bank and cultured them for bacteria. The antimicrobial sensitivities of the isolates were also determined. RESULTS: 14 blood bags representing 17.5% grew isolates of various bacteria. Ten (10) of the 14 isolates were Gram positive cocci representing 71.42% making it the commonest contaminant. 50% of the gram positive cocci were identified to be coagulase negative staphylococci and 21.42% were Staphylococcus aureus. There were 14.28% isolates which were Gram positive rods, and were identified to be Corynebacterium diphtheroids. There were two isolates which were Gram negative rods; one was identified as Escherichia coli and the other one Klebsiella pneumoniae. Sensitivity among the organisms were varied; as all the 14 (100%) of the organisms isolated were sensitive to amikacin, only 14.28% of the coagulase negative staphylococci were sensitive to co-trimoxazole, 28.5% were sensitive to ampicillin, 42.8% were sensitive to cefuroxime and 71.4% were sensitive to ciprofloxacin. Sensitivity to gentamicin was observed to be 85.7% and 28.5% were sensitive to Tetracycline. Only the 10 Gram positive cocci were tested against erythromycin and Cloxacillin; where 70.00% were sensitive to cloxacillin and 90% were sensitive to erythromycin. CONCLUSION: All the Staphylococcus aureus isolated were resistant to both ampicillin and cotrimoxazole. Potential dangers and consequences of transfusing multidrug resistance bacteria have been discussed.

Bacterial Contamination of Donor Blood at the Tamale Teaching Hospital; Ghana

Background: Transfusion of bacterially contaminated blood can result in sepsis and will constitute a substantial health burden to the patient. Objective: To assess the level of transfusion related sepsis and the bacterial types responsible for the contamination at the Tamale Teaching Hospital in Ghana. Method: We sampled 80 refrigerated donor blood at the blood bank and cultured them for bacteria. The antimicrobial sensitivities of the isolates were also determined. Results: 14 blood bags representing 17.5grew isolates of various bacteria. Ten (10) of the 14 isolates were Gram positive cocci representing 71.42making it the commonest contaminant. 50of the gram positive cocci were identified to be coagulase negative staphylococci and 21.42were Staphylococcus aureus. There were 14.28isolates which were Gram positive rods; and were identified to be Corynebacterium diphtheroids . There were two isolates which were Gram negative rods; one was identified as Escherichia coli and the other one Klebsiella pneumoniae . Sensitivity among the organisms were varied; as all the 14 (100) of the organisms isolated were sensitive to amikacin; only 14.28of the coagulase negative staphylococci were sensitive to co-trimoxazole; 28.5were sensitive to ampicillin; 42.8were sensitive to cefuroxime and 71.4were sensitive to ciprofloxacin. Sensitivity to gentamicin was observed to be 85.7and 28.5were sensitive to Tetracycline. Only the 10 Gram positive cocci were tested against erythromycin and Cloxacillin; where 70.00were sensitive to cloxacillin and 90were sensitive to erythromycin. Conclusion: All the Staphylococcus aureus isolated were resistant to both ampicillin and cotrimoxazole. Potential dangers and consequences of transfusing multidrug resistance bacteria have been discussed