Browsing by Author "Ali, M.A."
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Item Ambiguous genitalia: clinical management of adult female with male assigned gender: a case report(Journal of Medical Case Reports, 2021) Ali, M.A.; Maalman, R.S-E; Donkor, Y.O.; Mensah, J.E.Background: Disorders of sex development are anomalies in which the development of urogenital ridge is undif‑ ferentiated for the male and female child. Imaging plays a vital role in investigating the gross anatomy and associated anomalies. Ultrasonography, such as genitography and magnetic resonance, is the primary modality for demonstrat‑ ing internal gonads and genitalia. Early multidisciplinary approach in the management of ambiguous genitalia includ‑ ing early surgical intervention is the predominant practice, with few current considerations on deferral of genital reconstruction until adolescent age. Case presentation: We report the rare case of a 24-year-old adult female from a majority ethnic group of the Volta region, Ghana who was diagnosed and raised as male, now requiring surgical restoration to the female gender. The surgical team decided to assign external genitalia to correspond with the already intact internal organs, thus con‑ structing the vulva. Consent was given by the client and her family members for management and surgical interven‑ tion. The surgery was scheduled and duly performed with a successful outcome. Understanding and consent was sought from the patient for the purpose of using her images for teaching, scientifc publication, and demonstrations. Conclusion: The advantages of deferring surgical reconstruction with psychological counseling after early assess‑ ment need to be considered to prevent inappropriate gender assignmentItem Ambiguous genitalia: clinical management of adult female with male assigned gender: a case report(Journal of Medical Case Reports, 2021-07) Ali, M.A.; Donkor, Y.O.; Mensah, J.E.; Ayamba, M.Background: Disorders of sex development are anomalies in which the development of urogenital ridge is undif‑ ferentiated for the male and female child. Imaging plays a vital role in investigating the gross anatomy and associated anomalies. Ultrasonography, such as genitography and magnetic resonance, is the primary modality for demonstrat‑ ing internal gonads and genitalia. Early multidisciplinary approach in the management of ambiguous genitalia includ‑ ing early surgical intervention is the predominant practice, with few current considerations on deferral of genital reconstruction until adolescent age. Case presentation: We report the rare case of a 24-year-old adult female from a majority ethnic group of the Volta region, Ghana who was diagnosed and raised as male, now requiring surgical restoration to the female gender. The surgical team decided to assign external genitalia to correspond with the already intact internal organs, thus con‑ structing the vulva. Consent was given by the client and her family members for management and surgical interven‑ tion. The surgery was scheduled and duly performed with a successful outcome. Understanding and consent was sought from the patient for the purpose of using her images for teaching, scientific publication, and demonstrations. Conclusion: The advantages of deferring surgical reconstruction with psychological counseling after early assessment need to be considered to prevent inappropriate gender assignmentItem Amyand’s hernia- outcome of nylon darn repairs after complicated appendix surgeries in a district hospital: case series(2021) Ali, M.A.; Hagbevor, I.; Kyei, M.Y.; Nanga, S.Introduction: Complicated appendix is a least expected sac content of inguinal hernias that always require appendix surgery and hernia repair. The current recommendations for posterior wall repairs however, continue to attract conflicting views as to which modality gives the best outcome in infected surgical wounds. New posterior wall repair methods with properties to withstand surgical site infections, minimise hernia recurrence, affordable and easy skill to acquire with a potential to be widely adopted are continuosly sort. Aim: To determine the surgical outcomes of complicated Amyand Hernias repaired using the open tissue base Nylon Darn posterior wall re-enforcement method. Method: A retrospective review of medical records of patients who had surgery for emergency inguinal hernia with intra-operative confirmation of complicated appendix in the hernia sac from January 2015 to December 2020 at the Margaret Marquart Catholic Hospital, Kpando were included. Data on age, sex, clinical presentation, surgical procedure, intra-operative findings, post operative complications were captured and presented as descriptive statistics. Results: Twelve out of 286(4.6%) repairs were complicated Amyand Hernias in patients aged 6weeks to 76-years {median age 54.5-years}. Most of them were adults, long-standing hernias. All diagnosis were made on-table. Surgical site infections was the most frequent complication in types III and IV AHs which resolved with antibiotic treatment. Conclusion: The incidence of complicated AHs is higher and should be anticipated in surgeries for long-standing complicated inguinal hernias. Even though complications were significantly associated with longer hospital stay, no second procedure or mortality was recorded.Item Closed non‑suction drain placement as haematoma and seroma formation preventive measure post‑nylon darn surgery for inguinoscrotal hernias in adults(Springer, 2021) Hagbevor, I.; Ali, M.A.; Awuku, G.A.Purpose Inguinal hernia is a common male surgical disease. Intervention carries a wide range of complications such as scrotal haematoma and seroma which may require surgical re-intervention or predispose patients to developing infections, pains or feeling of mass. This could lead to long hospital stay. Scrotal tamponade by bandaging or wearing of tight pants and elevation are practiced to reduce bleeding and haematoma formation. These methods require prolong use. Closed suction drains are scarcely used in resource-deprived communities due to high cost and non-availability. Aim This study was to determine the effectiveness of a closed non-suction drain in preventing scrotal collection requiring further surgical intervention and the predisposition to developing surgical site infection following nylon darn repair of inguinoscrotal hernia. Methods Forty (40) participants were recruited for a preliminary study and assigned into control and interventional groups (CG, IG) for purposes of inserting fexible feeding tube (FFT) wound drain after nylon darn (ND) repair. Daily measurement of drained scrotal collection was carried out in the IG till the day drainage was zero. Residual volumes in IG and wound collection in the CG who were not candidates for re-intervention were determined at 14th and 28th post-operative days using ultrasound scan. Data were analyzed using SPSS version 25. Results Three (3) patients (15.8%) in the CG required re-intervention. Surgical site infection rates for the CG and IG were, respectively, 2/19 versus 0/21 (ρ=0.134).There was a numerical significant difference in the mean volumes of scrotal collections between the control (0.95±0.42 ml) and the intervention group (0.44±0.33 ml) [p value of 0.041] but with no clinical impact. Conclusion Simple inexpensive flexible feeding tube placement significantly reduced scrotal collection which forms a base for larger sample size in subsequent studies. This could reduce the feared risk of re-intervention, wound infection and long hospital stay post-operative.Item Solitary kidney functional damage due to caesarean ureteric injury monitored for 2 years after acute management: A case report(Case Reports in Women's Health, 2022) Ali, M.A.; Oyortey, M.A.; Maalman, R.S-E.; Donkor, Y.O.; Adanu, K.K.; Kyei, M.Y.women with a solitary kidney has far-reaching effects if the diagnosis is delayed. The case report describes the successful acute management with stenting of ureteric damage after caesarean section in a woman with a solitary kidney. A 29-year-old woman presented with anuria, hypertension (174/101 mmHg) and flank pain 3 days after caesarean section. Physical examination was significant for peri-orbital oedema, left flank tenderness, pallor and delirium. A diagnosis of acute kidney injury was confirmed by elevated blood urea and creatinine levels. An ultrasound scan revealed a solitary hydronephrotic left kidney. She had successful acute management at a resource-deprived facility, with normal renal function at a 2-year follow-up. Proteinuria lasted for about three months after surgery. Recovery of solitary kidney function with acute kidney injury due to caesarean section ureteric injury may be associated with prolonged proteinuria without evidence of further functional deterioration.