Browsing by Author "Atiase, Y."
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Item A case of Cushing Syndrome due to accidental intake of dexamethasone: a call for enforcement of regulatory laws(Ghana Med J, 2021) Asamoah, K.T.; Akpalu, J.; Atiase, Y.; Yorke, E.Cushing syndrome could be a complication of long-term steroid use, resulting in a wide range of clinical presentations. Whereas some patients take medically prescribed doses of conventional medicines, including steroids for various ailments, others inadvertently consume unspecified doses by adulterating traditional medicines with these orthodox medications to increase their therapeutic appeal. Furthermore, some individuals with access to conventional medica tions may sell them in unlabelled packages as traditional medicines (TMs) to unsuspecting customers. This may lead to undesirable side effects and safety concerns. The case report highlights the problem of poorly regulated access to medications and makes suggestions to protect patrons' health of traditional medicines.Item Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report(Ghana Medical Journal, 2017-03) Akpalu, J.; Atiase, Y.; Yorke, E.; Fiscian, H.; Kootin-Sanwu, C.; Akpalu, A.Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines. It also brings to the fore the need for clinicians to look out for clinical features suggestive of hypothyroidism particularly among high risk individuals for early diagnosis and treatment.Item A comparison of indices of glucose metabolism in five black populations: Data from modeling the epidemiologic transition study (METS)(BioMed Central Ltd., 2015) Atiase, Y.; Farni, K.; Plange-Rhule, J.; Luke, A.; Bovet, P.; Forrester, T.G.; Lambert, V.; Levitt, N.S.; Kliethermes, S.; Cao, G.; Durazo-Arvizu, R.A.; Cooper, R.S.; Dugas, L.R.Background: Globally, Africans and African Americans experience a disproportionate burden of type 2 diabetes, compared to other race and ethnic groups. The aim of the study was to examine the association of plasma glucose with indices of glucose metabolism in young adults of African origin from 5 different countries. Methods: We identified participants from the Modeling the Epidemiologic Transition Study, an international study of weight change and cardiovascular disease (CVD) risk in five populations of African origin: USA (US), Jamaica, Ghana, South Africa, and Seychelles. For the current study, we included 667 participants (34.8∈±∈6.3 years), with measures of plasma glucose, insulin, leptin, and adiponectin, as well as moderate and vigorous physical activity (MVPA, minutes/day [min/day]), daily sedentary time (min/day), anthropometrics, and body composition. Results: Among the 282 men, body mass index (BMI) ranged from 22.1 to 29.6 kg/m2 in men and from 25.8 to 34.8 kg/m2 in 385 women. MVPA ranged from 26.2 to 47.1 min/day in men, and from 14.3 to 27.3 min/day in women and correlated with adiposity (BMI, waist size, and % body fat) only among US males after controlling for age. Plasma glucose ranged from 4.6∈±∈0.8 mmol/L in the South African men to 5.8 mmol/L US men, while the overall prevalence for diabetes was very low, except in the US men and women (6.7 and 12 %, respectively). Using multivariate linear regression, glucose was associated with BMI, age, sex, smoking hypertension, daily sedentary time but not daily MVPA. Conclusion: Obesity, metabolic risk, and other potential determinants vary significantly between populations at differing stages of the epidemiologic transition, requiring tailored public health policies to address local population characteristics.Item Effect of Physical Activity on Metabolic Syndrome Markers in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis(Sports, 2023) Amin, M.; Kerr, D.; Atiase, Y.; Aldwikat, R.K.; Driscoll, A.People with Type 2 diabetes mellitus (T2DM) are reported to have a high prevalence of metabolic syndrome (MetS), which increases their risk of cardiovascular events. Our aim was to determine the effect of physical activity (PA) on metabolic syndrome markers in people with T2DM. The study design was a systematic review and meta-analysis of randomised controlled trials evaluating the effect of PA on MetS in adults with T2DM. Relevant databases including SPORTdiscus, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, PsycINFO, EMBASE, SocINDEX were searched up to August 2022. Primary endpoints were changes in MetS markers (blood pressure, triglyceride, high-density lipoprotein, fasting blood sugar, and waist circumference) after an exercise intervention. Using a random effect model with 95% confidence interval (CI), the mean difference between intervention groups and control groups were calculated. Twenty-six articles were included in the review. Overall, aerobic exercise had a significant effect on waist circumference (Mean Difference: −0.34 cm, 95% CI: −0.84, −0.05; effect size: 2.29, I 2 = 10.78%). The effect sizes on blood pressure, triglyceride, high-density lipoprotein, fasting blood sugar were not statistically significant. No significant differences were found between exercise and control group following resistance training. Our findings suggest that aerobic exercise can improve waist circumference in people with T2DM and MetS. However, both aerobic and resistance exercise produced no significant difference in the remaining MetS markers. Larger and higher-quality studies are required to determine the full effects of PA on MetS markers in this populationItem Expert Opinions about Barriers and Facilitators to Physical Activity Participation in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study(Sports, 2023) Amin, M.; Kerr, D.; Atiase, Y.; Andrea Driscoll, A.Most adults with type 2 diabetes mellitus (T2DM) do not meet their physical activity (PA) goals despite its importance in improving their health outcomes. Our study aim was to explore the opinions of healthcare professionals regarding barriers and facilitators to PA participation in Ghanaian adults with T2DM. Using qualitative descriptive design, data were collected through semi-structured interviews with 13 healthcare professionals experienced in diabetes management in Ghana. Three main themes relating to PA barriers and facilitators were identified in a thematic analysis: health system-related factors, healthcare practitioner factors, and patient factors. Inadequate accessibility to physical therapists and therapy centres hindered the provision of PA programs. Nurses and doctors lacked sufficient knowledge and training on effective PA interventions for individuals with T2DM. Time constraints during patient consultations limited discussions on PA, while the cost associated with accessing physical therapy posed a significant challenge. Patients often disregarded PA advice from physical therapists due to their reliance on doctors, and some perceived PA as irrelevant for diabetes treatment. Despite these barriers, healthcare professionals expressed belief in PA facilitators, including integrating physical therapists and diabetes educators into diabetes care, providing structured exercise resources, improving curriculum planning to emphasise PA in health science education, and addressing knowledge gaps and misconceptions. Overall, this study highlights patient-related and healthcare system-related factors that influence PA behaviour in Ghanaian adults with T2DM. Findings from this study should inform the development of tailored PA programs for this populationItem Impact of structured education on glucose control and hypoglycaemia in Type-2 diabetes: a systematic review of randomized controlled trials(Ghana medical journal, 2018-03) Yorke, E.; Atiase, Y.Evidence for the use of structured education in diabetes management is accumulating and has shown positive influence in the management of Type-2 diabetes. Objective To assess the impact of structured education on glucose control and hypoglycaemia in the management of Type-2 diabetes. Methods A systematic review was done using Medline via Ovid and EMBASE databases of published English literature between 1980 and 2014. Included studies were randomized control trials that assessed the impact of structured education on glucose control and hypoglycaemia. Results Out of the 12,086 full text articles were identified, 36 full text articles were finally considered for this review after applying both inclusion and exclusion criteria, of which 34 were exclusively on the effect of structured diabetes education on glucose control whilst 2 were studies on the effects of structured diabetes education on glucose control and hypoglycaemia. Majority of the studies included a predominant Caucasian population. There was heterogeneity in the included studies such as intervention methods and intensity as well as follow up periods. Group based education was preferred over individual education by most studies. Overall, most of the studies showed a significant positive effect on glycaemic control compared with control groups. One study showed a significant impact of structured education on hypoglycaemia. Conclusion Structured education has positive impact on glucose control and hypoglycaemia in Type-2 diabetes and must be incorporated in routine care.Item Improving Metabolic Syndrome in Ghanaian Adults with Type 2 Diabetes through a Home-Based Physical Activity Program: A Feasibility Randomised Controlled Trial(International. Journal Environmental. Research and Public Health, 2023) Amin, M.; Kerr, D.; Atiase, Y.; Samir, M.M.; Driscoll, A.There is a high prevalence of metabolic syndrome (MetS) among people with type 2 diabetes mellitus (T2DM). Physical activity has the potential to improve health outcomes for individuals with type 2 diabetes. Our study aim was to determine the effect of a 12-week culturally appropriate home based physical activity program on metabolic syndrome markers and quality of life in Ghanaian adults with T2DM. A secondary objective was to examine the feasibility of implementing the PA program. A feasibility randomised controlled trial (RCT) was conducted. A purposive sample of 87 adults with T2DM at the Korle-Bu Teaching Hospital, Ghana, were randomized into either the control group (CG) (n = 43) or the intervention group (IG) (n = 44). Participants in the IG received the physical activity program in addition to their usual diabetes care; those in the CG received their usual diabetes care. Measurements for feasibility, MetS markers, and quality of life (SF-12) were performed at baseline and 12-week follow-up. Following the 12-week program, participants in the IG showed a significant improvement in fasting blood glucose (2.4% vs. 0.4%, p < 0.05), waist circumference (5.4% vs. 0.4%, p < 0.05), and systolic blood pressure (9.8% vs. 1.5%, p < 0.05). There were no statistical differences between the IG and CG regarding high-density lipoprotein, triglycerides, and diastolic blood pressure at the 12-week follow-up. Classification of MetS were reduced in the IG compared to the CG (51.2% vs. 83.3%, p < 0.05). The MetS severity score improved in the IG compared to the CG (8.8% vs. 0.5%, p < 0.05). The IG improved in two of the eight SF-12 dimensions (physical function and vitality, p < 0.05) compared to the CG. Thirty-two (72.7%) participants completed all 36 exercise sessions. Another 11 (25%) participants completed 80% of the exercise sessions. No adverse events were reported. In conclusion, a 12-week home-based physical activity program is feasible and safe. The intervention has the potential to improve MetS and quality of life in Ghanaian adults with T2DM. The preliminary findings of this study need to be confirmed in a large-scale multi-centre RCT.Item Macrovascular and renal microvascular complications in West Africans with intermediate hyperglycemia living in West Africa and Europe: The RODAM study(Heliyon, 2023) Bannerman-William, E.; Hayfron-Benjamin, C.F.; Atiase, Y.; et al.Background: Metabolic conditions, including intermediate hyperglycemia (IH), affect migrants to a greater extent than the populations of origin. Evidence suggests that IH increases the risk of vascular complications, but it is unclear whether the differences in IH between the non-migrant and migrant populations translate to differences in vascular complications between the two populations. We compared the prevalence of macrovascular and renal microvascular complica tions among West Africans with IH living in West Africa and their migrant compatriots in Europe. Methods: Data from the multicenter Research on Obesity and Diabetes among African Migrants (RODAM) study were analyzed. Ghanaians with IH(524 non-migrant and 1439 migrants) were included. Logistic regression analyses were used to determine the associations between migrant status and macrovascular [coronary artery disease(CAD) and peripheral artery disease(PAD)] and renal microvascular[nephropathy] complications with adjustment for age, sex, socioeconomic status, smoking, systolic blood pressure, BMI, total cholesterol, HbA1c, C-reactive protein, and serum uric acid. Findings: The prevalence of microvascular/macrovascular complications was higher in non migrants than in migrants(nephropathy 15.3vs.9.7%; PAD 3.1%vs.1.3%; and CAD 15.8% vs. 5.0%). The differences persisted in the fully adjusted model: nephropathy [odds ratio, 2.12; 95% CI(1.46–3.08); PAD, 4.44(1.87–10.51); CAD 2.35(1.64–3.37)]. Non-migrant females had higher odds of nephropathy[2.14(1.34–3.43)], PAD[7.47(2.38–23.40)] and CAD [2.10(1.34–3.27)] compared to migrant females. Non-migrant males had higher odds of nephropathy[2.54 (1.30–4.97)] and CAD[2.85(1.48–5.50)], but not PAD[1.81(0.32–10.29)],than their migrant peersItem Macrovascular and renal microvascular complications in West Africans with intermediate hyperglycemia living in West Africa and Europe: The RODAM study(Heliyon, 2023) Williams, E.B.; Benjamin, C.F.H; Atiase, Y.Background: Metabolic conditions, including intermediate hyperglycemia (IH), affect migrants to a greater extent than the populations of origin. Evidence suggests that IH increases the risk of vascular complications, but it is unclear whether the differences in IH between the non-migrant and migrant populations translate to differences in vascular complications between the two populations. We compared the prevalence of macrovascular and renal microvascular complica tions among West Africans with IH living in West Africa and their migrant compatriots in Europe. Methods: Data from the multicenter Research on Obesity and Diabetes among African Migrants (RODAM) study were analyzed. Ghanaians with IH(524 non-migrant and 1439 migrants) were included. Logistic regression analyses were used to determine the associations between migrant status and macrovascular [coronary artery disease(CAD) and peripheral artery disease(PAD)] and renal microvascular[nephropathy] complications with adjustment for age, sex, socioeconomicItem Management of recurrent pheochromocytoma in pregnancy in a young Ghanaian(Ghana Medical Journal, 2022) Akpalu, J.; Ampong, C.; Atiase, Y.; Yorke, E.; Takyi, C.; Cole-man, J.The co-existence of pheochromocytoma and pregnancy is rare, with poor maternal and foetal outcomes. This is a case report of a young Ghanaian woman with a pre-existing diagnosis of recurrent pheochromocytoma who became preg nant and experienced elevated blood pressure in the third trimester with proteinuria and abnormal liver function. She was managed as an in-patient and delivered a live baby via caesarean section at 34 weeks after detecting intra-uterine growth restriction. Management of such cases by a multidisciplinary team is recommended for optimal outcomes.Item Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana(Pathogens, 2021) Anafo, R.B.; Atiase, Y.; Dayie, N.T.K.D.; Kotey, F.C.N.; Tetteh-Quarcoo, P.B.; Duodu, S.; Osei, M.; Alzahrani, K.J.; Donkor, E.S.Aim: This study investigated the spectrum of bacteria infecting the ulcers of individuals with diabetes at the Korle Bu Teaching Hospital in Accra, Ghana, focusing on Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), with respect to their prevalence, factors pre disposing to their infection of the ulcers, and antimicrobial resistance patterns. Methodology: This cross-sectional study was conducted at The Ulcer Clinic, Department of Surgery, Korle Bu Teaching Hospital, involving 100 diabetic foot ulcer patients. The ulcer of each study participant was swabbed and cultured bacteriologically, following standard procedures. Antimicrobial susceptibility testing was done for all S. aureus isolated, using the Kirby-Bauer method. Results: In total, 96% of the participants had their ulcers infected—32.3% (n = 31) of these had their ulcers infected with one bacterium, 47.9% (n = 46) with two bacteria, 18.8% (n = 18) with three bacteria, and 1.0% (n = 1) with four bacteria. The prevalence of S. aureus and MRSA were 19% and 6%, respectively. The distribution of the other bacteria was as follows: coagulase-negative Staphylococci (CoNS) (54%), Escherichia coli (24%), Pseudomonas spp. (19%), Citrobacter koseri and Morganella morgana (12% each), Klebsiella oxytoca (11%), Proteus vulgaris (8%), Enterococcus spp. (6%), Klebsiella pneumoniae (5%), Proteus mirabilis and Enterobacter spp. (4%), Klebsiella spp. (2%), and Streptococcus spp. (1%). The resistance rates of S. aureus decreased across penicillin (100%, n = 19), tetracycline (47.4%, n = 9), cotrimoxazole (42.1%, n = 8), cefoxitin (31.6%, n = 6), erythromycin and clindamycin (26.3% each, n = 5), norfloxacin and gentamicin (15.8% each, n = 3), rifampicin (10.5%, n = 2), linezolid (5.3%, n = 1), and fusidic acid (0.0%, n = 0). The proportion of multidrug resistance was 47.4% (n = 9). Except for foot ulcer infection with coagulase-negative Staphylococci, which was protective of S. aureus infection of the ulcers (OR = 0.029, p = 0.001, 95% CI = 0.004–0.231), no predictor of S. aureus, MRSA, or polymicrobial ulcer infection was identified. Conclusions: The prevalence of S. aureus and MRSA infection of the diabetic foot ulcers were high, but lower than those of the predominant infector, coagulase-negative Staphylococci and the next highest infecting agent, E. coli. Diabetic foot ulcers’ infection with coagulase-negative Staphylococci protected against their infection with S. aureus. The prevalence of multidrug resistance was high, highlighting the need to further intensify antimicrobial stewardship programmes.Item Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage among patients with diabetes at the Korle Bu Teaching Hospital(PLOS ONE, 2021) Anafo, R.B.; Atiase, Y.; Kotey, F.C.N.; Dayie, N.T. K. D.; Tetteh-Quarcoo, P.B.; Duodu, S.; Osei, M.M.; Alzahrani, K.J.; Donkor, E.S.To investigate the epidemiology of S. aureus and MRSA nasal carriage among people with diabetes at the Korle Bu Teaching Hospital in Accra, including the prevalence, predictors of carriage, and antibiotic resistance. This study was cross-sectional, involving 300 diabetes patients and 106 non-diabetic individuals. Swab specimens of the nares were obtained from the participants and bacteriologically- cultured. Identification and characterization of S. aureus and MRSA were based on standard bacteriological methods; antimicrobial susceptibility testing was by the Kirby- Bauer method.The prevalence of staphylococcal carriage, the diabetes group relative to the non-diabetes group, were 31.0% and 10.4% (S. aureus), and 3.3% and 0.0% (MRSA). Presence of diabetes predisposed to S. aureus carriage, but not MRSA nor coagulase-negative staphylococci (CoNS) carriage (OR = 3.88; p < 0.0001). Colonization with CoNS was protective of S. aureus (OR = 0.039, p < 0.001) and MRSA (OR = 0.115, p = 0.043) colonization among the diabetics. The antimicrobial resistance patterns recorded among the S. aureus isolated from the diabetic individuals relative to the non-diabetics were as follows: penicillin (95% vs. 91%), tetracycline (37% vs. 27%), cotrimoxazole (30% vs. 36%), erythromycin (17% vs. 0%), norfloxacin (13% vs. 0%), clindamycin (12% vs. 0%), gentamicin (9% vs. 0%), fusidic acid (10% vs. 9%), linezolid (4% vs. 0%), and rifampicin (5% vs. 0%). The proportion of multidrug resistant S. aureus was 41% (n = 38) in the diabetes group and 0% in the non-diabetes group; this difference was statistically significant (p = 0.01). The presence of diabetes predisposed the participants to S. aureus carriage by almost four folds, but not MRSA carriage. Colonization with CoNS was protective of S. aureus and MRSA carriage in the diabetes group. Finally, linezolid remains a good therapeutic agent for anti-MRSA therapy.Item Pachydermoperiostosis in a patient with chronic hepatitis B virus infection referred as acromegaly: a case report(Journal of Medical Case Reports, 2018-03) Atiase, Y.; Yorke, E.; Akpalu, J.; Opoku-Asare, B.; Adjei, P.; Amissah-Arthur, M.B.; Akpalu, A.Background Primary hypertrophic osteoarthropathy also known as pachydermoperiostosis is a rare genetic disorder that has often been confused with acromegaly because of similar clinical features. Vascular endothelial growth factors which have been implicated in the clinical features of pachydermoperiostosis, have also been shown to be present in chronic hepatitis and implicated in the malignant transformation of hepatitis B infection to hepatocellular carcinoma. To the best of our knowledge there is one reported case of pachydermoperiostosis with chronic hepatitis B infection. We do not imply a causal relationship between pachydermoperiostosis and hepatitis B infection because pachydermoperiostosis is a genetic disorder; however, the question is raised whether hypertrophic osteoarthropathy is one of the many extrahepatic manifestations of chronic hepatitis B infection. Case presentation A 21-year-old African (Ghanaian) man with chronic hepatitis B infection was referred to our Endocrine unit as having acromegaly with changing facial features, enlarging hands and feet, and large knee joint effusions which affected activities of daily living. He was finally diagnosed as having pachydermoperiostosis when acromegaly, rheumatological disorders, as well as cardiopulmonary disorders were ruled out. He improved with arthrocentesis, a tapering regime of steroids, non-steroidal anti-inflammatory drugs, and proton pump inhibitors. Conclusions The possible role of hepatitis B in hypertrophic osteoarthropathy, that is, secondary hypertrophic osteoarthropathy, needs to be explored; however, with digital clubbing in his father our patient is likely to have pachydermoperiostosis.Item Psychosocial Experiences of Patients with Type -2 Diabetes Mellitus: A Study at the Korle-Bu Teaching Hospital(University of Ghana, 2016-07) Owusu, Y.; Korsah, K.A.; Atiase, Y.; University of Ghana, College of Health Sciences, School of NursingDiabetes mellitus is a metabolic disease resulting from the body’s inability to produce and utilize insulin effectively. Living with type -2 diabetes mellitus has been associated with several challenges. Identification of these challenges would help in holistic healthcare provision for persons living with type-2 diabetes mellitus. This study explored the lived experiences of persons living with type-2 diabetes mellitus in Accra by examining their psychosocial experiences as well as how they cope with their condition. A total of 12 persons living with type-2 diabetes mellitus were purposively sampled and semi-structured individual interviews were conducted with the patients. The study used the exploratory descriptive approach to qualitative research. Data collected in this study was analyzed using interpretative content analysis developed by Polit & Beck (2005). Results from the study showed that type-2 diabetes mellitus has severe negative physical consequences on the lives of the patients in the form of low physical energy, fatigue and weight loss. Living with type-2 diabetes mellitus has been found to result in severe negative psychological consequences for the patients and the most prevalent of all are depression and anxiety. However, some of the patients in the study did not report symptoms of psychological problems since they reported that they are able to handle their condition. It was also found that living with type-2 diabetes mellitus has severe negative consequence on the economic lives of the patients in the form of job loss and lack of employment opportunities. Additionally, results showed that patients experience some negative social consequences of their illness in the form of social restrictions, isolation and stigmatization from the community members due to the severe weight loss which is misconstrued to be HIV. Finally, it was observed from the analysis of the narratives that the respondents use several coping strategies including support from their social networks, religion and self-care practices. It is therefore noted that living with type-2 diabetes mellitus has severe negative Psychosocial Experiences of Patients with Type -2 Diabetes. psychosocial consequences for the patients and healthcare personnel should look out for these challenges of patients in order to offer the needed support and care. Predictive factors of the psychological problems among persons living with type -2 diabetes mellitus should be explored using a larger sample size in the future studies. Similarly, from the findings of this study, there may be the need to do further research to explore how spirituality or religiosity in particular is used to manage a chronic disease like diabetes mellitus.Item Screening for Cushing Syndrome at the Primary Care Level: What Every General Practitioner Must Know(International Journal of Endocrinology, 2017-07) Yorke, E.; Atiase, Y.; Akpalu, J.; Sarfo-Kantanka, O.Cushing's syndrome is a rare entity, and a high index of suspicion is needed for screening in a primary care setting. The clinical awareness of the primary care physician (PCP) to the highly indicative signs and symptoms such as facial plethora, proximal myopathy, reddish purple striae, and easy bruisability should alert him to look for biochemical evidence of Cushing's syndrome through any of the first-line screening tests, namely, 24-hour urinary free cortisol, overnight dexamethasone suppression test, or late-night salivary cortisol. Commonly used random cortisol measurements are unreliable; hence, general practitioners are encouraged to understand the use of these more reliable tests with increased sensitivity and specificity for screening Cushing's syndrome. In this write-up, we set out to increase awareness about the presentation of Cushing's syndrome and current recommended screening methods as well as their strengths and weaknesses. We relied mainly on the recommendations by the Endocrine Society Guidelines. © 2017 Ernest Yorke et al.Item Steroid-induced dysglycaemia in patients with haematological disorders a ten-year review in a tertiary hospital in Ghana(Ghana medical journal, 2019-06-02) Dei-Adomakoh, Y.A.; Akpalu, J.; Yawson, A.E.; Ekem, I.; Reynolds, M.; Atiase, Y.Background: Glucocorticoids (steroids) play a key role in the management of multiple medical conditions including haematological disorders. This study looked at the prevalence of steroid induced dysglycaemia in patients with haematological disorders receiving steroids as part of their treatment with the view of modifying its use and selection of patients where necessary. Methods: A retrospective review of haematology patients on treatment regimens including steroids. Information extracted included, demographic characteristics, clinical information such as age, gender, haematological disorder, type of steroid, daily and cumulative dose of steroid, duration of therapy, family history of diabetes and alcohol use. Results: The case records of 351 haematology patients were reviewed. However, eight patients with dysglycaemia before therapy were excluded. The median age of patients was 51.0 ± 26.0(IQR: Interquartile Range) years, with an age range of 13 to 87 years, and a female: male ratio of 1.2: 1 (p= 0.778). The prevalence of Steroid-Induced Dysglycaemia (SID) was 3.79% with a mean diagnosis interval of 8.8 + 2.1 months. Overall, 245 (71.4%) patients were on continuous steroids. Among the 13 patients who developed SID, 11 (84.6%) were on continuous steroids. In the majority of the patients (97.1%) there was no family history of diabetes in a first degree relative. Significant differences were found between patients with normoglycaemia and those with dysglycaemia with respect to age (p=0.049) and duration of steroid therapy (p=0.024). Conclusion: The prevalence of steroid-induced dysglycaemia is relatively low among Ghanaian patients with haematological disorders on steroid based chemotherapy.Item Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana(Stroke Research and Treatment, 2018-09) Akpalu, J.; Yawson, A.E.; Osei-Poku, F.; Atiase, Y.; Yorke, E.; Adjei, P.; Nkromah, K.; Akpalu, A.Background Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.