Browsing by Author "Der, E.M."
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Follicular Thyroid Carcinoma in a Country of Endemic Iodine Deficiency (1994–2013)(Journal of Thyroid Research, 2018-02) Der, E.M.Background Follicular thyroid cancer (FTC) has historically been linked to iodine deficiency. Although Ghana is among the iodine deficient regions of the world, the proportions, trends, and the clinical features of FTCs have not been studied as a single disease entity. The aim of this study was to determine the relative frequencies, trends, and the clinicopathological characteristics of FTCs among all thyroid malignancies in our institution. Materials and Methods This was a retrospective study from January 1994 to December 2013. Data were analysed using SPSS software version 23 (Chicago) and Graph pad prism version 5.00. Results Follicular thyroid cancer was the second thyroid malignancy (35.0%) and showed a gradual rise in relative proportions over the period. The male-female ratio was 1 : 1.5. The mean ages were 46.9 (SD ±17.3) for males and 46.4 (SD ±13.3) years for females. Enlarged palpable anterior neck swelling was the commonest symptom in males (86.7%) and females (91.3%) (P = 0.730). Hurthle cell carcinoma was the commonest variant of FTC, with 26.7% males and 10.6% females (P = 0.116). Distant spread was found in 23.3% of males compared to 19.1% of females (P = 0.633). The common sites of distant spread were bones (57.2%) in males and cervical lymph nodes (44.4%) in females (P = 0.106). Conclusion Follicular thyroid cancer was the second common thyroid malignancy (35.0%) with a gradual rise in trend over the study period and male-female ratio of 1.5 : 1. Large anterior neck swelling was the commonest clinical presentation of FTC.Item Pregnancy Related Causes of Deaths in Ghana: A 5-Year Retrospective Study(Ghana medical journal, 2013-12) Der, E.M.; Moyer, C.; Gyasi, R.K.; Akosa, A.B.; Tettey, Y.; Akakpo, P.K.; Blankson, A.; Anim, J.T.Objective: Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Method: Autopsy log books of the Department of Pa-thology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy relat-ed deaths. Data were entered into a database and ana-lyzed using SPSS statistical software (Version 19). Results: Of 5,247 deaths among women aged 15-49, 12.1% (634) were pregnancy-related. Eighty one per-cent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) re-sulted from direct obstetric causes, including: haemor-rhage (21.8%), abortion (20.8%), hypertensive disor-ders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coag-ulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hyper-tensive disorders (19.4%), infections (9.1%) and ectop-ic gestation (8.7%). Conclusion: Ghana continues to have persistently high levels of preventable causes of maternal deaths. Com-munity based studies, on maternal mortality are urgent-ly needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.Item Triple-negative breast cancer in Ghanaian women: The Korle Bu Teaching Hospital experience(Breast Journal, 2015-11) Der, E.M.; Gyasi, R.K.; Tettey, Y.; Edusei, L.; Bayor, M.T.; Jiagge, E.; Gyakobo, M.; Merajver, S.D.; Newman, L.A.Breast cancers that have negative or extremely low expression of estrogen receptor and progesterone receptor and non-amplification of human epidermal growth factor receptor-2 (HER2)/neu are termed triple-negative breast cancer (TNBC). The majority of TNBC tumors belong to the biologically aggressive basal subtype, and they cannot be managed with targeted endocrine or anti-HER2/neu agents. In western, high resource environments, risk factors for TNBC include younger age at diagnosis and hereditary susceptibility. Women of African ancestry in the United States and in continental Africa have higher frequencies of TNBC, prompting speculation that this risk may have an inherited basis and may at least partially explain breast cancer survival disparities related to racial/ethnic identity. Efforts to document and confirm the breast cancer burden of continental Africa have been hampered by the limited availability of registry and immunohistochemistry resources. Our goal was to evaluate the breast cancers diagnosed in one of the largest health care facilities in western Africa, and to compare the frequencies as well as risk factors for TNBC versus non-TNBC in this large referral tertiary hospital. The Korle Bu Teaching Hospital is affiliated with the University of Ghana and is located in Accra, the capital of Ghana. We conducted an institutional, Department of Pathology-based review of the breast cancer cases seen at this facility for the 2010 calendar year, and for which histopathologic specimens were available. The overall study population of 223 breast cancer cases had a median age of 52.4 years, and most had palpable tumors larger than 5 cm in diameter. More than half were TNBC (130; 58.3%). We observed similar age-specific frequencies, distribution of stage at diagnosis and tumor grade among cases of TNBC compared to cases of non-TNBC. Ghanaian breast cancer patients tend to have an advanced stage distribution and relatively younger age at diagnosis compared to Caucasian Americans and African Americans. The triple-negative molecular marker pattern was the most common subtype of breast cancer seen among this sample of Ghanaian women, regardless of age, tumor grade, or stage of diagnosis. Research into the molecular pathogenesis of TNBC may help elucidate the reasons for its increased prevalence among women with African ancestry. © 2015 Wiley Periodicals, Inc.