Browsing by Author "Naaeder, S. B."
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Item Acute appendicitis and dietary fibre intake.(1998-10) Naaeder, S. B.; Archampong, E. Q.It has been postulated that acute appendicitis is the first serious disease to emerge with the adoption of fibre-depleted diets. The incidence of acute appendicitis is rising in Africa and this has been attributed to socio-economic advancement and the adoption of low residue diets. The aim of this study was to determine whether income levels and the level of dietary fibre intake play any role in the rising incidence of acute appendicitis in Ghana. Between June and November 1997 patients aged 13 years and above with acute appendicitis were studied. Their monthly net income levels or those of their parents if they were minors were ascertained and a dietary fibre questionnaire completed on each patient in order to assess his or her dietary fibre intake. The clinical details of each patient were recorded on a proforma. One hundred and seventy-three patients, 128 males and 45 females, mean age 29.2 (range 13-75) years were studied. 14 percent presented within 6 h, 46.8 percent within 24 h and 41.6 percent after 2 or more days. 53.2 percent had acute appendicitis and 42.8 percent presented with complicated appendicitis. The appendix was normal in 4.0 percent. Two patients died (1.2 percent). 61.3 percent of patients were low income earners and 38.7 percent were high income earners. The overall dietary fibre intake was 39.4 g per day with no significant difference in fibre consumption between low income earners (39.0 g/day) and high income earners (43.5 g/day). We conclude that dietary fibre may not be the important factor in acute appendicitis and other luminal and/or morphological factors may be predisposing factors.Item Amputation of the lower limb in korle-bu teaching hospital, Accra.(1993-01) Naaeder, S. B.With the increasing life expectancy of our population, peripheral vascular disease will soon become a major problem in our society. The incidence of neoplasia affecting the lower limbs is reported to be on the increase in Africa. The increased activity of our herbal colleagues has brought in its wake large numbers of patients with disastrous complications of cellulitis. The lack of sophisticated methods of diagnosis and treatment coupled with the ignorance of our people and late presentation mean that many limbs that could be salvaged will continue to be lost. We, as health workers, can lessen the emotional and social burden of these unfortunate patients by ensuring their early and rapid integration back into their communities.Item Cancer of the colon and rectum in Ghana: A 5-year prospective study.(1994) Naaeder, S. B.; Archampong, E. Q.A prospective study of 134 patients who presented to a teaching hospital in Ghana for the first time with colorectal cancer between January 1987 and December 1991 is reported. The mean number of new patients per year was nearly three times that of a decade ago. The disease afflicts both sexes equally and the age of highest incidence is in the seventh and eighth decades. Some 65 patients had colonic cancer and 69 rectal lesions. Most patients presented with advanced disease and only four of 109 in whom disease was staged (3.7 per cent) had Dukes A tumours. Right-sided cancer of the colon was more common than that of the left. The importance of rectal examination is emphasized by the finding that 78 per cent of rectal tumours were within reach of the examining finger. 'Curative' resection was possible in 60 per cent of patients with colonic cancer but in only 36 per cent of those with rectal tumours. The postoperative mortality rate of patients who underwent laparotomy was 13.6 per cent and in those who had resection 5.5 per cent. Long-term follow-up was poor. These results emphasize the need for accurate data collection on colorectal carcinoma, public education on the importance of early diagnosis and follow-up after treatment. These findings also call for a study of the epidemiology and aetiology of colorectal cancer in Ghana.Item Changing pattern of acute intestinal obstruction in Accra.(1993-04) Naaeder, S. B.; Archampong, E. Q.Five hundred and fifty-two cases of intestinal obstruction were seen over a two year period, January 1987 to December 1988. Strangulated external hernias and adhesions still remain the most common causes of intestinal obstruction in Accra, but there has been a change in their relative incidence with external hernias falling to 59.8 per cent and adhesive obstruction increasing to 21.0 per cent. There has been no change in the overall mortality and mortality from inguinal hernia which are still 9.4 per cent and 4.9 per cent respectively. However, there has been a significant improvement in mortality rate from volvulus and a slight improvement in mortality from adhesive obstruction even though the overall resection rate has increased from 12.7 per cent to 17.6 per cent.Item Clinical spectrum of acute abdominal pain in Accra, Ghana.(1999-01) Naaeder, S. B.; Archampong, E. Q.In a 12-month prospective study 370 patients with acute abdominal pain were admitted to a single surgical unit of a large teaching hospital. The most common diagnoses were appendicitis (23.5 percent), Non-specific abdominal pain (NSAP) (21.4 percent), acute intestinal obstruction (10.8 percent), gynaecological causes (9.5 percent, and peptic ulcer (9.2 percent). Emergency operations were performed in 146 patients (39.5 percent). Appendicectomy was the commonest operation (77 cases or 52.7 percent) and there was a high incidence of complicated appendicitis (41.6 percent). Eleven patients (3.0 percent) died within 30 days of admission (8 postoperative and 3 non-operative deaths). The clinical spectrum of the acute abdomen in this study shows that surgeons in developing countries are not facing surgical challenges similar to those of their counterparts in developed countries and the most important diagnostic distinction surgeons in both localities have to make is that between acute appendicitis and non-specific abdominal pain.Item Effect of acute dietary fibre supplementation on colonic pH in healthy volunteers.(1998-07) Naaeder, S. B.; Evans, D.F.; Archampong, E. Q.Dietary fibre and undigested starch are fermented to short chain fatty acids by colonic bacteria with acidification of the colon. It has been suggested that acidification of the colon by these fatty acids inhibits bacterial metabolism, but this concept has been disputed. The aim of this study was to investigate the short term effect of a dietary fibre load on colonic metabolism. Colonic pH and breath hydrogen was measured in healthy omnivorous British male volunteers following ingestion, in turn and at weekly intervals, of 15g lactulose, wheat bran biscuits, oat bran biscuits and ispaghula husk. All the test meals caused a reduction in caecal pH and an increase in breath hydrogen production. The changes were greatest with lactulose. Lactulose and wheat bran caused acidification of the right and left colon whereas oat bran and ispaghula husk caused acidification of mainly the right colon. An inverse correlation between right colonic pH and breath hydrogen was observed in only the oat bran study. This study has demonstrated the ability of dietary fibre to lower right colonic pH and to increase breath hydrogen excretion. The changes were greater with soluble fibre than with insoluble fibre but the change in luminal pH was persistent all round the colon with insoluble fibre.Item Ileal stricture following strangulated inguinal hernia.(2007-10-01) Dakubo, J. C. B; Akoto, H.; Etwire, V. K.; Naaeder, S. B.Small intestinal stenosis due to ischaemia following strangulated hernia is uncommon as patients with external hernias have ready access to elective herniorrhaphy. Small intestinal stenosis secondary to ischaemiamay lead to acute small bowel obstruction, acute-on-chronic obstruction or chronic small bowel obstruction. Itmay also give rise to the blind loop syndrome. Preoperative diagnosis of this condition is difficult.We report four cases of small intestinal stenosis who presented to one surgical unit at the Korle-BuTeaching Hospital with acute intestinal obstruction over a period of 15 months.Item Multiple primary carcinomas of the gastrointestinal tract.(1998-10) Naaeder, S. B.; Jumah, K.B.A case of multiple primary Carcinomas of the gastrointestinal tract is reported in a man presenting with Carcinomas of the rectum and oesophagus.Item One-stage resection of acute sigmoid volvulus.(1995) Naaeder, S. B.; Archampong, E. Q.Item Upper Gastrointestinal edoscopy at the Korle-Bu Teaching Hospital(Ghana Medical Journal 41{1): 12-16, 2007) Aduful, H.K.; Naaeder, S. B.; Darko, R.; Baako, B. N.; Clegg-Lamptey, J. N. A.; Nkrumah, K. N.; Adu-Aryee, N. A.; M