Browsing by Author "Nyame, P.K."
Now showing 1 - 14 of 14
Results Per Page
Sort Options
Item Amodiaquine-induced dystonic reactions: Case reports and implications for policy change in Ghana(International Journal of Risk and Safety in Medicine, 2005-01) Akpalu Jr., A.K.; Nyame, P.K.; Dodoo, A.N.O.Ten cases of amodiaquine-induced dystonic reactions observed in a single ward in Ghana's Premier Teaching Hospital, over a period of 4 years are presented. All the reactions resolved without sequalae on treatment with diazepam and benztropine. The importance of increased safety monitoring of amodiaquine as it is (in combination with artesunate) introduced as first line treatment for uncomplicated malaria in Ghana is highlighted. © 2005 - IOS Press and the authors. All rights reserved.Item Assessment of anthropometric measurements, blood analytes and liver enzymes in Ghanaian alcoholics(West African Journal of Medicine, 1992) Quaye, I.K.; Nyame, P.K.; Dodoo, D.K.; Gyan, B.; Adjei, A.A.Anthropometric measurements of alcoholics and non alcoholics of similar economic background were compared and the results reveal that there are no marked differences between the two. However, the biochemical analyses indicates that alcohol predisposes to fat storage, may contribute to iron deficiency and plays a direct etiologic role in liver disease.Item Biochemical and haematological markers of alcohol intake in Ghanaians(West African Journal of Medicine, 1992) Quaye, I.K.; Nyame, P.K.; Dodoo, D.; Gyan, B.; Adjei, A.A.The serum gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), urate and triglyceride and mean cell volume (MCV) were determined in 60 total abstainers, 56 social drinkers and 100 alcoholics. Both enzymes and urate showed progressive rise with increasing alcohol intake. The mean cell volume was only moderately elevated. Gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and urate are sensitive enough to detect people who take in alcohol regularly and yet may be regarded as normal and not alcohol dependent.Item Cervical Spondylosis in Blue Collar and Office Workers: A Comparison of Heavy Manual and Sedentary Workers.(Ghana Medical Journal, 1992) Nyame, P.K.; Jumah, K.B.The occurrence of cervical spondylosis in a group of blue collar workers was compared with the occurrence of this condition in a group of office workers. The study showed a prevalence rate of 34% in the blue collar workers, significantly higher than the office workers. it is concluded that cervical spondylosis is not exclusively an ageing phenomenon, but heavy manual labour as an occupation plays an aetiologica1 role.Item Computed tomographic patterns of intracranial infarcts in Ghanaians.(2002) Obajimi, M.O.; Nyame, P.K.; Jumah, K.B.; Wiredu, E.K.Computed tomography has given a boost to intracranial imaging in general, and the diagnosis of the subtypes of Cerebrovascular Accident (CVA) in particular. In this study of 1,172 cases of CVA examined by Computed Tomography (CT), 552 (47.10%) showed features of cerebral infarction. There was a male prevalence in the study and the mean age was 59.8 years. As in all infarcts the diagnostic appearance was a wedge shaped hypodensity within the brain parenchyma. This was most often found in the parietal lobe (73.6%) and was always without a mass effect. Even though solitary infarcts were frequent, multiple lesions were reported in 9.3% of cases and these group of respondents presented mostly with seizures. Diabetes mellitus was an important predisposing factor and was found in 163% of cases, while hypertension was found in only 9.1% of cases studied. Other CT findings were cerebral and cerebrellar atrophy. Calcification of the falx and the basal ganglia were also noted.Item Current trends in the incidence of cerebrovascular accidents in Accra.(West African Journal of Medicine, 1994) Nyame, P.K.; Bonsu-Bruce, N; Amoah, A.G.; Adjei, S.; Nyarko, E.; Amuah, E.A; Biritwum, R.B.The incidence of cerebrovascular accidents (CVA) in Accra during three periods--1960-1968, 1976-1983, and 1990-1993, was compared. There was dramatic increase in the incidence between 1990-1993. Uncontrolled hypertension due to non-compliance with drug therapy seems to be the main cause. The economic plight of the people may explain the non compliance. The case fatality was between 41.9% to 50.3% for the years 1990-1993. Cardiovascular diseases, notably hypertension and CVA, have become the major causes of morbidity and mortality in Accra.Item Epilepsy: knowledge, attitude and practice in literate urban population, Accra, Ghana(West African Journal of Medicine, 1997) Nyame, P.K.; Biritwum, R.BA cross sectional survey was conducted among Government workers and the general public in Accra, Ghana. A total of 380 persons were interviewed. Almost everybody could describe accurately, an epileptic person. However, 172 (45.3%) out of the 380 respondents did not know the cause of epilepsy, and 37.6% did not know how it could be treated. Out of the 358 responses to the cause of epilepsy, 114 (31.8%) said it was inherited disease, 100 (27.9%) said it was due to witchcraft/juju or spiritual. With respect to treatment, 150 out of 333 responses mentioned sending the individual to the medical doctor, 95 (28.5%) said the use of herbs/visits to fetish priest, 59 (17.7%) suggested prayers, 20 (6.0%) said to do nothing. For prevention, 77 (29.1%) out of 319 responses indicated prayers, 49 (15.45%) cautioned marrying into epileptic family, and 13 (4.1%) responses indicated not to touch patient fitting. Those who answered "don't know" regarding knowledge about epilepsy were mostly the young, the lower educational status and the single respondents. However, the most important characteristic of the respondent that was associated with the appropriateness of the responses was the educational status. Although a lot of misconceptions about epilepsy existed in the study population, e.g. epilepsy can be spread by contact and that epileptics must be isolated or avoided, several respondents would share a room, eat or employ persons with epilepsy. The study has shown that the traditional beliefs and attitudes about epilepsy are still held firmly by the adult working population and that the educational level of the respondent was positively related to the appropriateness of the responses. It is therefore suggested that additional efforts must be made to increase the knowledge of the general population through the use of social marketing strategies in order to improve the management of persons with epilepsy.Item Korle-Bu Teaching Hospital: Bed Occupancy and Manpower Statistics (1991 and 1992).(Ghana Medical Journal, 1994) Biritwum, R.B.; Nyame, P.K.In 1991, the daily bed occupancy rate for the hospital was 75.2% with bed turnover rate of 2 per month and bed turnover interval of 4 days. There was a daily average of 57 floor -patients in the hospital. Nurses and other medical staff on admission formed about 2% of the daily population. The seriously ill patients formed 6.4% of the patient population. The average daily patient population was 1166 with average daily admissions of 92 patients (SD 21.2). discharges of 87 (SD 9.7) and the daily deaths of 11 (SD 3.7). The corresponding figures for [992 were very close. In 1992, daily patient population was 1151. daily admissions was 103. discharges 90 and daily deaths was 11. Thus, about 10% of the hospitals daily patient population is admitted daily and about 1% die daily. With respect to the individual wards or departments, the highest daily admission rate was at Chenard Ward A. for gynaecological emergencies with about 10 patients a day, Children's wards followed with a rate of about 5/day. then Medical wards with about 3/day. Maternity wards and Surgical wards with 2/day and Orthopaedic wards (Allied Surgical wards C. D. H. I and N) with about 1day. The highest number of deaths occurred in emergency wards. (Children's emergency, Neonatal Intensive Care Unit (NICU). Surgical/Medical emergency. Korle-Bu Polyclinic and Accident centre). The ranking order of departments with deaths in the wards were Children's. Medical, Chest. Surgical and Obstetrics (Maternity). On average there were 16 nurses and 7 orderlies to a ward running three shins a day. Excluding housemen. Surgical wards had an average of 3 doctors to a ward, Medical wards had 8 doctors per ward, Obstetrics and Gynaecology had 6 doctors to a ward. Children's block had 8 doctors to a team and Allied Surgical wards had an average of 6 doctors to a ward. The policy implications of these statistics are discussed.Item Laboratory diagnosis of typhoid fever in Accra(Ghana Medical Journal, 2000-06) Mensah, P.; Noora, R.; Welbeck, I.; Nyame, P.K.The aim of this investigation was to evaluate the most appropriate method for the diagnosis of Salmonella typhi septicaemia. This involved the culture of blood samples, Widal test and antibiotic sensitivity test. Of 50 patients suspected of having typhoid fever, blood cultures of 38 (76%) yielded no bacterial growth, while 12 (24%) produced bacterial growth. Organisms encountered included Salmonella typhi, Kblebsiella species and Staphylococcus aureus. Antibody to the 0 and H antigens was detected in 20 serum samples using the Widal test. Out of this number, 7 patients diagnosed to have S typhi infection had antibodies titres of 1/80. Convalescent sera from all diagnosed cases of S typhi showed at least a two-fold rise in titre. In addition those infected with Klebsiella sp. and Staphylococci also had low antibodies titres to 0 and H antigens. It was also discovered that 9 patienls who had no bacterial growth also had titres of <1/80 to 0 and H antigens. The S typhi isolates were all sensitive to Cefotaxime and Ofloxacin, both third line drugs so it will be prudent to keep them as such. Although one strain was resistant to Chloramphenicol, it still remains the antibiotic of choice. The widal test, like all inununological assays, cannot be positive by mere detection of antibody but based on a cut-off point. It must, therefore, be carefully interpreted and used together with blood cultures and clinical findings to safely diagnose S. typhi infections.Item Nutritional status and levels of liver Enzymes in Ghanaian alcoholics.(Ghana Medical Journal, 1990) Quaye, I.K.E.; Nyame, P.K.; Nyarko, A.K.; Akanmori, B.D.; Adjei, A.A.; Dodoo, D.; Gyan, B.Levels of major liver enzymes were measured for a group of malnourished alcoholics, well-nourished alcoholics and non -drinkers who were age and sex-matched in the fasted state. Their nutritional Status were determined from anthropometric and biochemical assessments. The levels of the liver enzymes were higher in the alcoholics when compared with the lion-alcoholics. Gamma-glutamyltransferase levels were highest. Aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels followed sequentially. The well flourished alcoholics appeared to have some protection from alcoholic liver damage. although their fat levels were higher which may predispose to cardiac disease. Alcoholics, therefore, show some degree of impaired liver function which is more severe among those who are malnourished?Item Plasma Homocysteine as a Risk Factor for Strokes in Ghanaian Adults(Ghana Medical Journal, 2009-12) Akpalu, A.K.; Nyame, P.K.Background: Stroke is an increasing problem in Ghana and the West African sub-region. New and modifiable risk factors for stroke have gained prominence in the last decade but have not been adequately researched in West Africa. Methods: This was a case-control study with plasma Homocysteine (Hcy) as an independent risk factor for stroke. 80 consecutive stroke patients with 80 age-sex matched controls were venesected in the fasting state for assay of Hcy and other biochemical parameters. Results: Mean Hcy level in stroke cases of 40.7 + 9.5μmol/l was significantly higher than 16.8 + 10.6μmol/l in controls [p<0.0001]. There was a significant association of hyperHcy with stroke [χ2; p<0.0001]. OR of stroke calculated for quartiles of Hcy, demonstrated an increase in OR of 1.37 (25th percentile) to an OR of 3.80 (75th percentile). Conclusions: Hcy was elevated in patients with stroke and should be considered as a modifiable risk factor for stroke in Ghanaian adults.Item Spontaneous intracranial haemorrhage: Computed tomographic patterns in Accra.(2002) Obajimi, M.O.; Nyame, P.K.; Jumah, K.B.; Wiredu, E.K.The diagnosis of stroke and the ability to distinguish the subtypes is central in the management of patients. This CT study has confirmed an increased prevalence of stroke (CVA) among Ghanaians. It has also reaffirmed a relatively higher incidence (52.9%) of spontaneous intracranial haemorrhage over cerebral infarcts among the 1,172 stroke patients studied. The study points to a male preponderance and a mean age of 55.7 years. Parenchymal haemorrhage was found to be the commonest variety of these haemorrhages. It occurred in 83.6% of cases while primary subarachnoid haemorrhage was reported in only 8.1% of cases. Ventricular extension of the parenchymal haemorrhage was reported in 22.7% of cases. The latter were mostly unilateral and on the left side especially in the parietal lobe (70.9%), subdural haemorrhage like the parenchymal variety was also reported to be more on the left, mainly unilateral and acute. Haemorrhages in the cerebellum and pons which are normally difficult to diagnose were also outlined with ease in the CT images. Other CT findings in these patients include parilesional oedema and mass effect found in 87.10% and 77.4% respectively.Item Stroke mortality in Accra: A study of risk factors(Ghana Medical Journal, 2001-12) Wiredu, E.K.; Nyame, P.K.We studied risk factors in consecutive autopsy cases of fatal strokes in persons aged 20 years and above at the Korle Bu Teaching Hospital, Accra. The presence of the following modifiable risk factors was noted: Hypertension. atherosclerosis, diabetes mellitus, cardiac diseases and obesity. Nonmodifiable risk factors noted were age and sex. We calculated the age-adjusted proportionate mortality for each sex and assessed sex differences using the X2 with Yates correction. Mortality from stroke rose with age, increasing suddenly after 39 years, peaking at 50-59 years in males and 70·79 years in females, and declining thereafter. There were sex differences in mortality with male proportionate mortality exceeding females up to 39 years after which female proportionate deaths were higher than in males. Haemorrhagic stroke was a more common cause of death than infarctive stroke before 70 years in males and 60 years in females, After these ages, there was a reversion with more deaths from infarction than haemorrhage. Hypertension was the dominant risk factor of stroke mortality being involved in 77% of all cases. However, cerebral atherosclerosis was the main risk factor for infective stroke, but appeared unimportant in cerebral haemorrhage. Other risk factors such as diabetes mellitus, thrombotic phenomena, and pre-existing cardiac disease were present in a minority of cases. Obesity as a risk factor for stroke appeared to be more of a female problem than a male one. The results of the study are compared with those of studies conducted elsewhere and the role of each risk factor in stroke is discussed.Item Stroke-related mortality at Korle Bu Teaching Hospital, Accra, Ghana(East African Medical Journal, 2001-05) Wiredu, E.K.; Nyame, P.K.Objectives: To determine whether mortality from and the pattern of stroke have changed since the last study in Accra in 1981, the sites of the different types of stroke and the role of hypertension and cerebrovascular disease and to describe the age and sex distribution. Design: Cross-sectional study of fatal stroke cases over a five-year period. Setting: Korle Bu Teaching Hospital, Accra, Ghana. Subjects: All fatal strokes in persons aged 20 years and above, confirmed at autopsy. Results: Mortality from stroke constituted eleven per cent of autopsies carried out at the Korle Bu Teaching Hospital, Accra, in the five-year period 1994 to 1998. A similar study in 1981 showed the same proportion indicating that the proportion of deaths due to stroke has not changed. The overall male to female ratio was 1.2:1 but the relative risk (RR) of death from stroke was higher for females at 1.23 (95% Cl=1.10-1.38). Although haemorrhagic stroke was still more common than cerebral infarction the proportion (61%) was much less than that of the previous study (89%). Males were more likely (RR 2.07 95% Cl=1.75-2.45) to die from haemorrhagic stroke than females (RR 1.32, 95% Cl=1.10-1.57). Sixty nine per cent of stroke patients died in less than 24 hours after onset of stroke. The peak age of fatal haemorrhagic stroke was 50-59 years and that of infarction was 60-69 years. Male mortality exceeded female mortality in all age groups up to 60-69 years after which female mortality became preponderant (χ2 with Yates correction =4.28,0.05>p<0.02). Hypertension was the dominant factor in haemorrhage and an important factor in infarction while cerebral atherosclerosis was the major factor in infarction. Haemorrhage into intraparenchymal sites, mainly the cerebral hemispheres, was more common than into the subarachnoid space. Conclusion: The proportion of deaths from stroke in autopsy cases has not changed since the last study in 1981 and stroke still remains an important cause of death in Accra. Cerebral haemorrhage is still a more common cause of fatal stroke than infarction, although the pattern appears to be changing gradually. Females have a slightly greater risk of dying from stroke than males. A community-based study is needed to provide more insight into some aspects of the problem and to provide the basis for appropriate interventions and policy, especially with regard to a control of risk factors.