Department of Physiology
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Item Brain regulation of appetite and satiety(2008-12) Ahima, R.S.; Antwi, D.A.Interest in the control of feeding has increased as a result of the obesity epidemic and rising incidence of metabolic diseases. The brain detects alterations in energy stores and triggers metabolic and behavioral responses designed to maintain energy balance. Energy homeostasis is controlled mainly by neuronal circuits in the hypothalamus and brainstem, whereas reward and motivation aspects of eating behavior are controlled by neurons in limbic regions and the cerebral cortex. This article provides an integrated perspective on how metabolic signals emanating from the gastrointestinal tract, adipose tissue, and other peripheral organs target the brain to regulate feeding, energy expenditure, and hormones. The pathogenesis and treatment of obesity and abnormalities of glucose and lipid metabolism are discussed.Item Prevalence of newborn brachial plexus palsy in Accra, Ghana.(2008) Hamzat, T.K.; Carsamer, S.; Wiredu, E.K.The aim of this study was to provide hospital-based epidemiological information about newborn brachial plexus palsy (NBPP) in Accra, Ghana. The records of all pediatric patients treated over a 5-year period (December 1999 and December 2004) were retrieved to identify those with NBPP. The records of those who had NBPP were further reviewed to document their sociodemography, diagnosis, labor and birth history, presentation at birth, mode and place of delivery. A total of 773 patients' records were reviewed out of which 210 (27.2%) were cases of NBPP. Using the 1987 Narakas system of classification, majority (94.8%) of the NBPP cases were of group∼I type brachial plexus injury or Erb's palsy, with a male predominance (61.4%), and most (79.5%) were delivered by normal vaginal delivery (52.9%) and most (70.9%) were cephalic in presentation at birth. About 55.2% cases were referred for physiotherapy within one month of diagnosis. The treatment disposition for majority (88.1%) of the NBPP patients was not documented and only (4.8%) was formally discharged from physiotherapy. The results indicate that birth weight exceeding 4.0 kg, vertex presentation and vaginal delivery were the noticeable co-existing factors for NBPP in this population. The Erb's type was the modal type of NBPP in the sample and majority were delivered in private clinics. The clinical, economic and sociocultural implications of this disorder, as well as the importance of better clinical documentation in physiotherapy and needs for a national survey for NBPP in Ghana was discussed.Item Fetal hemoglobin during infancy and in sickle cell adults(2006-03) Edoh, D.; Antwi-Bosaiko, C.; Amuzu, D.Background: Fetal hemoglobin has been implicated in the modulation of sickle cell crisis though it is functional during infancy. Objective: The purpose of this study was to determine the warning time of fetal hemoglobin (HbF) and its persistence in later life. Method: Ninety infants aged 0-12 months, admitted at hospital, were tested for their HbF levels. Adult patients numbering 690 were also examined for their sickle cell status and a sickle positive patient of SS type with HbF had her family members recruited and their sickle cell types determined. Results: The results revealed that HbF was highest (98%) at birth, decreasing at 5% per week till 6 months when it wane off. Ten infants aged 6-12 months had HbF persisting at a level of 10% or more. Adult patients examined showed proportions of their sickle cell types as AS forming 51%, AC 20%, SS 19%, and SC 10%. An SS adult patient with mild sickle cell crisis had an ASF father who had no crisis and a mother and brother with AS each who had severe crisis. Conclusion: These findings suggest that HbF wanes off during infancy but persist in some adults and may modulate crisis in these adults. This has implications in sickle cell management.Item Some effects of the medicinal plant kalanchoe pinnata.(2002) Isaac, J.A.; Antwi, D.A.; Tete-DonkorThe hepatoprotective and choleretic effects of Kalanchoe pinnata syrup prepared from its extract were studied using the rat model of toxic hepatitis, produced by the administration of the hepatotoxic compound 50% solution of carbon tetrachloride. The syrup was introduced in a dosage of 30 mg/kg. After the administration of syrup Kalanchoe (per os) in rats with toxic hepatitis, the following enzymes considered to be informative during toxic hepatitis were determined: alanine transaminase, alkaline phosphatase and triglycerides. The cholagogic (choleretic) effect was determined by cannulating the common bile duct and determining the amount and content of bile produced within three hours. The antimicrobial activity of the syrup was determined using a microbial inhibition assay. The Kalanchoe syrup was seen to normalize the level of alaninetransaminase, alkaline phosphatase and triglycerides in the animals with toxic hepatitis and increase the secretion of bile with the contents of cholesterine. Acids and the cholato-cholesteric coefficient in the bile remained unchanged. The syrup was found to react with some strains of Staphylococcus aureus and Escherchia coli. This finding demonstrates the hepatoprotective, choleretic and antimicrobial activity of syrup Kalanchoe.Item A novel I247T missense mutation in the haptoglobin 2 β-chain decreases the expression of the protein and is associated with ahaptoglobinemia(Human Genetics, 2004) Teye, K.; Quaye, I.K.E.; Koda, Y.; Adjei, A.A.; Pang, H.; Tsuneoka, M.; Kimura, H.We have identified a novel base substitution at codon 247 in the β-chain of the haptoglobin 2 (Hp 2 ) allele in a Ghanaian with the Hp0 (ahaptoglobinemic) phenotype. The heterozygous T→C substitution caused reduced expression of the protein when the mutant was transfected into COS7 cells. The base substitution resulted in a missense change of the non-polar amino acid isoleucine to the polar amino acid threonine at a position in the β-chain that is highly conserved among several species. We had previously identified a mutation in the Hp gene promoter region for the same individual, which gives her genotype as –61CHp 2 /–61CHp 2 (I247T). Since the –61C mutation also leads to low Hp expression, the genotype represents the first and most definitive ahaptoglobinemic case reported in Africa.Item Prevalence of human immunodeficiency virus infection among tuberculosis suspect patients in Accra, Ghana.(West African Journal of Medicine, 2006) Adjei, A.A.; Adiku, T.K.; Ayeh-Kumi, P.F.; Hesse, I.F.A.BACKGROUND: Acquired immunodeficiency syndrome is a major public health concern worldwide, particularly in Ghana, where recent reports indicate an increase of the disease. A close association between infection with human immunodeficiency virus (HIV) and tuberculosis (TB) is well known. A previous study showed a 16.8% seroprevalence of HIV in TB patients on admission at the chest clinic of the Korle-Bu teaching hospital. However this was in severely ill patients on admission and there was a likely selection bias. This study was therefore designed to determine the prevalence of HIV infection among patients suspected of TB attending the laboratory of the chest clinic of the Korle-Bu Teaching hospital, Accra, Ghana. METHODS: Pulmonary TB was diagnosed using clinical, sputum smear microscopy and chest x-ray features. HIV was determined using particle agglutination test (HIV-1 and HIV-2) and synthetic peptide-based immunoassay (Peptilav I and II ELISA). RESULTS: Of the 277 subjects examined, 108 (39%) were diagnosed as TB. The seroprevalence of HIV was 46.2% in all TB suspect patients. It was 47.2% and 45.6% in those with and without tuberculosis, respectively. in both groups, the peak age distribution of subjects positive for HIV antibodies was from 20 to 59 years. CONCLUSION: The results show a great increase in HIV seroprevalence in TB patients in Korle-Bu. The high HIV seroprevalence suggests that subjects suspected of TB should be tested for HIV as well.Item Inhibition of ADRP prevents diet-induced insulin resistance(American Journal of Physiology 295(3): G 621-8, 2008) Antwi, D. A.