University of Ghana Medical School
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Item Clinical disease activity in autoimmune rheumatic patients receiving COVID-19 vaccines(BMC Rheumatology, 2024) Dey, D.; Katso, B.; Amoako, E.; Manu, A.; Bediako, Y.Background Vaccines are a crucial component of the global efforts to control the spread of COVID-19. Very little is known about COVID-19 vaccine responses in patients living with autoimmune rheumatic conditions in Africa. We examined the clinical reaction to COVID-19 vaccinations in Ghanaians diagnosed with autoimmune rheumatic disease. Methods This was a hospital-based interventional cohort study of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients recruited via regular face-to-face clinic visits. The systemic lupus erythematosus disease activity index Selena modification (SELENA-SLEDAI) and the disease activity score 28-joint count-erythrocyte sedimentation rate (DAS28-ESR) were used to measure changes in disease activity levels. Results Thirty-eight (38) patients of which 21 (55.3%) were diagnosed with SLE and 17 (44.7%) with RA contributed data for analyses. Most (89.5%) of the patients were females, with a mean age of 37.4 years. The SLE patients experienced a notable increase in severe flares during weeks three and six, as well as the third and sixth months, followed by subsequent decreases in the twelfth month, while remission levels increased throughout the same period. Among RA patients, high disease activity decreased during weeks three and six, as well as the third, sixth, and twelfth months, with remission levels increasing during the same time. A low dose (≥50<75 mg) dose of azathioprine was at some point associated with having a severe flare among SLE patients. After both vaccine doses, SLE patients were the majority having experienced both local and systemic reactions, all resolving within 24 h. Approximately 73.7% of the patients were COVID-19 negative at baseline. During post-vaccination visits, this increased to 100% by week six, with no positives thereafter. Conclusion This study explores COVID-19 vaccine responses in Ghanaian autoimmune rheumatic disease patients, revealing disease activity levels in RA patients improved after vaccination compared to SLE patients. Our findings identify a potential link between low-dose azathioprine and severe flares in SLE patients, particularly evident in the third-week post-vaccination. Further research is warranted to clarify these findings and guide tailored treatment approaches in this medically significant population during pandemics and vaccination efforts.Item Pattern of Abdominal injuries in Korle Bu Teaching Hospital, Accra(Ghana Medical Journal, 1990-09) Naaeder, S.B.Two Hundred and thirty-four cases of abdominal trauma over the past 6 years were reviewed. There were four times as many male as female patients. The peak age incidence was in the second and third decades. Road traffic accidents were the commonest causes of blunt injures whereas stab wounds predominated penetrating injuries. The spleen and the small bowel were the most common Viscera injured. Although accidental injury ill our environments is a common cause of morbidity fatalities are few in those with abdominal traumaItem A Comparative Study of Isradipine and Nifedipine in the Monotherapy of Mild to Moderate Hypertension in the Ghanaian.(Ghana Medical Journal, 1994) Adukwei Hesse, I.F.; Addy, J.H.; Acheampong, I.W.; Wood, I.G.A.Clinical experience with the new dihydropyridine calcium antagonist. isradipine. is reported. Isradipine was compared with nifedipine in a multicentre open. parallel group. clinical therapeutic trial involving 70 patients with mild to moderate hypertension. A four week placebo washout period was followed by a 12 week active treatment period during which patients were randomized to receive cither 2.5 mg isradipine twice daily (n = 40) or 10 mg nifedipine three times daily ( n=30). Isradipine significantly reduced sitting systolic /diastolic blood pressures from 176.7 ± 21.0/l06.7±7.0mmHg to l42.9± 15/93.1±7.7mmHg (p< 0.001) at the end of 12 weeks. Similarly. nifedipine reduced sitting systolic/diastolic blood pressures from 170.2±1 9.5/1 06.2±7.4mmHg to 139. 1±9.7/92. 1±7.8 mmHg (p< 0.001). Normalisation (diastolic<90 mmHg) rates were 67% and 60% for isradipine and nifedipine respectively while good response (diastolic fall > 10mmHg) rate was over 85% on cither drug. Heart rate did not significantly change with either treatment. Three (3) patients taking isradipine experienced headache and 7 patients taking nifedipine had drug related adverse effects (5 had headache. I insomnia and I first dose hypotension). Therapy was Withdrawn in 4 patients taking nifedipine and 1 taking isradipine. It is concluded that isradipine is comparable to nifedipine and is an effective and well-tolerated antihypertensive agent In the Ghanaian.Collection Collection Collection Collection Collection Collection
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