Socio-Demographic and Clinical Characteristics of Patients Presenting with Lower Urinary Tract Symptoms Secondary to BPH, in a Tertiary Hospital

Background: Benign prostatic hyperplasia (BPH) is the proliferation of the stromal and epithelial cells of the prostate gland, resulting in an increase in its size. This may result in obstruction of the lower urinary tract causing storage and voiding symptoms. Methods: This was a prospective cross-sectional study from August 2020 to July 2021, to evaluate the characteristic of patients presenting to the Tamale Teaching Hospital with lower urinary tract symptoms secondary to BPH. Results: The median age at presentation with LUTS secondary to BPH is 68.88 ± 11.10 years with an average prostate volume of 70 g. The average time of presentation to the hospital is 5 months, mostly with moderate to severe symptoms. Correlation between Prostate volume (PV) and age yielded a positive relationship;however, this was not statistically significant, (r = 0.028, p-value = 0.747). There was a significant positive relationship between PV and the IPSS score, (r = 0.334, p-value Conclusion: Our patients with symptomatic BPH present at age 60 years and above, with nearly all of them presenting with moderate to severe LUTS.

Functional Outcomes of Adult Tibia Shaft Fractures Treated with Solid Intramedullary Nails versus Hollow Nails: A Systematic Review

Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes.

Catheter-Associated Bacteria Urinary Tract Infection and Antibiotic Susceptibility Pattern in a Tertiary Hospital, in Ghana

Background: This study seeks to identify the prevalence of catheter associated urinary infection and the type of bacteria that are associated with this infection, as well as the antibiotic susceptibility patterns of the organisms isolated. This would guide the choice of antibiotics when there is catheter associated urinary tract infection. Method: From 1 November 2015-31 April 2016 a cross-sectional study was conducted among patients with urinary catheter in-situ. Urine samples collected were processed and cultured on CLED agar plates. Pure colonies of isolated organism were Gram and Biochemically characterized. A disc diffusion antibiotic susceptibility determined by Kirby-Bauer disc diffusion method was performed on each uropathogen isolated. Data obtained was cleaned, analyzed and presented. Result: There were 122 study subjects of which, 73 (59.8%) were males and 49 (40.2%) were females. Their median age was 42.5 (range 33 - 65) years. Significant bacterial growth was obtained in 88 (72.1%) of the urine specimen cultured of which males constituted 48 (54.5%) and females 40 (45.5%). The most prevalent uropathogens isolated were Escherichia coli 41 (46.6%), Klebsiella spp. 18 (20.6%), Pseudomonas aeruginosa 10 (11.4%), Enterobacter spp. 6 (6.8%) and Staphylococcus aureus 5 (5.8%). Bacterial isolates showed some susceptibility to Amikacin 73 (83.0%), Levofloxacin 34 (38.6%) and Ciprofloxacin 26 (29.5%) respectively. The uropathogens were least susceptible to Gentamicin 3 (3.4%), Ampicillin 3 (3.4%) and Cefuroxime 1 (1.1%) respectively. Conclusion: Catheter associated bacterial urinary tract infection (CABUTI) is prevalent at the Tamale Teaching Hospital. Micro bacterial isolates demonstrated substantial decrease in susceptibility to antibiotics commonly used. Understanding the local antibiotic susceptibility pattern could guide the choice of antibiotics used in treating CABUTI.

Effect of Varicocelectomy on Semen Parameters of Men Seeking Infertility Treatment in Tamale, Ghana

The study aimed to determine the effect of microsurgical sub-inguinal varicocelectomy on semen parameters among men seeking infertility treatment in Ghana. This was an intervention study conducted at Tamale Teaching Hospital in the Tamale Metropolis from September 2017 to August 2021. The study involves two groups;the surgery group (n = 75) and the observed group (n = 63). Duplicate semen samples (mean values adopted) were collected at the onset and assessed according to the criteria established by World Health Organization (WHO), 2010. Varicocelectomy was performed for the surgery group and no intervention was given to the observed group. The two groups were followed for 180 days and repeated semen samples were collected and analyzed. The data was computed using GraphPad Prism (v8.0) at an alpha of 0.05. All the men had varicocele and were aged between 46.0 and 67.0 years old. There was no difference between semen parameters among the two groups before the surgery. However, after 180 days of follow-up, all of the semen parameters significantly improved in the surgery group (p < 0.0001), while sperm concentration (p = 0.0068), progressive motility (p = 0.0281), and normal sperm morphology (p = 0.0015) decreased in the observed group. The surgery group had an overall percent increase in total sperm count (840.7%;p = 0.0197), sperm concentration (582.1%;p = 0.0125), total viable sperms (155.2%;p < 0.0001), and normal sperm morphology (110.9%;p < 0.0001) while immotile sperms (-51.71%;p < 0.0001) reduced. A pregnancy rate of 25.3% (19/75) was reported among the surgery group but none was reported among the observed group after 180 days. Microsurgical sub-inguinal varicocelectomy improves semen parameters and hence effective treatment of infertile men with a clinically palpable varicocele. It is recommended to use this choice for similar patients, however, further studies with a larger sample size are needed to provide more evidence to recommend this therapy.

Intraligamentary Pregnancy with Recurrent Urine Retention: Case Report

An intraligamentary pregnancy is an extremely rare form of ectopic pregnancy, with only a few cases reported. We report a 20-year-old woman who had an ongoing pregnancy at about 22 weeks gestation, consulted for recurrent urinary retention and severe lower abdominal pain of two days duration. Pelvic ultrasonography revealed an extrauterine gestation of 19 weeks and four days on the left adnexal region. Exploratory laparotomy was performed that found left intraligamentary pregnancy (unruptured) measured 20 - 25 cm across, attached posteriorly to the bowel (sigmoid colon) and extended to the pouch of douglas impinging on the bladder base. Resection of ectopic pregnancy was successfully performed, urine retention resolved, and the patient was discharged with no postoperative complications. Early recognition of this rare form of ectopic gestation is of considerable importance because of the risk of a life-threatening haemorrhagic complication necessitating emergency surgical intervention.

Status Epilepticus in Children: A Study of 54 Cases

Objectives: To review the clinical character, the management and outcome of status epilepticus in children. Methodology: We conducted a retrospective review of 54 cases treated between 1996 and 1997 at the Royal Alexandra Hospital for Children, Sydney, Australia. Among the variables collected for analysis in this study were age, sex, etiology of status epilepticus, median length of Paediatric Intensive Care Unit (PICU) stay and days of mechanical ventilation, and mortality of status epilepticus. Results: Of the patients with status epilepticus, 61% were male and 39% female, with an age range of 3 months to 15 years (mean 5.3 years). The etiology of status epilepticus is largely age related, with acute causes common in 1 - 3 year and 4 - 7 year ages, 44 cases (81.5%). The etiology of status epilepticus included febrile (35.18%), acute symptomatic (27.58%) and idiopathic (16.6%), total was 44 cases (81.4%). Median length of PICU stay and days of mechanical ventilation were 3.02 ± 1.6 days and 1.24 ± 0.5 days respectively. Mortality was 5.3%. Most patients were treated with diazepam and phenytoin. The total number of the patients with a favorable outcome was 41 (75.89%). Conclusions: One of the most common neurologic emergencies in children of status epilepticus remains a major problem in morbidity and mortality. There are multiple causes of status epilepticus that include the categories of idiopathic, febrile, acute symptomatic and remote symptomatic. Intravenously administered phenytoin and diazepam remains the first-line therapy for status epilepticus. Most of the patients will respond to this treatment. The etiology of status epilepticus included febrile (35.18%), acute symptomatic (27.58%), idiopathic (16.6%) and total was 44 (81.4%).

Knowledge of Factors Associated with Teenage Pregnancy among Junior High School Students in the Talensi District of the Upper East Region of Ghana

World Health Organization (WHO) defines teenage pregnancy as occurring between the ages of 10 and 19. Although teenagers make up just 22% of the Ghanaian population, in 2014, a Demographic and Health Survey report indicated that teenagers account for 30% of all births recorded. Pregnancies and births during the teenage period are associated with higher risks than older women. This study aimed to identify and establish the knowledge of factors linked to teenage pregnancies among junior high school students in the Talensi District Assembly in the Upper East of Ghana. Method: A cross-sectional study was conducted with 95 Junior High School students from January to February, 2022 for a period of six weeks. Convenience sampling was used to select the participants. Primary data was obtained using a structured questionnaire;secondary data was obtained from the Talensi District Health Directorate and the Talensi District Assembly. Data were analysed using SPSS Version 22. Results. Thirty-six (36, 25.2%) of the respondents intimated that curiosity was a significant cause of teenage pregnancies in the Talensi District, which recorded 19.6% in 2021, an increase over the 2020 figure of 17.7%. Reasons why teenagers would want to engage in sexual activities, included curiosity about sex—36 (27.17%), social media influences—8 (19.58), peer pressure—27 (18.88%) and favours to partners—19 (13.29%). Concerning their knowledge about contraceptive use, the participants mentioned friends (32.26%) as being the prime informants, parents and relatives (17.74%) and radio broadcasts (12.10%). Conclusion: The Talensi District Assembly is entreated to roll out poverty alleviation programmes for families in the area with teenage girls attending school and to enact legislation prohibiting early marriage. Measures that will help reduce teenage pregnancies in the district should include adequate financial support by parents of their wards, sex education in schools and various houses, and schooling of the teenagers to resist peer pressure.

Factors Associated with Rising Trend in Teenage Pregnancy within the West Gonja Municipality of the Savannah Region of Ghana

Background: Teenage pregnancy is a major public health problem worldwide, also in northern Ghana. The aim of this study was to identify factors contributing to the rising trend in teenage pregnancy and the resultant effects. Materials and Methods: This was a cross-sectional study using a quasi-structured questionnaire on 60 pregnant teenagers. Demographic data and factors associated with teenage pregnancy were collected/analyzed. Results: The mean age of respondents was 17.25 ± 1.93 years. Junior high school students or graduates accounted for 55%. About 35% of participants dropped out of school due to pregnancy. The following factors were identified to be associated with teenage pregnancy: low socio-economic status, no/less sexual- and reproductive-communication with parents, low level of education, no sexual and reproductive health knowledge, and unsafe sexual behaviours. The consequences of teenage pregnancy identified were: truncation of the girls’ education, psychological trauma, and worsening family relationships. The following health consequences were identified;anaemia in pregnancy, severe malaria, hypertension in pregnancy, and prolonged labour. Conclusion: The following factors may account for the rising trend in teenage pregnancy in this area: family-related problem, sociocultural factors, low education level, and the lack of adequate knowledge on reproductive health. Teenage pregnancy caused several problems in themselves and their family members.

Effect of Varicocelectomy on Gonadal Function among Patients Reporting with Sexual Dysfunction in Ghana

Background: Long-standing varicocele is often associated with testicular hypoxia and that might worsen Leydig cell function, a significant risk factor for hypogonadism. This may affect both the secretory and endocrine functions of the testis. This study aims to determine the effect of microsurgical sub-inguinal varicocelectomy on gonadal function among men reporting sexual dysfunction in Ghana. Methods: This was an intervention study conducted at the Tamale Teaching Hospital from September 2017 to August 2021. A total of 103 participants were randomized into two groups;the surgery group (n = 52) and the observed group (n = 51). Venous blood samples were collected at baseline, varicocelectomy was performed for the surgery group, and no intervention was given to the other. Blood samples were subsequently collected at 12-, 24-, 36-, and 48-month intervals for assay of serum total testosterone, FSH, and LH. The data were analyzed in GraphPad Prism (v8.0) at an alpha value of 0.05. Results: All the participants had varicocele and were aged between 55.0 to 69.0 years old. At the baseline of the study, all participants presented with sexual dysfunction but a significant improvement (p Conclusions: Microsurgical sub-inguinal varicocelectomy improved gonadal function among varicocele patients reporting sexual dysfunction. It is recommended to use this choice for similar patients;however, these findings should be verified by a multi-institutional study to provide more evidence for this choice.