Postgraduate Medical Journal of Ghana

Dysmenorrhea among University of Ghana Medical and Dental Students: Prevalence and management options

KE Hasford, SK Amponsah, AE Yawson — Tue, 05 Nov 2024 00:00:00 +0000

Objective: Dysmenorrhea or menstrual pain is a common gynaecological disorder that affects the quality of life of most women in their reproductive years. Many women resort to the use of drugs and other remedies in an attempt to relieve this menstrual pain. The aims of the current study were to determine the prevalence of dysmenorrhea among female students of the University of Ghana Medical and Dental School, and also to identify common management strategies among these students.
Methodology: This was a cross-sectional study conducted in 2020, using an online questionnaire among 170 female students in the University of Ghana Medical and Dental School. Data was coded, stored and analyzed using SPSS version 23. Results: Prevalence of dysmenorrhea among respondents was 91%; with significant correlation between dysmenorrhea and family history, duration of bleed, onset of pain and duration of pain. Data showed that 89% of students with dysmenorrhea engaged in self-medication. The commonest drug used by respondents with dysmenorrhea was paracetamol. A large number of the respondents who had dysmenorrhea had mood disturbances and majority also reported that dysmenorrhea affected their day-to-day (academic) activities.
Conclusion: Dysmenorrhea was found to be highly prevalent among female medical and dental students, with self-medication being the most common management strategy. Among the various drugs used in management, paracetamol was found to be commonest.

A formula for the determination of appropriate chest tube size and length of insertion in children

Tue, 05 Nov 2024 00:00:00 +0000

Objective: The study was carried out to develop a formula that uses the child’s age or body surface area(BSA) to determine the appropriate size and length of the chest tube to be inserted.
Methodology: Children aged 12 years and below who had chest tube insertion at the National Cardiothoracic Centre from July 2015 to August 2016 were retrospectively enrolled into the study. The inclusion criterion was those who had the chest tube data recorded in their notes. This was the derivative cohort. The chest tube type used was SURUCATH ULTRA®. The BSA was calculated using the Mosteller formula. The statistical analysis was performed using Microsoft excel 2013. The data of the derivative cohort was plotted on a graph, and an equation was deduced from the graph, representing the data. This equation is the formula. The formula was then used to determine the appropriate chest tube size and length of insertion on a validation cohort from January 2021 to April 2022.
Results: In the derivative cohort, there were 50 children, 34.0% being males. The mean age was 4.2 ± 2.9 years. The weight ranged from 3.5 – 50 kg, the height ranged from 50 – 159 cm and the body surface area ranged from 0.2 – 1.5 m². In the validation cohort, there were 56 children, 48.0% being males. The mean age was 4.4 ± 2.8. The weight ranged from 5 – 40 kg, the height ranged from 54 – 152 cm and the body surface area ranged from 0.3 – 1.3 m². The outcome of the validation was good. The chest tubes functioned well and there were no chest tube-associated complications. The formulae obtained were S (FG) = A + 16, L (cm) = 0.3A + 3.5, S (FG) = 6B + 16, L (cm) = 3.5B + 3, where S is the size of the chest tube, A is the age in years, L is the length of insertion and B is the body surface area. The L is the length of the tube that has gone into the chest.
Conclusion: A formula has been developed to guide in determining the most appropriate chest tube size and length of insertion in children, using the age and body surface area.

A comparison of two dosing regimens of misoprostol in labour induction: A randomised controlled trial

Tue, 05 Nov 2024 00:00:00 +0000

Objective: To compare the effectiveness and safety of 50μg of sublingual misoprostol administered six (6) hourly to that of 50μg of vaginal misoprostol administered four (4) hourly.
Methodology: A non-blinded, randomized controlled trial conducted from Sept 1, 2014, to Nov 31, 2014, at a tertiary hospital in Ghana. Hundred and sixty women with medical or obstetric indications for labour induction were randomized into two groups.
Results: The rate of vaginal delivery, caesarean section, uterine tachysystole and uterine hyperstimulation were similar in both groups. Sixty-three (78.8%) and 66 (82.5%) mothers in the vaginal and sublingual groups delivered vaginally. More (10.0%) mothers in the vagina group required emergency caesarean for foetal distress. Six (vaginal group) and 8 (sublingual group) of the mothers required emergency caesarean for cephalopelvic disproportion. Three mothers from each group had an emergency caesarean section due to failed labour induction. Almost the same number of mothers had uterine tachysystole in both groups. More (3.8%)
mothers in the vaginal group had uterine hyperstimulation. Differences in the mean induction delivery interval and the need for oxytocin augmentation were not significant. No differences were found in the intrapartum passage of meconium, blood loss in the third stage of labour, 5-minute Apgar score <7, and neonatal intensive care unit admissions.
Conclusion: The sublingual regimen was as effective and safe as the vaginal regimen in achieving vaginal delivery.

The myths of alcohol use in Ghana

EK Dordoye, TMA Aku, TDA Avle, E Dziwornu — Tue, 05 Nov 2024 00:00:00 +0000

Objective: Alcohol has become a regular part of social functions in many cultures. Before the advent of alcohol use disorder becoming a nosological entity, many cultures noted the detrimental association with alcohol use, particularly in its excess use. With such observation, many cultures and even medical research, have tried in many ways to either justify or explain away the harmful effects of alcohol use and gone ahead to promote the use for the most mundane effects. Such explanations for alcohol use over time become acceptable in many cultures and can be viewed as myths. Four of such myths associated with alcohol use in Ghana, are presented here.
Methodology: These myths were drawn from a bigger study that looked at the prevalence of alcohol use disorder in an engineering company with mixed methods. A thematic analysis of their responses was used to arrive at these myths.
Results: Participants believed that alcohol is sexually potentiating, improves appetite and quality of sleep, and has medicinal qualities like “curing” chicken pox and necessary for successful surgery. Apart from the inconclusive evidence of alcohol, particularly red wine, protecting against cardiovascular death, we could not substantiate any of these claims from medicine.
Conclusion: Myths of alcohol use in different cultures need to be incorporated in preventive strategies adopted for alcohol use disorder for a comprehensive public health approach to curb the menace. Such myths should be integrated in the training of health workers to help them understand the addictive behaviour of alcohol users and the anthropological underpinnings to alcohol use.

Special Articles - History of diagnostic radiology in Ghana

WO Brakohiapa, EKK Brakohiapa, SS Asiamah, EA Idun, A Kaminta, K Dzefi-Tettey — Tue, 05 Nov 2024 00:00:00 +0000

No abstract.

The value of food: A necessary rhetoric

Ekem IAE — Tue, 05 Nov 2024 00:00:00 +0000

No abstract.

Development of postgraduate education at the 37 Military Hospital

E Asumanu — Tue, 05 Nov 2024 00:00:00 +0000

No abstract.

Medical tourism in Ghana: The role of the GCPS

JD Seffah — Tue, 05 Nov 2024 00:00:00 +0000

No abstract

Acute complications of leiomyoma during pregnancy: Report of three (3) cases that required antepartum myomectomy

Tue, 05 Nov 2024 00:00:00 +0000

Introduction: Some women with uterine leiomyoma can experience life threatening complications during pregnancy. These leiomyomas are usually large and their associated symptoms were either neglected before the onset of the pregnancy or surgical treatment may have been rejected earlier by the patient.
Case Presentation: Three cases of antepartum myomectomy are reported in this paper. They had severe abdominal pains not responding to medical treatment with gross abdominal distention. Additionally, they had severe life-threatening symptoms including right hypochondria pain and shallow breath in case no.2 and intestinal obstruction in case no.3, an acute surgical complication which could not be resolved by conservative management. All three patients had successful antepartum myomectomy using a new flap techinique not previously described in the literature on reported cases of myomectomy during pregnancy. All the patients recovered successfully from the operation and their pregnancies continued to delivery of their babies at term by caesarean section. Cases no.1 and 2 presented in this report were managed in health facilities in Tamale, Northern Region in 2019. Case no.3 was managed in Accra at the Greater Accra Regional Hospital in 2022.
Conclusion: Pregnant women may present with life threatening complications of leiomyomas, antepartum myomectomy can be considered and successfully performed to improve quality of life or prevent maternal mortality. The procedure for the myomectomy in such situation may not be routine but a special approach is required to avoid fatal complications for both mother and foetus.

Bilateral tubal ectopic pregnancy: A case report

J Ashong, EK Agbeno, B Anane-Fenin, K Ulzen-Appiah, A Agyekum — Tue, 05 Nov 2024 00:00:00 +0000

Introduction: Bilateral tubal ectopic pregnancy without prior fertility treatment is rare and, although true incidence is unknown, about 250 cases have been reported in medical literature so far. Its diagnosis is commonly made during surgery as pre-operative diagnosis is difficult. To the best of our knowledge, this is the first reported case of spontaneous bilateral tubal ectopic pregnancy in Ghana.
Case Presentation: We report on a 25-year-old G2P1A who had an exploratory laparotomy done on account of a ruptured right ectopic pregnancy. Examination of the contralateral tube at surgery, however, revealed an unruptured ampullary ectopic pregnancy and diagnosis was thus revised to a bilateral tubal ectopic pregnancy. A right salpingectomy and left salpingostomy were carried out as she had future fertility wish.
Conclusion: Bilateral tubal ectopic pregnancies present a number of diagnostic challenges pre-operatively and examination of the contralateral tube, especially for those cases requiring surgical intervention, cannot be over – emphasized in the management of tubal ectopic pregnancies in general.