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Birth and Emergency Planning: A Cross Sectional Survey of Postnatal Women at Korle Bu Teaching Hospital, Accra, Ghana
EA Udofia, SA Obed, BNL Calys-Tagoe, KP Nimo
African Journal of Reproductive Health , 2013,
Abstract: Birth and emergency planning encourages early decision making, helps overcome barriers to skilled maternity care and reduces preventable maternal and newborn deaths. A facility based postnatal survey of 483 childbearing women in Accra, Ghana determined birth and emergency planning steps, awareness of obstetric danger signs, reported maternal and newborn complications and birth outcome based on length of hospital stay. Supervised antenatal care and delivery were nearly universal. Overall, 62% had a birth plan, 74% had adequate knowledge of danger signs, while 64% and 37% reported maternal and newborn complications respectively. Accompaniment by a birth companion and saving money were considered the most useful planning steps. Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with reported birth outcome. Birth and emergency planning as a critical component of antenatal care can influence birth outcomes and should be extended to all pregnant women. Résumé La planification des naissances et d'urgence encourage la prise de décision rapide, aide à surmonter les obstacles aux soins de maternité qualifiés et réduit les décès maternels et néonatals évitables. Une enquête post-natale qui a été basée sur l’établissement, et auprès des 483 femmes en age de procréer à Accra, au Ghana a déterminé les étapes de planification des naissances et d'urgence, la sensibilisation des signes de danger obstétrical, a rapporté des complications maternelles et néonatales et les résultats des naissances selon la durée du séjour à l'h pital. Les soins prénatals et l'accouchement surveillés étaient presque universels. Dans l'ensemble, 62% avaient un plan de naissance, 74% avaient une connaissance adéquate des signes de danger, tandis que 64% et 37% ont déclaré des complications maternelles et néonatales, respectivement. Le fait d’être accompagné par un compagnon de naissance et d’économiser de l'argent ont été considérés comme les étapes de planification les plus utiles. La connaissance des signes de danger a été associée à la naissance et à la planification d'urgence et la planification des naissances et d'urgence a été associée à des résultats des naissances déclarées. La planification des naissances et d'urgence comme un élément essentiel des soins prénatals peuvent influer sur les résultats de grossesses et devrait être mis a la portée de toutes les femmes enceintes.
Risk Factors for Buruli Ulcer in Ghana—A Case Control Study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region
Ernest Kenu ,Kofi Mensah Nyarko,Linda Seefeld,Vincent Ganu,Michael K?ser,Margaret Lartey,Benedict Nii Laryea Calys-Tagoe,Kwodwo Koram,Richard Adanu,Oliver Razum,Edwin Afari,Fred N. Binka
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0003279
Abstract: Background Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. Its exact mode of transmission is not known. Previous studies have identified demographic, socio-economic, health and hygiene as well as environment related risk factors. We investigated whether the same factors pertain in Suhum-Kraboa-Coaltar (SKC) and Akuapem South (AS) Districts in Ghana which previously were not endemic for BU. Methods We conducted a case control study. A case of BU was defined as any person aged 2 years or more who resided in study area (SKC or AS District) diagnosed according to the WHO clinical case definition for BU and matched with age- (+/?5 years), gender-, and community controls. A structured questionnaire on host, demographic, environmental, and behavioural factors was administered to participants. Results A total of 113 cases and 113 community controls were interviewed. Multivariate conditional logistic regression analysis identified presence of wetland in the neighborhood (OR = 3.9, 95% CI = 1.9–8.2), insect bites in water/mud (OR = 5.7, 95% CI = 2.5–13.1), use of adhesive when injured (OR = 2.7, 95% CI = 1.1–6.8), and washing in the Densu river (OR = 2.3, 95% CI = 1.1–4.96) as risk factors associated with BU. Rubbing an injured area with alcohol (OR = 0.21, 95% CI = 0.008–0.57) and wearing long sleeves for farming (OR = 0.29, 95% CI = 0.14–0.62) showed protection against BU. Conclusion This study identified the presence of wetland, insect bites in water, use of adhesive when injured, and washing in the river as risk factors for BU; and covering limbs during farming as well as use of alcohol after insect bites as protective factors against BU in Ghana. Until paths of transmission are unraveled, control strategies in BU endemic areas should focus on these known risk factors.
Differences in Acute Phase Reactants between Gout and Pseudogout  [PDF]
Clement E. Tagoe, Yasmin Raza
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.412A2003
Abstract:

Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients and Methods: Eleven patients with definite gout, 12 patients with pseudogout and 5 patients with CIA were included in the study. Results: The erythrocyte sedimentation rate (ESR) was significantly different between gout (68.2 ± 49.9 mm/Hr) and CIA (113.8 ± 37.2 mm/Hr) but not between gout and pseudogout (83.9 ± 45.6 mm/Hr) or between pseudogout and CIA. The C-reactive protein (CRP) was significantly increased between gout (10.1 ± 7.9 mg/dL) and pseudogout (18.9 ± 9.8 mg/dL), gout and CIA (36.5 ± 12.4 mg/dL) as well as between pseudogout and CIA. The peripheral white cell count was significantly different between gout (9.27 ± 3.7 k/μL) and CIA (16.5 ± 6.8 k/μL), and between pseudogout (8.9 ± 3.2 k/μL) and CIA. Conclusions: Measurement of ESR and CRP are helpful in crystal-induced arthritis. The CRP has more discriminating utility than the ESR in distinguishing between gout, pseudogout and CIA. Peripheral wbc is most useful for differentiating crystal-induced arthritis from CIA.

Transmetatarsal Amputation: A Case Series and Review of the Literature
Ryan McCallum,Mark Tagoe
Journal of Aging Research , 2012, DOI: 10.1155/2012/797218
Abstract: Foot ulceration is a major cause of morbidity amongst patients with diabetes. In severe cases of ulceration, osteomyelitis and amputation can ensue. A distinct lack of agreement exists on the most appropriate level of amputation in cases of severe foot ulceration/infection to provide predictable healing rates. This paper provides an overview of the transmetatarsal amputation (TMA) as a limb salvage procedure and is written with the perspective and experiences of the Department of Podiatric Surgery at West Middlesex University Hospital (WMUH). We have reflected on the cases of 11 patients (12?feet) and have found the TMA to be an effective procedure in the management of cases of severe forefoot ulceration and infection. 1. Introduction In recent times, increased attention has been placed on the alarming increase in the incidence of diabetes. Diabetic foot ulcers occur in up to 15% of diabetic patients [1], and amputation rates amongst this population have been documented as 11% [2]. In particular cases of severe foot infection, amputation should not necessarily be looked upon as failure of care, but rather the most appropriate intervention for preventing more proximal spread and persistent hospital attendance. Aggressive management of severe foot infection/ulceration can reduce the risk of proximal amputation. 2. Transmetatarsal Amputation A proportion of the diabetic community experience serious and debilitating complications associated with their feet, with a 12–25% increased risk of developing foot ulceration [3]. Development of diabetic foot ulceration is often a multifactorial process; however, the presence of influences such as neuropathy and peripheral vascular disease is recognised as significant contributing factor. The neuroischaemic ulceration accounts for 90% of those encountered in the diabetic population [4], and approximately half of diabetic foot wounds develop an infection, the majority involving only soft tissue [5]. In circumstances where soft tissue infection is severe or where underlying bone is infected, amputation may be considered an appropriate line of treatment. Mills et al. [6] recognised that infection and gangrene due to microvascular disease were two major factors that resulted in failure of wound healing, resulting in amputation. At WMUH, a treatment pathway has been developed for patients with severe foot ulceration/infection who have been deemed suitable candidates for undergoing TMA (see Assessment and Treatment below). Patients are urgently admitted into the hospital and are assessed by the medical and surgical teams,
The double-edged sword: financial source of household healthcare expenditure in Ghana
Henry Armah Tagoe
Journal of Public Health in Africa , 2012, DOI: 10.4081/jphia.2012.e17
Abstract: In many regions, some of the most formidable enemies of health are joining forces with the allies of poverty to impose a double burden of disease, disability and premature death. This paper looks at the main financial sources households use to finance healthcare in Ghana. It examines the spatial and socio-economic dynamics and the challenges these pose to health and development. Analysis of the 2003 Ghana World Health Survey data indicates that approximately 41% of households depend on more than one financial source with 88% depending on household income to finance healthcare expenditure. The high dependency on household income will erode gains in the economic and health sector in the midst of the recent global economic recession. Comprehensive national health insurance programs that cover emerging disease conditions will mitigate the double burden of disease on households in emerging economies.
Imaging and Dosimetric Consideration for Titanium Prosthesis Implanted within the Irradiated Region by Cobalt-60 Teletherapy Unit  [PDF]
Vaino Indongo, Samuel Nii Adu Tagoe, Kwame Kyere, Cyril Schandorf
International Journal of Medical Physics,Clinical Engineering and Radiation Oncology (IJMPCERO) , 2018, DOI: 10.4236/ijmpcero.2018.72014
Abstract: The aim of this research is to observe dose distributions in the vicinity of titanium prosthetic implants during radiotherapy procedures on 60Co teletherapy machine, Prowess Panther treatment planning system (TPS). Data were obtained using a locally fabricated tissue equivalent phantom CT images with titanium prosthesis which was irradiated with 60Co gamma radiation. Prowess TPS (1.25 MeV) estimated less variations. Proximal ends of the metal recorded slight increase in doses as a result of backscatter with dose increment below acceptable tolerance of ±3%. Doses measured decreases on the distal side of the prosthesis at a distance less than dmax from the plate on each beam energy. The depth dose increases marginally after a certain depth level which generally originated from the unperturbed dose due to increase in the electron fluence. The percentage of depth doses decrease with the increase in plate thickness. A reduction in the above trend was also noticed with an increase in beam energy primarily because scattered photons are more forwardly directed. Prowess TPS (convolution superposition algorithm) was found to be better at reducing dose variation when correction for artifact. Manual calculations on blue phantom data agree with results from Prowess. This treatment system is capable of simulating dose around titanium prosthesis as its range of densities, 0.00121 to 2.83, excludes titanium density (rED for titanium is 3.74).
Observation of a New J(PC)=1(+-) Isoscalar State in the Reaction Pi- Proton -> Omega Eta Neutron at 18 GeV/c
BNL-E852 Collaboration,:,P. Eugenio
Physics , 2000, DOI: 10.1016/S0370-2693(00)01347-2
Abstract: Results are presented on a partial wave analysis of the Omega Eta final state produced in Pi- Proton interactions at 18 GeVc where Omega -> Pi+ Pi- Pi0, Pi0 -> 2 Gammas, and Eta -> 2 Gammas. We observe the previously unreported decay mode Omega(1650) -> Omega Eta and a new 1(+-) meson state h1(1595) with a mass M=1594(15)(+10)(-60) MeV/c^2 and a width Gamma=384(60)(+70)(-100) MeV/c^2. The h1(1595) state exhibits resonant-like phase motion relative to the Omega(1650).
Very Long Baseline Neutrino Oscillation Experiment for Precise Determination of Oscillation Parameters and Search for nu_mu -> nu_e Appearance and CP Violation
BNL Neutrino Working Group,M. Diwan
Physics , 2002,
Abstract: The possibility of making a low cost, very intense (1MW) high energy proton source at the Brookhaven Alternating Gradient Synchrotron (BNL-AGS) along with the forthcoming new large underground detectors (approaching 1 MT in mass) at the National Underground Science and Engineering Laboratory (NUSEL) in Homestake, South Dakota or at the Waste Isolation Pilot Plant (WIPP) in Carlsbad, New Mexico, allows us to propose a program of experiments that will address fundamental aspects of neutrino oscillations and CP-invariance violation. This program is unique because of the very long baseline of more than 2500 km from BNL to the underground laboratory in the West. We used the running scenario of a low energy, wide band neutrino beam with 1 MW AGS, 500 kT of fiducial mass water Cherenkov detector, and 5x10^7 seconds of running time. In this report we show that with these conditions we precisely measure dm^2_32 and sin^2(2theta_23) and have excellent sensitivity to sin^2(2theta_13) with a distinctive signal spectrum. If sin^2(2theta_13) > 0.01 the experiment is sensitive to the CP-violating phase in the mixing matrix with only neutrino running. By running in the anti-neutrino mode we distinguish between the cases dm^2_31 > 0 versus dm^2_31 < 0 using distinctive distortions to the electron or positron spectrum. Lastly, the very long baseline allows the measurement of dm^2_21 (in the LMA region) with approximately the same resolution as KAMLAND but in the nu_mu -> nu_e appearance channel.
Healthy lifestyle behaviour among Ghanaian adults in the phase of a health policy change
Henry A Tagoe, Fidelia AA Dake
Globalization and Health , 2011, DOI: 10.1186/1744-8603-7-7
Abstract: Descriptive, bivariate and multivariate regression techniques were employed on two nationally representative surveys (2003 World Health Survey (Ghana) and 2008 Ghana Demographic and Health Survey) to arrive at the results.While the prevalence of some negative lifestyle behaviours like smoking has reduced others like alcohol consumption has increased. Relatively fewer people adhered to consuming the recommended amount of fruit and vegetable servings per day in 2008 compared to 2003. While more females (7.0%) exhibited healthier lifestyles, more males (9.0%) exhibited risky lifestyle behaviours after the introduction of the policy.The improvement in healthy lifestyle behaviours among female adult Ghanaians will help promote healthy living and potentially lead to a reduction in the prevalence of obesity among Ghanaian women. The increase in risky lifestyle behaviour among adult male Ghanaians even after the introduction of the health policy could lead to an increase in the risk of non-communicable diseases among men and the resultant burden of disease on them and their families will push more people into poverty.The overall health of individuals is impacted by lifestyle behaviours including healthy diets, physical activity, smoking and alcohol consumption. Unhealthy lifestyle behaviours particularly poor dietary practices, physical inactivity and smoking are major risk factors for conditions like overweight, obesity and chronic non-communicable diseases [1-3]. Research in Ghana indicates that the prevalence of obesity is increasing especially among women [4]. The rising prevalence of obesity in Ghana is worrying because epidemiological studies have consistently shown an increased risk of morbidity, disability and mortality with obesity [5]. Findings from a study using data from a nationally representative sample survey (World Health Survey 2003) conducted in Ghana revealed that about 18% of the respondents had been diagnosed with one or more chronic non-communicable di
Thermodynamics of heavy-light hadrons
Heng-Tong Ding,for the BNL-Bielefeld-CCNU collaboration
Physics , 2014,
Abstract: Ratios of cumulants of conserved net charge fluctuations are sensitive to the degrees of freedom that are carriers of the corresponding quantum numbers in different phases of strong interaction matter. We calculate second and fourth order cumulants of net charm and strange fluctuations and their correlations with other conserved charges such as net baryon number and electric charge. Simulation are performed on $N_\tau$=6 and 8 lattices using the Highly Improved Staggered Quark (HISQ) action with a light to strange quark mass ratio of 1/20 and having charm quarks treated in the quenched approximation. Analysing appropriate ratios of these cumulants we observe that both open strange and charm hadrons start to get dissociated in the chiral crossover region. We provide indirect evidence for the existence of additional, experimentally yet unobserved open charm and strange hadrons from QCD thermodynamics. This is done by comparing lattice QCD results to Hadron Resonance Gas (HRG) model calculations performed with a hadron spectrum as listed in the Particle Data Tables as well as with a spectrum predicted in the relativistic quark model and observed in lattice QCD calculations. We also discuss the influence of these experimentally yet unobserved states on the determination of freeze-out temperature and chemical potentials from heavy ion collision experiments. We found that including these additional states in the HRG model leads to a systematic 5-8 MeV decrease in the freeze-out temperature of strange hadrons.
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