SUMMARYObjective: To determine the prevalence, social demographic characteristics and types of pelvic organ prolapse that patients present with at the Tamale Teaching Hospital (TTH). Methods: A descriptive study of pelvic organ prolapses at the Tamale Teaching Hospital from 1 st January 2010 to 31 st December 2011. Results: The 118 pelvic organ prolapse cases constituted (2.68%) of the 4403 gynaecological out-patient cases seen during the two year study period. The mean age and standard deviation was (45.9± 15.1) and the modal age group was 30-39 years with 32 (27.1%) of cases. There were 112 (94.9%) cases of uterine prolapse, 95 (80.5%) had cystocele, 16 (13.5%) patients had rectoceles and 3 (2.5%) had enterocele. Their main occupations were trading 66 (55.9%) and farming 44 (37.3%), seventy (62.5%) of the patients with uterine prolapse were premenopausal while (10) 14.3% of the premenopausal cases had an ongoing pregnancy. The parity ranged from zero to 13 with mean and standard deviation of (4.4±1.7). Fifty five (46.6%) were from the Tamale metropolis and only 12 (10.5%) had all their deliveries in hospital. The commonest complication was decubitus ulcer present in 20 (16.9%) patients, 16(80%) of it in patients with procedentia. Conclusion: Pelvic organ prolapse is not a rare gynaecological condition at the Tamale Teaching Hospital. The patients are relatively young and are from various districts in the northern region. Some occupational, socio-cultural practices and reproductive characteristics may be contributory to severity of pelvic organ prolapse.
Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.
Essential nutrients are necessary for reducing the risk of maternal mortality, prenatal mortality, and low-birthweight infants. Dietary diversity can play an important role in supplying essential nutrients to both the mother and the foetus. We evaluated nutrition knowledge, attitudes, and dietary diversity of pregnant women. In addition, we investigated the sociodemographic determinants of dietary diversity among pregnant women from a rural district in Ghana. Participants were pregnant women receiving antenatal care from a rural district hospital in Ghana. Dietary diversity was measured using a 24-hour dietary recall questionnaire. Multiple linear regression was used to determine the sociodemographic characteristics of dietary diversity. About 85% of the pregnant women knew that they should eat more in comparison to nonpregnant women, and only 16.9% knew the importance of folic acid supplementation during pregnancy. Mean (SD) dietary diversity score of the participants was 5.27 (1.35), 85.4% did not consume any fruits, and 82.3% did not take milk and milk products. Almost all participants took at least one food item in the starchy staples and green leafy vegetables food groups. Moreover, 53% consumed vitamin A-rich fruits, vegetables, and tubers; 7.7% organ meats; and 30.8% eggs. Those who earned a monthly income of ≥GHC 500 or US$ 87 (B = 1.82; 0.90–2.73; p < 0.001 ) significantly had higher dietary diversity scores compared to those who earned less. Dietary diversity of the pregnant women was suboptimal. The consumption of vitamin A- and iron-rich foods was inadequate. Income was an important determinant of the dietary diversity of pregnant women from Northern rural Ghana.
Lymphatic vessels function as transport channels for tumor cells to metastasize from the primary site into the lymph nodes. In this experiment we evaluated the effect of Sulfatase-1 (Sulf-1) on metastasis by upregulating it in murine hepatocarcinoma cell line Hca-F with high lymph node metastatic rate of >75%. The study in vitro showed that upregulation of Sulf-1 in Hca-F cells significantly reduced cell proliferation, migration and invasion (p<0.05). Also, the forced expression of Sulf-1 downregulated Mesothelin (Msln) at both the protein and mRNA levels. The experiment in vivo further showed that up-regulation of Sulf-1 with the attendant downregulation of mesothelin delayed tumor growth and decreased lymph node metastasis. In conclusion, our findings show that Sulf-1 is an important tumor suppressor gene in hepatocellular carcinoma (HCC), and its overexpression downregulates Msln and results in a decrease in HCC cell proliferation, migration, invasion, and lymphatic metastasis. This functional relationship between Sulf-1 and Msln could be exploited for the development of a novel liver cancer therapy.
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