Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.428-434
Eric K Anku, Harriet G ADU-AMOAH, J. Ainuson-Quampah
Background: Malnutrition is commonly reported among hospitalized paediatric patients. However, it is often not diagnosed leading toprolonged hospital staysand other medical complications. Objective: This study aimed at evaluating the validity ofthe Screening Tool for Risk of Nutritional Status and Growth (STRONGkids) and mid-upper arm circumference (MUAC)for assessing malnutrition in paediatric inpatients between the ages of 6 months and 5 years. The weight-for-height (WFH) z-score was used as areference standard for the evaluation. Methods: A cross-sectional study design was used in this study. A total of 96 individuals were enrolled in the study from both the Princess Marie Louise Children’s Hospital and Korle Bu Teaching Hospital, located in Accra, Ghana. Data were collected on demographics, admission details, weight, height, MUAC, and length of hospital stay. The STRONGkids screening tool was used for nutrition risk screening. Data analysis was performed using R version 4.1.0. Descriptive statistics were used to report frequencies, averages, percentages, standard deviations, and interquartile ranges. Diagnostic values were computed for STRONGkids and MUAC using WFH z-scores. Cohen's kappa was utilized to measure inter-rater agreement, with statistical significance set at p < 0.05. Results: Males accounted for 59.3%(n = 57/96)of the study sample. The prevalence of malnutrition in this study was 30%[n = 27/96; 95% confidence interval (CI): 21-39%]. The sensitivity and specificity of STRONGkids were 70% (95% CI: 52-86%) and 43% (95% CI: 31-55%), respectively. The sensitivity and specificity of MUAC were 45% (95% CI: 27-63%) and 93% (95% CI: 86-99%), respectively. The inter-rater agreement, based on two blinded assessments, for STRONGkids, was 0.57 (p= 0.006). Conclusion: The study revealed that STRONGkids had a low overall degree of validity, while MUAC had a high validity for specificity but lower validity for other diagnostic values. As a result, it is not recommended to use STRONGkids or MUAC individually for screening pediatric malnutrition in this setting, but rather in conjunction
{"title":"Validity of STRONGkids and MUAC as nutritional screening tools for predicting acute malnutrition among hospitalized children in Accra, Ghana","authors":"Eric K Anku, Harriet G ADU-AMOAH, J. Ainuson-Quampah","doi":"10.46829/hsijournal.2023.6.4.1.428-434","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.428-434","url":null,"abstract":"Background: Malnutrition is commonly reported among hospitalized paediatric patients. However, it is often not diagnosed leading toprolonged hospital staysand other medical complications.\u0000Objective: This study aimed at evaluating the validity ofthe Screening Tool for Risk of Nutritional Status and Growth (STRONGkids) and mid-upper arm circumference (MUAC)for assessing malnutrition in paediatric inpatients between the ages of 6 months and 5 years. The weight-for-height (WFH) z-score was used as areference standard for the evaluation.\u0000Methods: A cross-sectional study design was used in this study. A total of 96 individuals were enrolled in the study from both the Princess Marie Louise Children’s Hospital and Korle Bu Teaching Hospital, located in Accra, Ghana. Data were collected on demographics, admission details, weight, height, MUAC, and length of hospital stay. The STRONGkids screening tool was used for nutrition risk screening. Data analysis was performed using R version 4.1.0. Descriptive statistics were used to report frequencies, averages, percentages, standard deviations, and interquartile ranges. Diagnostic values were computed for STRONGkids and MUAC using WFH z-scores. Cohen's kappa was utilized to measure inter-rater agreement, with statistical significance set at p < 0.05.\u0000Results: Males accounted for 59.3%(n = 57/96)of the study sample. The prevalence of malnutrition in this study was 30%[n = 27/96; 95% confidence interval (CI): 21-39%]. The sensitivity and specificity of STRONGkids were 70% (95% CI: 52-86%) and 43% (95% CI: 31-55%), respectively. The sensitivity and specificity of MUAC were 45% (95% CI: 27-63%) and 93% (95% CI: 86-99%), respectively. The inter-rater agreement, based on two blinded assessments, for STRONGkids, was 0.57 (p= 0.006).\u0000Conclusion: The study revealed that STRONGkids had a low overall degree of validity, while MUAC had a high validity for specificity but lower validity for other diagnostic values. As a result, it is not recommended to use STRONGkids or MUAC individually for screening pediatric malnutrition in this setting, but rather in conjunction","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125318801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.435-442
B. A. Asare, Grace Asare
Background: To improve the fight against faecal-orally transmitted rotavirus infection, which is the leading cause of severe diarrhoea among children aged < 5 years, Ghana has incorporated rotavirus vaccination into its expanded programme of immunization. Rotavirus diarrhoea constitutes a significant portion of all-cause acute childhood diarrhoea (ACD) in children. Objective: This study was designed to investigate the impact of routine rotavirus vaccination on ACD cases. Methods: The study was completed through a cross-sectional review of health institutional childhood diarrhoea surveillance data from 2012 to 2021, which includes the year when rotavirus vaccination was introduced. The study dataset was abstracted from the DHIMS-2 internet-based health data repository and was descriptively analyzed by administrative regions using Epi InfoTM version 3.5.1(CDC, USA). Results: The burden of ACD in terms of both absolute and mean values remained the lowest among infants aged under 28 days across all regions, as they had not yet received rotavirus vaccination. In contrast, children aged 1 to 4 years, who are typically exposed to rotavirus serotypes 1 and 2, consistently experienced the highest burden of ACD. With increasing rotavirus vaccination coverage, children aged 1 month to 4 years recorded a marginal, but sustained decline in mean ACD cases from 2016 to 2021. The ACD also similarly declined slowly among the rotavirus vaccine naïve infants aged < 28 days. Despite a spike in 2017, the burden of ACD was low in the Ahafo administrative region. However, increasing rotavirus vaccination coverage did not appear to have a significant impact on reducing ACD in the Ashanti, Bono, Bono East, Eastern, and Northeast administrative regions. From 2012 to 2021, the Central, Greater Accra, Oti, Upper East, Volta, and Western administrative regions recorded a marginal decline in the burden of ACD among children aged 1 to 4 years, and this was accompanied by an increase in rotavirus vaccination coverage. The ACD cases rose as rotavirus vaccination coverage decreased in the Western North Region between 2015 and 2019. Conclusion: Routine rotavirus vaccination may have contributed to a reduction in severe childhood ACD cases even though this study cannot exclude the impact of other anti-diarrhoeal interventions. To evaluate the population effectiveness of rotavirus vaccines, it is recommended to widely promote routine rotavirus disease surveys, which can be nested within ACD surveillance.
{"title":"A health surveillance data-based assessment of the impact of routine paediatric rotavirus vaccination on all-cause acute childhood diarrhoea","authors":"B. A. Asare, Grace Asare","doi":"10.46829/hsijournal.2023.6.4.1.435-442","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.435-442","url":null,"abstract":"Background: To improve the fight against faecal-orally transmitted rotavirus infection, which is the leading cause of severe diarrhoea among children aged < 5 years, Ghana has incorporated rotavirus vaccination into its expanded programme of immunization. Rotavirus diarrhoea constitutes a significant portion of all-cause acute childhood diarrhoea (ACD) in children. \u0000Objective: This study was designed to investigate the impact of routine rotavirus vaccination on ACD cases.\u0000Methods: The study was completed through a cross-sectional review of health institutional childhood diarrhoea surveillance data from 2012 to 2021, which includes the year when rotavirus vaccination was introduced. The study dataset was abstracted from the DHIMS-2 internet-based health data repository and was descriptively analyzed by administrative regions using Epi InfoTM version 3.5.1(CDC, USA).\u0000Results: The burden of ACD in terms of both absolute and mean values remained the lowest among infants aged under 28 days across all regions, as they had not yet received rotavirus vaccination. In contrast, children aged 1 to 4 years, who are typically exposed to rotavirus serotypes 1 and 2, consistently experienced the highest burden of ACD. With increasing rotavirus vaccination coverage, children aged 1 month to 4 years recorded a marginal, but sustained decline in mean ACD cases from 2016 to 2021. The ACD also similarly declined slowly among the rotavirus vaccine naïve infants aged < 28 days. Despite a spike in 2017, the burden of ACD was low in the Ahafo administrative region. However, increasing rotavirus vaccination coverage did not appear to have a significant impact on reducing ACD in the Ashanti, Bono, Bono East, Eastern, and Northeast administrative regions. From 2012 to 2021, the Central, Greater Accra, Oti, Upper East, Volta, and Western administrative regions recorded a marginal decline in the burden of ACD among children aged 1 to 4 years, and this was accompanied by an increase in rotavirus vaccination coverage. The ACD cases rose as rotavirus vaccination coverage decreased in the Western North Region between 2015 and 2019.\u0000Conclusion:\u0000Routine rotavirus vaccination may have contributed to a reduction in severe childhood ACD cases even though this study cannot exclude the impact of other anti-diarrhoeal interventions. To evaluate the population effectiveness of rotavirus vaccines, it is recommended to widely promote routine rotavirus disease surveys, which can be nested within ACD surveillance.","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114145825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.473-480
Background: Due to high academic demands, many medical students reportedly sleep fewer hours than they would desire. However, the impact of their sleep habits on their mental health is unclear. Objective: This study aimed to determine the level of sleep deprivation among University of Ghana Medical School students and assess the relationship between sleep deprivation and depression, anxiety, and stress. Methods: This cross-sectional study recruited 112 medical students from the University of Ghana Medical School. A series of self-administered questionnaires were used to obtain data from participants. Sleep was assessed using the sleep deprivation index (SDI) and the Epworth sleepiness scale (ESS), whereas mental health status was assessed using the Depression Anxiety Stress Scale (DASS). Results: Males (43.8%, n =49) and females (56.2%, n =63) from both preclinical (39.3%, n = 44) and clinical (61.7%, n =68) years participated in this study. Self-reported sleep duration was 5.6±0.12 hours on weekdays and 7.2 ± 0.13 hours on weekends, resulting in an SDI of 1.56 ± 0.12 hours. Regarding daytime sleepiness, 53.8% of the participants were classified as normal, 31.3%as excessive, and 15.1% as severe on the ESS. When compared to students with normal daytime sleepiness, students with severe daytime sleepiness scored significantly higher on measures of depression (3.4 ± 0.4 vs 6.9 ±0.6), anxiety (3.9± 0.5versus 8.0± 0.8) and stress (2.7 ± 0.5versus6.9 ± 0.9). The evidence indicated a weak positive correlation between daytime somnolence, as measured by the DASS, and depression, anxiety, and stress (r2= 0.199, p< 0.0001). However, there was no correlation between these mental health conditions and sleep deprivation (r2= 0.020, p= 0.1). Further analysis revealed that daytime sleepiness significantly predicted depression, anxiety, and stress, as measured by the DASS. Conclusion: Our findings showed that sleep deprivation among medical students could lead to daytime sleepiness and an increased risk of developing depression, anxiety, and stress. Furthermore, daytime sleepiness was predictive of the mental health status of the study participants
{"title":"Daytime sleepiness reflects depression, anxiety, and stress among students at the University of Ghana Medical School","authors":"","doi":"10.46829/hsijournal.2023.6.4.1.473-480","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.473-480","url":null,"abstract":"Background: Due to high academic demands, many medical students reportedly sleep fewer hours than they would desire. However, the impact of their sleep habits on their mental health is unclear. \u0000Objective: This study aimed to determine the level of sleep deprivation among University of Ghana Medical School students and assess the relationship between sleep deprivation and depression, anxiety, and stress. \u0000Methods: This cross-sectional study recruited 112 medical students from the University of Ghana Medical School. A series of self-administered questionnaires were used to obtain data from participants. Sleep was assessed using the sleep deprivation index (SDI) and the Epworth sleepiness scale (ESS), whereas mental health status was assessed using the Depression Anxiety Stress Scale (DASS).\u0000Results: Males (43.8%, n =49) and females (56.2%, n =63) from both preclinical (39.3%, n = 44) and clinical (61.7%, n =68) years participated in this study. Self-reported sleep duration was 5.6±0.12 hours on weekdays and 7.2 ± 0.13 hours on weekends, resulting in an SDI of 1.56 ± 0.12 hours. Regarding daytime sleepiness, 53.8% of the participants were classified as normal, 31.3%as excessive, and 15.1% as severe on the ESS. When compared to students with normal daytime sleepiness, students with severe daytime sleepiness scored significantly higher on measures of depression (3.4 ± 0.4 vs 6.9 ±0.6), anxiety (3.9± 0.5versus 8.0± 0.8) and stress (2.7 ± 0.5versus6.9 ± 0.9). The evidence indicated a weak positive correlation between daytime somnolence, as measured by the DASS, and depression, anxiety, and stress (r2= 0.199, p< 0.0001). However, there was no correlation between these mental health conditions and sleep deprivation (r2= 0.020, p= 0.1). Further analysis revealed that daytime sleepiness significantly predicted depression, anxiety, and stress, as measured by the DASS.\u0000Conclusion: Our findings showed that sleep deprivation among medical students could lead to daytime sleepiness and an increased risk of developing depression, anxiety, and stress. Furthermore, daytime sleepiness was predictive of the mental health status of the study participants","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124628794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.417-418
J. Ainuson-Quampah
The duration and time of sleep affect the general health and well-being of individuals. It has been recommended that adults, aged 18 –64 years, should sleep for 7 to 9 hours per night, however, many people struggle with sleep problems of various kinds and hardly meet these recommendations. Sleep is necessary for cognition, alertness, vigilance, and sustenance of attention as well as control of emotions. The effects of sleep deprivation on cognitive performance and other psychological variables have been widely studied. Sleepiness, the short-term effect of inadequate sleep, may lead to irritability, reduced alertness, poor motor skills, and attention problems. Among the long-term effects are obesity, type 2 diabetes, hypertension, and mental health disorders. Sleep deprivation in adults of all ages is defined as getting less than 7 hours of sleep per night.
{"title":"Sleep quality and psychological well-being of university students","authors":"J. Ainuson-Quampah","doi":"10.46829/hsijournal.2023.6.4.1.417-418","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.417-418","url":null,"abstract":"The duration and time of sleep affect the general health and well-being of individuals. It has been recommended that adults, aged 18 –64 years, should sleep for 7 to 9 hours per night, however, many people struggle with sleep problems of various kinds and hardly meet these recommendations. Sleep is necessary for cognition, alertness, vigilance, and sustenance of attention as well as control of emotions. The effects of sleep deprivation on cognitive performance and other psychological variables have been widely studied. Sleepiness, the short-term effect of inadequate sleep, may lead to irritability, reduced alertness, poor motor skills, and attention problems. Among the long-term effects are obesity, type 2 diabetes, hypertension, and mental health disorders. Sleep deprivation in adults of all ages is defined as getting less than 7 hours of sleep per night.","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"248 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115767996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.457-464
R. A. Azie, L. Bagrmwin, T. Ndanu, P. Aniteye
Background: Sexual and reproductive health communication is an important conversation challenge between parents and their adolescent children. Studies have established that parent-adolescent communication about sex can greatly reduce adolescents' risky sexual behaviour. Factors such as attitude, religious beliefs, perceived behavioural control, and behavioural intentions have been reported to affect parent-adolescent communication. Objective: This study assessed the communication practices between adolescents and their parents in the Wa West District in the Upper West Region of Ghana and factors that may be associated with this communication process. Methods: A community-based cross-sectional study design was employed using a four-stage sampling technique. A total of 420 parents with adolescents aged 10to 19years were recruited to answer structured questions using Somers and Canivez's sexual communication tool. The tool yielded sexual communication mean scores. The analysis of variance test was used to compare mean scores. Binary logistic regression was used to determine possible factors affecting SRH communications. All analyses were done using IBM SPSS Statistics (Version 25). Results: The study found that most of the respondents had good communication on sexual and reproductive health with their adolescents. There was a significant difference between Dagaabas and the other ethnic groups (p=0.025, 95% confidence interval (95% CI) = 0.05-1.25), between public sector employees and farmers (p=0.008, 95% CI = 0.07-0.90), and between Christians and Muslims (p=0.032, 95% CI= 0.01-0.38) on SRH communication. Conclusion: Though parents' communication with adolescents was good, health stakeholders need to empower parents with information on sexual and reproductive health to ensure effective counselling of their adolescents
{"title":"Sexual and reproductive health communication between parents and adolescents: the case of Wa West District of the Upper West Region, Ghana","authors":"R. A. Azie, L. Bagrmwin, T. Ndanu, P. Aniteye","doi":"10.46829/hsijournal.2023.6.4.1.457-464","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.457-464","url":null,"abstract":"Background: Sexual and reproductive health communication is an important conversation challenge between parents and their adolescent children. Studies have established that parent-adolescent communication about sex can greatly reduce adolescents' risky sexual behaviour. Factors such as attitude, religious beliefs, perceived behavioural control, and behavioural intentions have been reported to affect parent-adolescent communication. \u0000Objective: This study assessed the communication practices between adolescents and their parents in the Wa West District in the Upper West Region of Ghana and factors that may be associated with this communication process.\u0000Methods: A community-based cross-sectional study design was employed using a four-stage sampling technique. A total of 420 parents with adolescents aged 10to 19years were recruited to answer structured questions using Somers and Canivez's sexual communication tool. The tool yielded sexual communication mean scores. The analysis of variance test was used to compare mean scores. Binary logistic regression was used to determine possible factors affecting SRH communications. All analyses were done using IBM SPSS Statistics (Version 25).\u0000Results: The study found that most of the respondents had good communication on sexual and reproductive health with their adolescents. There was a significant difference between Dagaabas and the other ethnic groups (p=0.025, 95% confidence interval (95% CI) = 0.05-1.25), between public sector employees and farmers (p=0.008, 95% CI = 0.07-0.90), and between Christians and Muslims (p=0.032, 95% CI= 0.01-0.38) on SRH communication.\u0000Conclusion: Though parents' communication with adolescents was good, health stakeholders need to empower parents with information on sexual and reproductive health to ensure effective counselling of their adolescents","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116935308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.419-427
Background: Bendroflumethiazide is often prescribed with fluoxetine or imipramine for patients with both depression and hypertension. However, there is little data on the potential interactions between these drugs. Objective: The objective of this study was to investigate the potential antidepressant effects of bendroflumethiazide, as well as sub-effective dose combinations of bendroflumethiazide with fluoxetine or imipramine. Methods: Forced swimming and tail suspension tests were used to investigate the behavioural effects of bendroflumethiazide [5-20 mg/kg; per os (p.o],imipramine (3-30 mg/kg; p.o) and fluoxetine (3-30 mg/kg; p.o). Mean immobility, swimming, climbing, curling,and swinging scores were measured. Median effective dose (ED50) values were calculated from the immobility scores. The antidepressant effect of the combination of bendroflumethiazide with imipramine or fluoxetine at sub-effective doses was then investigated. Isobolographic analyses were performed on these combinations to investigate possible synergism, additivity or antagonism. Results: Bendroflumethiazide produced a significant diminution in mean immobility scores, suggestive of an antidepressant-like effect, while increasing swimming, climbing and swinging scores. Imipramine and fluoxetine also exhibited antidepressant-like effects. A combination of bendroflumethiazide and imipramine at sub-effective doses showed a synergistic antidepressant-like effect with an interaction index of 0.31 as did the bendroflumethiazide-fluoxetine combination (interaction index:0.41). Conclusion: This study demonstrated the acute antidepressant-like effect of bendroflumethiazide. Moreover, bendroflumethiazide-imipramine combinations offer greater synergy when compared to bendroflumethiazide-fluoxetine combinations.
{"title":"Sub-effective doses of a bendroflumethiazide-imipramine combination offer greater synergistic antidepressant effect compared to a bendroflumethiazide-fluoxetine combination: an isobolographic analysis","authors":"","doi":"10.46829/hsijournal.2023.6.4.1.419-427","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.419-427","url":null,"abstract":"Background: Bendroflumethiazide is often prescribed with fluoxetine or imipramine for patients with both depression and hypertension. However, there is little data on the potential interactions between these drugs.\u0000Objective: The objective of this study was to investigate the potential antidepressant effects of bendroflumethiazide, as well as sub-effective dose combinations of bendroflumethiazide with fluoxetine or imipramine.\u0000Methods: Forced swimming and tail suspension tests were used to investigate the behavioural effects of bendroflumethiazide [5-20 mg/kg; per os (p.o],imipramine (3-30 mg/kg; p.o) and fluoxetine (3-30 mg/kg; p.o). Mean immobility, swimming, climbing, curling,and swinging scores were measured. Median effective dose (ED50) values were calculated from the immobility scores. The antidepressant effect of the combination of bendroflumethiazide with imipramine or fluoxetine at sub-effective doses was then investigated. Isobolographic analyses were performed on these combinations to investigate possible synergism, additivity or antagonism.\u0000Results: Bendroflumethiazide produced a significant diminution in mean immobility scores, suggestive of an antidepressant-like effect, while increasing swimming, climbing and swinging scores. Imipramine and fluoxetine also exhibited antidepressant-like effects. A combination of bendroflumethiazide and imipramine at sub-effective doses showed a synergistic antidepressant-like effect with an interaction index of 0.31 as did the bendroflumethiazide-fluoxetine combination (interaction index:0.41).\u0000Conclusion: This study demonstrated the acute antidepressant-like effect of bendroflumethiazide. Moreover, bendroflumethiazide-imipramine combinations offer greater synergy when compared to bendroflumethiazide-fluoxetine combinations.","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134185324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.481-484
A. A. Tamatey, K. Adomako, G. Offei-Larbi, I. Okyere, M. Ntumy
Spontaneous pneumothorax occurring in pregnancy is a rare condition that can be life-threatening if not recognized and treated on time. We present a 38-year-old primigravida at 34 weeks gestational age who presented with a 2-week history of progressive dyspnoea. Clinical assessment was consistent with a right pneumothorax which was confirmed by a chest x-ray. She was managed with a right chest tube insertion. She later had an elective cesare an delivery. Six months later, both mother and baby were fine. The clinical significance of this article is that pneumothorax in pregnancy may mimic some complications of pregnancy itself and may thus be missed if the clinician does not have pneumothorax also in mind
{"title":"Spontaneous pneumothorax in pregnancy: a case report and literature review","authors":"A. A. Tamatey, K. Adomako, G. Offei-Larbi, I. Okyere, M. Ntumy","doi":"10.46829/hsijournal.2023.6.4.1.481-484","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.481-484","url":null,"abstract":"Spontaneous pneumothorax occurring in pregnancy is a rare condition that can be life-threatening if not recognized and treated on time. We present a 38-year-old primigravida at 34 weeks gestational age who presented with a 2-week history of progressive dyspnoea. Clinical assessment was consistent with a right pneumothorax which was confirmed by a chest x-ray. She was managed with a right chest tube insertion. She later had an elective cesare an delivery. Six months later, both mother and baby were fine. The clinical significance of this article is that pneumothorax in pregnancy may mimic some complications of pregnancy itself and may thus be missed if the clinician does not have pneumothorax also in mind","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"1 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114101967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.443-447
Background: The COVID-19 pandemic was caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first detected in Wuhan, Hubei province, China in December 2019. The virus rapidly spread worldwide, with mutations in various parts of its genetic material affecting its transmissibility and infectivity. Objective: This study addressed some of the mutations present in the human SARS-CoV-2 spike proteins relative to Wuhan-Hu-1 reference sequence from China, according to different countries from West Africa. Methods: The SARS-CoV-2 spike protein sequences were obtained from the National Center for Biotechnology Information virus database in the FASTA format on November12,2021. The multiple sequence alignment of the proteins was carried out by MAFFT version 7 online. The human SARS-CoV-2 spike protein sequences from selected West African countries were analyzed by comparing them with the reference SARS-CoV-2 protein sequence from Wuhan-Hu-1, China. Results: Out of 148 spike protein sequences analyzed, 137 proteins had one or more mutations. A total of 486 mutations were observed corresponding to 47 distinct mutation sites. In the analysis of the spike proteins in the study, it was observed that the Receptor Binding Domain which is involved in the interactions with human angiotensin-converting enzyme-2 (ACE-2) receptor causing infection leading to the COVID-19 disease had 8 distinct mutation sites. The D614G mutation is the most common in the SARS-CoV-2 spike protein observed so far among all the West African countries examined in this study and thus the most predominant. In this study, we examined spike proteins not associated with mutations, the distribution of mutations in spike proteins, mutation density in different regions of the spike protein sequence, spike protein sequences with multiple mutations and the Human SARS-CoV-2 spike protein mutation in West Africa and implications for vaccination and drug development purposes. Conclusion: The identified mutations in SARS-CoV-2 are significant for infection prevention, control, and public health interventions. Further studies are imperative to understand the mutations in the virus's spike proteins to guide vaccine development and antiviral drug designs. Investigations should also be conducted to determine the infectivity of emerging variants in West Africa and their response to vaccines and available drugs to address public health concerns on vaccination and drug design goals
背景:2019冠状病毒病大流行是由2019年12月在中国湖北省武汉市首次发现的严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2)引起的。该病毒在世界范围内迅速传播，其遗传物质的各个部分发生突变，影响其传播性和传染性。目的:本研究针对西非不同国家的SARS-CoV-2人类刺突蛋白中与中国武汉-胡-1参考序列相关的一些突变进行了研究。方法:于2021年11月12日以FASTA格式从国家生物技术信息中心病毒数据库中获取SARS-CoV-2刺突蛋白序列。蛋白的多序列比对采用MAFFT version 7进行在线比对。选择来自西非国家的人SARS-CoV-2刺突蛋白序列与来自中国武汉-湖-1的参考SARS-CoV-2蛋白序列进行比较分析。结果:148个刺突蛋白序列中，137个蛋白有一个或多个突变。总共观察到486个突变，对应于47个不同的突变位点。在对研究中刺突蛋白的分析中，观察到与人血管紧张素转换酶-2 (ACE-2)受体相互作用导致COVID-19疾病的受体结合域有8个不同的突变位点。在本研究调查的所有西非国家中，D614G突变是迄今为止观察到的SARS-CoV-2刺突蛋白中最常见的，因此也是最主要的。在这项研究中，我们研究了与突变无关的刺突蛋白、刺突蛋白中的突变分布、刺突蛋白序列不同区域的突变密度、多突变刺突蛋白序列和西非人类SARS-CoV-2刺突蛋白突变，以及对疫苗接种和药物开发目的的影响。结论:发现的SARS-CoV-2突变对预防、控制感染和公共卫生干预具有重要意义。进一步的研究必须了解病毒刺突蛋白的突变，以指导疫苗的开发和抗病毒药物的设计。还应开展调查，以确定西非新出现变种的传染性及其对疫苗和现有药物的反应，以解决有关疫苗接种和药物设计目标的公共卫生关切
{"title":"Human SARS CoV-2 spike protein mutations in West Africa","authors":"","doi":"10.46829/hsijournal.2023.6.4.1.443-447","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.443-447","url":null,"abstract":"Background: The COVID-19 pandemic was caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first detected in Wuhan, Hubei province, China in December 2019. The virus rapidly spread worldwide, with mutations in various parts of its genetic material affecting its transmissibility and infectivity. \u0000Objective: This study addressed some of the mutations present in the human SARS-CoV-2 spike proteins relative to Wuhan-Hu-1 reference sequence from China, according to different countries from West Africa. \u0000Methods: The SARS-CoV-2 spike protein sequences were obtained from the National Center for Biotechnology Information virus database in the FASTA format on November12,2021. The multiple sequence alignment of the proteins was carried out by MAFFT version 7 online. The human SARS-CoV-2 spike protein sequences from selected West African countries were analyzed by comparing them with the reference SARS-CoV-2 protein sequence from Wuhan-Hu-1, China.\u0000Results: Out of 148 spike protein sequences analyzed, 137 proteins had one or more mutations. A total of 486 mutations were observed corresponding to 47 distinct mutation sites. In the analysis of the spike proteins in the study, it was observed that the Receptor Binding Domain which is involved in the interactions with human angiotensin-converting enzyme-2 (ACE-2) receptor causing infection leading to the COVID-19 disease had 8 distinct mutation sites. The D614G mutation is the most common in the SARS-CoV-2 spike protein observed so far among all the West African countries examined in this study and thus the most predominant. In this study, we examined spike proteins not associated with mutations, the distribution of mutations in spike proteins, mutation density in different regions of the spike protein sequence, spike protein sequences with multiple mutations and the Human SARS-CoV-2 spike protein mutation in West Africa and implications for vaccination and drug development purposes.\u0000Conclusion: The identified mutations in SARS-CoV-2 are significant for infection prevention, control, and public health interventions. Further studies are imperative to understand the mutations in the virus's spike proteins to guide vaccine development and antiviral drug designs. Investigations should also be conducted to determine the infectivity of emerging variants in West Africa and their response to vaccines and available drugs to address public health concerns on vaccination and drug design goals","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125054855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.465-472
Background: The risk of developing chronic cardiovascular diseases (CVDs) is a significant public health concern for people living with HIV (PLWH). This recognition has been in place for over a decade. The lack of resources in some settings means that most older PLWH will receive limited care, requiring further research to identify CVD risk and accurate estimation methods. Such research enables the identification of optimal models of care, improving outcomes for this population. Objective: This study aimed to perform a CVD risk assessment (using three different assessment tools) on PLWH attending the HIV clinic at the Korle-bu Teaching Hospital (KBTH). Methods: A hospital-based cross-sectional study involving 311 PLWH was conducted at the HIV Clinic of the KBTH using a questionnaire adopted from the WHO STEP wise approach to chronic disease risk factor surveillance. Blood pressure, anthropometric measurements and fasting blood samples were taken for metabolic/biochemical parameters. A retrospective chart review of clinical folders for HIV and ART-related data was done. To determine the level of risk for cardiovascular disease (CVD), three estimation methods were used: the 10-year Framingham risk score(FRS), the 10-year WHO/International Society of Hypertension (ISH)risk prediction chart, and the 5-year Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) cardiovascular risk score. Results: The estimated 10-year moderate to high risk of CVD was 20.6% using the FRS, 13.2% using the WHO/ISH risk score, and 52.4% using the D:A:D score. The majority of study participants were classified as having a low risk of cardiovascular disease (CVD) according to the FRS and WHO/ISH scoring systems. However, the D:A:D cardiovascular scoring system identified that over 50% of the participants were at a moderate to high risk of developing CVD. Conclusion: This study indicates that when using the D:A:D risk assessment system, over 50% of the individuals who participated were found to have moderate-to-high risks of CVD. This underscores the importance of conducting a cardiovascular risk assessment before initiation of antiretroviral therapy as well as regular assessments to promptly identify and manage these risk factors, thereby aiding in preventing the occurrence of cardiovascular events. Additionally, the findings highlight the need for CVD management to be included in the HIV clinic
背景:发生慢性心血管疾病(cvd)的风险是艾滋病毒感染者(PLWH)的一个重要公共卫生问题。这种认识已经存在了十多年。在一些环境中缺乏资源意味着大多数老年PLWH将得到有限的护理，需要进一步研究以确定CVD风险和准确的估计方法。这样的研究能够确定最佳的护理模式，改善这一人群的结果。目的:本研究旨在对在Korle-bu教学医院(KBTH) HIV门诊就诊的PLWH进行心血管疾病风险评估(使用三种不同的评估工具)。方法:在KBTH HIV诊所进行了一项以医院为基础的横断面研究，涉及311名PLWH，采用了世界卫生组织STEP明智的慢性病危险因素监测方法的问卷。采集血压、人体测量值和空腹血液样本以测定代谢/生化参数。对艾滋病病毒和抗逆转录病毒治疗相关资料的临床资料进行回顾性分析。为了确定心血管疾病(CVD)的风险水平，采用了三种估计方法:10年Framingham风险评分(FRS)、10年WHO/International Society of Hypertension (ISH)风险预测图和5年抗hiv药物不良反应数据收集(D:A:D)心血管风险评分。结果:使用FRS，估计10年CVD中至高风险为20.6%，使用WHO/ISH风险评分为13.2%，使用D:A:D评分为52.4%。根据FRS和WHO/ISH评分系统，大多数研究参与者被归类为心血管疾病(CVD)风险较低。然而，D:A:D心血管评分系统发现，超过50%的参与者患心血管疾病的风险为中至高风险。结论:本研究表明，当使用D:A:D风险评估系统时，超过50%的参与者被发现具有中至高风险的心血管疾病。这强调了在开始抗逆转录病毒治疗之前进行心血管风险评估以及定期评估以及时识别和管理这些风险因素的重要性，从而有助于预防心血管事件的发生。此外，研究结果强调了将心血管疾病管理纳入HIV诊所的必要性
{"title":"Cardiovascular disease risk assessment among adults attending HIV Clinic at Korle-bu Teaching Hospital","authors":"","doi":"10.46829/hsijournal.2023.6.4.1.465-472","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.465-472","url":null,"abstract":"Background: The risk of developing chronic cardiovascular diseases (CVDs) is a significant public health concern for people living with HIV (PLWH). This recognition has been in place for over a decade. The lack of resources in some settings means that most older PLWH will receive limited care, requiring further research to identify CVD risk and accurate estimation methods. Such research enables the identification of optimal models of care, improving outcomes for this population.\u0000Objective: This study aimed to perform a CVD risk assessment (using three different assessment tools) on PLWH attending the HIV clinic at the Korle-bu Teaching Hospital (KBTH).\u0000Methods: A hospital-based cross-sectional study involving 311 PLWH was conducted at the HIV Clinic of the KBTH using a questionnaire adopted from the WHO STEP wise approach to chronic disease risk factor surveillance. Blood pressure, anthropometric measurements and fasting blood samples were taken for metabolic/biochemical parameters. A retrospective chart review of clinical folders for HIV and ART-related data was done. To determine the level of risk for cardiovascular disease (CVD), three estimation methods were used: the 10-year Framingham risk score(FRS), the 10-year WHO/International Society of Hypertension (ISH)risk prediction chart, and the 5-year Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) cardiovascular risk score.\u0000Results: The estimated 10-year moderate to high risk of CVD was 20.6% using the FRS, 13.2% using the WHO/ISH risk score, and 52.4% using the D:A:D score. The majority of study participants were classified as having a low risk of cardiovascular disease (CVD) according to the FRS and WHO/ISH scoring systems. However, the D:A:D cardiovascular scoring system identified that over 50% of the participants were at a moderate to high risk of developing CVD.\u0000Conclusion: This study indicates that when using the D:A:D risk assessment system, over 50% of the individuals who participated were found to have moderate-to-high risks of CVD. This underscores the importance of conducting a cardiovascular risk assessment before initiation of antiretroviral therapy as well as regular assessments to promptly identify and manage these risk factors, thereby aiding in preventing the occurrence of cardiovascular events. Additionally, the findings highlight the need for CVD management to be included in the HIV clinic","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133191078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-25DOI: 10.46829/hsijournal.2023.6.4.1.448-456
Raymond DK Toseafa, I. Braimah, N. N. Tagoe, B. Abaidoo, Y. Adam, Edith M Dogbe, V. Essuman
Background: Topical steroids are used to reduce post-operative inflammation after ocular surgery with the potential risk of ocular hypertension, glaucoma and blindness. There is a paucity of published data globally and locally on steroid-induced ocular hypertension (SiOH) post pterygium excision(PE) with conjunctival autograft (CAG). Objective: We aimed to determine the incidence and risk factors of SiOH post-PE with CAG in Korle-Bu Teaching Hospital, Accra, Ghana. Methods: In this prospective observational study, the demographic and clinical data of patients undergoing PE with CAG were collected and analyzed. Post-operative intraocular pressures (IOP) were measured on days 1, 7, 14, 28, and 42. The cumulative incidence of SiOH (proportion of the increase in IOP ≥10mmHg at six weeks compared to baseline) and mean change in IOP from baseline were computed. Risk factors of SiOH were determined using a multiple logistic regression model. The Kaplan-Meier survival curve was used in estimating the median time to develop SiOH. Results: Overall, 101 patients participated in this study with a mean age of 46.8±11.9 years. The majority (65.3%, n= 66/101) of participants were females. The mean pre-operative IOP in the study eyes was 15.3±3.0 mmHg. The overall mean post-operative IOP was 18.6±2.8 mmHg (p= 0.001). The overall incidence of SiOH six weeks post-PE with CAG was 32.7% (95% confidence interval (CI)= 23.7-42.7%). Male sex was the only independent factor associated with the development of SiOH [odds ratio (OR) = 3.3; 95% CI = 1.1-9.7; p= 0.032]. The median time to develop SiOH was 42 days (95% CI= 37.1-46.9 days, p= 0.022). Conclusion: The study showed that SiOH post-PE is a common complication with an overall six-weeks post-excision incidence of 32.7%. Males are more likely to develop SiOH after PE with CAG. Patients undergoing PE with CAG should be closely monitored postoperatively to prevent complications associated with prolonged raised IOP.
{"title":"Incidence and risk factors of steroid-induced ocular hypertension following pterygium excision with conjunctival autograft","authors":"Raymond DK Toseafa, I. Braimah, N. N. Tagoe, B. Abaidoo, Y. Adam, Edith M Dogbe, V. Essuman","doi":"10.46829/hsijournal.2023.6.4.1.448-456","DOIUrl":"https://doi.org/10.46829/hsijournal.2023.6.4.1.448-456","url":null,"abstract":"Background: Topical steroids are used to reduce post-operative inflammation after ocular surgery with the potential risk of ocular hypertension, glaucoma and blindness. There is a paucity of published data globally and locally on steroid-induced ocular hypertension (SiOH) post pterygium excision(PE) with conjunctival autograft (CAG). \u0000Objective: We aimed to determine the incidence and risk factors of SiOH post-PE with CAG in Korle-Bu Teaching Hospital, Accra, Ghana.\u0000Methods: In this prospective observational study, the demographic and clinical data of patients undergoing PE with CAG were collected and analyzed. Post-operative intraocular pressures (IOP) were measured on days 1, 7, 14, 28, and 42. The cumulative incidence of SiOH (proportion of the increase in IOP ≥10mmHg at six weeks compared to baseline) and mean change in IOP from baseline were computed. Risk factors of SiOH were determined using a multiple logistic regression model. The Kaplan-Meier survival curve was used in estimating the median time to develop SiOH.\u0000Results: Overall, 101 patients participated in this study with a mean age of 46.8±11.9 years. The majority (65.3%, n= 66/101) of participants were females. The mean pre-operative IOP in the study eyes was 15.3±3.0 mmHg. The overall mean post-operative IOP was 18.6±2.8 mmHg (p= 0.001). The overall incidence of SiOH six weeks post-PE with CAG was 32.7% (95% confidence interval (CI)= 23.7-42.7%). Male sex was the only independent factor associated with the development of SiOH [odds ratio (OR) = 3.3; 95% CI = 1.1-9.7; p= 0.032]. The median time to develop SiOH was 42 days (95% CI= 37.1-46.9 days, p= 0.022).\u0000Conclusion: The study showed that SiOH post-PE is a common complication with an overall six-weeks post-excision incidence of 32.7%. Males are more likely to develop SiOH after PE with CAG. Patients undergoing PE with CAG should be closely monitored postoperatively to prevent complications associated with prolonged raised IOP.","PeriodicalId":285465,"journal":{"name":"Health Sciences Investigations Journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117304793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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