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Background: Measurement of health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes mellitus (T1DM) is as important as metabolic control in the management and prevention of diabetes-related complications. Aim: To describe the self-reported HRQOL outcomes in Ghanaian children and adolescents with T1DM compared with healthy controls and perceived HRQOL by caregivers. Setting: Out-patient clinics of the Departments of Child Health, Medicine and Therapeutics, Family Medicine, and Ophthalmology, the National Diabetes Management and Research Centre (all at the Korle Bu Teaching Hospital), and the Cape Coast Teaching Hospital (CCTH). Methods: Socio-demographic and clinical characteristics of study participants were documented. Participants completed the PedsQL™ 4.0 Generic Core Scales. Data analysis was done with SPSS Version 25.0. An unpaired t-test was used in comparing the HRQOL scores between children and adolescents with T1DM and controls, and parental proxy reports. Results: Fifty children and adolescents with T1DM, 50 parents/caregivers, and 80 healthy non-diabetic controls took part in this study. There was no significant difference in mean score between the patients and the caregivers for overall HRQOL (p = 0.270). Patients reported significantly worse overall HRQOL than their controls (p = 0.001). Males with diabetes reported better HRQOL than females (p = 0.007). Conclusion: Children and adolescents with T1DM and their parents/caregivers reported lower HRQOL scores compared to healthy controls. Males reported better HRQOL than females. Potential implications: HRQOL should be routinely assessed together with proxy reports from parents to identify those who might benefit from further attention including referral to a psychologist.

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: The aim of this study was to investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-center case–control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns adjusting for relevant confounders. Results: Overall, mean age was 59.0 ± 13.9 years, and 3992 (54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95% CI) for risk of stroke by second and third tertiles (using the lowest and first tertile as reference) of dietary patterns was 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02), for “poultry product and organ meat”; 1.69 (1.47, 1.96) and 1.51 (1.31, 1.75) for “red meat”; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for “fried foods and sweetened drinks”; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for “vegetables”; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for “whole-grain and fruit drinks”; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for “fruits” respectively ( p Conclusion: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.

The co-existence of pheochromocytoma and pregnancy is rare, with poor maternal and foetal outcomes. This is a case report of a young Ghanaian woman with a pre-existing diagnosis of recurrent pheochromocytoma who became pregnant and experienced elevated blood pressure in the third trimester with proteinuria and abnormal liver function. She was managed as an in-patient and delivered a live baby via caesarean section at 34 weeks after detecting intra-uterine growth restriction. Management of such cases by a multidisciplinary team is recommended for optimal outcomes.

Aims The relationship between vegetable consumption and hypertension occurrence remains poorly characterized in sub-Saharan Africa. This study assessed the association of vegetable consumption with odds of hypertension among indigenous Africans. Methods and results We harmonized data on prior vegetable consumption and hypertension occurrence (defined as one of the following conditions; systolic blood pressure ≥140 or diastolic blood pressure ≥90 mmHg or previous diagnosis or use of antihypertensive medications) from 16 445 participants across five African countries (Nigeria, South Africa, Kenya, Ghana and Burkina Faso) in the Stroke Investigative Research and Educational Network and Africa Wits-INDEPTH partnership for Genomic studies. Vegetable consumption (in servings/week) was classified as ‘low’ ( Conclusion Indigenous Africans who consumed at least 12 servings of vegetables per week were less likely to be found hypertensive, particularly among males and young adults.

PurposeDaily COVID-19-related morbidity and mortality rates are still high globally, and masking is considered a reliable method of preventing its infections. Yet, the rate of voluntary compliance with masking remains very low in most parts of the world, especially in developing countries. The authors hypothesize that the decision to wear a mask entails some benefit-cost analysis that involves time discounting. In addition, the authors surmise that feel-good benefits from pro-social behavior and from wearing fashionable masks are substantial.Design/methodology/approachThe study is based on a survey of 900 fishermen and fish traders in Ghana. A simple experiment was designed to elicit individual rates of time preference. In addition, the fishers were asked questions about their political affiliation and knowledge of the COVID-19 pandemic, among others. A logit model is used to investigate the determinants of the decision to wear a mask.FindingsThe authors found that masking compliance increases in time discounting for fishmongers, suggesting that private benefits from pro-social behavior or feel-good benefits from wearing a mask are very strong. In addition, those who belonged to the ruling political party were more likely to wear a mask. Other factors increasing the likelihood of masking include affiliation with the ruling political party, knowledge of COVID-19 and knowledge of someone who lost his/her job due to COVID-19.Originality/valueTo the best of the authors’ knowledge, this is the first study to investigate the effect of time discounting on the voluntary compliance of a health safety measure, which could provide a direct utility. In addition, the study explores the effect of political affiliation on voluntary masking behavior.

Stroke is a major cause of death in Sub-Saharan Africa (ssa) and genetic factors appear to play a part in its pathogenesis. This led to the development of stroke biobanking and genomics research in ssa. Existing stroke studies have focused on causes, incidence rates, fatalities and effects. However, scant attention has been paid to the legal issues about stroke biobanking and genomics research in the sub-region. Therefore, this article examines the legal implications of stroke biobanking and genomics research in Sub-Saharan Africa from a human rights perspective. The study argues that the right to dignity of the human person, the right to privacy, the right to freedom of information, the right to freedom from discrimination, the right to own property, the right to self-determination and the right to health may be implicated. The study concludes that the court may have to be involved in balancing one right against the other which may prove somewhat herculean depending on the circumstances of each case.

The West African Dwarf (WAD) goat has genetic potentials that can be exploited for improved goat production. However, their testicular morphometric parameters and sperm reserves in Ghana are not well known. A cross-sectional study was conducted at the Sabtiu Musah abattoir in Kumasi, Ghana, to evaluate the gross testicular morphometric parameters and sperm reserves in 10 indigenous WAD goats. The samples were stored on an ice chest and transported to the Regional Veterinary Laboratory for analysis on the day of collection. In the laboratory, the testes and epididymis were separated by dissection and then freed of all connective tissue and the Tunica albuginea. The weight, length, width and volume of the testis were determined. A segment of testicular parenchyma was incised and homogenized in a 20 ml normal saline solution. The resulting homogenate was stored in the refrigerator overnight and a filtered aliquot used for estimating spermatid concentration and sperm reserves. The weight, length, width, volume of the testis and the gonadosomatic index were 70.09 ±14.19 gm, 7.46 ± 0.52 cm, 5.08 ± 0.62, cm, 102.40 ± 29.40 ml and 5.09 ± 0.07%, respectively. The sperm reserves per the whole testis, sperm reserves per gramme testis, Daily Sperm production (DSP), and DSP per gramme testis of Ghanaian WAD bucks were 146.0 ± 50.95, 2.2 ± 0.62, 41.01 ± 14.3 and 0.62 ± 0.17 x109 spermatozoa, respectively. Indigenous West African Draft goats have a high potential for sperm production. It is recommended that further research be conducted on the semen quality parameters of this breed.

Bait tuna vessels in developing coastal countries often compete with artisanal fishers for small pelagic species such as anchovies. Owing to the capital-intensive nature of tuna fishing, th...

Objectives: Depression is a risk factor for stroke. There is a knowledge gap on the predictors of prestroke depression in stroke survivors living in low- and middle-income countries (LMICs). We estimated prevalence and predictors of prestroke depression, as well as its association with poststroke depression (PSD) in the largest study of stroke in Africa. Methods: We evaluated information collected as part of the Stroke Investigative Research and Education Network (SIREN) study, a multicentre, case-control study conducted at 15 sites in Ghana and Nigeria. Prestroke depression status was ascertained in stroke survivors using a validated self-report tool, while PSD was assessed using a stroke specific screening tool for depression (“HRQOLISP-E”). Independent associations were investigated using complementary log-log regression and binary logit models. Results: Among 1,977 participants, prestroke depression was found in 141 (7.1%). In multivariate analyses, prestroke depression was significantly associated with tachycardia (OR = 2.22, 95% CI = 1.37-3.56) and low consumption of green leafy vegetables (OR = 1.91, 95% CI = 1.12-3.24). Forty-one (29.1%) of the prestroke depression sub-sample developed PSD. However, prestroke depression was not significantly associated with PSD. Conclusion: The findings should energize before-the-stroke identification and prioritization of limited treatment resources in LMICs to persons with depression who have multiple, additional, risks of stroke.

Stroke is a major cause of death in Sub-Saharan Africa (SSA) and genetic factors appear to play a part. This led to the development of stroke bio-banking and genomics research in SSA. Existing stroke studies have focused on causes, incidence rates, fatalities and effects. However, scant attention has been paid to the legal issues about stroke bio-banking and genomics research in the sub-region. Therefore, this article examines how genomics research and stroke bio-banking in SSA can be regulated through legislation. The article reports that there are germane issues to be addressed such as appropriate consent model, commercial use of biological samples, ownership right in biological samples and return of research results but that the position of the law on these issues is not satisfactory because there are no statute directly regulating them while existing regulations in these countries are either absent, outdated, conservative or difficult to navigate. The article therefore applies the theory of symbolic legislation and argues for legislative intervention through positive symbolic approach. It recommends that the statute to be enacted should only address policy issues by way of legal rules without being detailed while the understanding of the rules should be fostered in explanatory notes. The explanatory notes should contain examples borne of decided cases, cases settled out of court and the ethical guidelines prepared by Human Heredity and Health in Africa (H3 Africa). Where they are inadequate, recourse may be had to other ethical guidelines subject to the demands of local circumstances.

The aim of this study was to assess the knowledge and willingness of fishers in four selected fishing communities (Ayitepa/Kponor, Ngyiresia, Adjoa, and Miemia) in Ghana for seaweed cultivation in terms of gender, age, education, and distance. The study used both qualitative and quantitative approaches to collect data and household spatial position recorded by the global positioning system (GPS). The findings show that an average of 95.8% of fishers knew seaweed and 86.5% were willing cultivate it. A chi-square test shows no significant association between gender, age, education, distance, and the willingness of fishers to participate in the seaweed cultivation. In a regression model, only age group between the ages of 18 and 64 have a strong effect on the willingness of fishers to grow seaweed (P

Background New strategies to increase measles and rubella vaccine coverage, particularly in low- and middle-income countries, are needed if elimination goals are to be achieved. With this regard, measles and rubella vaccine microneedle patches (MRV-MNP), in which the vaccine is embedded in dissolving microneedles, offer several potential advantages over subcutaneous delivery. These include ease of administration, increased thermostability, an absence of sharps waste, reduced overall costs and pain-free administration. This trial will provide the first clinical trial data on MRV-MNP use and the first clinical vaccine trial of MNP technology in children and infants. Methods This is a phase 1/2, randomized, active-controlled, double-blind, double-dummy, age de-escalation trial. Based on the defined eligibility criteria for the trial, including screening laboratory investigations, 45 adults [18–40 years] followed by 120 toddlers [15–18 months] and 120 infants [9–10 months] will be enrolled in series. To allow double-blinding, participants will receive either the MRV-MNP and a placebo (0.9% sodium chloride) subcutaneous (SC) injection or a placebo MNP and the MRV by SC injection (MRV-SC). Local and systemic adverse event data will be collected for 14 days following study product administration. Safety laboratories will be repeated on day 7 and, in the adult cohort alone, on day 14. Unsolicited adverse events including serious adverse events will be collected until the final study visit for each participant on day 180. Measles and rubella serum neutralizing antibodies will be measured at baseline, on day 42 and on day 180. Cohort progression will be dependent on review of the unblinded safety data by an independent data monitoring committee. Discussion This trial will provide the first clinical data on the use of a MNP to deliver the MRV and the first data on the use of MNPs in a paediatric population. It will guide future product development decisions for what may be a key technology for future measles and rubella elimination. Trial registration Pan-African Clinical Trials Registry 202008836432905. ClinicalTrials.govNCT04394689

Background: The association of vegetable consumption with hypertension remains poorly described in sub-Saharan Africa. This study assessed the relationship between vegetable consumption and hypertension among indigenous Africans. Methods: We harmonized data on the frequency of vegetable consumption (servings/week) and hypertension (defined as systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg or previous diagnosis or use of antihypertensive medications) from 16,445 participants across five African countries (Ghana, Burkina Faso, Kenya, Nigeria and South Africa) from the SIREN and AWI-Gen studies. Using the recommendation of at least five servings/day (35 servings/week) adapted from the World Health Organization recommendations, and vegetable consumption was classified as 'inadequate' (P Results: The mean age of participants was 53.0±10.7years, 45.9% (7,552 of 16,445) were males, and 42.9% (7,070 of 16,445) were hypertensives. Adequate vegetable consumption was associated with lower odds of hypertension; OR: 0.86 (95%CI: 0.76, 0.97). The sex-stratified odds was; OR: 0.87 (95%CI: 0.73, 1.02) for females and 0.84 (95%CI: 0.71, 1.00) for males. Conclusion: These findings provide new evidence for promoting regular vegetable consumption in the guidelines for the primary prevention of hypertension among Africans.

Background: Secondhand smoking (SHS) is the exposure to smoke arising from a burning cigarette or exhaled by a smoker. It is a significant public health problem worldwide and whether it is associated with hypertension, particularly among Africans, is yet to be clearly understood. This study evaluated the relationship between SHS and hypertension among stroke-free adults who are non-smokers in the Stroke Investigation Research and Educational Network (SIREN) study. Methods: We identified 3905 adults (≥18years who had never smoked) in the SIREN study conducted in Ghana and Nigeria. Participants reported a history of SHS exposure in an indoor environment. Hypertension was defined as one of the following conditions; mean SBP≥140mmHg, DBP≥90mmHg or use of antihypertensive medications. Logistic regression was used to estimate the multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) for hypertension by SHS exposure at a two-sided P Results: Overall, mean age was 55.8±14.9years, 18.2% (712 of 3905) had SHS exposure, with a higher proportion among males 20.0% (360 of 1803) than females 16.7% (352 of 2102). SHS was associated with higher odds of having hypertension in the overall population; OR: 1.2 (95%CI: 1.0, 1.5) among females; OR: 1.6 (95%CI: 1.2, 2.1), but not among males; OR: 0.9 (95%CI: 0.7, 1.2). Conclusion: SHS was associated with higher odds of hypertension, particularly among females in this sample. The viability of public interventions in mitigating the potential effect of SHS cannot be underestimated in managing the hypertension burden among Africans, pending longitudinal studies to establish causal associations between SHS and hypertension.

Background We report a case of an elderly woman who developed an Ischemic stroke. Thrombolytic therapy was successful as evidenced by functional and neurological improvement. This is the first well-documented case of such intervention in Korle-Bu Teaching Hospital (KBTH), Stroke unit. Case Information: Our patient is a 64-year-old woman who is known to have hypertension and diabetes. She had been relatively well until she developed an ischemic stroke. Five days prior to this, she had experienced two episodes of Transient Ischemic Attacks (TIA). Thrombolytic therapy was successful with Tenecteplase given at 4.5 hours post-episode. MRS (Modified Ranking Scale) and NHISS (National Health Institute of Stroke Scale) pre thrombolysis were 4 and 10 respectively. NHISS 2hrs post thrombolysis was 4. MRS and NHISS 24hrs post thrombolysis were 0 and 1 respectively. We sought to identify why only a few cases of thrombolytic therapies are carried out in developing countries, and we found that the strict eligibility for the initiation of therapy was the main barrier. Conclusion In acute infarctive stroke management, intervention is time-dependent, as thrombolysis has been shown to prevent permanent disability if instituted early enough. We believe that many more individuals may benefit from thrombolytic therapy if more studies are carried out with systematic reviews of case reports and research, factoring in key challenges met in middle to low-income countries.

Stroke is a major cause of death in Sub-Saharan Africa (SSA) and genetic factors appear to play a part. This has led to stroke biobanking and genomics research in SSA. Existing stroke studies have focused on causes, incidence rates, fatalities and effects. However, scant attention has been paid to the legal issues in stroke biobanking and genomics research in the sub-region. Therefore, this article examines the legal implications of stroke biobanking and genomics research in SSA. The article adopts a textual analysis of primary and secondary sources in law. It reports that there are laws from the perspectives of human right, the common law, and intellectual property. However, there are gaps to be filled. The article therefore argues for legislative intervention. It concludes that pending the time the statute will be enacted, genomics researchers in Africa should adopt the ethical guidelines prepared by Human Heredity and Health in Africa (H3 Africa).

Objective: To evaluate the prevalence and patterns of psychiatric disorders in epilepsy patients at the Korle-Bu Teaching hospital, Accra, Ghana.Design: The study design was a cross-sectional surveySetting: The study was conducted at the Neurology Clinic of the Department of Medicine and Therapeutics, Korle-nBu Teaching hospital, Accra, Ghana.Participants: A total of one hundred and sixty-six patients diagnosed with epilepsy aged at least 18 years and accessing services at the neurology clinic participated in the study.Main Outcome Measure: Prevalence and patterns of psychiatric disorders among patients diagnosed with epilepsy using the Brief Symptom Inventory.Results: The mean age for onset of epilepsy was 20.1 ± 16.9 years, and generalized epilepsy (73.2%) was the major type of epilepsy identified. The aetiology of the epilepsy condition was unknown in most patients (71.1%). The estimated mean Brief Symptom Inventory scores in all the nine diagnostic psychiatry characteristics (Depression, Anxiety, Somatization, Hostility, Phobic Anxiety, Obsessive Compulsive Disorder, Psychoticism, Interpersonal Sensitivity, and Paranoid Ideation) were higher in the epilepsy patients compared to the normative data scores for non-patients. Global Severity Index scores for females were significantly higher (p=0.002) than the scores for males on all the psychological outcomes except hostility.Conclusion: Psychological disorders were prevalent among epilepsy patients, with females more likely to experience psychological problems than males. The findings call for a holistic approach in managing epilepsy to highlight and manage some exceptional psychological comorbidities.

There are limited data from Africa on the burden and associations between pre-diabetes (pre-DM), diabetes mellitus (DM) and stroke occurrence in a region experiencing a profound rise in stroke burden.To characterize the associations between stroke and dysglycemic status among West Africans.The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with clinical and radiological evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular factors were performed. Pre-diabetes was defined as HBA1c of 5.7%-6.4% or Fasting blood glucose (FBG) 5.6-7.0 mmol/L and DM as HBA1c6.5% or FBG7.0 mmol/L. We used conditional logistic regression to estimate adjusted odds ratios (aOR) with 95% Confidence Interval.Among 2,935 stroke cases the mean age was 60.0 ± 14.2 years with 55.2% being males. By glycemic status, 931 (31.7%) were euglycemic, 633 (21.6%) had Pre-diabetes and 1371 (46.7%) had DM. Of the age- and sex-matched stroke-free controls 69.2% were euglycemic, 13.3% had pre-DM and 17.5% had DM. Pre-DM [aOR (95% CI): 3.68(2.61-5.21)] and DM [4.29 (3.19-5.74)] were independently associated with stroke. The aOR of Pre-DM for ischemic stroke 3.06 (2.01-4.64)] was lower than 4.82 (3.37-6.89) for DM. However, the aOR of Pre-DM for hemorrhagic stroke 6.81 (95% CI: 3.29 - 14.08)] was higher than 3.36 (1.94-5.86) for DM. Furthermore, the aOR of pre-DM for ischemic stroke subtypes were 9.64 (1.30-71.57) for cardio-embolic stroke, 3.64 (1.80-7.34) for small-vessel occlusive disease and 4.63 (0.80-26.65) for large-vessel disease.Pre-DM is strongly and independently associated with stroke in Africans. Improving glycemic control through screening, healthy lifestyle and pharmacotherapy at a population level may be strategic in reducing the rising burden of stroke in Africa.

To better understand the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant lineage distribution in a college campus population, we carried out viral genome surveillance over a 7-week period from January to March 2021. Among the sequences were three novel viral variants: BV-1 with a B.1.1.7/20I genetic background and an additional spike mutation Q493R, associated with a mild but longer-than-usual COVID-19 case in a college-age person, BV-2 with a T478K mutation on a 20B genetic background, and BV-3, an apparent recombinant lineage. This work highlights the potential of an undervaccinated younger population as a reservoir for the spread and generation of novel variants. This also demonstrates the value of whole genome sequencing as a routine disease surveillance tool.

In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer's disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome-associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes. Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium.

Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community‐dwelling stroke‐free population in Ghana and Nigeria. Data for 4267 community‐dwelling stroke‐free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti‐hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p

Irrigation experiments of cocoa tend to concentrate on yield of matured cocoa trees compared to field establishment of young seedlings. Seedling survival leading to optimum population density are fundamental to obtaining maximum yield of crops. The aim of this experiment was to determine the effect of mulching and irrigation on survival of hybrid cocoa clone raised in three different growing media during the establishment phase. The experimental design was a 2 x 2 x 3 factorial arranged in a split-split plot design, with irrigation as the main plot factor, mulching as the subplot factor and growing media as the sub-sub plot factor with three replications. Cocoa pod husk (CPH) was used as the mulching material and each plant received 5kg at a rate of 5.6 t/ha. Irrigation was done daily by applying 4L of water except when it rains. Data was collected on soil moisture, plant height, leaf number, stem girth and plant survival. Results indicated that irrigation and mulching significantly (P

Radiotherapy is a valuable treatment in the management algorithm of pituitary adenomas and craniopharyngiomas. However, the risk of second brain tumour following radiotherapy is a major concern. We assessed this risk using non-irradiated patients with the same primary pathology and imaging surveillance as controls.In this multicentre, retrospective cohort study, 4292 patients with pituitary adenoma or craniopharyngioma were identified from departmental registries at six adult endocrine centres (Birmingham, Oxford, Leeds, Leicester, and Bristol, UK and Ferrara, Italy). Patients with insufficient clinical data, known genetic predisposition to or history of brain tumour before study entry (n=532), and recipients of proton beam or stereotactic radiotherapy (n=81) were excluded. Data were analysed for 996 patients exposed to 2-dimensional radiotherapy, 3-dimensional conformal radiotherapy, or intensity-modulated radiotherapy, and compared with 2683 controls.Over 45 246 patient-years, second brain tumours were reported in 61 patients (seven malignant [five radiotherapy, two controls], 54 benign [25 radiotherapy, 29 controls]). Radiotherapy exposure and older age at pituitary tumour detection were associated with increased risk of second brain tumour. Rate ratio for irradiated patients was 2·18 (95% CI 1·31-3·62, p0·0001). Cumulative probability of second brain tumour was 4% for the irradiated and 2·1% for the controls at 20 years.Irradiated adults with pituitary adenoma or craniopharyngioma are at increased risk of second brain tumours, although this risk is considerably lower than previously reported in studies using general population controls with no imaging surveillance. Our data clarify an important clinical question and guide clinicians when counselling patients with pituitary adenoma or craniopharyngioma on the risks and benefits of radiotherapy.Pfizer.

A study was conducted in the Guinea and Sudan Savannah zones in the Upper East Region of Ghana to investigate the effects of Faidherbia albida on some important soil fertility indicators. Soil sampling and analysis, litter trap, and litter bag techniques were employed to determine the soil’s content of major nutrients, the rate of litterfall production and litter decomposition, respectively. Analysis of variance (ANOVA) was performed to determine differences among treatment means, while Tukey’s highest significant difference (HSD) was used to perform post hoc tests among means within the same sample set. Soils under F. albida tree canopies were found to contain significantly higher organic carbon and total nitrogen than those outside the canopies. Peak leaf litter production occurred during the first three months of the onset of the rainy season. Annual leaf litterfall was 340 g m-2 year-1 in the Guinea Savannah zone and 264 g m-2 year-1 in the Sudan Savannah zone. The high leaf litterfall, followed by high decomposition and mineralization at the beginning of the cropping season, the high nutrient content of its leaves, coupled with its nitrogen fixing ability, make F. albida a potential candidate for soil improvement and improved productivity of major crops in smallholder farming systems. About 37 and 59 adult F. albida trees will be required to supply significant amounts of nitrogen in the Guinea and Sudan Savannah zones, respectively. Key words: Litter bag technique, litter decomposition, litter fall, litter trap technique, soil organic carbon, soil

Africa is the world’s most genetically diverse, second largest, and second most populous continent, with over one billion people distributed across 54 countries. With a 23% lifetime risk of stroke, Africa has some of the highest rates of stroke worldwide and many occur in the prime of life with huge economic losses and grave implications for the individual, family, and the society in terms of mental capital, productivity, and socioeconomic progress. Tackling the escalating burden of stroke in Africa requires prioritized, multipronged, and inter-sectoral strategies tailored to the unique African epidemiological, cultural, socioeconomic, and lifestyle landscape. The African Stroke Organization (ASO) is a new pan-African coalition that brings together stroke researchers, clinicians, and other health-care professionals with participation of national and regional stroke societies and stroke support organizations. With a vision to reduce the rapidly increasing burden of stroke in Africa, the ASO has a four-pronged focus on (1) research, (2) capacity building, (3) development of stroke services, and (4) collaboration with all stakeholders. This will be delivered through advocacy, awareness, and empowerment initiatives to bring about people-focused changes in policy, clinical practice, and public education. In the spirit of the African philosophy of Ubuntu “I am because we are,” the ASO will harness the power of diversity, inclusiveness, togetherness, and team work to build a strong, enduring, and impactful platform for tackling stroke in Africa.

Aims: To identify an appropriate boiled water pre-sowing treatment regime for improved germination, survival and early growth performance of Faidherbia albida (Delile) A. Chev., in three ecological zones of Ghana. Study Design: The design was a Completely Randomized Block Design (CRBD) in three replicates, where the three different ecological zones were considered as blocks. Place and Duration of Study: The study was conducted in Bolgatanga (Guinea Savannah Zone), Abofuor (Forest-Savannah Transitional Zone), and Kumasi-Mesewam (Moist Semi-deciduous Forest Zone) between April 2017 and April 2018. Methodology: Matured seeds of F. albida were harvested, dried and cleaned. For each treatment replicate, one hundred F. albida seeds were immersed in boiled water (100ºC) for 0, 30, 60, 120, 180 and 300 seconds and then, soaked in water at room temperature for 24 hours. Seeds were then sown in drills on well prepared seed beds, and then observed for germination. Watering was done to keep the soil moist until the onset of germination. Results: There were significant interactive effects between ecological zones and pre-sowing treatments with respect to Final germination percentage (P

Objectives To explore the prevalence and risk factors of obesity among older adults from low- and middle-income countries (LMICs). Methods This is a secondary analysis of data obtained from the SIREN study through in-person interviews and measurements from healthy stroke-free older adults (≥60 years). Overweight/obesity was defined as body mass index ≥25 kg/m2. Abdominal obesity was defined as waist-to-hip ratio (WHR) of >0.90 for males and >0.85/females or waist circumference (WC) of >102 cm for males/>88 cm for females. Adjusted odds ratio (aORs) with 95% confidence interval (CIs) of the relationship between obesity and sociodemographic factors were assessed at P Results Overall, 47.5% of participants were overweight/obese, 76.6% had a larger than recommended WHR, and 54.4% had a larger than recommended WC. Abdominal obesity (WC; aOR: 9.43, CI: 6.99–12.50), being a Nigerian (aOR: 0.55; CI: 0.42–0.72), living in an urban setting (aOR: 1.92; CI: 1.49–2.46 ), earning >$100/month (aOR: 1.53; CI: 1.19–1.96), and having formal education (aOR: 1.42; CI: 1.08–1.87) were associated with overweight/obesity. Conclusion Living in urban settings, earning a higher income, and having a formal education were associated with a higher odds of obesity among older adults from LMICs.