Search

Objective. The study sought to determine the diagnostic accuracy of body adiposity index (BAI) and relative fat mass (RFM) to predict BIA-derived BFP among patients with type 2 diabetes in the Ho municipality. Materials and Method. This hospital-based cross-sectional study involved 236 patients with type 2 diabetes. Demographic data, including age and gender were obtained. Height, waist circumference (WC), and hip circumference (HC) were measured using standard methods. BFP was estimated on a bioelectrical impedance analysis (BIA) scale. The validity of BAI and RFM as alternative estimates for BIA-derived BFP was evaluated based on mean absolute percentage error (MAPE), Passing-Bablok regression, Bland-Altman plots, receiver-operating characteristic curve (ROC), and kappa statistics analyses. A p value less than 0.05 was considered statistically significant. Results. BAI showed systematic bias in estimating BIA-derived BFP in both genders, but this was not evident between RFM and BFP among females ( t = − 0.62 ; p = 0.534 ). While BAI showed “good” predictive accuracy in both genders, RFM exhibited “high” predictive accuracy for BFP (MAPE: 7.13%; 95% CI: 6.27-8.78) among females according to MAPE analysis. From the Bland-Altman plot analysis, the mean difference between RFM and BFP was acceptable among females [0.3 (95% LOA: -10.9 to 11.5)], but both BAI and RFM recorded large limits of agreement and low Lin’s concordance correlation coefficient with BFP ( Pc < 0.90 ) in the two gender populations. The optimal cut-off, sensitivity, specificity, and Youden index for RFM were >27.2, 75%, 93.75%, and 0.69, respectively, while those of BAI were >25.65, 80%, 84.37%, and 0.64, respectively, among males. Among females, the values for RFM were >27.26, 92.57%, 72.73%, and 0.65, whereas those of BAI were >29.4, 90.74%, 70.83%, and 0.62, respectively. The accuracy of discriminating between BFP levels was higher among females [BAI (AUC: 0.93) and RFM (AUC: 0.90)] compared to males [BAI (AUC: 0.86) and RFM (AUC: 0.88)]. Conclusion. RFM had a better predictive accuracy of BIA-derived BFP in females. However, both RFM and BAI failed as valid estimates for BFP. Furthermore, gender-specific performance in the discrimination of BFP levels for RFM and BAI was observed.

BACKGROUND: Pregnant women, particularly in developing countries are facing a huge burden of preeclampsia (PE) leading to high morbidity and mortality rates. This is due to delayed diagnosis and unrecognised early targeted preventive measures. Adapting innovative solutions via shifting from delayed to early diagnosis of PE in the context of predictive diagnosis, targeted prevention and personalisation of medical care (PPPM/3 PM) is essential. The subjective assessment of suboptimal health status (SHS) and objective biomarkers of oxidative stress (OS) and angiogenic growth mediators (AGMs) could be used as new PPPM approach for PE; however, these factors have only been studied in isolation with no data on their combine assessment. This study profiled early gestational biomarkers of OS and AGMs as 3 PM approach to identify SHS pregnant mothers likely to develop PE specifically, early-onset PE (EO-PE) and late-onset PE (LO-PE). METHODS: A prospective cohort of 593 singleton normotensive pregnant (NTN-P) women were recruited at 10–20th (visit 1) and followed from 21 weeks gestation until the time of PE diagnosis and delivery. At visit 1, SHS was assessed using SHS questionnaire-25 (SHSQ-25) and women were classified as SHS and optimal health status (OHS). Biomarkers of OS (8-hydroxy-2-deoxyguanosine [8-OHdG], 8-epi-prostaglansinF2alpha [8-epi-PGF2α] and total antioxidant capacity [TAC]) and AGMs (vascular endothelial growth factor [VEGF-A], soluble Fms-like tyrosine kinase-1 [sFlt-1], placental growth factor [PlGF] and soluble endoglin [sEng]) were measured at visit 1 and time of PE diagnosis. RESULTS: Of the 593 mothers, 498 (248 SHS and 250 OHS) returned for delivery and were included in the final analysis. Fifty-six, 97 and 95 of the 248 SHS mothers developed EO-PE, LO-PE and NTN-P respectively, versus 14 EO-PE, 30 LO-PE and 206 NTN-P among the 250 OHS mothers. At the 10–20th week gestation, unbalanced levels of OS and AGMs were observed among SHS women who developed EO-PE than LO-PE compared to NTN-P women (p

Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This study comprised 30 preeclamptic women and 30 healthy normotensive pregnant women with over 20 weeks of gestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight, height, socio-demographics, medical and previous obstetric history were taken and recorded. Blood samples were collected for the estimation of homocysteine and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) were obtained from maternal records. This study was carried out in 2019. 80.0% of women with PE used the hormonal contraceptive “depot medroxyprogesterone acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about thirty-fold increase in the odds of developing PE (OR = 29.71, p 0.001). Systolic blood pressure (P 0.001), diastolic blood pressure (P 0.001), triglycerides (P = 0.024), LDL-C (P = 0.026), and homocysteine levels (P 0.001) were significantly elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P 0.001), BWT (P 0.001) and HDL-C levels (P = 0.001) were significantly reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had intrauterine growth restriction and low birthweight infants, respectively. In conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA could partly contribute to endothelial dysfunction, hyperhomocysteinaemia, dyslipidaemia and excessive weight gain, all of which characterize PE.

Background. Preeclampsia is a major cause of maternal and neonatal morbidity and mortality in sub-Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of preeclampsia. This study assessed the level of the components of the arginine-nitric oxide pathway to evaluate endothelial dysfunction in normotensive pregnancies and pregnancies complicated with preeclampsia. Methods. This case-control study was conducted among pregnant women who visited Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Sociodemographic, clinical, and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of nitric oxide (NO∙), L-arginine, asymmetric dimethylarginine (ADMA), and 3-nitrotyrosine using an enzyme-linked immunosorbent assay technique. Results. The mean NO∙ ( p = 0.010 ) and L-arginine/ADMA ratio ( p < 0.0001 ) was significantly lower in PE compared to NP while mean L-arginine ( p = 0.034 ), ADMA ( p < 0.0001 ), and 3-nitrotyrosine ( p < 0.0001 ) were significantly higher in PE than NP. ADMA showed a significant positive association with systolic blood pressure ( β = 0.454 , p = 0.036 ) in severe PE. Women with PE had significant intrauterine growth restriction ( p < 0.0001 ) and low birth weight infants ( p < 0.0001 ) when compared to NP. Conclusion. Preeclampsia is associated with reduced NO∙ bioavailability, L-arginine/ADMA ratio, and elevated levels of ADMA and 3-nitrotyrosine. Measurements of the levels of these parameters can help in the early prediction of endothelial dysfunction in preeclampsia. Exogenous therapeutic supplementation with L-arginine during pregnancy to increase the L-arginine/ADMA ratio should be considered to improve endothelial function in preeclampsia and pregnant women at risk of developing preeclampsia.

Aim: This study assesses the effects of HAART on liver and renal functions in HIV infected individuals on HAART. Study Design: Cross sectional study. Place and Methods: This study was conducted in Tamale, Ghana from August, 2015 to November 2017. Methodology: A total of 300 HIV infected participants with ages ranging from 19 to 79 years who have been administered with HAART for at least 6 months were recruited. Pre-HAART administration (baseline) demographic and clinical information, with initial liver and renal function test results were retrieved from the medical records of the participants present at the ART center. Post HAART administration blood sample (5 mLs) was taken from each participant into a gel separated vacutainer tube, allowed to clot and spun at 3000 rpm for 3 minutes to produce serum. The product (serum) was used for liver and renal function test analysis using a fully automated chemistry analyser (Vital Scientific Selectra Flexor XL). Results: Of the study population, 72% were administered with AZT/3TC/EFV, 13% with AZT/3TC/NVP, 6.7% with TDF/3TC/LPV/r and TDF/3TC/NVP, 1% with AZT/3TC/EFV while 0.7% were administered with TDF/FTC/EFV. The following parameters were significantly increased post HAART administration; ALT (25.53 ± 16.90 to 30.87 ± 19.28 U/L), ALP (163.7 ± 141.0 to 215.2 ± 143.4 U/L), GGT (37.27 ± 25.21 to 53.19 ± 41.71 U/L), Total protein (73.97 ± 17.08 to 82.31 ± 11.62 g/L), Albumin (38.02 ± 9.331 to 41.01 ± 7.471 g/L), Globulin 38.02 ± 15.71 to 42.79 ± 25.20 (g/L). There were however significant reductions in Total bilirubin (12.13 ± 10.85 to 9.434 ± 4.560 µmol/L), Direct bilirubin (6.616 ± 5.770 to 4.184 ± 2.806 µmol/L), (Creatinine 73.19 ± 36.13 to 63.14 ± 27.14 µmol/L) and Urea (3.515 ± 2.552 to 3.011±1.274 mmol/L). Conclusion: HAART improves renal function, induces elevation in liver enzymes, stimulates the production of plasma proteins and reduces serum bilirubin concentration.

Preeclampsia is not fully understood; and few biomarkers, therapeutic targets, and therapeutic agents for its management have been identified. Original investigative findings suggest that abnormal placentation triggers preeclampsia and leads to hypertension, proteinuria, endothelial dysfunction, and inflammation, which are characteristics of the disease. Because of the regulatory roles that it plays in several metabolic processes, adiponectin has become a cytokine of interest in metabolic medicine. In this review, we have discussed the role of adiponectin in trophoblast proliferation, trophoblast differentiation, trophoblast invasion of the decidua, and decidual angiogenesis, which are the major phases of placentation. Also, we have highlighted the physiological profile of adiponectin in the course of normal pregnancy. Moreover, we have discussed the involvement of adiponectin in hypertension, endothelial dysfunction, inflammation, and proteinuria. Furthermore, we have summarized the reported relationship between the maternal serum adiponectin level and preeclampsia. The available evidence indicates that adiponectin level physiologically falls as pregnancy advances, regulates placentation, and exhibits protective effects against the symptoms of preeclampsia and that while hyperadiponectinemia is evident in normal-weight preeclamptic women, hypoadiponectinemia is evident in overweight and obese preeclamptic women. Therefore, the clinical use of adiponectin as a biomarker, therapeutic target, or therapeutic agent against the disease looks promising and should be considered.

Aim: This study assesses the effects of HAART on complete blood count parameters among HIV infected participants. Study Design: Case control study. Place and Methods: This study was conducted in Tamale, Ghana from August, 2016 to December, 2017. Methodology: A total of 300 HIV infected participants with ages ranging from 19–79 years, administered with HAART for at least 6 months were recruited. Pre-HAART administration (baseline) demographic and clinical information, with initial full blood count results were retrieved from the medical records of the participants. Post HAART administration blood sample (5mLs) was taken from each participant into an EDTA vacutainer tube and complete blood count (CBC) performed using URIT 5250 haematology analyser. Participants transfused with blood over the last 4 months were excluded from the study. Results: The study recorded significant decreases in WBC and Neutrophil (%) post HAART administration. Lymphocyte (%), Haemoglobin, Haematocrit, MCV, MCHC, RDW-SD were all significantly higher post HAART administration. Total Platelets count, MPV, PDW-SD, PCT and P-LCR were significantly lower post-HAART administration. A comparison of the effects of EFV and NVP administered with AZT/3TC backbone yielded the following results. The NVP group recorded a significantly higher HCT compared with the EFV group (p-0.0073). A significantly higher mean PCT, MPV, P-LCR, PLCC, PDW-SD were recorded in the EFV group compared to the NVP group respectively. Conclusion: The administration of HAART is associated with significant improvements in erythroid and lymphoid lineages, reduce anaemia, improves immunity and general patient well-being. NVP improve erythroid cell indices while EFV ameliorate platelet indices. HAART regimen should be chosen based on the pre-HAART laboratory tests conducted on the individual.

Objectives To assess the variability and predictability of adiponectin, leptin, resistin and their ratios in non-obese and obese women with anovulatory polycystic ovary syndrome (aPCOS). Results A total of 52 ovulatory controls (mean age = 31.63 ± 4.88 years, BMI = 25.33 ± 2.68 kg/m2); 54 non-obese (mean age = 32.11 ± 4.25 years, BMI = 25.72 ± 2.95 kg/m2) and 50 obese women with aPCOS (mean age = 33.64 ± 4.14 years, BMI = 39.19 ± 2.99 kg/m2) were recruited. The aPCOS group had lower adiponectin [13.0 (10.49–16.59) vs 18.42 (15.72–19.92) µg/ml, p

Background: The RODAM study has established a link between peripheral insulin resistance and varying fasting blood glucose levels among Ghanaian populations. However, associations of oxidative stress and inflammation with type 2 Diabetes Mellitus (T2DM) and obesity is yet to be assessed in this population. Objective: This study determined the association of inflammatory and oxidative stress markers in T2DM and obesity among Ghanaian migrants in Europe and non-migrants in Ghana. Methods: Socio-demographic and anthropometric variables were collected from 5350 participants of 25-70 years and stratified into migrant Ghanaians (n= 2921), urban (n=1411) and rural Ghanaians (n=1018). C-Reactive Protein (CRP), Uric Acid (UA) and ferritin were quantified and associations drawn between these markers and the metabolic disorders using logistic regression. Results: Overall mean ages (years) were highest for migrant Ghanaians [46.59, 95%CI (46.24, 46.93)] compared to rural [46.49 (45.72, 47.26)] and urban [45.24 (44.65, 45.83)]. CRP was associated with obesity and T2DM respectively in urban [OR=1.531, 95%CI (1.407, 1.666): OR=1.354, 95% CI (1.195, 1.535)] and migrant Ghanaians [OR=1.552, 95% CI (1.449, 1.662): OR=1.405, 95%CI (1.234, 1.600)]. Similarly, ferritin was positively associated (p Conclusion: CRP and ferritin are associated with T2DM in Ghanaian populations at varying magnitudes. Moreover, indulgence in lifestyles that elevate inflammation and oxidative stress has the potential to increase risk of T2DM and obesity among Ghanaian populations.

Breast cancer (BC) in Africans and people of African descent is generally aggressive, with poorer prognosis and worse clinical outcomes. The molecular basis of this is however not entirely understood. The CD44+ / CD24-/low BC stem cell is known for its tumourigenic potential, tumour aggressiveness and its association with poor prognosis. This study identifies the relationship between CD44+/ CD24-/low BC stem cells and clinicopathological features of breast cancer in an African population.Methodology A Ghanaian BC cohort (n= 222) was used to assess CD44 and CD24 expression. Tissue microarray was constructed from the cohort samples and Immunohistochemically stained with CD44 and CD24 antibodies. The associations between clinicopathological features and the expression of the individual markers and their combinations were analysed. Results Of the total 222 breast cancer samples, 81.9 % were cytoplasmic CD24 positive and were associated with higher tumour grade (OR-3.623; r=0.199; p=0.004), gender (OR-9.514; p=0.028), clinical prognostic grading (OR-2.357 r= 0.162; p=0.027) and Her2 positivity (OR-0.216; r=-0.155; p=0.026). CD44 was associated with higher tumour grade (OR-3.148; r= 0.145; p-0.037), and increased mitotic count (OR-3.043, r= 0.173; p=0.028). There was no association between CD44 expression and hormone receptor status. Together, CD44+/CD24-/low staining was associated with higher tumour grade (OR-3.162; r=0.166; p=0.018), gender (OR- 12.0; p=0.012), and higher clinical prognostic staging (OR- 2.888; r=0.186; p=0.011). An inverse association of CD44+CD24+ was found with tumour grade (OR-0.220; r=-0.246; p=0.000), mitotic count (OR-0.406; r=-0.190; p=0.017) and clinical prognostic staging (OR-0.486; r=-0.151; p=0.040). There was no association between CD44-CD24+ and all the clinicopathological features.Conclusion Combined, CD44+CD24-/low was associated with poor prognosis and tumour aggression and may contribute to the tumour aggressiveness of African breast cancer. CD24 expression as a stand-alone marker was found to correlate with clinical and pathological indicators of tumour aggressiveness and poor prognosis.

Background Hypovitaminosis D in pregnancy is associated with adverse health outcomes in mothers, newborns and infants. This study assessed the levels of 25-hydroxyvitamin D [25(OH)D] in normotensive pregnancies and in preeclampsia, evaluated the association between vitamin D deficiency and preeclampsia risk; and determined the foeto-maternal outcome in preeclamptic women with vitamin D deficiency. Methods This case-control study was conducted among pregnant women who visited the Comboni Hospital, in Ghana from January 2017 to May 2018 for antenatal care. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Socio-demographic, clinical and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of 25- hydroxyvitamin D [25(OH)D] using enzyme-linked immunosorbent assay technique. Lipids (total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol) were also estimated. Results A total of 81.7% of the study participants had vitamin D deficiency. Of these, 88.6% of the women with PE had vitamin D deficiency compared to 75.0% in the NP. Vitamin D levels were significantly reduced in the PE women compared to the normotensive pregnant women (p = 0.001). A higher proportion of the preeclamptic women who were vitamin D deficient had preterm delivery (p p p p p = 0.008), LDL (p p = 0.017) and a significantly reduced HDL (p = 0.001) as compared to NP. In the preeclamptic women, serum 25(OH) D showed an inverse, but not significant association with TC (β = − 0.043, p = 0.722, TG (β = − 0.144, p = 0.210) and LDL (β = − 0.076, p = 0.524) and a positive, but not significant association with HDL (β = 0.171, p = 0.156). Conclusion The prevalence of vitamin D deficiency is high in both normotensive pregnancies and pregnancies complicated by preeclampsia but amplified in preeclampsia. Higher proportion of pregnant women with hypovitaminosis D had preterm babies and delivered low birth weight neonates. Additional studies are needed to explore the potential benefits and optimal dosing of vitamin D use in pregnancy, especially in sub-Saharan Africa.

Highly active antiretroviral therapy (HAART) is known to cause lipid abnormalities such as dyslipidaemia in HIV-infected individuals. Yet, dyslipidaemia may not independently occur as it may be worsened by single nucleotide polymorphisms (SNPs) in lecithin cholesterol acyltransferase (LCAT) and lipoprotein lipase (LPL). This case–control study was conducted in three-selected hospitals in the Northern part of Ghana. The study constituted a total of 118 HIV-infected participants aged 19–71 years, who had been on HAART for 6–24 months. Dyslipidaemia was defined based on the NCEP-ATP III criteria. HIV-infected individuals on HAART with dyslipidaemia were classified as cases while those without dyslipidaemia were grouped as controls. Lipid profile was measured using an automatic clinical chemistry analyzer and genomic DNA was extracted for PCR (GeneAmp PCR System 2700). Overall, the prevalence of dyslipidaemia was 39.0% (46/118). High levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and reduced levels of high-density lipoprotein cholesterol (HDL-C) were observed in all cases. A total of 256 selected PCR amplicons comprising 137 LPL (exons 3, 5 and 6) and 119 LCAT (exons 1, 4, and 6) were sequenced in 46 samples (Inqaba Biotech). Six (6) clinically significant SNPs were identified in exons 1 and 4 for LCAT whereas 25 non-clinically significant SNPs were identified for LPL in exons 5 and 6. At position 97 for LCAT exon 1, there was a deletion of the nucleotide, ‘A’ in 32.5% (13/40) of the sampled population while 67.5% (27/40) of the sample population retained the nucleotide, ‘A’ which was significantly associated with dyslipidaemic outcomes in the study population (p = 0.0004). A total of 25 SNPs were identified in exons 5 and 6 of LPL; 22 were substitutions, and 3 were insertions. However, none of the 25 SNPs identified in LPL exon 5 and 6 were statistically significant. SNPs in LCAT may independently contribute to dyslipidaemia among Ghanaian HIV-infected individuals on HAART, thus, allowing genetic and/or functional differential diagnosis of dyslipidaemia and creating an opportunity for potentially preventive options.

Background Chronic kidney disease (CKD) is a significant comorbidity among hypertensive patients. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) have been demonstrated to be significantly associated with CKD, among African- and European-derived populations. We investigated the spectrum of MYH9-associated CKD among Ghanaian hypertensive patients. Methods The study constituted a total of 264 hypertensive patients. Hypertensive patients with glomerular filtration rate (eGFR) 2 (CKD-EPI formula) or clinically diagnosed were defined as case subjects (n = 132) while those with eGFR ≥60 ml/min/1.73m2 were classified as control subjects (n = 132). Demographic data were obtained with a questionnaire and anthropometric measurements were taken. Five (5) millilitres (ml) of venous blood was drawn from study subjects into gel and EDTA vacutainer tubes. Two (2) mL of EDTA anticoagulated blood was used for genomic DNA extraction while three (3) mL of blood was processed to obtain serum for biochemical measurements. Genotyping of MYH9 polymorphisms (rs3752462) was done employing Tetra primer Amplification Refractory Mutation System (T-ARMS) polymerase chain reaction (PCR). Spot urine samples were also collected for urinalysis. Hardy-Weinberg population was assessed. Logistic regression models were used to assess the associations between single nucleotide polymorphisms and CKD. Results The cases and control participants differed in terms of age, sex, family history, and duration of CKD (p-value Conclusions We have demonstrated that MYH9 polymorphisms exist among Ghanaian hypertensive patients and rs3752462 polymorphism of MYH9 is associated with CKD. This baseline indicates that further longitudinal and multi-institutional studies in larger cohorts in Ghana are warranted to evaluate MYH9 SNP as an independent predictor of CKD among hypertensive patients in Ghana.

Background:Adherence is the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behaviour to produce a therapeutic result. The study is aimed at assessing adherence to medication and its relation to therapeutic outcomes among people living with diabetes in the Ho Municipality.Methodology:A cross-sectional study was conducted involving 150 diabetic patients attending the diabetic clinic at the Ho Municipal Hospital. Urine glucose and urine protein were measured using a two-parameter dipstick. The current fasting blood glucose and blood pressure, as well as the measurements of two previous visits, were documented. A semi-structured questionnaire including the Diabetes Complication Checklist and the Morisky, Green and Levine Adherence Scale were used to capture biodata, clinical information and medication adherence.Results:Optimal medication adherence was 60.67%. Glycaemic control and controlled blood pressure were 33.33% and 58.67%, respectively. The prevalence of glycosuria and proteinuria was 10.67% and 3.3%, respectively. Percentage glycaemic control and controlled blood pressure were found to be higher among the medication adherent group, while glycosuria and proteinuria were the highest among participants presenting with low medication adherence.Conclusion:In this group of patients living with diabetes in the Ho Municipality, high level of uncontrolled glycaemia and blood pressure exist.However, these two treatment outcomes may be modulated by optimal medication adherence.

Breast Cancer Stem Cells has become the toast of many breast cancer investigators in the past two decades owing to their crucial roles in tumourigenesis, progression, differentiation, survival and chemoresistance. Despite the growing list of research data in this field, racial or ethnic comparison studies on these stem cells remain scanty. This study is a comparative racial analysis of putative breast cancer stem cells. Research articles on the clinicopathological significance of breast cancer stem cells within a period of 17 years (2003–2020) were reviewed across 5 major races (African/Black American, Asian, Caucasian/White, Hispanic/Latino, and American). The associations between the stem cells markers (CD44+/CD24−/low, BMI1, ALDH1, CD133, and GD2) and clinicopathological and clinical outcomes were analysed. A total of 40 studies were included in this study with 50% Asian, 25% Caucasian, 10% African, 5% American and 2.5% Hispanic/Latino, and 7.5% other mixed races. CD44+/CD24−/low has been associated with TNBC/Basal like phenotype across all races. It is generally associated with poor clinicopathological features such as age, tumour size, lymph node metastasis and lymphovascular invasion. In Asians, CD44+/CD24−/low was associated with DFS and OS but not in Caucasians. ALDH1 was the most studied breast CSC marker (40% of all studies on breast cancer stem cell markers) also associated with poor clinicopathological features including size, age, stage, lymph node metastasis and Nottingham Prognostic Index. ALDH1 was also associated with DFS and OS in Asians but not Caucasians. Racial variations exist in breast cancer stem cell pattern and functions but ill-defined due to multiple factors. Further research is required to better understand the role of breast CSC.

Background This study aimed to describe the burden, treatment patterns and, age threshold for predicting hypertension among rural adults in Nyive in the Ho Municipality of the Volta Region, Ghana. Methods A population-based cross-sectional study design was employed. A total of 417 adults aged 20 years and above were randomly selected from households within the Nyive community. The WHO STEPwise approach for non-communicable diseases risk factor surveillance (STEPS) instrument was used to obtain socio-demographic and clinical information including age, gender, educational background, marital status, and occupation as well as hypertension treatment information. Blood pressure was measured using standard methods. The risk of hypertension and the critical age at risk of hypertension was determined using binary logistic regression model and the receiver-operator characteristics (ROC) analysis. Results The direct and indirect age-standardized hypertension prevalence was higher in males (562.58/487.34 per 1000 residents) compared to the females (489.42/402.36 per 1000 residents). The risk of hypertension among the study population increased by 4.4% (2.9%-5.9% at 95% CI) for one year increase in age while the critical age at risk of hypertension was >39 years among females and >35 years among males. About 64(46.72%) of the hypertensive participants were not on treatment whereas only 42(30.66%) had their blood pressure controlled. Conclusion Rural hypertension is high among adults in Nyive. The critical age at risk of hypertension was lower among males. The estimated annual increase of risk of hypertension was 4.7% for females and 3.1% for males. High levels of undiagnosed and non-treatment of hypertension and low levels of blood pressure control exist among the rural folks.

Introduction: Alcohol usage has largely been seen as a risk factor for the development of sexual dysfunction as well as erectile dysfunction. Others have reported that prolonged alcohol usage and abuse is compatible with normal sexual function in the absence of endocrinological problems as well as hepatic dysfunction. About seventy five (75) percent of alcoholics have various sexual difficulties with improvements in sexual functions occurring after treatment of alcoholism and psychosexual therapy. It is evident from the various reports over the years that mild and occasional alcohol usage is not as much implicated in the causation of SD and its other forms as heavy, addictive or dependent alcohol usage. Alcohol usage has also long been linked to hypogonadism, testicular atrophy as well as leydig cell toxicity. Alcohol induced hypogonadism has been reported to resolve after withdrawal of alcohol use. Since both diabetes and alcohol usage have been strongly associated with both hypogonadism and sexual dysfunction, it is logical to expect that diabetics who frequently consume alcohol will have a worsened hypogonadal state and sexual function. This research therefore seeks to provide evidence of an association between alcohol consumption in diabetics and a worsened sexual dysfunction in comparison to diabetics who did not consume alcohol. Methods: Type II diabetic patients attending the Diabetic Clinic at the Maamobi General Hospital between the periods of January 2010 and March 2011 were consecutively recruited for this study. Diabetics with other known endocrinological diseases and physical disabilities were excluded from the study. Sexual function was assessed using the GRISS-M. Early morning fasting samples were used in lipid and testosterone profile assays. Results: Study participants who consumed alcohol recorded higher levels of triglycerides and LDL-Cholesterol. They also recorded significantly lower levels of bioavailable testosterone. Furthermore they also recorded higher scores for impotence, premature ejaculation, non-sensuality and infrequency but lower scores for avoidance and were about six times more likely to be infrequent in their sexual activity in comparison with those who did not consume alcohol. Conclusion: Alcohol consumption among diabetic males is associated with hypogonadism and has an impact on several domains of male sexual function. Diabetic males should be advised to avoid alcohol abuse in order to facilitate the management of diabetes associated sexual dysfunction.

Disordered body fat distribution and plasma lipid levels promote atherosclerosis, a major risk factor for cardiovascular disease (CVD). The process of atherosclerosis is vigorous and rapid in diabetes and hypertension. This study sought to determine the ...

BACKGROUND: Physical activity (PA) offers considerable health benefits for diabetic patients. However, extensive high levels of inactivity has been reported among diabetic patients. This study sought to assess the patterns of physical activity and its relationship with two management-relevant outcomes (glycaemic and blood pressure control)among people living with diabetes in the Ho Municipality, Ghana.METHODS: A hospital-based cross-sectional study was carried out from January 2017 to April 2017 among 150 purposively recruited diabetic patients who were receiving care at the diabetes clinics of the Volta Regional Hospital and the Ho Municipal Hospital. A semi structured questionnaire was used in capturing socio-demographic information. Physical activity was assessed using the International Physical Activity Questionnaire Short Form. Glycaemic and blood pressure control were evaluated within a three-month period from patients’ records.RESULTS: Physical activity estimates among participants were 21.33%, 48% and 30.67% for high, moderate and low PA respectively. Glycaemic control among the study participants was 33.33% and blood pressure control was 58.67%. Both glycaemic and blood pressure control were significantly associated with PA.CONCLUSION:In this group of PLWD in the Ho Municipality, high levels of inactivity, uncontrolled glycaemia and blood pressure exist. However, glycaemic and blood pressure control may be modulated by moderate-intensity physical activity.

Aldehyde dehydrogenase 1 member A1 (ALDH1A1) is one of the most well studied breast cancer stem cells. Its expression has been associated with poor clinicopathological features and clinical outcomes in several studies. This paper studies the expression of ALDH1A1 and its combination with CD44+/CD24−/low breast cancer stem cell and their association with clinicopathological parameters and molecular subtypes. METHOD: Tissue Microarray was constructed from 222 Formalin Fixed Paraffin Embedded (FFPE) breast cancer tissues. The expression of ALDH1A1, CD44 and CD24 were assessed by Immunohistochemistry (IHC). The association of ALDH1A1 and its association with clinicopathological parameters, molecular subtypes, CD44 and CD24 were studied in an African population. The association between CD44+/CD24−/low/ALDH1+ and the clinicopathological phenotypes were also studied. RESULTS: A high ALDH1A1 expression of 90% was recorded in this study. No association was found between ALDH1A1 and clinicopathological parameters. ALDH1A1 was positively associated with CD24 (r = 0.228, OR-4.599 95% CI- 1.751–12.076, p = 0.001) and CD44 (r = 0.228, OR-5.538 95%CI- 1.841–16.662, p = 0.001) but not associated with CD44+/CD24−/low (r = 0.134, OR- 2.720 95%CI- 0.959–7.710, p = 0.052). CD44+/CD24−/ALDH1+ however had significant associations with Age (p- 0.020, r = 0.161, OR- 2.771, 95%CI 1.147–6.697), Gender (p = 0.004, OR- 15.333 95%CI 1.339–175.54) ), Tumour grade(p = 0.005, r = 0.197, OR-3.913 95%CI 1.421–10.776) and clinical prognostic staging (p = 0.014, r = 0.182, OR-3.028 95%CI- 1.217–7.536). There was no association between CD44+/CD24−/ALDH1+ and the molecular subtypes. CONCLUSION: The high expression of ALDH1A1 in breast cancer makes it an important target for targeted therapy. This study further confirms the increased tumourigenicity of CD44+/CD24−/ALDH1+ combination phenotype and its association with increased tumour grade and clinical prognostic stage. Survival studies of ALDH1A1 and other breast cancer stem cells in African populations is strongly recommended to help further understand their effect on tumour aggressiveness.

Aims: To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population. Methods: Data from the RODAM study including Ghanaians aged 25–70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values. Results: WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47–2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4–93.7 vs 102 cm, BMI: 23.1–28.2 vs 30.0 kg/m 2). Conclusions: WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.

Background: This study is aimed at examining the dietary patterns and haematological profile in apparently healthy officers at the Ho Central Prisons. Methods: We employed a cross-sectional study to conveniently enroll 113 prison officers at the Ho Central Prisons. A semi-structured questionnaire was administered to obtain demographic information including age, gender, ethnicity, religion, and marital status as well as the number of children, educational level, occupational rank and duration of service. A Food Frequency Questionnaire (FFQ) and 24-Hour Recall (24HR) instrument were used to assess participants’ dietary intakes and consumption patterns. Portion sizes of all meals indicated were estimated using handy measures. Nutrient intakes were then determined using the FAO food composition database. Using standard methods, venous blood samples were obtained to determine participants’ full blood count (FBC). Anaemia and its morphological types were defined based on gender specific haemoglobin cut-off and MCV and MCH cut-off values respectively. Results: Only half of the total respondents [65 (57.5%)] followed the recommended daily eating pattern (breakfast, lunch and supper). Thirty-two (28.3%) had often skipped breakfast, 36 (31.9%) skipped lunch and 6 (5.3%) skipped supper while 16 (14.2%) skipped snacks. High protein intake was predominant among study participants [74(65.49%)], with a male preponderance [47(75.81%)]. Low folate, vitamins (C, B6, and B12) and fiber consumptions were proportionally higher among the study population whereas low thiamine [35(68.63%)] and copper [36(70.59%)] intakes were significantly higher among female compared to their male peers, [33(53.23%)] and [40(64.52%)]. The rate of anaemia was 36(31.86%). Normocytic normochromic anaemia was the commonest [76(67.26%)], followed by microcytic hypochromic anaemia [19(16.81%)]. Anisocytosis accounted for 18(15.93%) of the total study population, with a preponderance towards the male gender [10(16.13%)]. Conclusion: Good dietary practices is not optimal among the officers of the Ho Central Prisons. A third of the officers suffer from anaemia, with normocytic normochromic anaemia as the predominant anaemia type. Keywords: Dietary patterns, Dietary habits, Haematological profile, Anaemia

Despite the wide use of the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) in several populations, the instrument has yet to be validated among patients with type 2 diabetes. The aim of this study was to evaluate the validity and reliability of the GRISS for the estimation of clinically relevant sexual dysfunction among type 2 diabetes patients under clinical management. This cross-sectional study was conducted among a total of 136 and 126 type 2 diabetic males and females, respectively, using GRISS for male and female. Internal consistency, test-retest reliability, and scores of discriminant validity were calculated. Cronbach's alpha coefficient ranged from 0.71 to 0.90 in total samples of males and females. The values obtained were similar between the chronic diabetic patients with self-reported sexual problems and normal samples. Test-retest reliability gave fair scaling results of 0.94 overall for males and 0.97 for females using Pearson's correlation coefficient. GRISS subscales differentiated multivariately between men (F7,122 = 19.308; p = 0.000; eta2 = 0.721; power = 0.993) and women (F7,118 = 18.705; p = 0.000; eta2 = 0.526; power = 0.928) with and without sexual problems. GRISS appears to be valuable and reliable for use among the Ghanaian population. Regular use of the GRISS for the screening of sexual problems among diabetic patients appears warranted.

BACKGROUND:Advanced maternal age (AMA) has been associated with negative pregnancy outcomes. Oxidative stress (OS) and defective placental dysfunction are contributing factors. This study determined the association between AMA and adverse pregnancy outcomes, OS biomarkers and angiogenic growth mediators (AGMs) in normal pregnancies. METHODS:This prospective cohort study conducted at the Obstetrics and Gynaecology (O&G) Department of the Komfo Anokye Teaching Hospital (KATH) finally included 175 normal pregnant women comprising, 58 AMA (35-45 years), 55 (30-34 years) and 62 optimal childbearing age (20-29 years). Venous blood samples were collected at 28-32 weeks for soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PIGF), 8-epiprostaglandinF2-α (8-epi-PGF2α) and total antioxidant capacity (TAC) assays. RESULTS:Pregnancies of AMA had a significantly higher levels of sFlt-1, 8-epi-PGF2α and 8-epi-PGF2α: PIGF ratio but a reduced level of PIGF, TAC and PIGF: sFlt-1 ratio compared to 20-29 years (p

Background. Type 2 Diabetes Mellitus (T2DM) and menopause are associated with vitamin D status. Oestrogen decline during menopausal stages promotes hypovitaminosis D. However, the interplay between vitamin D, menopause, lifestyle, and T2DM cannot be overlooked. This study assessed vitamin D status among pre- and postmenopausal T2DM women and determined its association with glycemic control and influence of lifestyle habits on hypovitaminosis D.Methods. This cross-sectional study was conducted at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Structured questionnaires were administered to 192 T2DM women; blood samples were collected for estimation of 25(OH) D and insulin using ELISA. Fasting blood glucose (FBG), lipid profile, glycated haemoglobin (HbA1c), and calcium were measured. Statistical analyses were performed using Graphpad Prism 6.Results. The prevalence of vitamin D inadequacy was 92.2%. Hypovitaminosis D was more prevalent among the postmenopausal T2DM women (63.8% versus 58.2%). Hypovitaminosis D significantly associated with insulin [R2=0.01760,p=0.0008], HbA1c [R2=0.3709,p=<0.0001], and FBG [R2=0.3465,p=0.0001] in only the postmenopausal women.Conclusion. Vitamin D deficiency is prevalent in pre- and postmenopausal T2DM but higher among postmenopausal women. Adequate vitamin D levels in both groups were associated with improved glucose control while hypovitaminosis D in the postmenopausal women was related to poorer glucose control. Vitamin D screening should be incorporated into management plan for T2DM to serve as an early tool for prevention of vitamin D deficiency.

Background. Breast cancer remains a serious public health problem globally. It is particularly increasing among adolescents and premenopausal women. Breast self-examination (BSE) is the most effective and feasible means of detecting breast cancer early in developing countries. This study aimed at evaluating and comparing knowledge of BSE among secondary and tertiary school students and at revealing their attitudes and practices about BSE. Method. This cross-sectional study was conducted among 1036 female secondary and tertiary school students of Kwame Nkrumah University of Science and Technology and Technology Senior High School. Data was obtained using a pretested questionnaire to access sociodemography, knowledge, attitudes, and practice of BSE among the students. Result. Most students were within the age of 15–24 years; 90.9% were aware of BSE. A high level of knowledge on BSE was found in 54.5% of the students. Knowledge was significantly higher in tertiary than secondary school students (p=0.002). 24.1% of the students thought BSE could be performed anytime; however only 8.1% of the students performed BSE monthly as recommended, whilst 41.8% had never practiced. Of these, more secondary students had never practiced BSE as compared to the tertiary students. 22.3% indicated they would wait for a change in a detected breast lump before seeking medical attention. 96.3% of the participants agree BSE is a good practice which must be encouraged. Conclusion. Teaching of BSE should be intensified beginning at the high school level, emphasizing practice and its benefits for early detection of breast cancer.

Background. There is a dearth of information about the burden of cardiometabolic risk factors among the Ghanaian health workforce in the Western Region. This study sought to determine the prevalence of cardiometabolic risk factors among healthcare workers at the Sefwi-Wiawso Municipal Hospital in the Western Region of Ghana.Materials and Methods. A hospital-based cross-sectional study involving 112 employees of the Sefwi-Wiawso Municipal Hospital was conducted. The cardiometabolic risk variables assessed were obesity, hypertension, dyslipidaemia, and diabetes. Sociodemographic parameters were also captured. The prevalence of hypertension and obesity was determined using the JNC VII panel and WHO BMI criteria for obesity classifications. Blood lipids and glucose concentrations were evaluated using standard methods.Results. The prevalence of hypertension and prehypertension was 16.07% and 52.68%, respectively. About 38.39% of participants were overweight, and 12.50% were obese. Atherogenic dyslipidaemia was 26.79%, whereas prediabetes glycaemic levels and diabetes incidence were 5.41% and 4.50%, respectively. Fifty percent (50.00%) of participants presented at least one cardiometabolic risk factor. Aging and adiposity were associated with increasing cardiometabolic risk.Conclusion. Cardiometabolic risk factors are prevalent among healthcare providers in Sefwi-Wiawso. The cardiometabolic dysregulation observed among this cohort of healthcare professionals may be modulated by age and adiposity.

Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana/Komfo Anokye Teaching Hospital, Kumasi, Ghana. Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 3 Emena Diagnostic Centre, Aninwah Medical Centre, Kumasi, Ghana. Department of Clinical Biochemistry, Diagnostic Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Health Sciences, Ho, Ghana. 6 School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 7 Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Ghana.

Background: The ability to determine accurately, the blood loss during childbirth is of extreme importance in the diagnosis and management of primary postpartum haemorrhage (PPH). Aims: In this study, we evaluate the effectiveness of visual estimation of blood loss, as a method of diagnosing primary postpartum haemorrhage. Methodology: A cross - sectional study on 271 participants was conducted between April and October 2012, at the Komfo Anokye Teaching H ospital. Women who went through spontaneous Original Research Article

Quality of life (QoL) is an important component in the evaluation of the wellbeing of people living with HIV/AIDS (PLHIV). This study was aimed at evaluating the QoL of PLHIV attending the antiretroviral clinics in the Ho municipality. A cross-sectional study was conducted from January 2017 to April 2017 involving 158 purposively selected HIV-positive patients who were attending the antiretroviral clinics both in the Volta Regional Hospital and Ho Municipal Hospital. An Interviewer administered standard questionnaire (WHOQOL-HIV Bref) was used to collect information on sociodemography, medical history, and the quality of life (QoL) of the respondents. Among these 158 HIV-positive respondents, 126 (79.75) and 14 (8.86) presented with excellent and good overall QoL, respectively, whilst 18 (11.39) had their life negatively affected by HIV/AIDS. Religious/personal beliefs (19.62%) were the most affected QoL component, followed by the physical (15.82%) and level of independence (15.19%) domains. Patients’ occupation, perception of health, sexual activity, and state of the disease were associated with poor overall QoL. In general, being an HIV-infected man, symptomatic patient, not being sexually active, or being ART naïve was also associated with poorer QoL in several HIV/AIDS QoL domains.

The cooccurrence of diabetes mellitus and metabolic syndrome potentiates the cardiovascular risk associated with each of the conditions; therefore characterizing metabolic syndrome among people with type 2 diabetes is beneficial for the purpose of cardiovascular disease prevention. This study aims at evaluating the prevalence of metabolic syndrome and its components among 162 patients with type 2 diabetes attending the diabetic clinic of the Ho Municipal Hospital, Ghana. Data obtained included anthropometric indices, blood pressure, serum lipids, glucose, and sociodemographics and clinical information. The overall prevalence of metabolic syndrome among the study population was 43.83%, 63.58%, and 69.14% using the NCEP-ATP III, the WHO, and the IDF criteria, respectively. The most predominant component among the study population was high blood pressure using the NCEP-ATP III (108 (66.67%)) and WHO (102 (62.96)) criteria and abdominal obesity (112 (69.14%)) for IDF criteria. High blood pressure was the most prevalent component among the males while abdominal obesity was the principal component among the females. In this population with type 2 diabetes, high prevalence of metabolic syndrome exists. Gender vulnerability to metabolic syndrome and multiple cluster components were skewed towards the female subpopulation with type 2 diabetes.

BackgroundHepatitis B (HBV) or hepatitis C (HCV) virus co-infections in HIV are alarming during pregnancy due to the risk of vertical transmission and the eventual adverse effects on neonates. This study was conducted to ascertain the sero-prevalence of HIV/HBV and HIV/HCV co-infections, evaluate the effect of the co-infections on the immunological and virological characteristics and assess the association between some demographic and lifestyle characteristics and risk of HBV, HCV, HIV/HBV and HIV/HCV co-infections among pregnant women living in the Brong-Ahafo Region of Ghana.MethodsThis comparative cross-sectional study was conducted at the anti-retroviral therapy (ART) clinics of the St. Elizabeth Hospital and the Holy Family Hospital, Brong-Ahafo Region, Ghana. A total of 248 consecutive consenting pregnant Ghanaian women, 148 diagnosed with HIV [HIV (+)] and 100 who were HIV negative [HIV (-)], were recruited. Validated questionnaire was used to obtain demographic and lifestyle data. Venous blood samples were obtained and HCV status, HBV profile, CD4+ T cell count, and HIV-1 RNA load were determined.ResultsThe sero-prevalence of HIV (+) /HBV, HIV (+) /HCV, HIV (-)/HBV, and HIV (-)/HCV infections were 22 (14.9%), 6 (4.1%), 10 (10.0%), and 12 (12.0%) respectively. HIV-1 viral load was not significantly different between HIV/HBV, HIV/HCV co-infection and HIV mono-infection. However, CD4+ T lymphocyte count (364 vs 512 vs 514 cells/μl; p = 0.0009) was significantly lower in HIV/HBV co-infection compared to HIV/HCV and HIV mono-infection respectively. There was no significant association between demographic and lifestyle characteristics and risk of HBV and HCV infections in HIV positive and negative subjects except for late diagnosis of HIV and history of sharing razors blades and pins, where increased odds of HIV (+) /HBV and HIV (-)/HBV infection were observed.ConclusionsThe prevalence of HIV (+)/HBV (14.9%), HIV (+)/HCV (4.1%), HIV (-)/HBV (10.0%), and HIV (-)/HCV (12.0%) are high among pregnant women in the Brong Ahafo Region of Ghana. HIV/HBV is associated with reduced CD4+ T lymphocyte count but not HIV-1 viral load. Early diagnosis of HIV and intensification of routine antenatal HBV and HCV are essential to abate the risk of maternal to child transmission.

Background Vitamin D plays a major role in physiological processes that modulate mineral metabolism and immune function with probable link to several chronic and infectious conditions. Emerging data suggests a possible influence of vitamin D on glucose homeostasis. This study sought to provide preliminary information on vitamin D status among Ghanaian type 2 diabetics and assessed its association with glucose homeostasis. Methods In a case control study, 118 clinically diagnosed Type 2 Diabetes Mellitus (T2DM) patients attending Diabetic Clinic at the Nkawie Government Hospital were enrolled between October and December 2015. Hundred healthy non-diabetics living in Nkawie district were selected as controls. Structured questionnaires were administered to obtain socio-demographic data. Venous blood samples were taken from both cases and controls to estimate their FBG, Lipid profile spectrophotometrically and IPTH, 25OHD by ELISA. Statistical analyses were performed using SPSS v20.0 Statistics. Results The average age of the study participants was 58.81years for cases and 57.79year for controls. There was vitamin D deficiency of 92.4% among T2DM cases and 60.2% among the non diabetic controls. Vitamin D deficiency did not significantly associate with HOMA-β [T2DM: r2 = 0.0209, p = 0.1338 and Control: r2 = 0.0213, p = 0.2703] and HOMA-IR [T2DM: r2 = 0.0233, p = 0.1132 and Control: r2 = 0.0214, p = 0.2690] in both the controls and the cases. Conclusion Vitamin D deficiency is prevalent in both T2DM and non-diabetics. There is no association between vitamin D deficiency and insulin resistance or beta cell function in our study population. Vitamin D supplementation among type 2 diabetics is recommended.