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Biomedical subjects

A Mensah

Publications and source records attributed to A Mensah.

At least 19 recordsLinked to original sources
PubMed2003

Characteristics of adult tetanus in Accra.

BACKGROUND: Tetanus is a life threatening infection with an estimated annual global incidence of about 1 million cases and a mortality of 50%. It is very common in developing countries. The prevalence in Ghana is not known, however, cases continue to be admitted in hospitals in the country. This retrospective study was undertaken to define the characteristics of cases of tetanus in adults admitted to the Korle-bu Teaching Hospital, Accra, Ghana, from 1 January 1994 to 31 December, 2001. METHODS: Information was extracted from the admission and discharge registers of the Isolation Unit of Korle-bu Teaching Hospital, Accra and case notes were examined and analysed. RESULTS: There were 158 (76.6%) males) cases of tetanus with mean age of 32.7 +/- 15.0 years. The peak age was in the 20-29 year group. Admission rate was lowest during the raining season months of June-August. Traumatic injury occurred outdoors (56.9%) and was caused by deep prick (24.3%), or cut (16.2%). The most common site of injury was on the lower (44.6%) limbs. The time interval between injury and admission was 8.3 +/- 22.4 weeks (range 1-156 weeks) and the duration of symptoms was 2.9 +/- 2.7 days (range 1.0-21.0 days). The most common presenting features were locked jaw (82.4%), general spasm (62.2%), presence of a wound (53.7%) and neck stiffness (50.0%). Hospital admission was 11.4 +/- 11.6 (range 0-53) days. The case mortality was 50% (79/158). CONCLUSION: These results confirm that adult tetanus is still very prevalent in Ghana and is occurring in a younger age group compared to that in the developed countries. The case mortality is still very high.

Adolescent↗
PubMed2000

[Fibrinolytic syndrome during surgery for benign prostatic hypertrophy (50 cases in the urology service at the Aristide le Dantec University Hospital Center)].

Prostate's surgery is an haemorrhagic one owing to difficulties of surgical haemostasis and anomalies of the blood coagulation. The aim of this study to assess haemostasis anomalies after protatectomy for benign prostatic hyperplasia (BPH). We have performed a prospective study including 50 men of more of 55 years old. All of them underwent suprapubic open prostatectomy. Significant pertubation of haemostasis, particularly fibrinolysis has been found. We have noticed fibrin degradation product in 88% of cases after intervention versus 62% before (p < 0.001) and a decrease of plasminogen rate in 94.4% of operated patients versus 82% before. The older the patient were, more important were the pertubations. Moreover, the anomalies were most important when the duration of surgery lasted more than one hour and when the BPH was voluminous. However, the disturbance of haemostasis was rarely associated to clinical symptoms. So, we do not recommend any therapeutic when clinical symptoms are absent. Biological screening the day of surgery, the day after and one week later are necessary to prevent haemorrhage.

Academic Medical Centers↗
PubMed1998

[Peyronie's disease and peripheral neuropathies].

The association between Peyronie's disease and diabetes mellitus or Dupuytren's disease is well described in the literature with a certain frequency. Through our 10 patients with Peyronie's disease, when have noticed that only one of them is undergoing diabetes mellitus and no one has Dupuytren's disease. But 7 of them presented clinical and/or electromyographical signs of peripheral neuropathy. So after clinical examination in neurology and urology, we performed measurement of motor conduction velocity of tibial posterior nerves and peroneal nerves, then, we measured sensitive vetocity of sural nerves and dorsal nerve of the penis and we studied the cortical somesthesic evoked potential of the internal hontous nerve and the sympathetic evoked response of the skin. So we hypothesize that peripheral neuropathy with or without autonomic disorders might be an etiological co-factor of Peyronie's disease.

Adult↗
PubMed1998

[Epididymal manifestations of urogenital tuberculosis].

OBJECTIVE: To define the epidemiological, anatomical, clinical and therapeutic aspects of tuberculous epididymitis in adults in the tropics. MATERIAL AND METHODS: This was a retrospective study of 11 cases of confirmed and treated tuberculous epididymitis. RESULTS: The most frequently affected age-group was 40-49 years. The commonest expression was that of a chronic epididymal nodule. The diagnosis was confirmed by histological examination of the epididymectomy specimen (10 cases) and bacteriology in one case. Combination antituberculous chemotherapy was systematically administered and epididymectomy was performed in all patients. CONCLUSION: The diagnosis of tuberculous epididymitis is often very difficult in the absence of a history of recent or active tuberculosis. However, this diagnosis must be considered in any case of chronic epididymal nodule, particularly in a context of infertility. The very mutilating treatment consists of epididymectomy in chronic forms, which also constitutes a diagnostic confirmation procedure, hence the value of prevention based on eradication of tuberculosis.

Adult↗
PubMed1998

[Erectile dysfunction in diabetics. Epidemiological profile in Senegal].

OBJECTIVE: The objective of this study was to report the epidemiological profile of erectile dysfunction in a population of diabetic men. MATERIAL AND METHODS: This was a prospective study including 431 diabetic patients seen in the outpatients department. 69 of these patients suffered from erectile dysfunction. A control group of 138 patients was randomly selected according to age from among the remaining 362 patients. Each patient was submitted to complete clinical examination. The medical and surgical history, particularly vascular, neurological, endocrine and urological, was recorded. The patient's smoking and drinking habits and treatment with any antidiabetic or other drugs were also recorded. Statistical analysis was performed according to the case-control method. The limit of significance was p < 0.05. RESULTS: The overall prevalence of erectile dysfunction was 16%. This rate is lower than those reported in the literature. Among the various risk factors, only complications of diabetes, especially neurological complications, were clearly correlated with the risk of erectile dysfunction (p = 0.0004). Similarly, the prevalence of erectile dysfunction increased with the duration of diabetes (p = 0.049). CONCLUSION: The prevalence of erectile dysfunction in diabetic patients often appears to be overestimated in the literature. Methodological biases would explain the marked variation of reported prevalence rates. In contrast, our study confirms previous reports that neurological factors play a predominant role.

Adolescent↗
PubMed1997

[The role of Hühner's direct post-coital test in the evaluation of conjugal sterility in the African environment in Senegal. (Apropos of 2593 post-coital tests performed by the clinical cytology, cytogenetic and reproduction biology laboratory at the University Hospital Center in Dakar, Senegal) 1983-1993].

About 2593 post-coïtal tests (PCT) or Hühner direct tests were realised in the laboratory of clinical cytology, cytogenetics and reproductive biology of the University medical Centre of Dakar, Senegal from 1983 to 1993. Analysing the results, the authors showed the importance of the infectious factor in women and also the role of male deficiency in conjugal sterility in black African environment. These realities have been confirmed cytospermiologic test deficient results. These sperm exams have shown among other things, the prevailing number of azoospermia (25%) and of oligo-asthénotératozoospermia (44%) in husbands of sterile women in the black African environment of Senegal. Pap's Tests have been jointly realised at the same time as 1902 PCT. The results have enabled us to track down 120 cervix with precancerous and cancerous cell alterations; 81 condylomas (HPV), 25 CIN1, 11 CIN2 and 3 CIN3 (CIN: cervical intra-epithelial Neoplasia). These facts suggest a cautious technics, and a prudent interpretation of the results and taking into account the competence and the subjectivity of the practitioner. We have learnt from the study that we must give as much as possible to biologists of Reproduction in southern countries, where conjugal sterility and cervix precancerous and cancerous cell alterations are high, a polyvalent training so that they can practise jointly the post-coïtal or Hühner direct test (PCT) and the Papanicolaou Colpocytologic Test (TP), provided that one owes a microscope.

Adolescent↗
PubMed1996

[Neurologic aspects of vesico-vaginal fistula of obstetrical origin].

OBJECTIVE: To study the electromyographic alterations of the urethral sphincter, perineal muscles and lower limbs observed in women with obstetric vesicovaginal fistula. METHODS: We compared a group of 22 women with obstetric vesicovaginal fistula with a control group of 10 women without fistula. Each woman underwent a neurological examination of the perineum and lower limbs and electromyography of the lower limbs and urethral sphincter. According to the classification proposed by MENSAH, the fistulas were classified as simple (54.5%), complex (31.8%) and complicated (13.6%). RESULTS: Twenty women with VVF presented a peripheral nerve lesion. Five of these patients had a clinical and electromyographic lesion; while the other fifteen patients had a subclinical lesion. 68.18% of the fistula patients presented a clinical neuropathy in the perineum. This lesion was detected on electromyography in all patients with fistula. The severity of this denervation lesion ranged from moderate (36.37%) to severe (63.63%). No neurological lesions were detected in the control group. The degree of denervation has more severe in young women (21-25 years) and in primiparous women. In contrast, the severity of denervation did not appear to be related to the history of the fistula. The risk of treatment failure increased proportionally to the severity of denervation. 73% of fistulas with severe denervation remained "unsuturable", or required multiple operations with disappointing results in the form of persistent vesicosphincteric dysfunction. CONCLUSION: Although the psychosocial impairment and upper urinary tract repercussions have been well evaluated, the peripheral neurological lesion has always been underestimated in the management of obstetric vesicovaginal fistulas. The authors consider that the fistula is only the apparent manifestation of "neurovesical damage", which remains the decisive factor in the prognosis and which largely explains the high frequency of treatment failure.

Adult↗
PubMed1996

[Hemoglobinopathies and retinopathies in Lomé UHC].

BACKGROUND: There are few publications concerning retinal complications of hemoglobinopathies in our country. We studied recruited patients to evaluate these complications. MATERIAL AND METHODS: From October 1993 to August 1995, 66 patients were recruited among clinical hematology out patients; all of them underwent acetate electrophoretic diagnosis and fluorescein angiographic examination. RESULTS: The mean age of the patients was 26,92 years, ranging from 5 years to 50 years; the genotypic forms were 34 SC (51.51%), 15 SS (22.72%), 11 AC (16.66%), 2 AS (3.03%), 2 CC (3.03%), and 2 A2F (3.03%). Thirty eight patients (57.57%) had retinopathies. The majority were proliferative retinopathies in 55,26% cases and in 44,73% non proliferarive retinopathies. These retinopathies were essentially present with SC (26 cases for 34 SC, 76.47%), predominantly proliferative forms (21 cases for 26 SC, 80.76%). CONCLUSION: Retinal complications are common in Togolese sickle cell patients; clinical course usually leads to proliferations. Early screening could help improve prevention, including laser photocoagulation.

Adolescent↗
PubMed1996

[Chloroquine maculopathy and prevention of malaria].

PURPOSE: Chloroquine maculopathy is a major complication observed during prophylactic treatment of malaria. We present here 18 cases recently documented at Lomé Teaching Hospital. METHOD: Retrospective data of patients presenting with macular fluoroscopic bull's eye are analysed, all had a history of prophylactic treatment for malaria. RESULTS: These patients presented with three models of prophylaxy, total toxic doses were 185 g, 557 g and 1,300 g in the case of low, mild or high and massive continuous prophylaxy. All eighteen patients presented with macular angiofluorographic bull's eye; 11 were male, 7 female, mean age was 41.72 years. CONCLUSION: Chloroquine retinopathy is a rare complication observed at our hospital. Because of the poor prognosis of the disease and our geographical situation in an endemic area, the threshold dose might be 185 g. Patients should have undergone systematic screening before these cumulative doses. The incidence of this major complication which could increase would question chloroquine prophylaxy with actual doses and methods.

Adult↗
PubMed1996

[Epididymal manifestations of urogenital tuberculosis].

The morbidity of tuberculous epididymitis is due to the risk of male infertility secondary to vasal or epididymal obstruction or testicular necrosis. The aim of this study was to emphasize the epidemiological, clinical and therapeutical aspects of tuberculous epididymitis in adult. About eleven cases of epididymal localisation of urogenital tuberculosis, it appears that the diagnosis of the condition is rather difficult and often necessitate pathological exam of a specimen of epididymectomy. In other aspects, if antituberculous drugs are always effective in initial stages, surgery is usually radical, and rarely conservative. The latter procedures are vasovasostomy or vasoepididymostomy whose results are very hazardous.

Adult↗
PubMed1995

[Retinal complications in hemoglobinopathies: report of 32 cases].

Hemoglobinopathies especially sickle cell disease causes neovascularization in the retina and lead to hemorrhage. To gain insight into the features and incidence of this retinopathy, a study was carried out in Lome, Togo, in 32 subjects (mean age: 31.1 years) presenting hemoglobinopathy. There were 25 patients with SC disease, 3 with SS, 2 with AC, and 2 with A2F. All were examined by the same ophthalmologist and underwent fluorescein angiography. Retinopathy was observed in 22 of the 32 patients including 21 of the 25 patients (84%) with SC and one patient with AC who presented macular hemorrhage. The main findings in patients with SC were formation of new blood vessels in the peripheral retina characteristic of proliferating retinopathy in 11 cases, black sun spots characteristic of non-proliferating retinopathy in 3 cases, and evidence of vitreous hemorrhage in 2 cases. These findings confirm the high incidence and seriousness of retinal complications in patients with SC disease. Prevention is necessary and requires systematic screening to allow early detection of complications which can be treated by laser photocoagulation.

Adult↗
PubMed1994

[Delayed emergency repair of traumatic ruptures of the posterior urethra].

The management of posterior urethral injuries is still a matter of controversies. Some authors recommend a primary or delayed emergency repair procedure, while others prefer late repair. The analysis of our series of fifteen cases showed that when patients are treated by delayed emergency operation, the results are usually good. However, when repair is performed later, results are less satisfactory, and the rate of impotence is higher. We conclude that delayed emergency repair operation is the procedure of choice in the management of ruptured posterior urethra.

Adolescent↗
PubMed1992

[Conjugal sterility at Dakar CHU: epidemiological profile and evaluation limits apropos of 429 cases].

The writers draw up the outcome of the medical management of infertiles couples at Dakar's teaching hospital over a period of 7 years (1983-1989). Restrictives factors (low rate incomes, social and psychological obstacles) make that médical management difficult. The responsibilities are shared among the couple with sex ratio of 1 man for 3 women. Among the women the etiologies dominated are the sterility of the Phaloppe tubes (81%) among men with the oligo and the azoospermy (32 and 27%). Sterility within married couples is a problem of public health that becomes more acute every day. A better handling of this problem through preventive medicine and elementary sanitary training is necessary.

Adult↗
PubMed1992

["In-dartos" orchidopexy in the treatment of cryptorchism].

Undescended testis is a common congenital abnormality. The main complications are infertility and venue of malignant testicular tumor. If early orchiopexy can prevent infertility, it remains a high risk of venue of a malignant tumor. So, the best technique of orchiopexy is that which allows an easy clinical follow-up of the undescended testis after surgical treatment, and doesn't involv the hematoseminal barrier. From the analysis of fourty cases of scrotal pouch orchiopexy and a review of the literature, it appears that this procedure is efficient and gives more than 90% of good results.

Adolescent↗
PubMed1992

["In-dartos" orchidopexy in the treatment of cryptorchism].

Maldescended testis is a common congenital abnormality. The main complications are infertility and venue of malignant testicular tumor. If early orchiopexy can prevent infertility, it remains a high risk of venue of a malignant tumor. So, the best technique of orchiopexy is that which allows and easy clinical follow-up of the maldescended testis after surgical treatment, and doesn't involve hematoseminal barrear. From the analysis of fourty cases of scrotal pouch orchiopexy and a review of the literature, it appears that this procedure is efficient and gives more than 90% of good results.

Adolescent↗