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Biomedical subjects

E Y Kwawukume

Publications and source records attributed to E Y Kwawukume.

12 recordsLinked to original sources
PubMed2003

Ghana postgraduate obstetrics/gynecology collaborative residency training program: success story and model for Africa.

OBJECTIVE: We describe a residency program in Ghana that was developed to train obstetrics/gynecologist specialists for Ghana and the subregion to promote and manage the reproductive health of women and to reduce a high maternal mortality rate. STUDY DESIGN: The Carnegie-supported program, begun in 1989, is a 5-year residency in the two medical schools in Ghana, but with one central coordinating office. It has features that equip the graduate resident to practice in his/her environment. The fourth year of the program is unique: the resident attends a hospital management course for 3 months, goes for a clinical rotation in the United States or United Kingdom for 3 months, and moves to live and work in a rural district hospital for 6 months. RESULTS: The success rate of the Ghanaian residents in the examination of the West African College of Surgeons has been three to four times higher than the overall pass rate. As of October 2002, the program had produced 26 specialists, all of whom are practicing in Ghana. In contrast, of 30 specialists who were trained abroad between 1960 and 1980, only 3 specialist had returned home by the end of the 1980s. The current chairpersons of the two medical schools are graduates of the program. Carnegie financial support for the program came to an end in January 2000, but the Ghana Ministry of Health has increased its support enthusiastically. The program is being sustained. Maternal mortality and morbidity rates are falling slowly in the two teaching hospitals; case fatality rates have been reduced markedly. New residents are entering the program and are progressing to completion. CONCLUSION: The program has been an unqualified success and merits replication.

Education, Medical, Graduate↗
PubMed2001

Caesarean section in developing countries.

In developing countries, obstetric practice, including the performance of caesarean section, is complicated by problems that are no longer seen in developed countries. The various indications for caesarean section might be the same but the operation is often technically more difficult to perform in developing areas. Developing countries lack resources. This chapter highlights the problems encountered in the developing world. Because cephalopelvic disproportion is one of the main indications for performing caesarean section in our sub-region, the technique of delivery of the impacted fetal head is discussed and alternatives to caesarean section are also suggested. The current view on myomectomy at caesarean section is described; including the technique of bloodless myomectomy at caesarean section. It is hoped that, with the training of postgraduate doctors in anaesthesia and obstetrics, the delivery of obstetric care will be accessible to rural areas in the developing world.

Anesthesia, Obstetrical↗
PubMed1995

Oral nifedipine therapy in the management of severe preeclampsia.

OBJECTIVE: The purpose of this study was to compare the efficacy of nifedipine (Cordipin) and hydralazine in lowering blood pressure in severe preeclampsia. METHOD: A randomized, prospective study of 104 patients with severe preeclampsia in the Department of Obstetrics and Gynecology, Korle-Bu Teaching Hospital, Accra, Ghana, was conducted between January 1992 and June 1994. RESULTS: Of the 104 patients recruited into the study, six did not deliver at our hospital and were thus excluded from the study. Nifedipine and hydralazine as first-line drugs controlled the blood pressure in 44 and 35 patients, respectively, but failed in 5 and 14, respectively. This was statistically significant (P < 0.05). The mean birth weight was higher in the nifedipine group (2500+/-800 g vs. 2400+/-800 g). There were 11 admissions to the neonatal intensive care unit in the nifedipine group and 13 in the hydralazine group but the difference was not statistically significant. CONCLUSION: Nifedipine and hydralazine could both be used effectively to control blood pressure in severe preeclampsia in our subregion. While hydralazine is administered intravenously and needs strict monitoring, nifedipine is more effective, is easy to administer orally, less demanding on hospital staff, convenient and more predictable.

Administration, Oral↗
PubMed1994

Construction of an artificial vagina with sigmoid colon in vaginal agenesis.

OBJECTIVES: The study of 15 cases of colonic reconstruction for absent vagina. The outcome in cases of reconstruction of an artificial vagina using the colon is evaluated. METHODS: Fifteen female patients with congenital absence of vagina who were evaluated and treated with sigmoid colonic reconstruction at the Korle-Bu Teaching Hospital in Accra, Ghana were studied. RESULTS: This reconstructive method is successful in patients having a functioning vagina without progressive shrinkage or other symptoms. Disfigurement of the thighs and labia are avoided as is the need for active manipulation. CONCLUSION: Sigmoid colonic reconstruction for vaginal agenesis is an acceptable method especially in the developing world.

Adolescent↗
PubMed1993

Maternal height as a predictor of vaginal delivery.

OBJECTIVE: The purpose of the study was to establish a relationship between maternal height and vaginal delivery. METHOD: A prospective study of 900 primigravidas in labor in the Department of Obstetrics and Gynecology, Korle-Bu Teaching Hospital was conducted. A questionnaire was developed and administered by research assistants. The results were analyzed using the X2-test. RESULTS: Of the 900 patients who delivered, 538 were studied. The remaining patients were excluded from the study because of factors described under exclusion criteria. A critical height of 154 cm was chosen as the screening height for 'at risk' of cephalopelvic disproportion (CPD). This height would identify 71.1% of women who would develop CPD. CONCLUSION: Short women with heights up to 150 cm are at risk of failing spontaneous vaginal delivery and should be referred to hospitals where labor could be closely monitored and cesarean section performed if necessary.

Body Height↗
PubMed1993

Menopausal age of Ghanaian women.

OBJECTIVE: The purpose of the study was to determine the age of menopause among Ghanaian women. METHOD: A prospective survey involving 152 women in Akosombo District in Ghana was conducted. A questionnaire was developed including: age at menopause, symptoms of hot flushes or flashes, palpitations, anxiety, sleeplessness, headaches, frequency of urine, depression, irritability, tiredness, weight gain, poor memory and attitudes to coitus. RESULT: Of 152 women interviewed, 29 were excluded because they were not sure of their birth dates and 123 women were analyzed. The mean and median ages at menopause were 48.05 years +/- 3.62 S.D. and 48 years respectively. The major symptoms at menopause were tiredness 79.9%, sleeplessness 71.0%, palpitations 63.7%, weight gain 61.8%, hot flushes 56.5%, and irritability 56.5%. However, 85.6% of the women who experienced hot flushes reported this to be the most unpleasant. CONCLUSION: 1. The age at menopause in Ghanaian population was 48.05 +/- 3.62. 2. Tiredness, sleeplessness, palpitations, weight gain, hot flushes, irritability, anxiety and headache were the major symptoms at menopause. 3. Hot flushes or flashes was the most disturbing symptom at menopause.

Age Factors↗
PubMedDate not supplied

Eosinophilic enteritis--a diagnostic dilemma.

Eosinophilic enteritis is a rare condition of unknown aetiology, although it is generally believed to be due to intestinal allergy. It may mimic peptic ulcer, subacute (or chronic) intestinal obstruction, gastroenteritis, irritable bowel syndrome, and inflammatory bowel disease. The diagnosis is often difficult to make and most cases are only diagnosed after laparotomy/ laparoscopy and biopsy. It can be successfully treated with corticosteroids. We report a case of Eosinophilic enteritis in a 27 year old woman the symptoms of which appeared within six weeks of childbirth. With repeated episodes of abdominal pain, vomiting, occasional loose stools with weight loss, she was investigated and treated for many weeks in three hospitals without success. All investigations were inconclusive. Finally laparotomy revealed inflamed segments of small bowel, a biopsy of which showed Eosinophilic enteritis. The patient was subsequently treated successfully with Prednisolone.

Abdominal Pain↗
PubMedDate not supplied

Spontaneous rupture of the liver in severe preeclampsia. Case report.

Uncontrolled haemorrhage is the most common cause of death after spontaneous rupture of the liver in pregnancy. This severe complication of pregnancy-induced hypertension is associated with a high rate of both maternal and fetal mortality, and aggressive therapy should be instituted including treatment of haemorrhagic shock, control of hepatic bleeding, and delivery.

Adult↗