Position and susceptibility to inflammation of vermiform appendix in Accra, Ghana

OBJECTIVES: To determine the normal (non-inflamed) position of the vermiform appendix in Ghana and carry out a pilot study to test the hypothesis "The retrocaecal appendix is less prone to inflammation". DESIGN: Retrospective autopsy study. SETTING: The pathology department and the department of surgery theatres of the Korle Bu Teaching hospital in Accra, Ghana SUBJECTS: Consecutive autopsies and inflamed appendices at appendicectomy. Deaths occurring from untreated appendicitis were excluded from the autopsy study. Conversely non-inflamed appendices and appendices from interval appendicectomy were excluded from the appendicitis study. RESULTS: There were 1358 autopsies and 323 inflamed appendices. In the autopsy study the retrocaecal position was the most common (914 [67.3%]). Other positions were pelvic (294 [21.6%]), preileal (66 [4.9%]), postileal (51 [3.8%]) and paracaecal (33 [2.4%]). These positions were similar in males and females. The positions of 323 inflamed appendices were: retrocaecal (183 [56.7%]), pelvic (66 [20.4%]), preileal (20 [6.2%]), postileal (15 [4.6%]) and paracaecal (39 [12.1%]). Comparing the nonretrocaecal to the retrocaecal position by chi square, the non-retrocaecal position was more prone to inflammation (p<0.001). CONCLUSION: The position of the normal appendix in Ghana differs from Western literature. The retrocaecal position appears less prone to inflammation in Ghanaians.     

Breast cancer risk in patients with breast pain in Accra, Ghana

OBJECTIVE: To determine the risk of breast cancer in patients presenting with breast pain in Accra, Ghana. DESIGN: Retrospective clinical study. SETTING: A self-referral breast clinic in Accra, Ghana. SUBJECTS: Patients with breast pain as a presenting complaint, between January 2001 and December 2005. INTERVENTIONS: Patients were investigated by triple assessment. RESULTS: There were 447 patients with pain, 322 as the only symptom and 125 in addition to other symptoms like breast lump and nipple discharge. Patients with pain only were found to have no detectable abnormality 203 (63%) and fibroadenosis 78 (24.2%) as the most common diagnoses. Breast cancer was found in four (1.24%) of them, all of whom had abnormality on clinical breast examination. In patients with pain as well as other symptoms the common diagnoses were fibroadenosis 25 (20%), breast cancer 20 (16%) and normal 18 (14.4%). CONCLUSION: The risk of breast cancer is significantly higher in patients presenting with breast pain in addition to other symptoms, compared to patients with breast pain as the only symptom (16% and 1.24% respectively P < 0.0001). Patients with breast pain should always have breast examination and not simply reassured. Women should be encouraged to do breast self examination.     

Variation in frequency in breeding of Anopheles gambiae s.l. and its relationship with in-door adult mosquito density in various localities in Accra, Ghana

The work reported in this paper was undertaken to determine whether in a large urban area like Accra, emerging Anopheles gambiae s.l. adults are likely to invade the nearest houses to obtain a blood meal. Using data from previous studies, the frequency in breeding was compared with adult density graphically and by scatter diagrams. Graphically, frequency in breeding was associated with adult density in eight districts while on the geometric scatter plot, these parameters were associated in ten districts. The finding of association of low frequency in breeding with moderate adult density in only one district and a correlation coefficient significant at p less than 0.001 on 14 degrees of freedom for 8 districts indicates that in the majority of districts, most adult mosquitoes invaded the nearest human habitation.     

根治性切开引流与单纯切开引流治疗肛周脓肿临床效果的比较研究

目的比较根治性切开引流与单纯切开引流治疗肛周脓肿的临床效果。方法选取我院2009年12月~2012年12月住院治疗的肛周脓肿患者76例,随机分为观察组和对照组,每组各38例。观察组行根治性切开引流术,对照组行单纯切开引流术,比较两组的临床治疗效果及术后感染控制时间、疗程、复发。结果观察组患者治疗结束后1例症状或体征无改变,1例出现肛瘘。对照组患者治疗结束后5例症状或体征无改变,3例出现肛瘘,观察组治疗后的总有效率达94.74%,明显优于对照组,组间比较,差异具有显著性(P<0.05)。观察组患者术后应用抗生素控制感染时间(3.1±0.8)d,总疗程达(19.2±1.3)d,分别与对照组比较,明显短于对照组,组间比较,差异具有显著性(P<0.05)。且术后随访1年,观察组患者复发5例,对照组患者随访期间复发11例,两组复发率分别为13.2%、28.9%,差异具有显著性(P<0.05)。结论根治性切开引流治疗肛周脓肿临床效果明显优于单纯切开引流术,可以缩短住院时间,复发率低,值得广泛推广和应用。