scholarly journals Drug Treatment of Patients with Liver Cirrhosis in a Tertiary Hospital in Northern Ghana: Does It Comply with Recommended Guidelines?

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Baba Sulemana Mohammed ◽  
Matthew Aidoo
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Teaching Hospital ◽  
Drug Disposition ◽  
Tertiary Hospital ◽  
Northern Ghana ◽  
Inappropriate Drug ◽  
Cirrhotic Patients ◽  
Tamale Teaching Hospital ◽  
Safety Guidelines

The diverse influence of liver function on drug disposition can lead health-care practitioners to inappropriate drug selection, inappropriate drug dosing, or some level of therapeutic negativism. The aim of this study was to assess how drug prescribing in patients with liver cirrhosis at the Tamale Teaching Hospital comply with recommendations of pharmacotherapy and safety guidelines. A prospective cross-sectional study was conducted from February to July, 2019, at the medical ward of the Tamale Teaching Hospital. A total of 152 liver cirrhotic patients were included in this study. Common etiologies for liver cirrhosis were chronic hepatitis B 80 (52.6%) and chronic hepatitis C 30 (19.7%); about 12.5% of etiologies were unknown. Of the 1842 prescription issued, 69% (1270/1842) were compliant. Of the 572 noncompliant prescriptions, about 32% (183/572) were due to pharmacotherapy and 68% (389/572) due to safety guideline recommendations. There was a substantial number (31%) of prescription noncompliance with recommendations for pharmacotherapy and safety guidelines in liver cirrhotic patients at the tertiary hospital in northern Ghana. Prescribers need to be conscious of the role of the liver in drug elimination and prescribe as recommended by guidelines.

scholarly journals Evaluation of management of snake bites in a teaching hospital in northern Ghana: a retrospective descriptive study

2019 ◽  
Vol 6 (3) ◽  
pp. 920
Author(s):  
Abdul-Subulr Yakubu ◽  
Alhassan Abdul-Mumin ◽  
Odalys Rivera
Keyword(s):  
Teaching Hospital ◽  
Health Hazard ◽  
Public Health Problem ◽  
Northern Ghana ◽  
Average Amount ◽  
Local Conditions ◽  
Rural Farmers ◽  
Snake Bites ◽  
The Mean ◽  
Tamale Teaching Hospital

Background: Snakebite is a public health problem afflicting mainly rural farmers. We seek to examine the profile and management of snakebite cases presenting to the Tamale Teaching Hospital of Ghana over a 30-month period.Methods: One hundred and ninety-two cases of snakebites presenting to the Tamale Teaching Hospital over a 30-month period from January 2016 to June 2018 were retrospectively analyzed. Information about the clinical manifestation of the snakebites, treatment instituted as well as the outcome was extracted from patient folders for the analysis.Results: Out of the 192 cases of snakebite, 131 (68.2%) occurred in males. The mean age of the victims was 26.5 years. The major patterns of envenomation were coagulopathy (84.9%) and local swelling/pain (82.8%). The causative snake species was identified in only 11.5% of cases, all of which were vipers. Antivenom was administered in 94.8% of the victims and the average amount administered was 84.64 milliliters (approximately 8 vials). Reaction to antivenoms was observed in 13.5% of cases, comprising mostly minor reactions. Antibiotics were utilized in 99.5% of cases with more than half receiving more than one type of antibiotic. Steroids use was common (62%) whilst 22.9% received antifibrinolytics despite the absence of evidence supporting their use in snakebite.Conclusions: Snakebite is an occupational health hazard of mainly rural farmers. The unwarranted use of non-beneficial medications is still rife. In addition to ensuring the continuous availability of effective antivenoms, there is the need for the development and adherence to protocols that take into consideration the prevailing local conditions.

scholarly journals Evaluation of management of snake bites in a teaching hospital in Northern Ghana- a retrospective descriptive study

2018 ◽  
Author(s):  
Abdul-Subulr Yakubu ◽  
Alhassan Abdul-Mumin ◽  
Odalys Rivera
Keyword(s):  
Teaching Hospital ◽  
Health Hazard ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Medical Personnel ◽  
Northern Ghana ◽  
Local Conditions ◽  
Rural Farmers ◽  
Snake Bites ◽  
Tamale Teaching Hospital

ABSTRACTBACKGROUNDSnakebite is a public health problem afflicting mainly rural farmers. We seek to examine the profile and management of snakebite cases presenting to the Tamale Teaching Hospital of Ghana over a 30-month period.METHODSOne hundred and ninety-two cases of snakebites presenting to the Tamale Teaching Hospital over a 30-month period from January 2016 to June 2018 were retrospectively analyzed. Information about the clinical manifestation of the snakebites, treatment instituted as well as the outcome was extracted from patient folders for the analysis.RESULTSOut of the 192 cases of snakebite, 131 (68.2%) occurred in males. The mean age of the victims was 26.5 years. The major patterns of envenomation were coagulopathy (84.9%) and local swelling/pain (82.8%). The causative snake species was identified in only 11.5% of cases, all of which were vipers. Antivenom was administered in 94.8% of the victims and the average amount administered was 84.64 milliliters (approximately 8 vials). Reaction to antivenoms was observed in 13.5% of cases, comprising mostly minor reactions. Antibiotics were utilized in 99.5% of cases with more than half receiving more than one type of antibiotic. Steroids use was common (62%) whilst 22.9% received antifibrinolytics despite the absence of evidence supporting their use in snakebite.CONCLUSIONSnakebite is an occupational health hazard of mainly rural farmers. The unwarranted use of non-beneficial medications is still rife. In addition to ensuring the continuous availability of effective antivenoms, there is the need for the development and adherence to protocols that take into consideration the prevailing local conditions.AUTHOR SUMMARYSnakebite affects mainly rural farmers and is a disease of poverty. Unreliable epidemiological data in developing countries like Ghana makes ascertaining the true extent of snakebite difficult. We have examined the presentation and clinical management of snakebite cases presenting to the Tamale Teaching Hospital of Ghana which serves a mainly rural population. The Carpet Viper, which produces a syndrome of local swelling and bleeding, is implicated in most snakebites in this region. A variety of non-evidenced-based interventions are employed by medical personnel in managing snakebite victims underscoring the need to have written contextually appropriate protocols for snakebite management. Public education is also needed to minimize the delays in seeking healthcare following a snakebite whilst efforts at ensuring the continuous availability of effective antivenoms must be intensified.

scholarly journals Insulin Resistance in Non Diabetic Chronic Hepatitis C patients

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Mohamed S. Zaghlol, Mohamed T. Al-Sayed Ahmed Qasem Mohamed,
Keyword(s):  
Insulin Resistance ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Serum Insulin ◽  
Healthy Controls ◽  
Fasting Serum ◽  
Cirrhotic Patients ◽  
Chronic Hepatitis C Patients

Patients with chronic hepatitis have impaired glucose metabolism with hyperinsulinemia and insulin resistance, this hyperinsulinemia has been shown to be due to decreased insulin catabolism rather than increased pancreatic insulin secretion.We aim to evaluate insulin resistance in non diabetic patients with chronic hepatitis C virus infection. our study was a case-control study conducted in Tropical Medicine and Gastroenterology Department AL-Azhar University Hospital. 60 patients and 30 healthy controls were included in the study. The patients were classified into two groups:Group A: 30 patients with chronic hepatitis C infection were selected with positive HCV RNA in serum for at least 6 months; Patients were not receiving anti-viral therapy at the time of sampling They showed no evidence of cirrhosis. Group B: 30 patients with HCV related liver cirrhosis. They were divided according to Child Pugh score; twenty patients with HCV related compensated liver cirrhosis (Child A) Ten patients with HCV related decompensated liver cirrhosis (Child B and C). Group C: The control group: included 30 healthy individuals.  All patients and control were subjected to the following: Liver function tests: Alanine transaminase (ALT), Aspartate transaminase (AST), total and direct bilirubin, total protein, serum albumin. Prothrombin time (PT) & international normalization ratio (INR). Renal function tests: Blood urea nitrogen (BUN), Na, K. Complete blood count. Alpha fetoprotein (αFP).  Overnight fasting and two hours postprandial blood glucose level. Fasting serum insulin of each individual.  Insulin resistance was  determined via the Homeostasis  Model assessment (HOMA-IR) Statistical analysis of data will be done by using SPSS(statistical program for social science version22,produced by IBM SPSS Inc.,Chicago,USA). Results: We found that out of 30 CHC and 30 LC (20 compensated LC, 10 de compensated LC) 8 (26.7%); 8 (40%) patients and 5(50%) respectively had HOMA-IR levels greater than 2.5, which is consistent with IR diagnosis. Decompensated cirrhotic patients showed higher frequency of IR compared  to CHC, and compensated cirrhotic patients. Coclusion: In chronic hepatitis C patients, HOMA-IR, fasting serum insulin and fasting blood glucose were significantly higher than healthy controls.

scholarly journals Peculiarities of clinical course of Wilson's disease in children

2021 ◽  
pp. 6-12
Author(s):  
V.S. Berezenko ◽  
◽  
V.V. Krat ◽  
T.D. Zadoroznaja ◽  
I.M. Andrusishina ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Wilson Disease ◽  
Fulminant Hepatitis ◽  
Wilson’S Disease ◽  
Clinical Symptoms ◽  
Wilson's Disease ◽  
Lower Serum ◽  
Serum Ceruloplasmin ◽  
Cirrhotic Patients

Purpose — to discover peculiarities of Wilson disease course in children dependently on the variant of liver affection. Materials and methods. Anamnesis of the disease and clinical and paraclinical peculiarities of the course of the disease with consideration of liver affection severity have been studied in 50 children aged 5–17 years. Results. It was estimated that in 52% of children the disease had a form of chronic hepatitis with minimal clinical symptoms, 44% of patients had liver cirrhosis with predominant signs of edematous and ascitic syndrome and 4% had fulminant hepatitis in a debut of the disease. Complicated family anamnesis was detected in 4% of patients. Syndrome of cytolysis predominated in patients with liver damage in the form of chronic hepatitis (р<0.05). Typical biochemical changes in cirrhotic patients were hepatocellular insufficiency with hypoalbuminemia and coagulopathy, hyperbilirubinemia and minimal hypertransaminasemia (р<0.05). Children with cirrhosis in contrast to patients with chronic hepatitis had reliably lower serum ceruloplasmin concentration and reliably higher excretion of copper with urine. Specific for Wilson disease Kayser—Fleischer rings were found out in 36% of patients only. Conclusions. Wilson's disease in children is characterized by progressing course in the form of either chronic hepatitis or liver cirrhosis or, rarely, fulminant hepatitis. Clinical and paraclinical symptoms of the disease are estimated by the severity of liver affection and vary from a course with minimal symptoms in patients with chronic hepatitis to edematous and ascitic syndrome and hepatocellular insufficiency in patients with cirrhosis and fulminant hepatitis. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Wilson's disease, children, chronic hepatitis, liver cirrhosis, course of the disease.

Barriers to Timely Presentation of Patients with Surgical Conditions at Tamale Teaching Hospital in Northern Ghana

2018 ◽  
Vol 43 (2) ◽  
pp. 346-352 ◽  
Author(s):  
Stephen Tabiri ◽  
Ali Jalali ◽  
Richard E. Nelson ◽  
Michael C. Damah ◽  
Francis A. Abantanga ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Northern Ghana ◽  
Surgical Conditions ◽  
Tamale Teaching Hospital

scholarly journals Polymorphisms of α1-antitrypsin and Interleukin-6 genes and the progression of hepatic cirrhosis in patients with a hepatitis C virus infection

2016 ◽  
Vol 19 (2) ◽  
pp. 35-44 ◽  
Author(s):  
T Motawi ◽  
OG Shaker ◽  
RM Hussein ◽  
M Houssen
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Interleukin 6 ◽  
Liver Diseases ◽  
Multivariate Regression Analysis ◽  
Nucleotide Polymorphisms ◽  
Cirrhotic Patients ◽  
Chronic Hcv

AbstractHepatitis C virus (HCV) infection represents a serious health problem. The –174 G/C mutation in the pro inflammatory cytokine interleukin-6 (IL-6) is associated with developing liver diseases. Likewise, the S and Z mutations in the serine protease inhibitor α1-antitrypsin (A1AT) are associated with pulmonary emphysema and/or liver cirrhosis. We explored the distribution of the single nucleotide polymorphisms (SNPs) ofIL-6andA1ATgenes in chronic HCV-infected patients and evaluated their impact on the progression of liver cirrhosis.One hundred and fifty Egyptian HCV-infected patients together with 100 healthy controls were enrolled in this study. The patient groups were subdivided into chronic hepatitis patients (n= 85) and cirrhotic patients (n= 65). The SNP of IL-6 (–174 G/C, rs1800795), A1AT Z mutation (342 Glu/Lys, rs28929474) and A1AT S mutation (264 Glu/Val, rs17580) were determined using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Cirrhotic patients exhibited significantly increased frequency of the A1AT S allele compared with the controls (34.6vs. 5.0%), while the chronic hepatitis patients showed a higher frequency of the A1AT Z allele compared with the controls (14.7vs. 2.5%). Remarkably, IL-6 (CC genotype) was detected only in the chronic hepatitis patients. Multivariate regression analysis showed that aspartate transaminase (AST) and the S alleles of A1AT, represented as SS+MS genotypes, were significantly independent predictors for development of liver cirrhosis. We concluded that inheritance of deficient S and Z alleles of theA1ATgene but not IL-6 (–174 G/C), were associated with progressive liver diseases.

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