Health Sciences Investigations Journal

Welcome message from the Editor-in-chief 2023

2023-12-13T13:51:24+00:00

The Health Sciences Investigations Journal (HSI Journal) is pleased to present Volume 4 Issue 2, featuring an expanded selection of sixteen articles, including eleven original research articles, four medical case reports, and one clinical image. This substantial increase from the previous eight articles is attributed to the Journal's recent indexing in both African Journals Online (AJOL) and Elsevier's Scopus, a prestigious research database. This recognition positions the HSI Journal to make a significant impact on the global biochemical and clinical communities. Additionally, the Journal is actively pursuing indexing in other prominent online repositories, such as PubMed. To achieve this goal, we are continuously striving to enhance the quality of our publications with each issue. Since our indexing in Scopus, we have received an influx of manuscript submissions from Ghana and other regions. Our dedicated team is committed to further enhancing the Journal's visibility and recognition in PubMed and other online repositories. We extend our sincere gratitude to the Editorial Board members and reviewers for their invaluable contributions and suggestions in making this achievement possible. We also acknowledge the immense support and guidance provided by the Technical Team, Advisory Board, all authors, and publishers.

"Orchestrated" A painting motivated by the essence of love

2023-12-13T16:28:37+00:00

The man, portrayed with strength and confidence, has his arm lovingly draped over the woman's shoulders. His touch is both protective and affectionate, symbolizing his devotion to her. His hand rests gently on her shoulder, conveying a sense of comfort and reassurance. The woman, depicted with grace and elegance, leans into the man's touch, her face adorned with a serene expression. Her eyes reflect a deep sense of trust and adoration, as she gazes affectionately at her partner. Her body language suggests a sense of ease and contentment, as if she feels safe and cherished in his embrace. Surrounding the couple, the
background is a subtle blend of muted colors, allowing the couple to remain the focal point of the artwork. The absence of any specific setting or context emphasizes the timeless and universal nature of their love.

Urethral calculi: An uncommon but important cause of urinary retention in females

2023-12-13T13:10:37+00:00

Urinary retention is a stressful situation that requires appropriate and prompt management [1]. When it occurs, it leads to anxiety, pain and lower abdominal
discomfort [1]. When it is long-lasting, the backpressure of urine that results from the obstruction can lead to hydroureters and hydronephrosis, which can lead to kidney injury. Urethral obstruction in females is caused by previous incontinence surgery, urethral stricture and external obstruction of the urethra, such as from pelvic tumours like uterine fibroids and cervical cancer, among others [2].

Patients satisfaction with the quality of care upon implementation of electronic health records system at the 37 Military Hospital, Ghana

2023-12-15T10:48:44+00:00

Background: To resolve delays faced by patients when accessing health services, the electronic health records system (EHRs) was introduced as part of the health management information system (HMIS) to enhance the quality of care.
Objective: This study assessed patients' satisfaction with the quality of care upon the implementation of the electronic health records system at the 37 Military Hospital in Ghana.
Methods: The study adopted a cross-sectional study design using a quantitative method. A simple random sampling method was applied to recruit 228 outpatients who were seeking healthcare at the time of data collection to respond to a structured questionnaire. A Chi-square test and logistic regression analysis were used to assess the association between the dependent variable and independent variables. A p-value of 0.05 at a 95% confidence interval was used as the threshold for statistical significance.
Results: The results showed a high quality of care with respect to attention to patients' needs (M = 3.68, SD = 0.525), the responsiveness of health providers to emergencies (M = 3.81, SD = 0.651), the efficiency of services rendered (M = 3.78, SD = 0.576), timeliness of healthcare
(M = 3.78, SD = 0.576), patient-provider communication (M = 3.42, SD = 0.683) and general patients' care (M = 3.86, SD = 0.528). Similarly, the results showed high patient satisfaction in relation to waiting time for services (M = 4.32, SD = 0.93), adequacy of attention from health providers (M = 3.29, SD = 0.98), health provider-patient relationship (M = 3.63, SD = 1.05) and level of service provision after the implementation of EHRs (M = 3.89, SD = 0.95). Efficiency of services rendered (OR = 0.36, 95% CI; 0.276, 0.653, p < 0.05), timeliness of healthcare (OR = 0.42, 95% CI; 0.153, 0.693, p < 0.05), and general patients' care (OR = 0.43, 95% CI; 0.023, 0.678, p < 0.05) were strong predictors of patients' satisfaction.
Conclusion: The study demonstrated patients' overall satisfaction with the operation of electronic health records systems. The study recommends that the management of the 37 Military Hospital should continuously improve the quality of care of the health services to ensure sustained patient satisfaction.

Uptake of COVISHIELD vaccine and post-vaccination symptoms among healthcare workers at an academic primary care facility in Ghana.

2023-12-19T12:40:42+00:00

Background: The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected health systems globally. Although a safe, effective, and widely accessible vaccine is crucial to ending the pandemic, the results of studies on the acceptability of vaccines among healthcare workers (HCWs) globally have been conflicting. Documented post-vaccination experiences are also limited. This study describes the uptake of the first dose of the COVISHIELD vaccine and analyses the pattern of post-vaccination
symptoms among HCWs in Ghana.
Objective: This study sought to assess the uptake of the first dose of the COVISHIELD vaccine and analyse the pattern of post-vaccination symptoms among HCWs.
Methods: A cross-sectional survey was conducted at the Korle Bu Polyclinic/ Family Medicine Department (KPFMD) of the Korle Bu Teaching Hospital, Accra, in March 2021. Survey participants (n = 188) were staff of the department who completed a structured questionnaire within one week of receiving their first dose of the vaccine. The vaccine uptake rate was estimated from those who received the vaccine (n = 255) as a percentage of the total staff number at the department (n = 314).
Results: The uptake rate of the first dose of the COVISHIELD vaccine among HCWs was 81.2% (n = 255/314). The most frequently occurring post-vaccination symptoms were general malaise, headache, injection site pain and swelling, tiredness, muscle aches and fever.
These symptoms were largely mild to moderate in severity and occurred mostly within 24 hours after vaccination. Of the 84.6% (n = 159) respondents who reported at least one post-vaccination symptom, 77.4% (n = 123) took analgesics to manage their symptoms. There was no significant association between age, sex, chronic health condition, a previous positive test for COVID-19 and experiencing post-vaccination symptoms.
Conclusion: A high proportion of HCWs received the COVISHIELD vaccine in this study. The study's findings are comparable with prior studies that indicated that the vaccine is generally safe and well-tolerated. Various stakeholders in Ghana should continue to educate, reassure and encourage the population to accept the vaccine as a key intervention towards containing the pandemic.

The spectrum of computed tomography calcium scoring values of individuals testing for coronary artery disease in Accra: a study from a peripheral private clinic in Southern Ghana.

2023-12-19T10:13:21+00:00

Background: Coronary artery disease is a significant cause of morbidity and mortality globally. Most people with coronary artery disease are asymptomatic, making its early detection with coronary artery calcium scoring using multidetector computed tomography an important aspect of its management.
Objective: Our study aimed to describe the spectrum of computed tomography findings (such as the absolute coronary artery calcium scores and coronary artery risk percentiles) and associated risk factors of 325 patients evaluated for coronary artery disease in Accra.
Methods: The study was a retrospective study involving retrieving electronically stored coronary artery calcium score reports for 325 patients reported by two radiologists. Patient information, including weight, blood pressure, and a history of diabetes mellitus and hypertension, were recorded. Data were analysed using Statistical Package for the Social Sciences version 23.
Results: There were 62.2% (n = 202) males and 37.8% ( n = 123) females. Of the total number, 44.6% (n = 145) had a normal coronary artery calcium score of 0, while 55.4% (n = 180) had values ranging from 1 to 2,690 (mean 109.0 ± 325.4). The two most prevalent modifiable risk factors for coronary artery disease recorded for individuals with coronary artery calcium score above 0 were an abnormality of weight (overweight and obesity) and hypertension in decreasing order. A significant relationship was observed between coronary artery calcium
scoring and age (p = 0.001).
Conclusion: Our study showed that more than half of the participants had coronary artery calcification; abnormalities of weight followed by hypertension were the two commonest risk factors for CAD in Accra, and CAD occurred in individuals as young as 30 to 39 years old

Management of Acute Respiratory Distress Syndrome (ARDS): clinicians' knowledge and practice

2023-12-15T07:11:59+00:00

Background: Acute Respiratory Distress Syndrome (ARDS) is common in the Intensive Care Unit (ICU) setting and is associated with high mortality. Delayed diagnosis and failure to institute evidenced-based management have been associated with poor outcomes. Knowledge of the diagnostic criteria for ARDS and the adoption of recommended management practices by clinicians in the ICU is therefore required to reduce mortality.
Objective: This study sought to assess the knowledge and current management practices of ARDS among clinicians in a surgical ICU of the Korle-Bu Teaching Hospital.
Methods: This was a cross-sectional study involving a purposive sample of 15 clinicians (Specialist Anaesthesiologists) who work at the Korle-Bu Teaching Hospital Surgical ICU. A self-administered structured questionnaire was used to obtain data on the sociodemographic characteristics, knowledge and management practices of clinicians on ARDS. Clinicians' knowledge and management practices were scored based on conformity with the ARDSnet Ventilatory Protocol. Categorical data were summarised as frequencies and proportions, and continuous data as Mean ± standard deviation.
Results: Clinicians (Specialist Anaesthesiologists) had good knowledge about ARDS (Mean knowledge score = 21.00 ±3 .87), and their management practices were above average (Mean practice score = 8.53±2.50). The clinicians rarely (40%) or never (60%) practised prone ventilation.
Conclusion: Specialist Anaesthesiologists had good clinical knowledge of ARDS and applied appropriate management strategies. However, prone ventilation was rarely adopted

Predictors of in-hospital mortality of patients with COVID-19 infection in a major treatment facility in Ghana

2023-12-15T07:12:01+00:00

Background: An estimated 17 – 18% of hospitalised COVID-19 patients die. This has been attributed to varying symptomatic, prophylactic, patient management and health care factors. However, these factors have been shown to vary with population and setting dynamics. There is limited literature on the impact of these factors on COVID-19 mortality in the Ghanaian setting. This study, therefore, assessed the factors associated with mortality among COVID-19 hospitalised patients.
Objective: The study aimed to assess the clinical and health-related factors associated with the mortality of COVID-19 patients admitted to a major treatment facility in Ghana.
Methods: We conducted a retrospective study at Ghana Infectious Disease Center, involving a review of data collected on patients admitted to the facility from January 2021 to December 2021. Using a data abstraction tool on KoboCollect, data on patient sociodemographic characteristics, clinical presentation, underlying conditions and vaccination status were extracted from patient folders and other inpatient registers. We analysed the data and estimated Odds ratios and their respective 95% CI intervals.
Results: Out of the 271 patients admitted to the hospital within the study period, 8.86% (95% CI: 5.76 – 12.89) died. Being diabetic (aOR = 2.62, 95% CI: 1.08 - 6.35), having a cardiovascular-related disease (aOR = 4.06, 95% CI: 1.03 – 15.91), having a kidney disease (aOR = 4.56, 95% CI: 1.40 - 14.92), a chronic lung disease (aOR = 4.42, 95% CI: 1.45 - 13.53), and longer duration of admission (aOR = 1.06, 95% CI: 1.01 - 1.11) were associated with increased odds of death among the patients. Being vaccinated (aOR = 0.40, 95% CI: 0.11 - 0.49) was associated with a reduction in the odds of death among the patients.
Conclusion: This study revealed a less than 10% mortality rate among the patients. Being unvaccinated, having an underlying condition (diabetes, cardiovascular-related diseases, chronic lung diseases and kidney disease) and having a longer duration of admission in the hospital were associated with increased risk of death among the patients.

Swallowing difficulty among stroke patients at a primary-care facility and its association with their nutritional risk

2023-12-15T10:35:54+00:00

Background: Swallowing difficulty is common in stroke patients and is associated with prolonged inadequate food intake. This eventually leads to malnutrition and dehydration and contributes appreciably to stroke complications and mortality rates. The associated nutritional risk is often undetermined.

Objectives: To determine the prevalence of swallowing difficulty among stroke patients and its association with their dietary intake and nutritional risk.

Methods: Study design was cross sectional involving 57 stroke in-patients recruited from the Polyclinic, Korle-Bu Teaching Hospital. Swallowing difficulty and dietary intake were assessed using the water swallowing test and 24-hour recall interviews respectively. Nutritional risk was determined using the Nutritional Risk Screening tool (NRS-2002). Data was analysed using SPSS version 21.0 at a 95% confidence interval. Significance was set at p < 0.05.

Results: Mean age was 64.3 ± 15.9 years. Majority (57.9%) had swallowing difficulty with a 25-fold higher nutritional risk compared to those without swallowing difficulty [R² =34.3%; OR= 25.3; p < 0.001 (CI= 4.97-128.72)]. Median daily energy intake was significantly lower in the former [628kcal; (483-1003)] compared to the latter [(1,017kcal; 600-1586); p = 0.025].

Conclusion: Over half of participants had swallowing difficulty with a significantly higher nutritional risk and lower daily energy intakes. Early routine assessment of nutritional risk, followed with timely appropriate interventions is strongly advocated as part of standard operating procedures for stroke management in primary care, to reduce stroke complications and mortality rates.

Risk of hypertension in adult patients on antiretroviral therapy: a propensity score matching analysis

2023-12-15T07:12:04+00:00

Background: Hypertension is a major risk factor that contributes to cardiovascular diseases in adults with HIV infection. Although a relationship exists between antiretroviral therapy (ART) and components of the metabolic syndrome, it is unclear whether HIV or antiretrovirals are explanatory risk factors for hypertension in Persons Living with HIV (PLWH). The present study used propensity-scoredmatching (PSM) analysis to estimate ART's average treatment effect (ATT) on blood pressure and hypertension in PLWH.
Objective: The present study used PSM analysis to estimate the average treatment effect of ART on blood pressure and hypertension in patients attending the HIV clinic at the Korle-Bu Teaching Hospital (KBTH) in Accra.
Methods: A hospital-based comparative cross-sectional study was conducted at the HIV Clinic of the Korle-Bu Teaching Hospital in Accra, Ghana. A simple random sampling technique was used to recruit 59 ART-exposed and 59 ART-naïve study participants. The ATT was estimated using the kernel matching or weighting strategy with a bandwidth of 0.06, and standard errors were bootstrapped with 150 replications.
Results: The prevalence of hypertension in the ART-exposed and ART-naive study participants in the final propensity score-matching sample was 42.4% (95% CI, 36.2 - 48.8) and 17.0% (95% CI, 9.3 - 28.9) respectively and the estimated ATT was 26.2% (p < 0.001) indicating a statistically significant difference between the ART-exposed group and the ART-naive group. The estimated ATT on systolic blood pressure was 12.0 mmHg (95% CI, 5.7 - 18.3; p < 0.001) and that on diastolic blood pressure was 6.1 mmHg (95% CI, 1.3 - 10.8; p = 0.012)
Conclusion: A plausible causal link is reported between ART and hypertension. Significant ATT of ART suggests increases in blood pressure values represent a transition from association to causation. This transition could be a significant step in policy formulation in taking preventive action against hypertension and its complications among PLWH.

Functional status and quality of life of women with infertility in Southern Ghana: A cross-sectional study

2023-12-15T07:12:06+00:00

Background: The desire to have children seems more intense in cultures that perceive childbearing as the primary reason for marriage. In such cultures, infertility reduces the functional status of women.
Objective: This study investigated the relationship between functional status and quality of life of women with infertility in selected fertility centres in Ghana.
Methods: A total of 167 women were recruited from four infertility treatment hospitals in Southern Ghana. Two standardised questionnaires were used: Functional Status and the Fertility Quality of Life questionnaire (FertiQol). A cross-sectional design was used to examine the relationship between functional status and fertility-related quality of life (FertiQol). Pearson product-moment correlation and multilinear regression analysis were performed using the Statistical Package for Social Science (SPSS) version 20.0.
Results: The result of the Pearson product-moment correlation showed a statistically significant strong positive correlation between mental health and core areas (emotional, mind/body, relational and social) of fertility-related QoL (r = 0.616, p < 0.001). The regression analysis indicated the demographic characteristics and functional status of the women collectively explained approximately 44% of the variance in the women's Core FertiQoL (R2 = 0.437, F (12, 125) = 8.081, p < 0.001). Individual evaluation of the predictors showed that mental health (p < 0.001) and quality of social interaction (p = 0.005) statistically significantly contributed to the functional status of the women.
Conclusion: The findings suggest that to improve the quality of life (QoL) of women's infertility, their quality of social interaction, mental health, and work performance should be considered in their treatment and general care.

Anaemia and Dietary Diversity among Pregnant Women in Margibi and Grand Cape Mount Counties, Liberia.

2023-12-15T07:12:08+00:00

Background: Globally, anaemia remains a severe public health concern among women of reproductive ages, including pregnant women in developing countries such as Liberia. Poor dietary diversity is a major contributor to micronutrient deficiencies. However, there is limited documentation of anaemia prevalence and dietary diversity among pregnant women in Liberia.
Objective: The present study assessed the prevalence of anaemia and dietary diversity among pregnant women in the Margibi and Grand Cape Mount Counties in Liberia.
Methods: The study design was cross-sectional. Systematic sampling was used to recruit 139 pregnant women between 15 - 49 years from antenatal clinics in Margibi and Grand Cape Mount counties. Dietary intake obtained from a 24-hour recall was used to assess dietary diversity following the FAO dietary diversity determination protocol for women in their reproductive ages. Anaemia was determined from blood
obtained from finger pricks using a Hemocue.
Results: Nearly all the pregnant women (98.1%) consumed grains. Conversely, only a few women (23.7%) consumed vitamin A-rich fruits and vegetables. Anaemia was discovered in 54% of the pregnant women. The mean haemoglobin level was 10.44 ± 1.46 g/dl. The mean Minimum Dietary Diversity among women of reproductive age (MDD-W) was 3.57 ± 1.01. There was no significant association between anaemia and dietary diversity among 12 pregnant women. Poor dietary diversity was observed in 83.5% of the pregnant women, 85.1% in Margibi and 80.8% in Grand Cape Mount, respectively.
Conclusion: This study confirms evidence of anaemia and poor dietary diversity among pregnant women. It highlights evidence for the need to encourage and improve diversity in dietary intake. This can be achieved through awareness, education and knowledge of dietary diversity during pregnancy.

Pathological gambling is an underestimated risk factor for pilfering and suicide in Ghana: a case report

2023-12-15T10:13:31+00:00

Background: Gambling is a game of chance that involves putting money or something of value at risk to gain something better. Currently, in Ghana, sports betting is a growing public health concern. We present a case report of a 29-year-old accountant who presented with a year duration of recurrent suicidal thoughts, two years of depressive symptoms, and a four-year history of pilfering due to obsessive internet gambling. His symptoms were successfully managed at the Psychiatry Department of Korle-Bu Teaching Hospital. Pathological gambling is an underestimated risk factor for theft, depression, and suicide in Ghana. However, most people are unaware that it is a psychiatric condition that is manageable in the hospital. Advocacy, education, and publicity of pathological gambling as a psychiatric condition are needed to create awareness in the general public

Advanced secondary abdominal pregnancy: a case report

2023-12-15T10:00:07+00:00

Background: Abdominal pregnancy, although a rare condition, has life-threatening consequences. This case report aims to expose the clinical and diagnostic challenges encountered in its management. We report a case of a 28-year-old gravida 2, para 1 woman, 35 weeks pregnant, who presented to Korle Bu Teaching Hospital with generalised abdominal pain and an ultrasound indicating a major-degree placenta previa.
A repeat ultrasound assessment identified a viable abdominal pregnancy with the placenta attached to the uterine fundus. An emergency hysterectomy was done on account of a massive haemorrhage after the delivery of a live female foetus.

Orbital tuberculosis mimicking an ocular malignancy: a case report

2023-12-15T07:12:13+00:00

Background: Tuberculosis (TB), a multi-systemic disease caused by Mycobacterium tuberculosis, is associated with a high burden of morbidity and mortality worldwide. The diagnosis of TB in children is challenging, particularly when it presents in rarer sites such as the eye. We present a case of a female Ghanaian toddler with a right orbital mass which mimicked an orbital malignancy and was confirmed as TB on histopathology. This case report highlights the need for a high index of suspicion for TB among children who present with orbital masses, especially in TB-endemic regions.

Urethral calculus causing retention of urine in a female

2023-12-15T07:12:15+00:00

Abstract: Urethral calculi (stones) have been noted to be extremely rare in females due to their short urethra that has a straight course. And for such a calculus (stone) to cause retention of urine is extremely rare. Its management is to retrieve the calculus if it is small as to traverse the external Urethral meatus. This is best avoided if the calculus is large , in such a situation the calculus is manipulated back into the bladder and fragmented. The image of a urethra calculus impacted in the urethra of a female and causing retention of urine is presented in this clinical image with the intended course of management stated.