• Vesicocutaneous fistula in a 25 year old
    Urology

    Vesicocutaneous fistula in a 25 year old

    25 year old man was impaled on a cassava 6years ago. The event occurred during an attempt to catch bush rat. Patient tripped and fell on the cassava plant. A piece of the cassava plant pierced his right inguinal region. Patient broke of the remaining portion sticking out of the wound. He reported to a private health facility. He was evaluated with x-rays but no foreign body was found. The entry wound was closed primarily. He was discharged on antibiotics and analgesics. Several months after being discharged the, patient felt discomfort around the left perianal  region on siting down. This worsened over time causing him to drop out of school.…

  • Housemanship—-the deep thoughts of a doctor
    Uncategorized

    Housemanship—-the deep thoughts of a doctor

    Definition of a houseman In my opinion, a house officer is one who by the regulation of the Medical and Dental Council, Ghana has just completed medical school and undergoes training for a period of two years as a medical doctor under the supervision of senior colleagues permanently registered with the above council in order to be equipped with the knowledge and practices in the management of basic medical and surgical conditions that daily present to the hospital. Training Structure During this period, a houseman is required to rotate through the four core specialities, namely Medicine, Surgery, Obstetrics and Gynaecology and Child Health. I am Dr. Birgit Baah and currently…

  • housemanship in the teaching hospital….a critical look
    Uncategorized

    Housemanship in the teaching hospital….a critical look

    MY EXPERIENCE AS A HOUSEOFFICER AT KATH. According to Collins dictionary, a house officer is “a doctor who is the most junior member of the medical staff of a hospital”. The housemanship period which lasts for 2 years is a period of internship which commences after successfully passing the requisite examination and during this period the house officer undergoes training to consolidate and improve skill in medical care under supervision in an accredited institution. It lasts for a period of 2 years during which a trainee is expected to rotate through four different directorates namely; medicine, surgery, child health and obstetrics and gynaecology lasting six month each. Since it is…

  • Fellowship Training in Ghana- current challenges
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    Fellowship Training in Ghana- current challenges

    Post membership training has for the past 7 years  been saddled with challenges. One of the reasons for failure to complete the program is inability of trainees to submit thier dissertation. This factor though not the only one , has led to many post part one trainees staying in the program for too long. The colleges of training namely Ghana college of physicians and surgeons and the west African College of surgeons are available. What does it take to get into fellowship training? 1. Pass your membership examination 2. Attend an interview if you have intention of doing fellowship with Ghana college 3. With WACS , you don’t need to…

  • IVUmed USA -KATH UROLOGY SIX-DAY PAEDIATRIC UROLOGY WORKSHOP
    Urology

    IVUmed USA -KATH UROLOGY SIX-DAY PAEDIATRIC UROLOGY WORKSHOP

    Paediatric urologists from the US in collaboration with the Urology unit, KATH has embarked on a six day workshop ( 10th – 15th February). The program drew practicing urologists from various parts of the country. Case selection was done over several weeks prior. Basic labs , anaesthetic assessment and consent forms were obtained. Bed spaces were created on the various surgical wards for the cases. Theatre nurses, anaesthesiologists , scrub nurses , residents , house officers and technicians and the consultants at the unit were heavily engaged in the planning and smooth running of the workshop. Cases managed were mainly hypospadias and urethrocutaneous fistulaes ( post circumcision) . Three IVUmed…

  • Type 2 diabetes and local staples
    Uncategorized

    Type 2 diabetes and local staples

    There is a widely circulated and accepted view that Western foods on the markets is to blame for all the health woes of local folks. A quick reference is made to fried rice with chicken, imported frozen foods, imported white rice, sugar, spices to mention but a few. It is true that the average Western diet is high in calories and has largely contributed to obesity and the surge in Type 2 diabetes. Sugar , rice and spices form the base for most food sold . Sugar abounds in a lot of meals. Either added to a standard meal or as a snack or even a drink . It is…

  • Doctors and documents
    News

    Doctors and documents

    The appreciation of load of  paper work that comes with being a doctor is appreciated very early in the training. Clinical years  medical students often se house officers spending time to document lines and lines history, examination findings, lab and imagery results, management plans , new directives etc. Once in a while the audit of a mortality or badly managed case throws more light on the need to be extra careful on documentation. We are always reminded at ethics meetings to pay attention to proper documentation. Most Ghanaians won’t mind pressing charges for poor care in hospital.” Give it to God”, is what most people say even when they think…

  • Intrauterine growth retardation in severe pre-eclampsia
    Uncategorized

    Intrauterine growth retardation in severe pre-eclampsia

    We present a 22 year old gravida 4 para0+ 3( 1spont, 2 induced)  who was referred to our facility with complaints of headache, aggressive behavior and impared consciousness of 3 day’s duration. There was no account of seizures prior to presentation. Patient was then    35weeks pregnant. Patient was admitted for evaluation. Blood pressure 168/102mmHg, pulse 69bpm Temp 37.2 Examination Anicteric, afebrile, ill looking, restless behavior. Chest clear, heart sounds present and normal. SFH 26cm was lagging behind expected for gestational age Lie longitudinal Foetal heart 146bpm Cephalic presentation HB 13.0g/dl, wbc6.1, plt 146 , Malaria parasite +, Urinalysis: pH 6 Protein + Ketones ++ Uric acid+ Glucose neg Blood…

  • Treatment of Malaria in Ghana
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    Treatment of Malaria in Ghana

    Introduction   Malaria is found to have devastating impact on young children. Its mortality is as high as 80% in children less than 5 years in the sub-Sharan Africa out of the 863,000 death annually, World Health Organisation estimate 243 million cases annually. Patients present with fever,vomiting, abdominal discomfort and in some cases seizures,loss of consciousness, tachypnoea,cough or anaemia. With good history, physical examination and laboratory investigations confirm daiagnosis/complications which inturn directs ones management. The incidence of children dying as a result of severe malaria has been reduced owing to the introduction of anti-malarial medications. Children recover faster sparing them the burden of weakened immune system which would in effect…

  • ruptured ectopic pregnancy in a25 year old
    OBGYN

    ruptured ectopic pregnancy in a25 year old

    25 year old seamstress presented with bleeding per vaginam for days. Bleeding was not profuse.Pregnancy test was positive . She also had mild lower abdominal pain. There is no history of contraception usage. No gynaecological procedures nor surgeries has been done prior to presentation. Patient has a 5 year old child from previous relationship. Examination Not pale, afebrile,  anicteric, not ill looking BP 120/70 mmHg   Pulse 89   Temp 36.5C Chest clear , heart sounds normal Abdomen Full, full, mild lower abdominal tenderness on deep palpation An initial diagnosis of threatened abortion was made . Investigations Abdominal ultrasound revealed free fluid in pouch of douglas, right adnexa and the morrissons pouch.…

  • Ruptured ectopic pregnancy …a near miss
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    Ruptured ectopic pregnancy …a near miss

    We present a 19 year old girl who presented with severe lower abdominal pain, mild bleeding per vaginam. She came with a pelvic ultrasound that stated a non viable intrauterine pregnancy. Examination Bp 90/60mmHg . Pulse 98 bpm  …Temp SPO2 99%   Ill looking , pale , afebrile, abdomen full with generalised tenderness Vaginal examination, no active bleeding, cervix closed Investigation HB 7. , Gxm, Urine pregnancy test positive Repeat abdominal Ultrasound revealed a ruptured ectopic pregnancy in pouch of Douglas . The gestation was walled off by what appears to the uterine muscle. There was free fluid in both adnexae with bowel floating in it. Uterus was poorly visualised.…

  • Subdural abscess in a young girl
    Uncategorized

    Subdural abscess in a young girl

    We present a 16 year old girl who was brought to our facility with headache and abdominal pain of a week’s duration. Headache was associated with nasal discharge from right nostril. She also complained of right iliac fossa pain associated with nausea and vomiting. Examination Patient looked  ill at the time of presentation. Temp37.5 deg,    BP 120/80mmHg ,   pulse rate 80bpm Chest was clear, heart sounds normal Abdomen full , tenderness in right iliac fossa. Central nervous system: initially intact Investigation: WBC 23.3 HB :12g/dl Urine RE: cloudy appearance, prot ++, pus 15-20 Abdominal Ultrasound revealed tenderness in right iliac fossa with aperistaltic bowel and an inflammed appendix. Diagnosis…