Management of Hypoplastic Left Heart Syndrome in Low-Resource Settings and the Ethics of Decision-Making.

Hypoplastic left heart syndrome (HLHS) is possibly the most challenging congenital heart defect to confront in any setting. The highly specialized infrastructure and resources needed to treat HLHS is not available in many low-resource settings. However, low-resource settings must not be assumed to be synonymous with low- and middle-income countries as national income is not necessarily indicative of a country's prioritization of healthcare resources.

Outcome of life-threatening arrhythmias among patients presenting in an emergency setting at a tertiary hospital in Accra-Ghana.

Background: Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems. In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care systems. Little is known about life-threatening arrhythmia and their outcomes in SSA.

Psychiatry Meets Cardiology: A Case Report on the Need for Mental Health Assessment in the Evaluation of Cardiovascular Symptoms.

Cardiovascular symptoms like chest pain and palpitations are among the commonest reasons for outpatient hospital visits. Physician preoccupation with ruling out sinister cardiological diagnoses often results in a failure to recognise mental health-related disorders, which account for over 40% of such cases, especially among young women. These disorders can independently cause cardiovascular symptoms or worsen preexisting cardiovascular disease, worsening morbidity.

Changes in origin of acute chest pain in a sub-Saharan African setting.

Our aim was to demonstrate a shifting epidemiology of acute chest pain in Ghana. Efforts to increase physician awareness and best practices are urgently required. Patients presenting with acute chest pain to the two leading tertiary care centres in Accra were investigated.

Psychological Distress Amongst Medical Laboratory Professionals Involved in COVID-19-Related Duties: A Nationally Stratified Cross-Sectional Survey, Ghana.

To assess the prevalence and factors associated with psychological distress (PD) and Medical Laboratory Professionals (MLPs) involvement in COVID-19-related duties. This study adopted an online cross-sectional, nationally stratified survey among 473 MLPs using Google Form with a designated link; Depression, anxiety, and stress scale-21 (DASS-21) was used to measure depression, anxiety, and stress (secondary outcome). We employed generalized Negative Binomial (NBR) and Poisson regression analytical approach to our study outcomes.

Comparison of preoperative trans-thoracic echocardiography with intraoperative findings in patients with congenital heart disease undergoing surgery: a prospective observational study.

Objective: To determine the diagnostic accuracy and safety of trans-thoracic echocardiography alone for indicating surgery by correlating preoperative trans-thoracic echocardiography with intra-operative findings in patients with congenital heart disease (CHD) in a low resource, low volume center.

Methodology: The pre-operative trans-thoracic echocardiography and intra-operative findings of two hundred and fifty patients with CHD, undergoing surgery at the National Cardiothoracic Centre (NCTC), Korle Bu Teaching Hospital, from 2012 to 2017 were prospectively compared. Included in this prospective study, were all patients with CHD who had trans-thoracic echocardiography alone at the NCTC.

The Pivotal Role of Effective Communication in Patient Care: A Case of Coronary Stent Thrombosis.

Myocardial infarction is a significant cause of morbidity and mortality worldwide, resulting in millions of percutaneous coronary interventions being performed yearly. Coronary artery stents are, however, at risk of thrombosis, with a significant mortality rate. Stent thrombosis is, however, preventable using dual antiplatelets, barring other procedural or unique personal predisposing characteristics.

Acute Pulmonary Embolism in the COVID-19 Era: The Experience of a Ghanaian Patient.

The coronavirus pandemic has resulted in profound changes in healthcare delivery, some based on official reforms and others driven by healthcare professionals' fear of exposure to coronavirus disease (COVID-19). Many patients require screening tests of one form or the other before being attended to in hospitals. The protean clinical manifestations of this highly transmissible infection require that a high index of suspicion be maintained.

Myocardial Infarction with Nonobstructive Coronary Arteries: A Diagnostic Challenge.

Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a significant cause of cardiovascular morbidity, especially among non-white women younger than 55 years. It is a working diagnosis that warrants further investigation due to its varied underlying pathophysiologic mechanisms. Investigations may be hampered by unavailability of testing modalities, cost, and the expertise to carry out the tests, as they are highly specialized.

Improving the diagnostic recognition of thoracic endometriosis: Spotlight on a new histo-morphological indicator.

The diagnosis of thoracic endometriosis (TE) is challenging, hence resulting in under-diagnosis as well as long delays before arriving at a correct definitive diagnosis. Our aim is to review the histopathological findings in TE, summarise the diagnostic features, identify any major histo-morphological indicator(s) hitherto unrecognised as such, suggest diagnostic criteria; all with the aim of improving the diagnostic capacity and reducing observer error even where the clinical suspicion is low. A case-control study in which a search in the pathology archives of a referral hospital over a 10-year period was conducted.

Sex differences and factors associated with disability among Ghana's workforce: a nationally stratified cross-sectional study.

Objective: This study was conducted to estimate the prevalence of disability and associated factors and further quantify the associated sex differential among Ghana's workforce aged 15+ years.

Design: A nationally stratified cross-sectional study.

Setting: Ghana.

Flexible bronchoscopy in a tertiary healthcare facility: a review of indications and outcomes.

Objectives: Flexible Fibreoptic bronchoscopy (FFB) is a major diagnostic and therapeutic tool employed largely in respiratory medicine but its use in our country has been quite limited. We performed a retrospective review of the indications, overall diagnostic yield and safety of FFB at the Korle-Bu Teaching Hospital (KBTH).

Study Design: Retrospective study.

Thoracic endometriosis syndrome in Nigeria: a single-centre experience.

Objectives: Thoracic endometriosis syndrome (TES) is the presence of functional endometrial tissue in or around the lung. There seem to be differences in the clinical presentation of this condition among Nigerian patients. We aim to study the clinical presentation and management outcome of TES in our centre.

Factors Associated with Malaria Infection among Head Porters in Agbogbloshie Market in the Greater Accra Region of Ghana.

Background: Head porters constitute the mobile population who are at an increasing risk of being infected with malaria. They move around the city to carry out their duties with no accommodation. Therefore, they sleep wherever they find themselves in the evening and do not benefit from most of the malaria intervention programs such as the use of long-lasting insecticide net.

Teenage pregnancy and experience of physical violence among women aged 15-19 years in five African countries: Analysis of complex survey data.

Background: Pregnant teenage women are prime targets of violence against women perpetrated by intimate partners, family members, and miscreants in their neighborhoods. This study estimated the prevalence of Teenage pregnancy (TP) and Physical Violence (PV) and further assessed the relationship between TP and PV in five Low-and-Middle-Income Countries (LMICs).

Methods: The study was conducted among five LIMCs (Burkina Faso, Kenya, Malawi, Nigeria, and Tanzania) using data from the most recent Demographic and Health Surveys conducted in these countries.

Delivering pediatric cardiac care in sub-Saharan Africa: a model for the developing countries.

Purpose Of Review: It is projected that by 2050, around 40% of all births, and about 40% of all children, will be in Africa, up from about 10% in 1950. Consequently, this trend will cause an increase in noncommunicable diseases in children, such as congenital and rheumatic heart diseases. The current state of pediatric cardiac care in sub-Saharan Africa is dire with some countries without cardiac surgical services at all.

Early Impact of the COVID-19 Pandemic on Congenital Heart Surgery Programs Across the World: Assessment by a Global Multi-Societal Consortium.

The coronavirus disease 2019 (COVID-19) pandemic currently gripping the globe is impacting the entire health care system with rapidly escalating morbidities and mortality. Although the infectious risk to the pediatric population appears low, the effects on children with congenital heart disease (CHD) remain poorly understood. The closure of congenital heart surgery programs worldwide to address the growing number of infected individuals could have an unintended impact on future health for COVID-19-negative patients with CHD.

Visual impairment and social isolation, depression and life satisfaction among older adults in Ghana: analysis of the WHO's Study on global AGEing and adult health (SAGE) Wave 2.

Aim: To estimate the prevalence of visual impairment (VI) and associated factors and further quantify its association with social isolation, depression and life satisfaction among older adults in Ghana.

Methods: WHO Study on Global AGEing and Adult Health Ghana dataset for older adults 50 years and above was used for this study. Social isolation, depression and life satisfaction were our primary outcomes with VI being our secondary outcome.

Self-reported hypertension as a predictor of chronic health conditions among older adults in Ghana: analysis of the WHO Study on global Ageing and adult health (SAGE) Wave 2.

Introduction: Hypertension has been identified as a significant predictor of many chronic health conditions. Body Mass Index (BMI) and Quality of Life (QoL) are key determinants of hypertension especially among elderly populations. In this study, we examined the effect of self-reported hypertension (SRH) on chronic health conditions and quality of life among older adults in Ghana.

Electrocardiographic and Echocardiographic Findings in Ghanaian Female Soccer Players.

Objective: To examine the heart of Ghanaian adult and adolescent female soccer players using electrocardiography (ECG) and echocardiography (ECHO), and to describe typical ECG and ECHO findings in a cohort of west African female soccer players.

Design: Cross-sectional study of ECG and ECHO performed as part of precompetition medical assessment for 3 national female football teams preparing for various Fédération Internationale de Football Association (FIFA) tournaments in 2016.

Setting: Ghana National Football Association.

Twenty Years of Repair of Ventricular Septal Defects in Ghana.

Background: Ventricular Septal Defect (VSD) is the commonest congenital heart disease. Without appropriate treatment, it is associated with significant morbidity and mortality. Surgical repair under cardiopulmonary bypass has been the standard treatment.

Pregnancy in non-palliated functionally single ventricle: challenges of management in resource-poor settings.

Women with complex functionally univentricular hearts rarely survive into adulthood without corrective or palliative surgery. Reports of pregnancy outcome in this group of patients in resource-poor settings are sparse. We report a case of unrepaired pulmonary atresia ventricular septal defect (VSD) with major aorto-pulmonary collateral arteries (MAPCA) who survived into adulthood and was able to complete a successful pregnancy in a resource-poor country.