Electrocardiographic and Echocardiographic Findings in Elite Ghanaian Male Soccer Players.

Objective: To analyze the athlete's heart of adult and adolescent elite male soccer players by electrocardiography (ECG) and echocardiography (ECHO) and to describe typical ECG and ECHO findings in this cohort (West African elite soccer players).

Design: A cross-sectional study of ECGs and ECHOs conducted as part of precompetition medical assessment for national male soccer teams preparing for various Fédération Internationale de Football Association (FIFA) tournaments in 2016 and 2017.

Setting: Ghana National Football Association.

Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization's study on global AGEing and adult health, Wave 2.

Background: Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana.

Surgical leadership in Africa - challenges and opportunities.

Surgical care has been described as one of the Cinderellas in the global health development agenda, taking a backseat to public health, child health, and infectious diseases. In the midst of such competing health-care needs, surgical care, often viewed by policy makers as luxurious and the preserve of the rich, gets relegated to the bottom of priority lists. In the meantime, infectious disease, malnutrition, and other ailments, viewed as largely affecting the poor and disadvantaged in society, get embedded in national health plans, receiving substantial funding and public health program development.

Challenges of Caring for Functionally Single Ventricle Patients in Africa.

Surgical palliation has remarkably improved survival of functionally single ventricle (FSV) patients born in developed nations but such outcomes have not occurred in Africa. The poor care coverage for FSV patients in Africa exists within the larger sphere of deficient health care for children born with congenital heart defects (CHDs) in Africa generally. This review takes the position that to improve health-care coverage for CHD patients on the continent, political priority is paramount.

Palliation of Functionally Single Ventricle Patients in Sub-Saharan Africa-Is It Justifiable?

Resource constraints in many sub-Saharan African countries undermine efforts to provide the full spectrum of pediatric cardiology and cardiac surgery. Palliation of the child born with functionally single ventricle is the lowest priority for policymakers when viewed from the perspective of cost-effectiveness. This commentary focuses on the relative importance of different criteria that policymakers and the general public consider important in setting health-care priorities as it relates to palliation of the patient with functionally single ventricle in sub-Saharan Africa.

Genomics and Epigenomics of Congenital Heart Defects: Expert Review and Lessons Learned in Africa.

Congenital heart defects (CHD) are structural malformations found at birth with a prevalence of 1%. The clinical trajectory of CHD is highly variable and thus in need of robust diagnostics and therapeutics. Major surgical interventions are often required for most CHDs.

Colon bypass with a colon-flap augmentation pharyngoesophagoplasty.

Extensive caustic stricture of the upper aero-digestive system (oro- and hypo-pharynx) is a severe injury with limited surgical options. We adopted augmentation of the cicatrized upper aero-digestive tract with colon as our preferred management option. The aim of this report is to describe our initial experience with the technique of colon-flap augmentation pharyngo-esophagoplasty (CFAP) for selected patients with severe pharyngo-esophageal stricture.

Hypothermic cardiopulmonary bypass without exchange transfusion in sickle-cell patients: a matched-pair analysis.

Objectives: Sickle-cell patients undergo cardiopulmonary bypass (CPB) surgery in our institution without perioperative exchange transfusion. We sought to determine whether this protocol increased mortality or important sickle-cell-related complications.

Methods: We adopted a 1:1 matched-pair case-control methodology to evaluate the safety of our protocol.

Massive intrathoracic lipoma: a report of two cases, one being congenital.

Massive intrathoracic lipomas are uncommon. Few cases have been reported worldwide. We report two cases, one of which was congenital.

Cardiac surgery capacity in sub-saharan Africa: quo vadis?

Background: Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality.

Methods: A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues-26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet).

Thoracic endometriosis syndrome.

Background: Thoracic endometriosis syndrome is a rare constellation of different pathological entities arising from intrathoracic endometriosis. Reports from centers in Africa are scanty. Varying theories have been proposed but none satisfactorily explains the varying clinical manifestations.

Congenital division of the left atrium (cor triatriatum) in the setting of congenitally corrected transposition of the great arteries.

Congenital division of the left atrium (cor triatriatum) and congenitally corrected transposition of the great arteries are both rare congenital cardiac malformations; their coexistence is exceedingly rare with only two previous reports identified in the literature. This combination of lesions is characterized by a pressure-loaded morphologically left ventricle and a propensity for pulmonary edema dependent on the degree of pulmonary venous obstruction caused by the dividing left atrial shelf. The probable impact of this on the natural history and surgical decision making is discussed.

Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.

Boerhaave's syndrome (Spontaneous oesophageal perforation following forceful vomiting) is uncommon. However, when it occurs and the appropriate treatment is not given on time, it is fraught with early complications, leading to a very high mortality rate. This is a characteristic feature of this syndrome.

The challenges facing the management of arterial aneurysm in UNTH, Enugu.

Background: The management of arterial aneurysm either central or peripheral has undergone evolution over the past decades. We encounter both true and pseudo aneurysm on regular basis with its complications:

Objective: To assess the challenges of managing arterial aneurysm at UNTH, Enugu in view of the health complications of the condition.

Method: Medical records of all patients with documented arterial aneurysm over a 5-year period (2007-2011) were reviewed.

Hepatic venous occlusion during cardiopulmonary bypass in patients with heterotaxy syndrome: a safe but underutilized option.

Direct intracardiac drainage of separate right and left hepatic veins remote from each other (independent hepatic veins) in heterotaxy patients complicates procedures requiring cardiopulmonary bypass (CPB). Temporary occlusion of such independent hepatic veins during CPB is an alternative to cannulation but is rarely used because of concerns about acute congestive hepatopathy. Consequently, temporary single hepatic venous occlusion has not been well described as a safe and simple alternative to hepatic venous cannulation during CPB.

Junctional ectopic tachycardia following repair of congenital heart defects-experience in multimodal management from a West African Centre.

Background: Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre.

The National Cardiothoracic Centre, Accra Ghana: proceedings of the second International Update Course in Cardiology - improving the coverage of cardiology services.

Many developing countries now face the growing phenomenon of the double burden of disease. Most are still grappling with infectious diseases resulting from poor environmental sanitation and lack of access to good drinking water like malaria, cholera, and enteric fever. At the same time changes in diet and lifestyle in general in these countries is resulting in increasing numbers of people with obesity, sedentary life styles, increased salt intake from fast foods, increased smoking and consumption of alcohol and fizzy drinks, hypertension and diabetes.

Traumatic diaphragmatic rupture through the central tendon with herniation of the stomach and coils of small bowel into the pericardial cavity.

Unlabelled: Traumatic diaphragmatic rupture through the central tendon with herniation of the stomach and coils of small bowel into the pericardial cavity.

Method: Case note of a patient managed for traumatic diaphragmatic rupture through the central tendon with herniation of the stomach and coils of small bowel into the pericardial cavity was used with a review of relevant literature.

Summary: A 49-year old civil engineer who presented with 2-year history of easy fatigability and palpitations as well as a 6-month history of hypertension and was initially managed as a case dilated cardiomyopathy to rule out incipient CCF secondary to hypertension, was evaluated and found to have chronic diaphragmatic hernia through the central tendon with evisceration of the stomach and coils of the small bowel into the pericardial cavity.

Management of intrathoracic oesophageal perforation: analysis of 16 cases.

Intrathoracic oesophageal perforation remains a life-threatening lesion that requires early diagnosis and the appropriate intervention in order to reduce morbidity and mortality. Management depends largely on the cause of the perforation, the integrity of the oesophagus and the time lapse between the perforation and the commencement of treatment. Our aim was to evaluate the management options that were employed in the treatment of patients with oesophageal perforation and the outcome.

Permanent complete heart block following surgical correction of congenital heart disease.

Background: The risk of complete heart block (CHB) from congenital heart repairs in Ghana is unknown. This information is important for referring physicians and in pre-operative counselling of patients and facilitates the process of obtaining informed consent for such repairs.

Objectives: This study was undertaken to determine the incidence of permanent post-operative CHB requiring pacemaker implantation; and the post-operative problems related to the pacemaker.

Colopharyngoplasty for intractable caustic pharyngoesophageal strictures in an indigenous African community--adverse impact of concomitant tracheostomy on outcome.

Objectives: Surgical management of caustic strictures of the upper digestive tract poses difficult challenges. This is because reconstruction above the cricopharyngeal junction interferes with the mechanisms of swallowing and respiration. This report reviews the outcome of colopharyngeal reconstruction of severe diffuse pharyngoesophageal caustic strictures in an indigenous African community.

Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa.

Background: This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.

Patients And Method: This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts.