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Kofi Boamah Mensah,1 Adwoa Bemah Boamah Mensah,2 Peter Yamoah,3 Jennifer Manfo,4 Richmond Amo,5 Ebenezer Wiafe,6 Neelaveni Padayachee,7 Varsha Bangalee8 1Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 2Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 3Department of Pharmacy Practice, University of Health and Allied Sciences, Kumasi, Ghana; 4Pharmacy Department, Maternal and Child Health Hospital, Kumasi, Ghana; 5Internal Medicine & Department of Herbal Medicine, University Hospital & Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 6Pharmacy Department, Ho Teaching Hospital, Ho, Ghana; 7Department of Pharmacy and Pharmacology, University of the Witwatersrand, Johannesburg, South Africa; 8Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South AfricaCorrespondence: Kofi Boamah Mensah, Email kofimensah227@yahoo.co.ukIntroduction: The World Health Organization has reported a rise in cervical cancer in Ghana. Ghanaian women predominantly undergo opportunistic Pap smear screening for cervical cancer. Numerous studies have documented differences in the sociodemographic traits of participants undergoing Pap smear testing or screening, which correlates with their screening habits. This study aims to assess sociodemographic variables, including others that determine Pap test utilization at a single center in Ghana.Methods: A single-center survey was conducted by extracting data from the records of women who walked in for Pap smear testing. A telephone survey was also conducted among these women to document their barriers to utilizing the center. For data analysis, descriptive statistics and chi-square were utilized.Results: A total of 197 participants’ records were retrieved for the study. Most participants were market women (69.4%) and uneducated (71.4%). Their Pap smear screening records indicate that the majority (86%) had no history of cervical cancer screening, and only 3% tested positive for Pap smear test. Educational level, occupation and family history of cancer significantly correlated with participants’ Pap smear history (p< 0.05). However, most sociodemographic factors were not significant with the Pap test results of the participants (p> 0.05). The perceived barrier identified by most participants was the need for more information (67.40%) on the test.Conclusion: This study revealed that sociodemographic and gynaecological factors do not correlate with Pap test results. However, education level, occupation, and family history of cancer were significantly associated with the history of Pap smear uptake. The most significant barrier hindering Pap smear services was the need for more information.Keywords: pap smear, cervical cancer, sociodemographic factors, gynaecological factors, screening, women, Ghana

Objectives: To determine the pattern of impacted mandibular teeth among a Ghanaian population, as well as the prevalence and risk factors for complications following their surgical removal. Design: A descriptive retrospective study Setting: Department of Oral and Maxillofacial Surgery, University of Ghana Dental School and the Korle-Bu Teaching Hospital, Accra, Ghana. Subjects: Medical records of patients who had surgical extraction of lower third molars done. Main outcome measures: Variables obtained included sex, age, Winter’s classification of impaction, Class and Depth of tooth, Root morphology, and the modified Parant scale. Other variables were the indication for extraction, difficulty grade (Kharma scale), the presence of complications at review, and whether the present management accounted for the first visit to a dentist. Results: There was a total of 258 people included in the study. This consisted of 101 (39.1%) males and 157 (60.9%) females. Ranging from 18 to 74 years, the mean age was 29.6±9.4 years. Most impactions (47.3%) of the mandibular wisdom teeth were mesioangular. Recurrent pericoronitis was the most common reason for surgery, accounting for 115 (44.6%) of the study population. The occurrence of complications following the extraction of a mandibular wisdom tooth was found to vary significantly by the difficulty grade (p=0.021). Conclusion: Mesioangular impactions were the most common types of third molar impaction, while about 18% of patients had varying complaints following management. Kharma scale was found to be significantly associated with the occurrence of complications following surgical extractions. [ABSTRACT FROM AUTHOR]

Background: The clinical high-risk (CHR) period offers a temporal window into neurobiological deviations preceding psychosis onset, but little attention has been given to regions outside the cerebrum in large-scale studies of CHR. Recently, the North American Prodrome Longitudinal Study (NAPLS)-2 revealed altered functional connectivity of the cerebello-thalamo-cortical circuitry among individuals at CHR; however, cerebellar morphology remains underinvestigated in this at-risk population, despite growing evidence of its involvement in psychosis., Study Design: In this multisite study, we analyzed T1-weighted magnetic resonance imaging scans obtained from N = 469 CHR individuals (61% male, ages = 12-36 years) and N = 212 healthy controls (52% male, ages = 12-34 years) from NAPLS-2, with a focus on cerebellar cortex and white matter volumes separately. Symptoms were rated by the Structured Interview for Psychosis-Risk Syndromes (SIPS). The outcome by two-year follow-up was categorized as in-remission, symptomatic, prodromal-progression, or psychotic. General linear models were used for case-control comparisons and tests for volumetric associations with baseline SIPS ratings and clinical outcomes., Study Results: Cerebellar cortex and white matter volumes differed between the CHR and healthy control groups at baseline, with sex moderating the difference in cortical volumes, and both sex and age moderating the difference in white matter volumes. Baseline ratings for major psychosis-risk dimensions as well as a clinical outcome at follow-up had tissue-specific associations with cerebellar volumes., Conclusions: These findings point to clinically relevant deviations in cerebellar cortex and white matter structures among CHR individuals and highlight the importance of considering the complex interplay between sex and age when studying the neuromaturational substrates of psychosis risk., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objectives: Use of intrauterine balloon tamponades for refractory postpartum haemorrhage (PPH) management has triggered recent debate since effectiveness studies have yielded conflicting results. Implementation research is needed to identify factors influencing successful integration into maternal healthcare packages. The Ellavi uterine balloon tamponade (UBT) (Ellavi) is a new low-cost, preassembled device for treating refractory PPH., Design: A mixed-methods, prospective, implementation research study examining the adoption, sustainability, fidelity, acceptability and feasibility of introducing a newly registered UBT. Cross-sectional surveys were administered post-training and post-use over 10 months., Setting: Three Ghanaian (district, regional) and three Kenyan (levels 4-6) healthcare facilities., Participants: Obstetric staff (n=451) working within participating facilities., Intervention: PPH management training courses were conducted with obstetric staff., Primary and Secondary Outcome Measures: Facility measures of adoption, sustainability and fidelity and individual measures of acceptability and feasibility., Results: All participating hospitals adopted the device during the study period and the majority (52%-62%) of the employed obstetric staff were trained on the Ellavi; sustainability and fidelity to training content were moderate. The Ellavi was suited for this context due to high delivery and PPH burden. Dynamic training curriculums led by local UBT champions and clear instructions on the packaging yielded positive attitudes and perceptions, and high user confidence, resulting in overall high acceptability. Post-training and post-use, ≥79% of the trainees reported that the Ellavi was easy to use. Potential barriers to use included the lack of adjustable drip stands and difficulties calculating bag height according to blood pressure. Overall, the Ellavi can be feasibly integrated into PPH care and was preferred over condom catheters., Conclusions: The training package and time saving Ellavi design facilitated its adoption, acceptability and feasibility. The Ellavi is appropriate and feasible for use among obstetric staff and can be successfully integrated into the Kenyan and Ghanaian maternal healthcare package., Trial Registration Numbers: NCT04502173; NCT05340777., Competing Interests: Competing interests: Over the last decade, MP, JS, PC, PD, RO, AS, MM and EA-H have been directly involved in the development, introduction and scale of the Ellavi uterine balloon tamponade as part of their employment at PATH, which constitutes a non-financial conflict of interest. PATH, an international non-governmental organisation, did not receive any funding from Sinapi Biomedical to conduct this multisite study. The remaining authors have no conflicts of interest to declare., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study presents a novel geo-based metric to identify neighborhoods with high burdens of prostate cancer, and compares this metric to other methods to prioritize neighborhoods for prostate cancer interventions. We geocoded prostate cancer patient data (n = 10,750) from the Pennsylvania cancer registry from 2005 to 2014 by Philadelphia census tract (CT) to create standardized incidence ratios (SIRs), mortality ratios (SMRs), and mean prostate cancer aggressiveness. We created a prostate cancer composite (PCa composite) variable to describe CTs by mean-centering and standard deviation-scaling the SMR, SIR, and mean aggressiveness variables and summing them. We mapped CTs with the 25 highest PCa composite scores and compared these neighborhoods to CTs with the 25 highest percent African American residents and the 25 lowest median household incomes. The mean PCa composite score among the 25 highest CTs was 4.65. Only seven CTs in Philadelphia had both one of the highest PCa composite scores and the highest percent African American residents. Only five CTs had both the highest PCa composites and the lowest median incomes. Mean PCa composite scores among CTs with the highest percent African American residents and lowest median incomes were 2.08 and 1.19, respectively. The PCa composite score is an accurate metric for prioritizing neighborhoods based on burden. If neighborhoods were prioritized based on percent African American or median income, priority neighborhoods would have been very different and not based on PCa burden. These methods can be utilized by public health decision-makers when tasked to prioritize and select neighborhoods for cancer interventions., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: A case of a 2.7kg term baby with a large epignathus, a rare congenital teratoma arising from the palate is presented. Birth was by spontaneous vaginal delivery (SVD). The baby survived following a timely multidisciplinary approach to her management. This is the first reported case in Ghana.

Objectives: Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation., Methods: In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models., Results: Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%-80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (-0.19 μg/m 3 , p = .03)., Conclusions: Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement., Competing Interests: Conflict of Interest Statement There are no conflicts of interest to declare for any authors of this work.