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BACTERIAL INFECTION IN SURGICAL WOUND AFTER ORTHOPEDICS TRAUMA SURGERY AT THE TAMALE TEACHING HOSPITAL IN THE NORTHERN REGION OF GHANA

2025-10-31T11:37:11Z

Title: BACTERIAL INFECTION IN SURGICAL WOUND AFTER ORTHOPEDICS TRAUMA SURGERY AT THE TAMALE TEACHING HOSPITAL IN THE NORTHERN REGION OF GHANA Authors: FREDRICK, G. Abstract: Background: Orthopedic trauma surgery (OTS) can result in surgical site infections (SSIs), and the repercussions include prolonged and increased cost of treatment. This study sought to investigate surgical site infection after orthopedics trauma surgery. Methods: A prospective cohort study was conducted at the Tamale Teaching Hospital from September 2023 to August 2024. Data on demographics, comorbidities, preoperative, intra-operative, and postoperative parameters were collected from patients, medical records, and the operation report. Samples were collected from patients suspected of SSI, and cultured for bacterial isolation, identification and antimicrobial resistance characterization. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of surgical site infection. P-value <0.05 was considered statistically significant. Surgical site infection was defined following the Center for Disease Control and Prevention (CDC) criteria. Results: A total of 210 patients were enrolled, of which 6.7% (14) developed SSIs, including 1.0% (2) deep and 5.7% (12) superficial SSIs. The study reported a maximum and minimum age of 86 years and 0.67 years (8 months), respectively. The median age (Interquartile range) reported in this study was 35.5 (18 - 47). The incidence rate of SSI in open fractures and closed fractures in this study was 3.3% (7) and 2.9% (6), respectively. According to multivariate regression analysis, blood transfusion before surgery (p=0.034; OR=3.53; 1.10 – 11.33), was identified as an independent risk factor of SSI following OTS. Out of 19 specimens, 14(73.68%) were culture-positive, yielding 22 isolates. Pseudomonas aeruginosa 5 (22.73%) was the most common bacterial isolate, followed by Klebsiella spp. 4 (18.18%). ESβL-positive isolates were 3(23.08%). PCR confirmed the expression of CTXM and SHV genes by two Klebsiella spp., and the CTXM gene by Proteus vulgaris. Conclusion: The study reported the incidence rate of SSI after OTS to be 6.7% (67 per 1000 surgical operations) within one year. Blood transfusion before surgery was identified as an independent risk factor of SSI following OTS. ESβL positive isolates were 3(23.08%). PCR confirmed the expression of CTXM and SHV genes by two Klebsiella spp., and CTXM gene by Proteus vulgaris. Description: AWARD OF A MASTER OF PHILOSOPHY IN CLINICAL MICROBIOLOGY

T-CELL EXHAUSTION AMONG PULMONARY TUBERCULOSIS CLIENTS IN NORTHERN REGION, GHANA

2025-10-31T10:36:29Z

Title: T-CELL EXHAUSTION AMONG PULMONARY TUBERCULOSIS CLIENTS IN NORTHERN REGION, GHANA Authors: JACOB, N. O. A. Abstract: Pulmonary tuberculosis is commonly caused by Mycobacterium tuberculosis. Tuberculosis pathogenesis is based on immune cell depletion and immune system evasion. Peripheral blood mononuclear cells from pulmonary tuberculosis clients were studied for transcription patterns associated with immune cell exhaustion, cellular activity, and inflammatory response at various therapeutic stages of anti-TB therapy at the Chest Clinic of Tamale Teaching Hospital, an experimental study was carried out with twenty-five clients diagnosed with pulmonary tuberculosis and five healthy control clients, making a total of thirty clients. Based on the different stages of the anti-TB treatment, the clients were divided into six groups; namely: newly diagnosed (zero month), intensive phase (≤ 2 months), continuous phase I (>2 & ≤ 5 months), continuous phase II (>5 & ≤ 6 months), completed phased (>6) and healthy control group. Blood specimens were taken from every client in each group. Peripheral blood mononuclear cells were isolated, followed by Ribonucleic acid extraction, then complementary deoxyribonucleic acid synthesis, polymerase chain reaction of the biomarkers of T cells exhaustion, inflammatory cytokines and cellular activities markers. 1% agarose gel electrophoresis was used for the deoxyribonucleic acids bands visualization. The deoxyribonucleic acid gene expression and quantification were carried out using Image J software and Graph pad Prism version 8 statistical tool on the genes of T cell exhaustion, inflammatory cytokine and cellular activities markers. P-values of less than 0.05 were considered statistically significant between the groups. Programme cell death 1 protein, cytotoxic T lymphocytes associated protein 4, CD244 and lymphocyte activated gene 3 in peripheral blood mononuclear cells predict positive pulmonary tuberculosis prognosis during treatment. Correlation analysis suggests CD244 could be a strong marker for monitoring pulmonary tuberculosis treatment outcomes. Transcription of inflammatory cytokines was restored to normal following the initiation of anti-TB treatment. Cellular activity markers CD69, Ki67, Interleukin 7R, Interleukin 15R, GATA-3, CD4 and CD8 were restored to normal and could be used to monitor PTB treatment outcome. The study demonstrated the potential value of T-cell exhaustion markers, specifically PD-L1, inflammatory markers like Interleukin 2, Interferon-gamma and Tumor necrosis factor-a, as well as cellular activity indicators Kiel 67, CD69, GATA-3, CD4, and CD8 blood-based biomarkers can be used in place of sputum in monitoring treatment progress of pulmonary tuberculosis clients. Description: AWARD OF MASTER OF PHILOSOPHY IN CLINICAL MICROBIOLOGY

DEGREE OF RED BLOOD CELL REDUCTION IN DIFFERENT STRAINS OF SEMI IMMUNE MICE INFECTED WITH PLASMODIUM BERGHEI ANKA AFTER CHRONIC EXPOSURE

2022-07-12T11:49:29Z

Title: DEGREE OF RED BLOOD CELL REDUCTION IN DIFFERENT STRAINS OF SEMI IMMUNE MICE INFECTED WITH PLASMODIUM BERGHEI ANKA AFTER CHRONIC EXPOSURE Authors: Helegbe, G. K. Description: DOCTOR OF PHILOSOPHY IN MEDICAL SCIENCE IN INFECTION RESEARCH

PREVALENCE OF POST TRAUMATIC STRESS DISORDER AND ASSOCIATED FACTORS IN ADULT ORTHOPAEDIC TRAUMA PATIENTS SEEN AT MULAGO HOSPITAL, KAMPALA UGANDA

2022-07-12T11:14:43Z

Title: PREVALENCE OF POST TRAUMATIC STRESS DISORDER AND ASSOCIATED FACTORS IN ADULT ORTHOPAEDIC TRAUMA PATIENTS SEEN AT MULAGO HOSPITAL, KAMPALA UGANDA Authors: Dun Bo -ib, B. A. Abstract: Background Attempts to ensure total care of the trauma patient in order to reduce morbidity and mortality, has led to a drift of global concern towards the psychiatric sequelae of trauma patients. Psychiatric disorders following trauma are common with one of the commonest being posttraumatic stress disorder (PTSD) and are associated with poor functional and occupational outcomes. The prevalence of PTSD in orthopaedic trauma patients vary from place to place. Studies in United States, Kenya and Nigeria had 51, 13.3 and 26.7% of patients fulfilling the criteria for PTSD. No similar studies have been carried out in Uganda. PTSD in orthopaedic trauma patients causes unique problems for patients ranging from depression, anxiety, pain or sleep problems that may be more challenging than their orthopaedic trauma. Objective To determine the prevalence and associated factors of post- traumatic stress disorder in adult orthopaedic trauma patients seen at Mulago hospital. Methodology This was a hospital based cross-sectional descriptive study of adult orthopaedic trauma patients at Mulago hospital. A structured questionnaire containing injury characteristics and module for PTSD diagnosis in Diagnostic and Statistical Manual Fourth Edition Text Revised (DSM-IV-TR) was administered to consenting patients who met the inclusion criteria by systematic random sampling. Data was entered in Epi Data software and exported to STATA 10.0 for Univariate, bivariate and multivariate analysis using Mantel Haenszel method and logistic regression model. Results Two hundred and ninety seven (297) patients were recruited into the study of which the prevalence of PTSD in adult orthopaedic trauma patients seen at Mulago hospital was 17.85% (53/297). Spine injuries, duration of injury> 12 months, presence of death in an accident and absence of alcohol consumption were associated with post traumatic stress disorder after bivariate analysis (p <0.05). Multivariate logistic regression showed Presence of death in an accident and absence of alcohol consumption to be significantlyassociated with post traumatic stress disorder after adjusted for spine injury and duration ofinjury> 12 months. Conclusion The prevalence of PTSD in adult orthopaedic trauma patients in Mulago Hospital is 17.85%.Therefore there is the need for collaboration between Psychiatrists and Orthopaedic Surgeons in the management of these patients to ensure a better functional, occupational and psychological outcome. Description: MASTER OF MEDICINE IN ORTHOPAEDIC SURGERY