Browsing by Author "Yorke, Joseph"

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    A formulation of Clausena anisata (Willd.) Hook. f. Ex Benth and Cassia sieberiana DC. alleviates the symptoms associated with osteoarthritis: a single-blind, randomised controlled trial of a traditional Ghanaian remedy
    (Springer Open, 2019) Kwesi Prah, Thomford; Yorke, Joseph; Ama Kyeraa, Thomford; Amponsah, Isaac Kingsley; 0000-0002-5229-0340
    Background: Clinical validation of herbal medicinal products is important for their widespread acceptance and application. In this single-blind, randomised controlled trial, a traditional Ghanaian herbal medicine formulation with Clausena anisata (Willd.) Hook. f. ex Benth and Cassia sieberiana DC. as ingredients was evaluated for its safety and effectiveness in the management of patients with osteoarthritis. The formulation for the purposes of this study was labelled with the code GC-500. Methods: A total of 57 participants were randomly assigned to receive either this herbal remedy, GC-500, or the control treatment of diclofenac. Subjects were then followed up for a period of 8 weeks using a modified Graded Chronic Pain Scale (GCPS) for their efficacy assessments. The control treatment comprised 13 subjects and the GC 500 group 44 subjects. Results: Upon completion of the study, 28 (63.63%) subjects in the GC-500 group attained the primary outcome, (GCPS of Grade 0) compared to 5 (38.46%) subjects in the control group. Improvement in disease indicators such as characteristic pain intensity, disability score and disability days was comparable between the GC-500 and diclofenac. Intensity of pain reduced after 8 weeks of treatment; disability score and disability days also declined indicating an improvement in the quality of life of subjects. GC-500 was also shown to be safe for human use. Conclusion: The herbal medicine formulation GC-500, provides a credible treatment option for managing the pain associated with osteoarthritis.
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    A gist on an obscure neoplasm in Ghana: gastrointestinal stromal tumours
    (BMC Publisher, 2023) Yorke, Joseph; Brenu, Samuel Gyasi; Awoonor‑Williams, Ronald; Tabiri, Stephen; Seidu, Anwar Sadat; 0000-0002-5229-0340
    Background Gastrointestinal Stromal Tumour is a rare but potentially curable tumour of the gastrointestinal tract accounting for up to 1% of all gastrointestinal tumours. The discovery of Imatinib mesylate, a novel tyrosine kinase inhibitor has improved the chances even for unresectable, recurrent, or metastatic diseases. Methods This study sought to document the clinical and pathological characteristics of GISTs from two tertiary hos‑ pitals in Ghana that have undergone immunohistochemistry confrmation between 2014 and 2021. Results The median age of the subjects was 50 years with most of them (28.0%) being above 61 years. There were more females than males (64.0% vs. 36.0%). Abdominal mass and abdominal pain made up the majority of the clinical presentations. The majority of the subjects had partial gastrectomy (32.0%) which was followed by wedge resec‑ tion (28.0%). Appendectomy and sleeve gastrectomy were the least performed procedures (8% each). Four of the 25 patients (16.0%) had resections of involved contiguous organs done with splenectomy being the most common procedure. The majority of GISTs were found in the stomach (68.0%) followed by the appendix (12.0%) and small bowel (12.0%). Gastrointestinal bleeding (55.8%) and abdominal pain (38.5%) were the most reported symptoms. Free resection margins were observed in 84.0% of the subjects and only 3/25 (12.0%) experienced tumour recurrence. Conclusion GIST is a potentially curable tumour that once was obscure but currently gaining popularity. Surgical resection ofers the hope of a cure for localized disease while targeted therapies is a viable option for recurrent, meta‑ static, or unresectable tumours.
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    Acute Gastric Necrosis in a Teenager
    (Hindawi, 2020) Yorke, Joseph; Gyamfi, Frank Enoch; Awoonor-Williams, Ronald; Osei-Akoto, Ebenezer; Acheampong, Emmanuel; Acheampong, Emmanuella Nsenbah; Adinku, Michael Ofoe; Yamoah, Francis Akwaw; 0000-0002-5229-0340
    Gastric infarction is a rare condition often associated with high mortality due to a delay in diagnosis. The stomach which has a rich supply of blood is a rare site for such a condition. Gastric infarction has a long list of etiological factors. We report a case of a patient who was managed successfully following gastric infarction from gastric dilatation. An 18-year-old female student presented with a three-day history of abdominal pain associated with abdominal distension of two days. The abdomen was distended with generalized tenderness, rebound tenderness, and guarding. Bowel sounds were absent. Digital rectal examination was unremarkable, and a pregnancy test was negative. Biochemical tests were all normal. Intraoperatively, two litres of serosanguinous fluid was suctioned from the abdomen. About 300 mL of pus was suctioned from the pelvis. The gangrenous portion was resected, and repair was done in two layers using Conell and Lambert suture techniques. Acute gastric necrosis is a rare surgical condition that requires a high index of suspicion and prompts aggressive resuscitation and surgical intervention to obviate the high mortality rate associated with the condition.
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    Comparative analysis of breast cancer characteristics in young premenopausal and postmenopausal women inGhana
    (Nature, 2024) Bosompem, Kingsley; Yorke, Joseph; Buckman, TonniesAbeku; Brenu, SamuelGyasi; Nyantakyi, Michael; 0000-0002-5229-0340
    Breast cancer is increasingly common among young women in Ghana. BCa is heterogeneous with unique traits that impact causes, prognostic, and predictive outcomes of patients before and after menopause. However, limited evidence exists on diferences between young premenopausal (YPM) and postmenopausal cases in Ghana. This study compared breast tumour characteristics between YPM women (under 35 years) and postmenopausal women. We conducted a prospective cross-sectional study involving 140 BCa-diagnosed women at the Breast Care Clinic of Komfo Anokye Teaching Hospital (KATH), Kumasi from November 2019 to June 2021. Thirty-one (22.1%) of participants were YPM and 109 (77.9%) were postmenopausal. The median ages for YPM and postmenopausal were 32.0 (range: 25.0–35.0) and 57.0 (48.0–86.0) respectively. Invasive carcinoma was the most common histological type (97.1%). Left tumour location was the most frequent in both groups (51.6% for YPM and 51.8% for postmenopausal). Lumps detected were frequently in the outer upper quadrant in both groups (61.3% and 56.0%). The majority of the YPM women (80.7%) and postmenopausal women (87.0%) had stage III and IV diseases. Most YPM (64.5%) and postmenopausal women (64.4%) exhibited triple-negative breast cancer (TNBC). Both YPM 13 (56.6%) and postmenopausal participants 40 (56.3%) exhibited a predominantly partial response to neo-adjuvant chemotherapy but YPM women (21.7%) experienced disease progression than the postmenopausal women (12.7%). The study highlights consistent tumour characteristics and advanced clinical stages at diagnosis in both groups with a higher prevalence of TNBC. TNBC and HER2+subtypes respond better to Anthracycline based neoadjuvant chemotherapy. Establishing Breast Care Clinics in district and regional hospitals for early detection is crucial and further studies are warranted to understand the higher TNBC prevalence in black Africans and re-evaluate breast education programs to address the persistently late presentations.
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    Demographic, Clinical Profile of Rheumatoid Arthritis Patients and Their Association with Disease Severity in Ghana
    (Hindawi, 2024) Buckman, Tonnies Abeku; Sakyi, Samuel Asamoah; Yeboah-Mensah, Kwame; Antwi, Maxwell Hubert; Darban, Isaac; Owusu-Brenya, Lawrence; Yorke, Joseph; 0000-0002-5229-0340
    Background. Rheumatoid arthritis (RA) is one of the frequent chronic, systemic, inflammatory autoimmune disorders with an estimated global prevalence of 1%. RA leads to joint destruction and disability if left untreated. Ghana has seen very few studies on RA, and little is known about the disease’s severity and related variables. This study sought to characterize the clinical presentation and determine disease severity and associated risk factors with disease severity among RA patients in a tertiary hospital in Ghana. Methods. This cross-sectional study was conducted between September 2020 and August 2021. This study included 56 consecutively consenting RA patients from the Komfo Anokye Teaching Hospital orthopaedic unit. Diagnosis of RA was based on the updated American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2022 rheumatoid arthritis classification criteria by a rheumatologist. A study questionnaire was used to gather participant demographics and clinical features, and results from the laboratory were taken from the patients’ charts and medical records. The patients’ disease severity was evaluated based on the rheumatoid arthritis disease activity score, which is based on a 28-joint count (DAS28), and their functioning was evaluated using the modified health assessment questionnaire. Results. The participants’ mean age was 51 25 ± 13 22 years. Out of the total participants, 46 were females, and 10 were males (female-to-male ratio 4.6 : 1). Moreover, 37.50% had arthritis of the hand; 5.30% had severe disease, and 94.60% were not severe. A majority (76.80%) were on methotrexate medication. The most frequently involved joints were the knee (42.90%), wrist (32.10%), and elbow (12.50%). There was no statistically significant association with disease severity and a functional status score of >0.5 (cOR: 10.60, 95% CI (0.52-217.30); p = 0 124). In addition, marital status (p = 0 04), disease duration (p = 0 04), family complaints (p = 0 02), and ESR (p = 0 03) were significantly associated with disease severity. Conclusion. RA is predominant among elder populations and females. Disease duration, family complaints, and ESR are associated with disease severity. The findings of this study call for interventions towards ensuring early diagnosis of RA among high-risk populations to enhance good management practices.
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    Familial adenomatous polyposis: a case study
    (JCR, 2020) Yorke, Joseph; Yamoah, Francis Akwaw; Awoonor-Williams, Ronald; Okpoti Konney, Thomas; 0000-0002-5229-0340
    Familial adenomatous polyposis (FAP) is an inherited syndrome characterized by several adenomatous polyps of the gastroin testinal (GI) mucosa. If treatment is not provided, an average individual with classic FAP will develop colorectal carcinoma around the age of 40 years. The incidence rate of FAP in developing countries like Ghana is unknown compared to advanced countries. We present the first FAP case of a 22-year-old Ghanaian female who presented with massive lower GI bleeding and underwent surgical management after a thorough investigation. The initial assumption that colonic polyps are scarce in native Africans may be more than what is perceived. This highlights the need for the availability of endoscopic services in Ghana.
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    Giant primary scrotal lipoma in a low-resource setting: challenges with diagnosis and review of literature
    (JSCR, 2021) Seidu, Anwar Sadat; Yorke, Joseph; Danso, Patrick; Sukenibe, Seidu Suhewie; 0000-0002-5229-0340
    Lipoma is the commonest benign mesenchymal tumor composed of matured adipocytes. A literature search revealed few reported cases of giant scrotal lipoma. This article aims to report a giant scrotal lipoma weighing 1100 g and illustrate our challenges with the diagnostic process in a low-resource setting. A 28-year-old male presented with a huge right scrotal mass. Examination revealed the mass had no cough impulse. It was firm, non-tender and lobulated, with definite edges. Scrotal sonography was suspicious of lipoma. Intraoperatively, there was an encapsulated scrotal wall mass and an incidental inguinoscrotal hernia, content being the omentum. The scrotal mass was excised, hernia sac was ligated, and excised and the posterior wall was repaired. Histology confirmed the scrotal mass as a lipoma. Primary scrotal lipomas are rare but should be considered in the differential diagnosis of unusual scrotal masses. Ultrasonography is a useful diagnostic tool in resource limited setting
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    Height and sex estimation using percutaneous humeral length among Ghanaians
    (Forensic Science International: Reports, 2024-07) Tetteh, Joshua; Diby, Thomas; Abaidoo, Chrissie Stansie; Yorke, Joseph; Robertson, Juliet; Nketsiah, James; 0000-0002-5229-0340
    Introduction: Humerus is a long bone that contributes significantly to the total height of an individual. It is sexually dimorphic and is a well-preserved bone postmortem. Height and sex are essential in establishing one’s identity and can be estimated from long bones when standing height cannot be easily obtained. Previous studies report that sex and height are population-specific. Hence, the present study sought to establish the relationship between percutaneous humeral lengths and height and formulate models for height and sex determination for the Ghanaian population. Materials and methods: Measurement of standing height and percutaneous humeral lengths were taken from 286 Ghanaian consented participants with no noticeable lower and upper extremities traumas or pathologies. The data was analysed using Microsoft Excel 2013 and SPSS version 23.0 edition. Correlation analysis was done to determine the correlation of the percutaneous humeral length with height, linear regression and binary logistic analyses were used to derive equations for predicting height and sex from percutaneous humeral length. An independent samples t-test was used to determine the means between males and females, left and right percutaneous humeral lengths. Results: There was a strong positive correlation between standing height and left (r = 0.774) and right (r=0.759) humeral lengths. The left humeral length regression equation was a good height estimator in males (75.4%) and females (71.%). The left and right humeral lengths best predicted the sex for the population, with an accuracy of 78.0% and 77.8% for males and 53.8% and 54.6% for females, respectively. Conclusion: This study has added to the limited data on the use of percutaneous humeral length as a substitute for the determination of standing height and sex in the Ghanaian population, and it is also a significant identification tool which can be employed in the field of forensic anthropometry.
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    Momordica charantia L. for hyperlipidaemia: A randomised controlled assessment of the Ghanaian herbal medicinal product MCP-1
    (Elsevier, 2021) Kwesi Prah, Thomford; Ama Kyeraa, Thomford; Yorke, Joseph; Yeboah, Ronald; Appiah, Alfred Ampomah; 0000-0002-5229-0340
    Cardiovascular diseases are a public health burden for developing countries like Ghana. Scientifically validated herbal medicines are viable options in the prevention and treatment of such conditions. In this study, a rand omised controlled trial involving 15 healthy subjects identified with hyperlipidaemia was undertaken. Treatment comprised a traditional Ghanaian herbal formulation prepared from the leaves and twines of Momordica char antia (MCP-1) with a standard dietary guideline. A control group was managed using a standard dietary guideline alone. In all, 15 subjects completed the study: MCP-1 had 10 subjects and 5 subjects in the control group. At the termination of the trial after 8 weeks, reduction in lipoprotein values were recorded for all participants. In the MCP-1 group, triglycerides reduced by 3.46 % compared to 3.37 % for the control while total cholesterol was also reduced by 9.78 % and 9.43 % in the MCP-1 and control groups respectively. High density lipoproteins (HDL) levels increased by 6.92 % for MCP-1 and 3.92 % for the control group. However, these changes were not statistically significant except in the instance of the low-density lipoproteins (LDL-c; CI: -41.24 to -19.76) and very low-density lipoproteins (VLDL-c; CI: -26.87 to -8.192). Changes to other disease indices such as blood pressure (BP), fasting blood sugar (FBS) and body mass index (BMI) were also not different between the 2 groups. MCP-1 was well tolerated among the subjects and was shown to be safe from the biochemical and haematological indicators. The product, MCP-1 has therefore been shown to be a safe and prospective anti-lipidaemic agent.
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    The Prevalence and Risk Factors of Hepatitis B Virus Infection Among Dwellers in A Peri-Urban District of Ghana: A Cross Sectional Study
    (UDS PUBLISHING LIMITED, 2018) Opare-Asamoah, Kwame; Majeed, Saeed F; Osei Owusu, Alexander; Keelson, Kofi Okyere; Owusu, Emmanuel Abem; Wondoh, Paul M.; Kunfah, Sheba M. P.; Fosu, Samuel E.; Yorke, Joseph; Yakong, Vida Nyagre; 0000-0002-5229-0340
    Hepatitis B virus (HBV) infection is a significant health issue affecting about 296 million people worldwide. The disease is of great public health concern in Ghana as the country is within the endemic region of HBV infection. This study sought to determine the prevalence of HBV infection and associated risk factors among dwellers in a peri-urban district of Ghana. This cross-sectional descriptive study was conducted in the Sunyani West District of the Bono Region of Ghana. Respondents aged ≥18 years were purposively recruited from the four major towns in the District with health centres. A questionnaire was used to collect data from participants, and a rapid diagnostic test for the sero-presence or otherwise of hepatitis B infection was conducted. A total of 992 respondents took part in the study, with the prevalence of HBV infection using HBsAg as a marker among all the study participants being 2.9% (male 4.0% (12/298), female 2.5% (17/694)). Females aged between 20-29 years had a comparatively higher prevalence of hepatitis B infection than their corresponding males. The intake of alcohol (RR=4.23; 95% CI:2.05-8.74, p <0.000), previously diagnosed of having a sexually transmitted disease (RR= 2.43; 95% CI: 1.03-5.71, p = .04) and having multiple sexual partners (RR= 2.27; 95% CI: 1.11-4.65, p = .02) were the significant risk factors for HBV infection among the study participants. The study showed a low prevalence of HBV infection in the Sunyani West District of Ghana using HBsAg as a serum marker to diagnose the infection.
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    Urethroplasty among Elderly Men, Surgical Techniques and Outcomes
    (Scientific Research Publishing, 2024) Arhin Appiah, Kwaku Addai; Amoah, , George; Opoku Manu Maison, Patrick; Azorliade, Roland; Otu-Boateng, Kwaku; Arthur, Douglas; Annor Mintah, Dominic; Yorke, Joseph; 0000-0002-5229-0340
    Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy post operatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bul bar urethral strictures. The repair methods employed were anastomotic ureth roplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethrop lasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Com plications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.