School of Medical Sciences

Postpartum fertility behaviours and contraceptive use among women in rural Ghana

2023-10-10T16:07:14Z

Postpartum fertility behaviours and contraceptive use among women in rural Ghana Eliason, Sebastian Kofi; Bockarie, Ansumana Sandy; Eliason, Cecilia Background: Although most women would want to wait for more than two years before having another baby, their fertility behaviours during the first year following birth may decrease or increase the length of the birth interval. The objectives of this study were to: assess how protected postpartum women in the Mfantseman municipal were against pregnancy, based on their patterns of amenorrhoea and sexual abstinence; determine the timing of postpartum contraception in relation to amenorrhoea and sexual abstinence; and determine the predictors of postpartum contraceptive use. Methods: This was a prospective study carried out in the Mfantseman Municipality of the Central region of Ghana. Out of 1914 women attending antenatal clinic in the municipal within the study period, 1350 agreed to be part of the study to ascertain their postpartum fertility and contraceptive behaviours a year following delivery. These women were traced to their communities using telephone and house numbers provided and only 1003 of the women were finally traced and interviewed. The women were asked about their breastfeeding behaviour, postpartum sexual abstinence, duration of amenorrhoea and postpartum contraceptive use. Results: The mean age of the respondents was 29.9 ± 6.5 years; adolescents constituted the least proportion (3.3%) of the women. More than half (54.1%) of the women had Middle, Junior secondary school or Junior high school education. Most (43.3%) of the women were married by means of traditional rites and more than half (51.4%) of them were petty traders. The mean durations of breastfeeding, amenorrhoea and sexual abstinence were 6.6 ± 2. 8 months, 7.8 ± 3.8 months and 4.4 ± 3.1 months respectively, whilst mean time of first contraceptive uptake was 3. 5 ± 2.7 months postpartum. The time to first use of modern contraceptive method during the postpartum period indicates that about 50% of the women had started use of modern contraceptive methods by 2.7 months postpartum, and occured 0.6 and 3.6 months before sexual relations and resumption of menses respectively. Occupation (likelihood ratio p = 0.013), area of residence (likelihood ratio p = 0.004), mode of delivery (likelihood ratio p < 0.001), breastfeeding (p = 0.024), period since delivery (p < 0.001), preferred number of children (p < 0.001) and parity (p < 0.001) were found to be predictors of postpartum contraceptive use. Conclusion: Postpartum women in the Mfantseman municipal who did not use contraceptives or delayed in the use of contraceptives after birth were least likely to be protected against pregnancy in the post partum period, whilst those who adopted postpartum family planning were likely to be better protected because they were likely to adopt it within the first three months after birth and before the onset of sexual relations and first menses. The predictors of postpartum contraceptive use were breastfeeding pattern, occupation, parity, preferred number of children, period since delivery, place of residence and mode of delivery.

Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn

2022-06-09T11:29:30Z

Inguinal Hernia Containing Uterus, Fallopian Tube, and Ovary in a Premature Newborn Cerit, KJvJlcJm Karadeniz; Rabia, Ergelen; Colak, Emel; Dagli, Tolga E. A female infant weighing 2,200 g was delivered at 34 weeks of gestation by vaginal delivery. She presented with an irreducible mass in the left inguinal region at 32 days of age. An ultrasonography (US) was performed and an incarcerated hernia containing uterus, fallopian tube, and ovary was diagnosed preoperatively. Surgery was performed through an inguinal approach; the uterus, fallopian tube, and ovary were found in the hernia sac. High ligation and an additional repair of the internal inguinal ring were performed. Patent processus vaginalis was found during contralateral exploration and also closed. The postoperative course was uneventful. After one year of follow-up, there have been no signs of recurrence 4p;, ill.

Nutritional management of cirrhosis patients: A qualitative study exploring perceptions of patients and health workers in Ghana

2022-06-07T12:04:40Z

Nutritional management of cirrhosis patients: A qualitative study exploring perceptions of patients and health workers in Ghana Nartey, Yvonne Ayerki; Asem, Mawuena; Agyei-Nkansah, Adwoa; Awuku, Yaw Asante; Setorglo, Jacob; Duah, Amoako; Bampoh, Sally; Ayawin, Joshua; Asibey, Shadrack Osei; Ye, Weimin; Mary, Mary Yeboah; Roberts, Lewis; Plymoth, Amelie Malnutrition is common among patients with end stage liver disease including liver cirrhosis and liver cancer. Optimal nutrition is important to reduce morbidity and mortality of these patients. There is limited qualitative data on nutritional status and management of chronic liver disease patients. We aimed to explore the knowledge, opinions and practices of cirrhosis patients and health workers in nutritional management of cirrhosis in Ghana, in order to determine whether there is a need to improve nutritional care for cirrhosis patients. Methods: We conducted a qualitative study using semi-structured interviews of cirrhotic patients (n ¼ 16) and healthcare providers (n ¼ 27) in three academic centers in Accra, Kumasi and Cape Coast (Ghana). Recruitment was by purposive sampling of patients attending specialist liver disease clinics. The recorded data were analyzed using NVivo 11 software, with generation of codes, themes and subthemes. Results: The major themes that emerged from the data included nutrition as part of care delivery during the hospital visit, nutritional recommendations, dietary changes and long-term practice improvement. The results showed that patients and health workers felt dietary recommendations for patients were frequently addressed, but could be significantly improved. We found that in the opinion of study participants, local guidelines are important and necessary in nutritional management of cirrhosis patients, and that participants felt it was difficult to change dietary habits following cirrhosis diagnosis. Conclusions: These results suggest that nutritional management of cirrhosis patients in Ghana requires improvement. Strategies to improve this could include a multi-disciplinary approach to nutritional management, development of local guidelines and continued nutritional assessment, monitoring and follow-up. 22p;, ill.

Palm Weevil Larvae (Rhynchophorus phoenicis Fabricius) and Orange-Fleshed Sweet Potato-Enriched Biscuits Improved Nutritional Status in Female Wistar Albino Rats

2022-06-07T11:42:24Z

Palm Weevil Larvae (Rhynchophorus phoenicis Fabricius) and Orange-Fleshed Sweet Potato-Enriched Biscuits Improved Nutritional Status in Female Wistar Albino Rats Ayensu, Jessica; Larbie, Christopher; Annan, Reginald Adjetey; Lutterodt, Herman; Edusei, Anthony; Loh, Su Peng; Asiamah, Ernest Amponsah Edible insects have emerged as an inexpensive alternative source of protein for reducing the burden of malnutrition worldwide. However, there is a dearth of evidence on its efficacy, and thus, the aim of this study was to investigate the effect of edible insect consumption on the nutritional status of female Wistar albino rats. )e study assessed the subchronic effect of palm weevil larvae (PWL) and orange-fleshed sweet potato- (OFSP-) enriched biscuits (fortified biscuits (FB), plain biscuits (PB), biscuits fortified with PWL (PWB), and biscuits fortified with OFSP only (SPB)) as a model to predict the potential of PWL to improve the nutritional status of pregnant women in Ghana. Twenty-five female Wistar albino rats were randomly assigned to five experimental groups to receive one of the five feed supplements for 28 days. After which, the effects of treatment on haematological and biochemical parameters including lipid profile were assessed. No significant differences were observed with haematological (Hb) parameters. However, total cholesterol levels of the FB, PB, PWB, and SPB were significantly higher than in the N group. Apart from elevated total cholesterol concentrations, biscuits fortified with PWL had no adverse effects and can be a nutritious snack for maintaining acceptable HB levels. 8p;, ill.