Hemolytic uremic syndrome (HUS) is associated with microthrombi ,mainly in the kidneys. It may be classified as typical HUS or atypical HUS (aHUS) .Majority of HUS occur in children (usually at 6 months of age), as a sequela of shigella infection. In aHUS, a genetic or sporadic insult causes dysfunction in the complement cascade, leading to complement deposition on endothelial cells, thickening of arterioles and capillaries, and endothelial swelling and detachment. Consequently, there is formation of obstructive thrombi in the vessel lumina and shearing of red blood cells, creating schistiocytes, that results in the triad of Coombs negative hemolytic anemia, renal impairment, and thrombocytopenia. We report a rare case of a 43-year-old black male who reacted to the 2nd booster dose (some 7 months after the 1st) of Astra Zeneca Covid-19 vaccine with aHUS. He had ophthalmoplegia, occipital headaches and suicidal ideation which all resolved on high dose oral prednisolone. The Astra Zeneca vaccine which uses a chimpanzee platform is the only one reported to have similar reactions and this is important to note and manage such potentially life threatening rare adverse event.
This paper examines selected expressions relating to the articulation of mental health challenges in three Akan speaking communities in Ghana, in the context of considering that language is reflective of human thought, and that human cultural practices and behavior emanate from people’s underlying appreciation of particular issues. Expressions of mental health challenges were extracted from a total of 37 one-on-one interviews and 12 focus group discussions. We note that the expressions used fall into 3 categories: idioms and proverbs, non-figurative language and code mixed utterances. Overall, indirection permeates all the categories. Furthermore, our observation is that the expressions provide an indication of the manifestations and perceived causes of the illnesses, which are familial, spiritual or biomedical. There is a strong tendency towards an expectation of communal support for the mentally ill. An appreciation of the languages and cultures of local communities provides the basis for appropriate diagnosis, effective management of mental illness and efficient public health education.
The present paper examines interactions in psychiatric care consultation in selected hospital settings in three Akan-speaking communities in Ghana, based on 45 audio-recorded doctor/nurse-patient interactions. Using a discourse pragmatics approach, we note how language is used in the management of communication in psychiatric consultations, and how the dominance of healthcare practitioners is enacted. Specifically, we focus on some of the strategies used by the participants to manage the multilingual communicative settings, such as code-mixing. Our findings also suggest that the use of proverbs as a diagnostic tool in psychiatric consultations in Ghana needs to be reviewed. We propose that in order for patients to experience consultation sessions that are more interactive, with possible therapeutic benefits, health practitioners need to make considerable efforts to involve the patients in decisions regarding their health.
Objective: Bipolar disorder commonly presents with substance use and there is the diagnostic challenge of one being a sequela of the other or the two being co-morbid conditions. The distinction is important as the effective treatment of the primary condition can lead to a concomitant remittance of the other. A misdiagnosis and a consequent ineffective treatment on the other hand, can lead to worsening prognosis of both conditions in the person. This aims at bringing attention to this diagnostic dilemma and the need to hone skills for proper diagnosis and eventual effective treatment.Case Presentation: Ms. KK is a 28-year-old divorcee and Human Resources Manager who presented with gregariousness, sleep difficulty and smoking of marijuana for two months. She had resumed smoking of marijuana after some 6 months break. She admitted to suicidal ideation and behaviours even though she also had many big plans to transform mental healthcare in Ghana. She was admitted a year earlier as schizophrenia for less than a week after which she had a divorce. Ms. KK was referred for management of substance induced psychosis to include residential rehabilitation. She was managed after review for bipolar disorder with substance use disorder. She was treated with long-acting second generation antipsychotic and she quit smoking with the remission of her mood symptoms after two months.Conclusion: Mood disorders can occur with substance use disorder as a co-morbid condition or part of the symptomatology of mood disorder. Substance use disorder can also present with mood symptoms or unmask mood disorders. When the correct diagnosis of aprimary mood disorder, bipolar disorder in this case, with co-morbid substance use disorder is made, effective treatment of the mood disorder can remit substance use.
Objective: Alcohol use disorder (AUD) is a common but usually undiagnosed and untreated condition. Persons with the condition tend to maintain their jobs until it severely incapacitates them. The ten years lag between frequent use of alcohol and development of AUDsignificantly contributes to this and until organizations actively screen and manage persons with the disorder, it continues to negatively affect productivity. The aim of this study was to determine the prevalence of AUD in an engineering company and establish a case for employee assistance program (EAP) for the management of AUD.Method: Staff of the company were systematically sampled and administered a questionnaire which involved the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. A cut off score of 8 was used as a positive screen for AUD.Results: Thirty-five (9.4%) out of 373 staff screened positive for AUD and half of them were between 31 and 40 years. Men were twice as likely to have AUD compared to females. Muslims were 2.4 times more likely to have AUD compared to Christians and juniorstaff were 4 times more likely to be diagnosed with AUD compared to senior staff.Conclusion: AUD is common among industry workers and therefore human resource policies are necessary for early detection and treatment for improved productivity and employee motivation.
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