Common Atypical Presentations of Covid-19, By Nana Dadzie Ghansah

As COVID-19 broke out, several of the authoritative bodies like the WHO and the CDC as well as clinicians from China listed three common presenting symptoms: fever, cough, and shortness of breath.However, as the disease has continued to spread worldwide, reports are rampant of atypical presentations. Diarrhea seems one of the more common atypical presenting signs. Guan in their paper in the NEJM that looked at 1009 Chinese patients found an incidence of 3.8%. In a paper to be published soon,Read More…

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Covid-19 Response in Accra, Ghana: The Perspective of a Citizen and Physician, By Dr. Teddy Totimeh

Lock down begins. I thought, going to work that I would see a ghost town. I did not. The traffic has definitely reduced, but there are still people on the streets. The shops are closed, or closing. The police stops are increasing. The first day, I was underwhelmed. I did not meet a single policeman on my way to work. Today, I was stopped more times. The grip is tightening slowly, but maybe not fast enough. I met a police woman this morning who did not have a mask on when she stopped me. I waRead More…

Summary of Updated data from the French Chloroquine/Azithromycin Study for Covid-19, Summarized by Nana Dadzie Ghansah

The French group in Marseille whose small study really got the ball rolling on using hydroxychloroquine and azithromycin to treat COVID-19 released data on 80 more patients. Six of those were from the first cohort of 20 patients. Important findings: The study is really an observational one and not a randomized controlled trial. The aims of the study were threefold – if aggressive treatment with the combo of drugs could reduce the need for oxygen therapy of transfer to the ICU, if treatRead More…

Covid-19 Pandemic in Africa, The Facts, Myths and The Unknowns, By Dr. Leonard Sowah

There have been multiple Coronavirus outbreaks in the pasts, SARS-CoV-1 was first reported in Asia in February 2003, though cases subsequently were tracked to late 2002. This virus quickly spread to about 26 countries mostly in the Far East and Toronto, Canada before being contained after about four months. Epidemiologists localized its source to Guangdong Province in China where it was believed to have originated from bats. Another coronavirus MERS-CoV was first reported in Saudi Arabia in 201Read More…

Unforgettable Lessons from the Frontlines in Healthcare? By Dr. Leonard Sowah

There are certain lessons in life that are difficult to forget. Unfortunately, some of these lessons are very costly, and in the medical field the costs is usually counted in human lives. I still remember this day like it was yesterday. The lone house officer on the medical floor on a Saturday morning after a call in Accra, Ghana. We had a lot of admissions and the ward was completely full. Rounding for me in those days was an ordeal that could be likened to an obstacle course with patient pRead More…

How Would Posterity Grade Us on our Handling of COVID-19, By Nana Dadzie Ghansah

There are subjects you study in med school that are meant as instruments of torture. One of these is “Embryology” – the study of how the fetus forms from the fusion of the female egg and the male sperm and how all the organs develop and end up at their final spots. I bet you didn’t know that the heart started off as a tube! With that intro, let’s go back in time to 1989…back to the University of Leipzig. It was one night in the winter, the night before an all-important embryology exaRead More…

Global Health & Pandemic Preparedness: A Key Piece of American Diplomacy, By Dr. Leonard Sowah

When it comes to infectious diseases national boundaries have never been a useful means of control. This is one very important reason why the World Health Organization (WHO) is so important. There is another organization that has done so much to support the WHO called the Center for Disease Control and Prevention (CDC). The CDC is virtually an Agency of the US Department of Health and Human Services but is recognized globally in its role in Pandemic Mitigation and Control. Before I got some Read More…

COVID-19 ON OUR MINDS: PERSONAL ADVICE FOR EVERYONE, BY NANA DADZIE GHANSAH

Surely the COVID-19 pandemic is on a lot of minds lately. The news from places like Northern Italy and Washington State are worrisome but there are examples of other communities that have stood up to it. If we all do the little things that matter, I believe we can help make our respective communities one of those with low mortalities and great outcomes. Now, to the matter at hand: A few things that make COVID-19 special:It is a novel virus so there is no immunity against it out there. Even a fRead More…

RNA VIRUSES & HUMAN SPILLOVER INFECTIONS, BY NANA DADZIE GHANSAH

Note: this is a really basic discussion of a very complex and still-evolving topic. The genetic information that codes for traits in all living organisms are found in DNA or RNA or a combination of the two. Even viruses, not really seen as living organisms, have genetic material. They either code them in RNA (RNA viruses) eg. Influenza or DNA (DNA viruses) eg. Herpes.Where DNA viruses are quite big, RNA ones are much smaller. Also, RNA viruses replicate (multiply) way more than DNA virusRead More…

A Tribute to Mr. Rudolf Darko, Are We Witnessing The Passing of an Era, By Dr. Leonard Sowah

I have a lot of memories of medical school, some pleasant and some that I would rather not remember. Most of these memories are associated with faculty who have had some impact or other on my time in training. After all what is the purpose of medical school and residency but a highly structured apprenticeship program, and what good is an apprentice who fails to take a piece of the master with them.
I know very well that most of my colleagues who have all gone on into different fields of medicineRead More…

On the HPV Vaccine Debate; What I Learned About Sexual Risk from a Colleague in Medical School, By Dr. Leonard Sowah

Anytime I hear any debate on the HPV vaccine Gardasil, I remember a fact that most of us tend to forget.  This simple piece of common sense was brought to my attention by a classmate in a class on sexual risk and cervical cancer.
I can still hear his voice ringing in my ears;
“Sowee; de ting ino bi how many people the chick sleep with, sometimes all you need is one bad dick” He went on to explain this with an analogy using cars, he compared 50,000 miles on the German Autobahn to 10, 000 miRead More…

Addressing the Risk of Anal Cancer in Baltimore City, By Dr. Leonard Sowah

On the first approach by our division chief to work on a project to develop an anal cancer screening program I must admit I was a skeptic. Like most physicians I believed high resolution anoscopies were not really supported by any good evidence and did not support the need for the procedure. Over the course of several months however a close evaluation of the medical literature left me with more questions than answers.
In 2014 as it is now there was no clear evidence supporting the benefit of anaRead More…

The Ambulance Conundrum in Ghana, Commissioning or Deployment; Which is More Important? By Dr. Teddy Totimeh

I passed by those ambulances on a daily basis. Lined up in neat rows on the parking lots of power. The controversy swirled around them. The need beckoned. The death data swelled. And still they sat, waiting for the word to be given. The dust accumulated. The rust must have started already, the salt breeze wafting off the coast just miles away.
So a few weeks ago, I was in traffic, trying to make my way across lanes without being hit by a motorbike, when I heard the siren. There was an ambulance Read More…

The Benefits of Boarding Schools in Ghana from the point of view of a Current Student, By Jacob Nii Adjetey

I deem it a great privilege to have the opportunity to express my opinion on the boarding system of education. Though the boarding system has its own demerits, its advantages convince me to opt for it rather than the day system.
To set the ball rolling is national integration, an indispensable factor in human development. As youthful as our population is, the hope of the nation thriving, depends greatly on us. Fortunately, the boarding system, among its numerous benefits, binds us together as a Read More…

When we Encroach, By Nana Dadzie Ghansah

He is seen as the first patient who got sick but some researchers believe the virus had already started raging earlier than that December 1st when he was admitted to a hospital in Wuhan, China with pneumonia. By December 10, there were 3 more patients and by the end of the month, there were 40 cases.
Soon the world would hear of a virus that was making people sick in Wuhan, China and was going to spread even beyond China.
Initial work by Chinese virologist soon showed what the causative agent waRead More…

Sleeping Rough in America Today, By Leonard Sowah

In my early days as a physician in Baltimore city I worked briefly with Healthcare for the Homeless and had many patients who were homeless. One thing that I learned was that the homeless in America have many varied life experiences beyond the common belief that mental illness and substance abuse are the most common causes of homelessness.
I still remember the mother of three who worked daily and lived at The House of Ruth a local shelter for women. Then there were a few who were chronically homRead More…

Preventing cervical cancer in Ghana: Education should be geared towards solving problems of the society, By Dr. Kofi Effah 

January is being celebrated in Ghana as cervical cancer awareness month. This is laudable considering the fact that cervical cancer, a very preventable disease, kills many Ghanaian women. It is great to create awareness about cervical cancer leading to action (lifestyle modifications, vaccination, screening and treatment of precancerous lesions of the cervix) to prevent cervical cancer. Unfortunately, many times, people will forget about cervical cancer till we are in January when this is broughRead More…

How Do We Get Together to Conquer Our Problems?, By Dr. Leonard Sowah

In the US and across the world things can appear very chaotic nowadays and many have expressed concern over the nature of the divisive political rhetoric in Washington. The initiation of impeachment proceedings against the Trump Administration has not helped this situation in any manner and only served to rev things up a few notches.
The question on the minds of most people is how long the dysfunction in our political climate can last without any adverse impact on our long-term economic and sociRead More…

Mass Incarceration and Prison Gerrymandering, By Dr. Leonard Sowah

In the last 2 decades most new jail and prison developments in the US a country with one of the highest prison populations in the world are in rural and suburban districts. Data reported by the London Institute of Criminal Policy Research reports our incarceration rate as 655 per 100,000 the highest rate in the world similar to countries like El Salvador, Thailand and Turkmenistan at 618, 553 and 552 per 100,000 persons respectively. When considering how many of our citizens we keep locked up, oRead More…

The Ravages of Addiction, By Nana Dadzie Ghansah

They are not hard to miss. There is just a look about them – haggard and emaciated. Besides, they carry the stigmata of their affliction like badges.
Their hair is often stringy and unkempt. Their faces bear marks of acne, scratches, cuts… The eyes are sunken into the sockets like there is nothing to hold them in place.
When they open their mouths, the dentition is always a dead giveaway. Terrible! The teeth are broken, carious, missing or loose.
Their lips are often parched and look whitish aRead More…

Should We Be Doing Virginity Checks?

I spent all of Friday making the video below after hearing rapper T.I. say he had accompanied his daughter now 18 years on each birthday to a gynecologist to check if she is still a virgin. I have heard so much ignorant comments on this subject that I had to make this 6 minute long video to dispel myths and misconceptions surrounding the hymen as well as the dangers virginity checks have on women everywhere in the world. For those who don’t have time to watch it, here are the main points: Read More…

Can we allow women to control their own bodies? By Dr. Leonard Sowah

The examination room gets cleaned at least 3 times a day however the ever pungent smell of blood appears to defy all the efforts of our ever zealous cleaning staff. The smell was strong and overpowering. Even as I entered the curtained area of the room which afforded some privacy for our clients I could tell there was something different about this lady’s condition. This was not the run of the mill incomplete and threatened abortions that flood our emergency room all day long.
The malodorous aroRead More…

Sex for Grades Controversy in Two Major Universities in West Africa, Recommendations for University of Ghana, By Emefa Gadze

A BBC report on sexual harassment and some blatant trading of sex for grades has raised a lot of concern within different levels of communities in Ghana and Nigeria. A Nigerian professor and pastor has been suspended from his church and university on this issue. In Ghana a lecturer of the University of Ghana cited in this report also faces suspension.
Whilst this has only been reported in University of Ghana and University of Lagos when these things happen we must as a society accept full responRead More…

How Worried Should We Be About Bernie’s Heart Attack? By Dr. Leonard Sowah

The Senator from Vermont and Democratic Presidential hopeful Bernie Sanders had a heart attack whilst on the Campaign trail. Such events in US Presidential campaigns are usually very major issues however fortunately or unfortunately Bernie’s heart attack was relegated to back pages of the political news on account of issues related to Trump’s impeachment inquiry.
Sander’s ended up in a hospital in Nevada and spent two days in hospital getting out on Friday, October 4th 2019. On his discharge BerRead More…

The Opioid Epidemic, Are Pharmaceutical Companies Responsible? By Dr. Leonard Sowah

Today in the United States many families, cities and communities are going through significant turmoil, heartache and despair from the scourge of opioid abuse and addiction. This epidemic which ran amok and unchecked for about 2 decades is pervasive and permeates many aspects of our lives. As a physician in Maryland in 2008/2009 I had heard and read about addicts and dealers in Appalachia traveling to poorly regulated pain clinics in Florida to stock up on Oxycontin. This situation had been enabRead More…

The Rise of Designer Synthetic Cannabinoids, By Dr. Leonard Sowah

Sometime in the 1990s a Harvard educated chemist funded by the National Institute of Drug Abuse worked with his colleagues to synthesize compounds that could stimulate the endocannabinoid system. John William Huffman and his colleagues were trying to find an effective cannabinoid that stimulates cannabinoid receptors better than THC (Tetrahydrocannabinol) the active euphoria creating hallucinogen in marijuana. This research it was hoped will help in understanding the effects of the cannabinoid rRead More…

The Ghanaian Health System: Hoping for A Better Tomorrow Without Trusting in Hope, Dr. Teddy Totimeh

When I saw the CT scan my heart sank. The beautiful symmetry that the brain has, the different shades that white and grey matter imprint on the LCD screen were gone. The lines that divide the electrical generating cells, from the transmitting cells, were gone. This was the aftermath of battle, and the brain cells had lost the ultimate war. And now even as the person’s heart and lungs worked together in the unison that is life’s rhythm, the brain was gone. Life had ended. And there was nothinRead More…

E-cigarettes and The Vaping Craze, Is this Safer Than Smoking Tobacco? By Dr. Leonard Sowah

As a physician taking care of a largely HIV positive population in Baltimore, Maryland in the early 2010s, I was surprised to learn that many of my patients who were about my age or a few years older than myself were coming down with strokes and heart attacks. I still remember one gentleman who in his 40s had already had 3 heart attacks and was fortunate to live to tell the tale.
The point of this short tale is that tobacco use is still by far the commonest cause of preventable deaths in most coRead More…

A Little Neglect May Breed Mischief, By Nana Dadzie Ghansah

Robert Mugabe aka Uncle Bob died last week at the ripe old age of 95. He followed a long list of African leaders who died abroad where they fled to seek treatment after neglecting the medical facilities in their home countries. Mugabe died in the Gleneagles Hospital in Singapore. Over the years, Singapore is where he went for his physicals and treatment while the common Zimbabwean had to make do with the terrible healthcare services at home.
Anytime one of these leaders dies in a hospital abroadRead More…

Maternal Mortality in Rural US and Ghana are there any Similarities? By Dr. Leonard Sowah

As a medical student in Ghana I still clearly remember trips made with my colleagues to parts of rural Volta Region in Ghana to learn about the impact of training of Traditional Birth Attendants on maternal mortality. This experience imprinted in my mind how simple interventions can impact health outcomes. In many parts of Ghana most people live at least a half days walk to the nearest health center. Most of these health centers are under the ministry of health and have facilities for delivery aRead More…

The Silent Killers, Is This Just a Myth? By Dr. Leonard Sowah

Talk of the silent killer has many people worried specifically related to sudden deaths. In health though silent killers abound and the anxiety related to their impact on our lives is not one that is easily assuaged. In my own life, over the course of about 5 years the numbers of friends, family members, and old classmates said to have died suddenly without any obvious antecedent illness continues to grow. It appears to me this situation is more common among friends and family living in Ghana aRead More…

Is Religion Driving Health Policy in The US? By Dr. Leonard Sowah

This summer, on August 19th 2019 the Planned Parenthood Federation of America made a decision to withdraw from Title X funding. This program which is older than most of us was enacted by President Richard Nixon as Public Health Law 91-572 a part of the Public Health Services Act in 1970. The law passed the Senate unanimously and the house voted 298 to 32 to send this Bill on to President Nixon for his signature.
Judging by the voting record this law was very popular in 1970 so why would Planned Read More…

Faith and Government, How Do We Achieve Balance Whilst Respecting All Our Faith Traditions? By Dr. Leonard Sowah

I grew up in a Christian family so I understand the expectations of a life lived for the honor of God. I understand the concept of Christians supporting each other to good works. I believe in the need for people of faith to pray for the good of their nation and its leaders.
In my life through I have seen and experienced some Christian traditions that go further than what I believed. I have heard and been instructed on the ideology of taking by force in Christian proselytizing which I reject. I hRead More…

Rewriting The New Colossus, By Dr. Leonard Sowah

Emma Lazarus a poet and activist wrote the poem on the plaque of the Statue of Liberty. The words say;
“Keep, ancient lands, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!”
These worlds welcomed immigrants to the United States from 1903 to 1954 when Ellis Island served as immigrant inspectionRead More…

The Good Guy with a Gun, By Nana Dadzie Ghansah

Yesterday, a 20-year-old armed man gave Walmart shoppers in Springfield, MO a horrible scare. It is unclear what was his motive for walking into the Walmart around 4 pm yesterday dressed in combat fatigues, body armor and armed with a tactical rifle, a handgun and more than 100 rounds of ammunition.
After the shootings a few days ago in El Paso and Dayton, a lot of people are on edge.
He was later arrested by an off-duty firefighter who had a gun and this is being hailed by those who are againstRead More…

A Tribute to Toni Morrison, a Giant in American Contemporary Literature, By Nana Dadzie Ghansah

Toni Morrison is one of those really great writers whose books I found so difficult to read because of the subjects they explored. Her work touched on the African-American experience – especially that of the black woman – so starkly that often, the sympathy I felt for her characters overwhelmed me. Full disclosure – stories and movies about slavery, apartheid, Jim Crow era, the holocaust…even what the Palestinians are going through now, depress me to the point where I just want to withdraw iRead More…

Why I Still Wonder, Man The Ultimate Miracle of Nature, By Dr. Teddy Totimeh

The human body is an ecosystem of value creation and dissemination. It is a collection of cells with an unimaginable capacity to achieve. The scope of what this collection of cells is able to create is mind blowing. To look around and see all that has been built by humanity, is to amaze oneself with the extent of what is possible. There is really no limit to what a human being can achieve. On the contrary there is also no limit to the extent to which one can fail.
How cells can harness simple moRead More…

America Does Not Have a Race or Gun Problem We Have a Leadership Problem, By Dr. Leonard Sowah

Last weekend, we had two mass shootings with a total death toll of 29. One of these shootings was in El Paso and is being judged a hate crime based on a manifesto posted by the shooter about 20 minutes before the incident. The shooter in El Paso, TX shot and killed 20 people in a Walmart used by Americans and Mexicans who cross over to shop. The other shooter killed 9 people in a popular club district at 1am on Sunday morning in Dayton, Ohio.
Anytime such shootings occur we hear the same words bRead More…

The Socialist Agenda, The Bogeyman Who is Coming to Get Us All, By Leonard Sowah

As a child I loved to garden and actually still do. One reason why I love gardening is the joy I get from watching plants grow and die. As a lazy gardener though I have learned to appreciate the beauty of perennials. Afterall, what is better than planting a flower once and having it come back to life year after year. My perennials except for losing their deer resistant traits overtime tend to do very well. I am however still wondering if the deer resistant feature was  designed to be lost just Read More…

Colon Cancer Prevention, Do we Really Know Enough? By Dr. Leonard Sowah

I recently visited my primary care doctor after more than a year. At the end of the visit he gave me some encouraging feedback. My weight was stable, he may be right there but I know the weight is not everything since my belt has advanced about a hole since my last visit. He mentioned that my blood pressure was stable and normal in spite of a positive family history of hypertension. Then he asked about my next birthday and I knew he was moving on to the dreaded territory of colonoscopies becauseRead More…