bluuebunny/crossref_metadata_2025 huggingface dataset:
PROSES PENULISAN LONTAR TUTUR AJI SARASWATI KARYA IDA BAGUS OKA MANOBHAWA DALAM FOTOGRAFI STORY
Authors: Permana I Kadek Dwiki Krishna , Raharjo Anis , Pramana I Made Bayu
Published: July 2023

Saat teknologi semakin canggih dan informasi sudah sangat mudah didapatkan salah satunya e-book melalui internet. Penulisan menggunakan lontar yang telah diwariskan mulai tertinggal digantikan oleh buku dan e-book. Sehubungan dengan praktik kerja program kegiatan MBKM di tempat magang Yayasan Janahita Mandala Ubud. Penulis mendokumentasikan foto program kegiatan yaitu Sarasastra dan konservasi naskah lontar. Dalam melakukan kegiatan tersebut penulis menyadari kekurangan daya minat dan informasi dari masyarakat mengenai naskah lontar sehingga kurangnya minat untuk melestarikan warisan budaya leluhur. Oleh karena itu, penulis membuat karya fotografi story yang berjudul “Proses Penulisan Lontar Tutur Aji Saraswati Karya Ida Bagus Oka Manobhawa Dalam Fotografi Story” yang mengilustrasikan tentang proses penulisan naskah lontar dari awal hingga selesai. Dalam pemotretan diawali dengan foto rumah pengawi, proses penulisan lontar, dan yang terakhir hasil jadi naskah lontar. Penulis melakukan studi pustaka melalui buku, jurnal, dan website serta melakukan observasi mengenai penulisan naskah lontar dan melakukan wawancara secara langsung. Penulis juga menggunakan teori EDFAT dan teori estetika dalam proses penciptaan karya foto. Dalam proses pemotretan penulis menerapkan beberapa teknik fotografi salah satunya yaitu teknik motion blur, dan pencahayaan melalui cahaya matahari dan flash eksternal. Diharapkan hasil foto penelitian dapat dilihat oleh masyarakat untuk ikut tertarik berkontribusi dalam pelestarian warisan budaya, sehingga tidak hilang seiring berjalannya waktu dalam perkembangan teknologi dan informasi yang cepat.
TABANAN : LUMBUNG PADI YANG TERGERUS
Authors: Anindya Krisna Widarma Dewa Gede , Pramana I Made Bayu , Bratayadnya Putu Agus
Published: July 2023

Dibalik besarnya produksi padi dan beras di kabupaten Tabanan, terjadi alih fungsi lahan yang cukup besar dan masif yang mengancam luas areal persawahan di kabupaten yang dikenal sebagai daerah lumbung padi ini. Pengggunan photo book sebagai medium, yang mana photo book dapat memeberikan rangkaian dari visual visual yang setiap gambarnya memeberikan cerita dan berhubungan dengan gambar gambar lainnya.Proses observasi dalam proses penciptaan karya ini, penulis melakukan melakukan observasi melalui media online maupun observasi lapangan mengenai kondisi serta masalah alih fungsi lahan pertaninan di kabupaten Tabanan. Pada awal proses pencarian data penulis melakukan wawancara terhadap beberapa tokoh serta orang orang yang berkaitan dengan pertanian secara langsung maupun tidak langsung untuk mendapatkan data serta informasi mengenai kondisi serta permasalahan alih fungsi lahan pertanian di Kabupaten Tabanan. Buku foto menyajikan rangkaian cerita yang dirangkai dengan visual karya fotografi mengenai kondisi pertanian di Kabupaten Tabanan khususnya mengenai isu alih fungsi lahan sawah, visual yang disajikan mengenai sawah yang semakin terhimpit dan berkurang akibat dari alih fungsi lahan sawah menjadi perumahan ataupun pemukiman. Terdapat beberapa tahapan yang dilalui dalam proses pencuptaan ini seperti proses pemotretan, tahap perancangan dan proses produksi.
IMPLEMENTASI GREEN DESIGN PADA INTERIOR KANTOR FAKULTAS ILMU KOMUNIKASI UNIVERSITAS KRISTEN PETRA
Authors: Wijaya Renita Camelia , Margaretha Grace
Published: July 2023

Kenyamanan dan kesejahteraan dalam aktivitas perkantoran dipengaruhi oleh keadaan lingkungan di sekitarnya.Seringkali kantor yang tidak kondusif dan mampu meningkatkan produktivitas dapat menurunkan tingkat kesejahteraan dari pegawai. Kantor konvensional umumnya lebih menekankan bahwa pegawai cukup hanya mengerjakan kegiatan administrasi sesuai jam operasional kantor tanpa memperhatikan kenyamanan secara psikologis dan kesejahteraan fisik maupun non fisik. Kenyataannya, dalam perancangan interior kantor hal-hal seperti visualisasi, ergonomi, kebersihan, dan sistem lain sering dianggap trivial berujung diabaikan karena memerlukan biaya untuk renovasi interiornya. Pada perancangan interior kantor ini yang merupakan kantor administrasi tata usaha fakultas ilmu komunikasi di Universitas Kristen Petra masih belum menerapkan green design dalam eko interior perkantorannya. Adapun aspek yang diperhatikan seperti jenis material dan inovasi daur ulang, sistem pelayanan, dan aktivitas manusianya. Selain itu, kantor juga belum menerapkan identitas dari fakultasnya sehingga masih terlihat seperti kantor konvensional. Penerapan identitas institusi/organisasi yang bersangkutan sangat membantu membangun nilai moral. Perancangan ini dilakukan dengan menggunakan 5 tahapan metode Design Thinking yaitu Empathize lokasi site dan pengguna kantor ilmu komunikasi, Define masalah, Ideate transformasi desain yang diharapkan sebagai solusi kantor yang menerapkan green design, Prototype hasil rancangan final, dan Test untuk mengevaluasi hasil desain ajuan.
DESAIN INTERIOR OBJEK WISATA EDUTOURISM MINUMAN FERMENTASI DAN DESTILASI KHAS BALI
Authors: Prayojani Ketut Indira Suasti , Remawa Anak Agung Gde Rai , Waisnawa I Made Jayadi
Published: July 2023

Minuman fermentasi dan destilasi khas Bali telah berpotensi untuk menjadi daya tarik pariwisata (food tourism) berkat adanya Peraturan Gubernur Bali No.1 Tahun 2020 mengenai Tata Kelola Minuman Fermentasi dan/atau Destilasi Khas Bali. Timbulnya peraturan pemerintah ini memberikan harapan bagi perekonomian masyarakat khususnya para perajin lokal untuk mengembangkan produknya hingga ke pangsa pasar internasional. Sehingga dibutuhkan sebuah objek yang dapat mewadahi kegiatan pemasaran produk minuman fermentasi dan destilasi khas Bali.

Objek wisata edukasi minuman fermentasi dan destilasi khas Bali dirasa mampu mewadahi kegiatan rekreasi sekaligus edukasi untuk mengenalkan dan memasarkan produk minuman fermentasi dan destilasi khas Bali yang diproduksi dengan cara tradisional. Penciptaan objek wisata edukasi minuman fermentasi dan destilasi khas Bali ini menggunakan pendekatan desain interior sebagai pemecahan masalahnya. Tujuan dari desain interior ini adalah untuk mengembangkan sektor pariwisata, memajukan perajin lokal, memasarkan produk dan memberikan edukasi mengenai produk khas daerah. Metode desain yang digunakan untuk mewujudkan tujuan tersebut adalah metode analitis (analitycal method) yang mengacu pada ‘berpikir sebelum menggambar’ (Jones, 1971) dan metode analisis data deskriptif kualitatif. Melalui metode yang digunakan akan menghasilkan konsep sebagai pemecah masalah desain. Konsep yang digunakan dalam desain interior ini adalah Saraka Mukti yang dapat diartikan sebagai kebangkitan bagi kegiatan pemasaran dan budaya konsumsi minuman keras. Konsep tersebut kemudian berfungsi sebagai pedoman untuk memvisualisasikan ide dan gagasan menjadi gambar konsepsual, gambar pengembangan dan gambar detail.
DESAIN INTERIOR PLANETARIUM SEBAGAI TEMPAT WISATA EDUKASI ILMU ASTRONOMI DI JIMBARAN, BALI
Authors: Satila Umma , Maharani Ida Ayu Dyah , Modouw James
Published: July 2023

Bali yang dikenal dengan pariwisatanya memiliki perkembangan yang sangat tinggi dalam sektor ini. Tingginya jumlah tempat pariwisata di Bali membuat masyarakat dan pemerintah mengemas banyak hal dengan dengan pariwisata. Seperti halnya edukasi yang juga dikemas dengan pariwisata untuk lebih menarik perhatian masyarakat dan juga dapat memberikan edukasi pada masyarakat dari segala kalangan usia secara lebih santai, menyenangkan dan efektif. Masyarakat yang lahir dan besar di Bali dapat dikatakan sedikit rendah tingkat literasinya di bidang sains jika dibandingkan dengan daerah lain yang sudah jauh lebih maju dengan sarana dan prasarana yang mereka miliki. Dalam karya tulis ini, solusi yang ditawarkan untuk memecahkan permasalahan dan gagasan ide dalam upaya meningkatkan tingkat literasi dan sektor pariwisata di Bali adalah dengan cara menciptakan Planetarium, dimana bangunan ini dapat menunjang dan memberikan kenyamanan bagi para civitasnya di dalam melaksanakan kegiatan berwisata dan edukasi mengenai objek benda langit di alam semesta. Metode yang digunakan dalam mendesain interior Planetarium menggunakan 3 metode, antara lain metode penulisan karya menggunakan metode deskriptif kualitatif, untuk metode pengumpulan data menggunakan metode kepustakaan, observasi, wawancara, dan dokumentasi, lalu untuk proses desain menggunakan metode glass box. Dari hasil metode penelitian tersebut akan menghasilkan sebuah solusi (konsep) yang menjawab permasalahan yang sebelumya dan divisualisasikan lewat gambar - gambar desain seperti gambar konsepsual, gambar pengembangan dan gambar kontruksi.
PELAKSANAAN REDESAIN PRESIDENTIAL SUITE ROOM 5070-5071 PADA SILOAM HOSPITALS BALI
Authors: Widyasari I Gusti Ayu Agung Istri , Artadi I Made Pande , Yupardhi Toddy Hendrawan
Published: July 2023

Pada program magang/praktik kerja MBKM ini berlangsung di perusahaan CV. Asta Loma. Program ini bertujuan untuk memberikan pengalaman yang cukup kepada mahasiswa melalui pembelajaran langsung di tempat kerja. Metode yang digunakan dalam penyusunan laporan ini diantaranya yakni metode wawancara, observasi, dokumentasi, serta studi literatur. Adapun beberapa pekerjaan yang telah dilaksanakan selama menjalankan kegiatan magang/praktik kerja, salah satunya diberikan kesempatan untuk ikut serta dalam melaksanakan proses pengawasan di lokasi proyek serta dalam pembuatan gambar as built drawing pada proyek redesain IPD (In Patient Department) Room atau ruang unit rawat inap pada Siloam Hospitals yang berlokasi di Jl. Sunset Road, Kuta, Bali. Pada penelitian ini diangkat salah satu ruang pasien rawat inap tersebut yakni pada redesain Presidential Suite Room 5070 - 5071. Dalam proses pelaksanaan redesain tersebut melalui tahapan-tahapan serta tidak lepas dengan mematuhi tata tertib konstruksi yang diberlakukan oleh pihak Siloam Hospitals Bali untuk tercapainya hasil yang maksimal. Selama melaksanakan proses pengerjaan redesain tersebut tentunya tidak terlepas dari adanya kendala-kendala yang dialami. Dengan adanya kendala tersebut, maka dibutuhkan upaya-upaya yang harus dilakukan untuk mengurangi atau mengatasi kendala tersebut agar pelaksanaan proyek dapat berjalan dan terselesaikan dengan baik. Dari kegiatan yang telah dilakukan oleh penulis selama melaksanakan magang/praktik kerja tersebut, penulis mampu memperoleh beberapa ilmu tambahan, mulai dari segi pengetahuan, keterampilan, ataupun teknologi baru yang telah didapatkan.
DINAMIKA PERANCANGAN INTERIOR VILLA UNGASAN DI PT. REKA MASSA ARCHITECT
Authors: Manuaba Ida Bagus Bagaskara
Published: July 2023

Perancangan interior Villa Ungasan merupakan sebuah proses yang sangat dinamis. Perubahan-perubahan konsep yang diminta dan waktu penyelesaiannya yang cepat menjadi suatu tekanan di dalam prosesnya. Pengalaman ini terjadi pada kegiatan magang mahasiswa, sebagai suatu upaya mendapatkan pengalaman langsung terhadap proses tersebut.Pendalaman yang dilakukan selama magang adalah bagaimana penerapan teori-teori perancangan interior di PT. Reka Massa Architect dilakukan secara maksimal, mengkombinasikan teori dengan ide-ide terbaru baik secara lokal, nasional maupun internasional, seperti ide-ide interior Jepang. Kendala selama proses perancangan yang dihadapi adalah sulitnya mengikuti keinginan klien yang berubah-ubah. Hal ini ditasi dengan selalu berkomunikasi, tidak membiarkan suatu masalah menjadi tertunda, dan menangani perubahan-perubahan secara lebih cepat sehingga menggiring klien untuk dapat mengambil keputusan final.Program Magang MBKM ini dilaksanaan dengan tujuan untuk lebih menyiapkan mahasiswa dalam menghadapi realitas dunia kerja. Jurang perbedaan pada bangku perkuliahan dengan dunia kerja merupakan hambatan tersendiri bagi mahasiswa untuk dapat beradaptasi. Dengan mengikuti Program Mata Kuliah Magang, merupakan kesempatan bagi mahasiswa untuk mengetahui lebih dini kondisi dunia kerja dengan praktik langsung di dalamnya.Pelaksanaan magang ini menggunakan Metode Kualitatif dengan teknik observasi, wawancara, dan kepustakaan. Teknik Observasi, dilakukan dengan terlibat langsung pada proyek perencanaan Villa Ungasan yang ditangani oleh PT. Reka Massa Architect. Keterlibatan langsung pada proses, maka mahasiswa dapat melakukan pengamatan secara teliti dengan pencatatan secara sistematis. Teknik Wawancara, dimana mahasiswa berhadapan dengan narasumber untuk mendapatkan informasi secara langsung (data primer). Sedangkan Teknik Kepustakaan, dilakukan dengan melakukan penelusuran literatur yang diperlukan sebagai data sekunder.Berdasarkan pengalaman tersebut maka pelaksanaan magang menunjukan bahwa Program Magang MBKM memberi perubahan yang signifikan terhadap mahasiwa dalam pembentukan mental dan percepatan pengetahuan lapangan. Pelaksanaan program tersebut juga menambah wawasan yang bermanfaat bagi mahasiswa dan kampus.
IMPLEMENTASI SPIRIT OF PLACE DALAM DESAIN INTERIOR UPAYA PEMBENTUKAN IDENTITAS SUATU TEMPAT STUDI KASUS HOTEL THE PLACE DISTRIK NANGANG
Authors: Aura Arista Widyani , Hanafiah Ully Irma Maulina
Published: July 2023

Place identity merupakan fenomena dimana individu mengidentifikasikan dirinya dengan suatu tempat. (Prohansky et. Al, 1983). Identitas suatu tempat (Place identity) yang terbentuk dan terpelihara dengan baik menyebabkan manusia akan merasa lebih ‘hidup’ karena tempat tersebut memiliki spirit of place yang dapat menciptakan lingkungan menjadi harmonis dan bermakna. Merupakan peran Desainer Interior dalam menanggapi berbagai kondisi masalah yang berkaitan dengan proses perancangan ruang untuk memulihkan atau menciptakan “Rasa” pada tempat tersebut. Oleh karena itu, penelitian ini bermaksud untuk mengkaji elemen pembentuk spirit of place dalam lingkup ruang interior studi kasus hotel The Place Distrik Nangang, sehingga dapat membentuk identitas ruang yang berkarakter. Pengumpulan data dilakukan dengan cara studi literatur dan referensi, yaitu dengan mengobservasi literatur dan teori yang berkaitan dengan struktur pembentuk ruang, spirit of place, dan Place Identity, kemudian menghubungkan variabel satu dengan variabel yang lain. Diharapkan penelitian ini dapat menjadi referensi bagi para peneliti maupun desainer interior yang akan melakukan perancangan dengan pendekatan spirit of place, dalam menciptakan identitas ruang interior yang berkarakter.
The Fight Against Cancers
Authors: Opoku B.K.
Published: July 2023

The Fight Against Cancers
Traumatic Experiences of Women Living with HIV/AIDS in Ghana
Authors: Ofosu Samuel Kwaku
Published: July 2023

Background: Trauma faced by women infected with HIV and AIDS poses great challenge to the coordinated fight against HIV and AIDS. Traumatising events impacting people living with HIV and AIDS, most notably women, impede diagnosis, prevention and treatment efforts.Methods: The study set out to investigate the lifethreatening experiences of thirty-eight women living with HIV and AIDS in the Lower Manya Krobo District of the Eastern Region, Ghana. The study used focus-groups as method of data collection. The data was analysed through theme identification and grouping, along with selection of relevant quotes.Results: The study revealed five major lifethreatening experiences of the women: disclosure, mental ill-health, isolation, stigmatisation and financial challenges. The study concluded that women living with HIV and AIDS suffer enormous psychological burden of the pandemic in addition to physical challenges. However, it is the social burden of the pandemic that contributes significantly tothe eventual death of the victims rather than the disease itself.Conclusion: Consequently, HIV and AIDS education campaign should be intensified using a variety of media, targeting those social issues identified in this research as part of the efforts to fight the disease.
Contemporary Needs In Medical Specialist Services In Ghana
Authors: Adanu R.M.K.
Published: July 2023

Editorial
Burden and Outcomes of Birth Asphyxia in Neonates Admitted to the Neonatal Intensive Care Unit of The Tamale Teaching Hospital
Authors: Abdul-Mumin A. , Bimpong K.A. , Owusu S.A. , Kpiniong J.M.
Published: July 2023

Objective: The aim of this study was to determine the burden, outcomes and factors associated with outcomes of birth asphyxia among sick neonates admitted to the Neonatal Intensive Care Unit (NICU) of the Tamale Teaching Hospital (TTH).Patients and Methods: A retrospective descriptive study design was used. Subjects included all neonates admitted to the unit with diagnosis of birth asphyxia, during the study period (January 2018-December 2019), who met the inclusion criteria. Descriptive statistics were presented in tables and graphs. Multiple logistic regression was used to identify independent predictors of mortality.Results: The prevalence of birth asphyxia was 17.6% of admissions. There were more males (594,60.3%) than females and most (707,74.3%) of the cases seen were inborn. Majority (617,63.3%) were delivered via spontaneous vaginal delivery. APGAR scores ≤ 3 wasseen in 259(26.3%) of the babies. The case fatality rate was 14.9% and more than half (78,53%) occurred within the first 24 hours of admission. Outborn babies were 2.7 times more likely to die from birth asphyxia compared to inborn babies(p-value=<0.001). Babies with APGAR scores ≤ 3 were 3.9 times more likely to die compared to babies with APGAR scores 4-6 at one minute, (pvalue=<0.001) and babies born to mothers < 20 years of age were 2 times more likely to die as compared to older mothers (p-value=0.048).Conclusions: Birth asphyxia is common in our facility. Outborn babies, babies with one-minute APGAR score ≤3, and maternal age < 20 years were significantly associated with mortality.
Hip and Knee Replacements in Ghana: A 2-Year Prospective Assessment of Outcomes
Authors: Konadu-Yeboah D. , Konadu P. , Okrah H. , Kwasi K. , Sobotie J. , Gudugbe S. , Boadi S.T. , Anarfi N. , Vormawor K. , Pokuaa M.
Published: July 2023

Objective: Our objective was to assess the outcomes of hip and knee replacements among patients at the Komfo Anokye Teaching Hospital in Ghana.Methodology: We recruited consenting patients who underwent a hip or knee replacement at the KATH over a 3-year period and followed up each study participant for 2 years. Prosthetic joint function was evaluated at 2 years following joint replacement. Complications of surgery were recorded for each patient during the follow-up period.Results: A total of 87 hip and knee replacements were performed in 78 patients over the 3-year period. Of the 78 patients enrolled in the study, 67.9% (53) were females and 32.1% (25) were males. Most, 47.2% (37), of the patients were aged between 61 and 80 years, with those less than 40 years constituting 7.7%. At 2 years follow-up, good to excellent outcome was reported in 95.5% THA, 91.2% hiphemiarthroplasty, and 90% TKA patients. The satisfaction rates were 95.5% THA, 97.0% hip hemiarthroplasty and 90% TKA participants.Conclusion: Women have a higher hip or knee replacement rate (67.9%) than men (32.1%) and the rate of hip or knee replacement increases with age for both men and women. Osteonecrosis of the femoral head is the most common indication for total hip arthroplasty in patients younger than 60 years. The presence of diabetes mellitus and sickle cell disease predicts less favourable patient reported outcomes following a hip or knee replacement. Arthroplasty of the knee or hip provides pain relief and improvement in function with a low complication rate and high patient satisfaction rate.
Depression Among Health Workers: A Study at the Ho Teaching Hospital in Ghana
Authors: Dziwornu E. , Dordoye E. , Anku A. , Hohl J.E. , Oboh L. , Addae A.K.
Published: July 2023

Objective: The current study is an effort to examine the level of depression and associated factors among health workers in Ghana.Methodology: The Patient Health Questionnaire 9 (PHQ- 9) was used to screen 127 health workers of the Ho Teaching Hospital. These were participants who presented themselves for screening at the facility during the 2019 world mental health celebration in Ghana.Results: Descriptive analysis revealed that over 30% of participants experience moderate level of depression with females experiencing higher levels than males. However, inferential analysis revealed that differences in the levels of depression are not significant withregards to gender and department/job description, as well as no significance age impact on depression. However, married health worker reported significantly lower level of depression compared to health workers who are not married.Conclusion: Health workers experience depression. Some factors determine the levels of these condition, thereby requiring further investigations.
Assessment of the Impact of Level of Maternal Education on Maternal Deaths in Eastern Region of Ghana; A Human Rights-Based Approach
Authors: Asare B.A.
Published: July 2023

Objective: The Human Rights-based Aproach to Social Development aims to positively transform power relations among duty bearers and rights holders with particular attention on social, economic, and cultural rights. This study analyzes the impact of formal education, (an inalienable human right progressively predicting better health, longer life and better health services utilization), onmaternal mortality.Methodology: A retrospective descriptive audit of all institutional maternal death records was completed for data abstraction. All records were assessed for consistency with the ICD-10 maternal death case definition. Data were analyzed across documented levels of education with epi info 3.5.1.Results: Mean maternal age was generally higher among women with ≤ JHS level of education. Mean gestational age at death varied insignificantly across all levels of education. Women with JHS level of education accounted for the highest proportion of maternal deaths while deaths among women with ≥ SHS level of education, (i.e. ≥ 12 years of formal education), remained low. Deaths amongwomen with informal occupations decreased with increasing level of education. Maternal deaths among women with ≤ JHS level of education occurred in higher proportions among women with spouses or partners of similar levels of education. Women unexposed to formal education poorly attended ANC, mostly needed blood transfusions and were further largely grand multiparous.Conclusion: All female gender-specific socio-economic, socio-cultural, geographical and religious barriers to accessing ≥ 12 years of formal education should be a research priority and targeted for elimination within the context of the HRBA.
Factors Influencing Receipt of Radiation Treatment in Women with Carcinoma of the Cervix in Ghana
Authors: Amo-Antwi K. , Nartey Y. , Nyarko K.M. , Hill P.C. , Cox B. , Yarney J.
Published: July 2023

Objective: We evaluated the influence of demographic and clinical features on access to radiotherapy among women with cervical cancer.Methodology: A cross-sectional analytical study design was used to review hospital records of women diagnosed with cervical cancer from 1st January 2010 and 31st December 2013 at Ghana’s two largest public cancer treatment centres. Basic demographic andclinical data were captured from the records. Multivariate logistic regression was used to determine the odds of receiving radiotherapy in women with carcinoma of the cervix.Results: One thousand seven hundred twenty-five (1725) women with cervical cancer were studied, of which 955 (57.7%) women received radiotherapy. The likelihood of receiving radiotherapy increased with increasing age (OR: 2.2; 95% confidence interval, CI,1.5-3.1, 70-79, versus ≤39 years. The indigenous semiurban dwellers (unadjusted OR: 2.4; 95% CI: 1.6-3.5), and foreign nationals (unadjusted OR: 4.1; 95% CI: 2.5- 6.9), were more likely to receive radiation treatment relative to those who resided in the metropolis. Women with three or more comorbidities (unadjusted OR: 0.2; 95% CI: 0.1-0.5), those recruited at the gynaecology unit (unadjusted OR: 0.01; 95% CI: 0.002- 0.01) and subjects with no histological diagnosis (unadjusted OR: 0.004; 95% CI: 0.002-0.01) were likely not to receive radiation treatment. After controlling for other variables, recruitment from the gynaecologic units was significantly associated with a probability of receiving radiation treatment (Adjusted OR: 0.1; 95% CI: 0.01- 0.3).Conclusion: Women diagnosed with cervical cancer at the gynaecologic departments were less likely to access radiation treatment.
Morel-Lavallée Lesion on the Left Calf of a Young Ghanaian Female – A Case Report
Authors: Nyarko O.O. , Ayisi-Boateng N.K. , Blay L.K. , Arkorful J. , Konadu P.
Published: July 2023

Objective: Morel-Lavallée lesions are frequently misdiagnosed soft tissue injuries. They are closed degloving injuries associated with high energy trauma with shearing forces. In this report, we discuss the challenges in making early diagnosis and instituting timely and appropriate management of such cases.Case Presentation:The index patient is a 36-year-old female who presented with a 3-week history of fluctuant and tenderleft leg swelling associated with skin bruises after experiencing a blunt trauma secondary to a motor vehicular accident. Ultrasound findings of the left leg showed a collection with internal echoes and septations occupying a space between the subcutaneous area and superficial fascia of the upper and middle third of the left leg. We made a diagnosis of a Morel-Lavallée lesion and performed an opendebridement and irrigation.Conclusion: Early diagnosis and treatment are of utmost importance as misdiagnosis and delayed
The Role Of The Diabetes Specialist Team In The Modern Management Of Diabetes Mellitus: A Call For Its Implementation In Ghana
Authors: Yorke Ernest
Published: July 2023

Many chronic illnesses require patient-centred care where behavioural change aimed at dealing and coping with the socio-psychological as well as the physical impact of the disease is emphasized.

Diabetes presents such a challenge especially in the developing world where both human and material resources are limited in dealing with this complex disease. Most centres in Ghana and Africa in general, rely on overburdened practitioners who have responsibilities to other acute and chronic illnesses in addition to diabetes care.

The Diabetes Specialist Team (DST) has become a tool in overcoming these complexities to improve care and outcomes. They work in a team with specialised and sometimes overlapping skills. Core members include Consultant physician diabetologists, specialist diabetes nurses, podiatrists, dieticians and clinical psychologists.

The positive impact of DST is noticed in the aspects of diabetes preventive services, early diagnosis, patient education, medication use, risk factor and complication identification and management, together with in-patient care and management of special groups.

Recognising that the needs of persons living with diabetes are under served, coupled with the fact that developing countries are expected to experience the greatest burden in terms of numbers and complications of diabetes, more resources are needed to reverse these expected grim statistics. Efforts should be made to develop and deploy DST as much as possible to provide specialised and dedicated services in the routine management of diabetes at least at the district or municipal health level. Resources are needed to maintain and snowball the impact of this approach.
A Rare Case Of Conjunctival Rhinosporidiosis Mimicking A Neoplasm In Ghana.
Authors: Ulzen-Appiah Kofi , Imbeah Emmanuel Gustav , Brookman Sylvia Bentil , Akakpo Patrick Kafui Akakpo
Published: July 2023

Introduction: Rhinosporidiosis has not been reported in the literature, in Ghana. It is however endemic in India, mostly presenting as tumorous growths within the nasal cavity and conjunctiva. Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi an organism initially thought to be a fungus, but now newly classified as belonging to a group of fish parasite DRIP clade (Mesomycetozoa) located in the middle (-meso) of the animal(-zoea) and fungal(-myceto) divergence. It has been proposed to be acquired by direct inoculation of traumatized mucosal membranes through contact with contaminated water bodies with aquatic animals as natural hosts. It usually presents as a red granular polypoid mass which may mimick a neoplasm.

Case Presentation: An 8-year-old boy was seen at the Eye clinic with a four-week history of a painless right palpebral conjunctival growth which progressively increased in size over the period. It was excised because it was suspicious for a neoplasm (Papilloma). Histopathological examination confirmed conjunctival Rhinosporidiosis. We report the clinical and histopathological findings of this entity and review the existing literature.

Conclusion: Conjunctival Rhinosporidiosis although rare occurs in our setting. Rhinosporidium seeberi is found in river bodies within our communities and Health care givers should be aware of this infection, which may mimick a neoplastic lesion. It should be included in their differential diagnoses of individuals who present with polypoid conjunctival and nasal masses, who hail from areas with stagnant freshwater bodies in which they routinely bathe or swim.
Covid-19 Associated High Mortality Among Patients With Acute Stroke In A University Hospital In Kumasi, Ghana – A Retrospective Study
Authors: Ayisi-Boateng Nana Kwame Ayisi-Boateng , Mohammed Aliyu Mohammed , Konadu Emmanuel Konadu , Sarfo Fred Stephen Sarfo
Published: July 2023

Objectives: The World Stroke Organization (WSO) has raised concerns about the global impact of COVID-19 on occurrence of stroke and its implications for stroke care, especially in low-middle-income countries. We sought to describe the profile and outcomes of acute stroke admissions in relation to COVID-19 status.

Methodology: This is a retrospective study involving all stroke patients admitted to the University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana from 1st March, 2020 to 30th November, 2020. Stroke was diagnosed clinically and confirmed with a head Computerized Tomography scan. After the diagnosis of stroke, all patients with presentations that fitted the case definition of COVID-19 were tested using real time polymerase chain reaction (RT-PCR). Bivariate analysis was performed to identify factors associated with in-patient mortality. Statistical significance level was set at p < 0.05.

Results: A total of 93 patients with confirmed acute stroke were hospitalized within a 9-month period with 3 (3.2%) having confirmed COVID-19 infection. All COVID-19 cases had ischemic stroke and all of them died. Bivariate analyses identified COVID-19 status (p=0.016), mean pulse rate (p=0.036) and patients who did not receive angiotensin receptor blocker (ARB) (p=0.029) or calcium channel blockers (CCB) (p=0.016) were associated with in-patient mortality.

Conclusion: COVID-19 occurring with acute stroke is a predictor of mortality in this sample of Ghanaians. In this era of COVID-19 pandemic, patients with acute stroke should also be screened for the infection and managed appropriately to minimize death.
The Myths of Alcohol Use in Ghana
Authors: DORDOYE EUGENE , Aku Thelma Mpoku Alalbila , Avle Theodocia Doe Ama , Dziwornu Emmanuel
Published: July 2023

Objective: Alcohol has become a regular part of social functions in many cultures. Before the advent of alcohol use disorder becoming a nosological entity, many cultures noted the detrimental association with alcohol use, particularly in its excess use. With such observation, many cultures and even medical research, have tried in many ways to either justify or explain away the harmful effects of alcohol use and gone ahead to promote the use for the most mundane effects. Such explanations for alcohol use over time become acceptable in many cultures and can be viewed asmyths. Four of such myths associated with alcohol use in Ghana, are presented here.
Methodology: These myths were drawn from a bigger study that looked at the prevalence of alcohol use disorder in an engineering company with mixed methods. A thematic analysis of their responses was used to arrive at these myths.
Results: Participants believed that alcohol is sexually potentiating, improves appetite and quality of sleep, and has medicinal qualities like “curing” chicken pox and necessary for successful surgery. Apart from the inconclusive evidence of alcohol, particularly red wine,protecting against cardiovascular death, we could not substantiate any of these claims from medicine.
Conclusion: Myths of alcohol use in different cultures need to be incorporated in preventive strategies adopted for alcohol use disorder for a comprehensive public health approach to curb the menace. Such myths should be integrated in the training of health workers to help them understand the addictive behaviour of alcohol users and the anthropological underpinnings to alcohol use.
The Poverty-Health Nexus: A Conundrum for a Fulfilling Life
Authors: Asenso-Okyere K.
Published: July 2023

“Wowo nkwa na wowo adee”, is a popular Ghanaian saying in the Twi language which means that if you have life then you have a treasure. You can have life if you are healthy or if you are not involved in an accident. There is also another saying, “The wealth of anation is the health of its people”. Both sayings emphasize the importance of health in wealth creation in a household or a country. Bad health drives people into poverty because they have to spend their money on seeking health care or they become invalid and cannot work to create wealth. When someone in the household is afflicted by ill health another person may stop work and provide care and so the loss of productivity in the household is compounded.
Modified Open Omental Plugging of Peptic Ulcer Perforation in a Municipal Hospital in Ghana
Authors: Wegdam H.H.J. , Hillah A.A.
Published: July 2023

Background: This prospective study conducted in the Holy Family Municipal Hospital in Techiman Ghana, aimed at providing data on gastric and duodenal perforations in a municipal hospital in a developing tropical country and to report and evaluate the outcome of surgery with regard to the use of a modified open omental plugging in our setting. 
Patients and Interventions: Between July 2004 and October 2008, 56 patients were recorded: 45 patients had gastric and 11patients duodenal perforation. (Gastric/Duodenal perforation ratio: 4.0:1). All patients received the same treatment with a modified techniqueof over-suturing the perforation with use of a “champagne cork” omental plug. The procedure of this plugging is described. Total mortality in the study was 6 (10.7 %), all in the gastric, none in duodenal perforations.
Conclusion: We conclude that the use of open “champagne cork” omental plugging is a reliable method of closure of perforations in peptic ulcer disease in our setting and contributed to an improvement of our mortality rate.
Science, Communication, and Compassion in Medical Practice
Authors: Ohene-Frempong K.
Published: July 2023

For the past 18years, I have been working with colleagues in Ghana in various health service and administrative institutions and settings. I have attended many lectures and have given several to many different audiences. Through four large international conferences, my colleagues and I have brought hundreds of foreign and local health scientists together to share knowledge and practices in my area of greatest scientific interest, sickle cell disease and other disorders of haemoglobin. I have also followed as closely as possible, events in Ghana that affect the health of our people.
Medical Negligence in Ghana - Another Look at Asantekramo
Authors: Plange-Rhule G.
Published: July 2023

Asantekramo alias Kumah v. Attorney-General [1975] 1 GLR 319 is a medical negligence case that is reported in the Ghana Law Report. The case was heard before the High Court in Kumasi. The basic facts of the case were that a female patient of the then Okomfo Anokye Hospital had an arm amputated following an operation for an ectopic pregnancy. A successful action for negligence wasbrought against the hospital. The article discusses the trial of this case and looks at some of the possible issues the hospital could have raised to defend itself. It comments on what appear to have been some fundamental errors made by the judge which appear tohave gone unchallenged, which may have resulted in heavy damages awarded against the hospital. It comments on the need for doctors, other health workers and health institutions to defend themselves where appropriate, recognising however that not all cases are defensible.
Brachial Artery Pseudo-aneurysm in a Toddler Due to Penetrating Trauma
Authors: Gyedu A. , Agbedinu K.
Published: July 2023

Objective: We present a toddler who developed a pseudo-aneurysm of the left brachial artery one month after sustaining a cut on his left forearm. Case Report and Interventions: A one and a half yearold boy was referred with a swollen and painful left forearm which was bleeding from a focal point. He was being managed as a case of venous hematoma and was referred when the bleeding could not be controlled. A clinical diagnosis of pseudo-aneurysm was confirmed by Doppler ultrasonography and repair done with a directclosure of the arterial defect. Conclusion: Although brachial artery pseudoaneurysms (BAPs) following penetrating trauma are most likely to be iatrogenic, they can also occur outside the clinical setting and should not be mistaken for a venous hematoma. Duplex ultrasonography should be used as an initial screening and diagnostic tool to secure an early diagnosis reserving more invasive tests for patients requiring more complex procedures. Management should be surgical.
Challenges of Health Care Delivery at a Municipal Health Facility under Ghana’s National Health Insurance Scheme
Authors: Yawson A.E. , Nimo K.P. , Biritwum R.B.
Published: July 2023

Introduction: Empirical evidence on challenges to health care delivery at district/municipal level under the National Health Insurance Scheme (NHIS) in Ghana is limited. This study determined challenges to optimal health care delivery at a municipal hospital underGhana’s NHIS.Method: A cross-sectional study was undertaken between January-March 2010 at the Winneba Municipal Hospital (WHM) in Ghana to review out-patients (OPD) records from 2005- 2008. A structured questionnaire was used to collect data from 345 outpatients(170 insured and 175 uninsured), and from their folders. Eleven key informants from the WMH were interviewed.Results: The NHIS was introduced at the WMH in 2006, resulting in an increased OPD attendance of 77.3% in 2007. Insured clients visited the OPD many times and at shorter intervals than uninsured clients. Disease patterns at the OPD were however similarbefore and after the introduction of NHIS at the Hospital. Key health providers at the WMH admitted to increasing OPD numbers and prolonged client waiting times. Over 40% of insured clients spent three hours or more to receive OPD services. Financial support fromthe Government to the WMH has reduced since the introduction of NHIS. In 2008, over 70% of total hospital revenue was from the NHIS; delays in payment by District/Municipal Mutual Health Insurance Schemes (DMHIS) significantly strained hospital financesand provision of drugs and supplies.Conclusions: Increased OPD numbers, prolonged client waiting times, consumer moral hazard, limited Government financial support and delayed NHIS funds were critical challenges at the WMH. Innovative measures to limit moral hazard (i.e. reward mechanismsfor non-frequent visits, and introduction of copayments for multiple visits) are recommended. Means to improve the skills of hospital staff dealing with NHIS and staff of the DMHIS are policies worth pursuing.
Changing Pattern of Childhood Cancers at Korle Bu Teaching Hospital, Accra, Ghana
Authors: Segbefia C.I. , Renner L.A. , Dei-Adomakoh Y. , Welbeck J.
Published: July 2023

Background: Worldwide, the incidence of childhood cancers is increasing and majority of children with cancers live in developing countries. The main aim of the study was to determine the current pattern of childhood malignancies at Korle Bu Teaching Hospital(KBTH), Accra.Methods: A retrospective review of registry data from the KBTH paediatric oncology unit between January 1, 2008 and December 31, 2011 was conducted, and results analysed.Results: Out of 495 new cases of cancer, lymphomas (30.7%), leukaemias (18.8%) and retinoblastomas (15.8%) were the commonest cancers diagnosed. CNS tumours were rare (3.4%). Overall, the male: female ratio was 1.3:1. Most patients (232/495; 47%) were inthe 5-10 year age group and majority of embryonal tumours were diagnosed in the 0-4 year age group. The peak ages for Burkitt’s lymphoma and acute lymphoblastic leukaemia were similar, in contrast to reports from developed countries.Conclusion: The number of children diagnosed with cancers at KBTH has increased significantly. Concerted efforts and advocacy towards improving childhood cancer care are required.
Clinical Research in Ghana: Accuracy and Reliability of Laboratory Results
Authors: Kuofie M.
Published: July 2023

The rising cost of clinical research is driving the current trend of outsourcing to developing countries1. Many developing countries, such as Ghana, conduct research but face many challenges in ensuring that the trial conduct and results conform to internationalstandards2. Such challenges include staff recruitment and retention3 and the reliability of laboratory results. Ethical aspects of research are governed by international regulations but policing and enforcing such regulations are less well documented. There arechallenges to overcome, including reliability of laboratory results and inadequate resources, with overreliance on those that are adequate. Thus there is a need to develop a research infrastructure that can cope with these challenges.
Smallpox Epidemic of 1900
Authors: Editor-In-Chief
Published: July 2023

Smallpox epidemic of 1900.
In-hospital Mortalities in General Surgery Unit, Korle Bu Teaching Hospital
Authors: Dakubo J.C.B. , Naaeder S.B.
Published: July 2023

Background: In-hospital mortality data is an invaluable resource that has been employed over the years to assess the quality of care provided to patients.Materials and Methods: A retrospective study was carried out from January 1999 to December 2012. Data was collected from theinformation sheets provided by the Department of Surgery for the monthly morbidity and mortality meetings. Information extracted included the total number of admissions and deaths, the demography of the deaths, duration of admission, diagnosis and causeof death.Results: Total admissions were 37,034 with 2033 deaths giving a mean crude mortality rate of 5.5%. Detailed analysis in this study was based on 2011 cases whose complete data was available. Males accounted for 1074 (53.4%) and females 937 (46.6%). Their mean age was 53.8 ±18.6 years. Malignancies were 890 (44.3%) whilst non-malignant conditions were 1121 (55.7%). Of the non-malignant cases 1007 (89.9%) were emergency or urgent. The most frequent malignant conditions were breast cancer 204 (22.9%), colorectal cancer 144 (16.2%), pancreatic cancer 133 (14.9%) and gastric cancer 130 (14.6%); while that for the non-malignant conditions were diabetic septic conditions 219 (19.5%), gastro-intestinal bleeding 136 (12.1%), typhoid perforation 76 (6.8%) and perforated peptic ulcer 75(6.7%). The overall median length of stay was 7 days, Interquartile Range (IQR),was 2-16 days. Nonmalignant cases stayed shorter compared with the malignant cases, 5 as against 9 days, z = -8.9, Asymp. Sig. (2-sided) of 0.0001. Septicaemia and septic shockcombined were the commonest cause of death in 719 (35.8%) cases, followed by metastatic tumour - 629 (30%).Conclusion: Death was inevitable in a large proportion of the cases admitted to the General Surgery unit of Korle-Bu Teaching Hospital largely because of the nature of the surgical pathology at presentation.
Evaluating Effectiveness of Blood Pressure Control in Mild to Moderate Hypertension at the Korle Bu Polyclinic, Accra
Authors: Bennin C.L. , Essuman A.
Published: July 2023

Objective: To evaluate the effectiveness of blood pressure treatment in patients with mild to moderate hypertension attending the Korle-Bu Polyclinic in Accra.Design: An observational study involving a retrospective review of patient charts.Subjects and Methods: We evaluated charts of patients managed at the Korle-Bu Polyclinic for mild to moderate hypertension over a 3 year period from 2005 to 2007. Charts were selected by multistage sampling and data including initial and follow-up blood pressuremeasurements were extracted by means of a checklist. Hypertension was diagnosed using the 2003 World Health Organization (WHO)/International Society for Hypertension (ISH) statement on the management of hypertension.Outcome measure: We expected to document a drop in blood pressure of at least 20mmHg (systolic) and or 10 mmHg (diastolic) as a consequence of treatment instituted at the poly clinic over the period under study.Results: The study reviewed 455 charts. About 1 in 4 patients (26.7%, [95% CI, 0.20 – 0.35])diagnosed and on drug treatment for hypertension had a decrease in blood pressure of 20 mm Hg (systolic) and or 10 mm Hg (diastolic). A similar number of patients (126,27.7%) less than 40 years of age were found with elevated blood pressure.Conclusion: Majority of the patients with mild to moderate hypertension showed poor response to treatment of their blood pressure. A significant proportion of patients with elevated blood pressure were young, i.e. less than forty years of age.
Percutaneous Dilatational Tracheostomy Performed by Anaesthesiologist in a Low Resource Setting: Preliminary Report on 19 Patients
Authors: Antwi-Kusi A. , Boakye G. , Sam-Awortwi W. , Konney A.
Published: July 2023

Background: Percutaneous dilatational tracheostomy (PDT) is an established alternative to surgical tracheostomy in intensive care patients deemed to require prolonged ventilation. The procedure is simple, cheap and is associated with less complication. Even though PDT is the preferred technique of tracheostomy in ICU’s in low resource countries like Ghana little is known about this technique. PDT using the percutwist set became available in the ICU of the Komfo Anokye Teaching Hospital recently and we report on 19 consecutive cases done so far.Objective: To determine the outcome of 19 percutaneous dilatational tracheostomy done under bronchoscopic guidance by anaesthesiologists in an Intensive Care Unit.Design: Retrospective study. 
Setting: Intensive Care Unit of the Komfo Anokye Teaching Hospital, Kumasi, GhanaSubjects and Methods: Nineteen consecutive patients who underwent percutaneous dilatational tracheostomy at the bedsideusing the percutwist set under bronchoscopy guidance. Using the admission/discharge books and the Nurses report book in the ICU, patients’ records were retrieved. The number and success of tracheostomies, and the complications were assessed.Results: There were 19 patients who underwent PDT during the period. 17 (95.24%) of the tracheostomies done were successful with easy ventilation of the lungs In one patient (4.76%) PDT was unsuccessful and was converted to surgical tracheotomy. One patient had a problem with ventilation after the tracheostomy tube was inserted. It was detected that the tube was short and was therefore replaced with a normal endotracheal tube. There was bleeding from the incision site in two of the patients (9.5%). This was controlled with pressure dressing.Conclusion: In a low resource country like Ghana where there is a limited number of ENT surgeons, PDT performed by the anaesthesiologist in the ICU can be an alternative technique to surgical tracheostomy. It is safe and success rate is high if done by skilled Anaesthesiologist in the appropriate patient.
Anatomy of the Medical Negligence Claim
Authors: Adwedaa E.
Published: July 2023

Special Article