Volume 97  ·   Issue 02  ·  1984

A 3-tier system of health manpower is being planned in Ghana in conformity with the primary health care strategy of that country. Front-line health workers who already exist in the communities will work in populations of 200 people or more. They will be responsible for primary preventive and promotive procedures and simple first level curative measures. Training and supervision of these front-line health workers will be done by conventional health workers. Emphasis is being put on these types of health workers because of the health problems encountered and unwillingness of highly trained health personnel to work in rural areas where they are most needed.

This is a study of spontaneous rosette test with rhesus monkey erythrocytes (EhRBCs). In order to clarify the character of RhRBC rosette test (ERh), the distribution of receptors for RhRBCs and sheep erythrocytes (SRBCs) on human lymphocyte populations, the independence of receptors for ERh and SRBC rosette test on the surface of lymphocytes and markers present in non-lymphocytic leukemia were studied. The results of the RhRBC rosette test, SRBC rosette test and the surface membrane immunofluorescent technic are compared with them in the classification of human lymphocytes.

The etiology, type, therapy and some factors affecting visual rehabilitation after congenital cataract extraction in 80 cases are analysed and discussed. Heredity and environmental insult induce infant cataract so genetic counselling and infection free gestation are necessary for prevention. Failure to achieve better acuity postoperatively is due to delayed operation. In our series 97% of the patients were operated upon over 3 years of age. One quarter of them remain blind. These cataracts should be removed before 6 months of age to obtain the best visual results and prevent development of deprivation amblyopia. Constant visual correction and treatment of amblyopia are essential.

A strain of Plasmodium cynomolgi from Vietnam is cultured by modified Trager-Jensen candle-jar method. By 1982, the parasites had been cultured in vitro over 140 days. Most trophozoites appear obviously ameboid and the parasitized blood cells are enlarged. After in vitro culture 80 days and storage in liquid nitrogen 11 days, the parasites revive and grow well. The plasmodia remain infective to rhesus monkeys after 100 days' culture.

Of the 504 resections performed for lung cancer at our institute from 1961 through 1981, 63 (12.5%) were pneumonectomies. Right pneumonectomy was done in 17 and left in 46 of the cases, for a right-to-left ratio of 1:2.7. The relatively low percentage of pneumonectomy in this series reflects: (1) the strict criteria for choosing this operation (pneumonectomy was reserved almost exclusively for patients who had adequate cardiopulmonary function and in whom, for technical or oncologic reasons, radical eradication of the tumor could not otherwise be achieved, palliative pneumonectomy was avoided whenever possible), and (2) the use of broncho-plastic lobectomy, which constituted 11.3% of all resections and has largely replaced pneumonectomy. Right pneumonectomy should be chosen even more cautiously than left because of the greater functional loss that results. The operative mortality of only l.6% (1/63) and the gratifying 5-year survival rate of 42.9% in this series imply that the criteria used in selecting patients for pneumonectomy were sound.

19 patients with hookworm infections were dewormed about 200 days later and 12 (63%) were positive for 4-5th stage Ancylostoma duodenale larvae. There may be long, persistent migration before the larvae reached the human intestine. The latency of larvae is probably only an ecologic characteristic of A duodenale. This finding has important, implications for the epidemiology, control and treatment of this hookworm infection.

In order to evaluate the significance of the sinus node function test by transvenous atrial pacing in the diagnosis of sick sinus syndrome (SSS), sinus node recovery time (SRT), corrected sinus node recovery time (CSRT) and total atrio-sinus and sino-atrial conduction time (SACT) are observed in 69 patients including non-SSS group 39 cases and SSS group 30 cases. According to our data, we suggest criteria for sinus node dysfunction as follows. SRT≥1,400 ms and/or A-V junctional escape before sinus recovery and/or secondary pause, CSRT≥560 ms. total SACT≥300 ms. With 1 item abnormal, the false positive rate in the non-SSS group is 7.7% and the false negative rate in the SSS group 3.3%, with 2 items abnormal, the false positive rate in the non-SSS group 0 and the false negative rate in the SSS group 6.7%. Atropine test results are compared with that of atrial pacing, 95.8% and 84.2% are compatible with each other in these 2 groups. In order to cut the use of invasive technic to the minimum, we propose performing the atropine test first. Only in those with unexplainable test results should the trial pacing test be resorted to.

1,330 autopsies performed at the Pathology Department of this hospital during 1958-1981, including 415 newborns, are studied. Among the 371 cases of congenital anomalies (110 newborns), 173 were congenital cardiovascular anomalies (66 newborns), a 13% morbidity forming 46.5% of all congenital anomalies seen. The 66 newborns were 60% of all neonatal congenital anomalies and 38.2% of all cardiovascular anomalies. Fetal stage diagnosis and early termination of pregnancy when necessary is the treatment of choice.

The serum C1q levels of 42 acute infectious hepatitis (AIH), 51 chronic infectious hepatitis (CIH) cases and 100 normal controls are determined by using sensitive rocket immunoelectrophoresis. The mean control value is 168.08±84.70 μg/ml, those of AIH and CIH are low (p<0.001). The significance of these findings is discussed.

Macrotia is seldom seen. We encountered a case in our hospital, and it is here reported.