This year’s observation focuses on arthritis, with an in-depth look at some forms of inflammatory arthritis, including rheumatoid arthritis and axial spondyloarthritis. The day marks the unity and solidarity of the global physiotherapy community. It is an opportunity to recognize the work physiotherapists do for their patients and community. To appreciate the work of physiotherapists, 51¶ŻÂţ (PU) threw its weight behind the Ghana Physiotherapy Association as they celebrated the week. PU partnered with the Ga West Municipal Hospital physiotherapists to conduct the week’s activities.

Monday, 4^th September, was the launch of the week and its activities at the Ga West Municipal Hospital. Tuesday, 5^th September, was an exposition of the work of physiotherapists in the management of arthritis at Ga West Municipal Hospital.

On Wednesday, 6^th September, the team made its stop on the campus of PU to deliver a lecture to faculty and students on “Exercise as Medicine: Tailored strategies for Osteoarthritis Patients” presented by Mr. Seidu Baluri Abdul Rahman. The lecture highlights were when Mr. Rahman gave faculty members and students personalized tactics to prevent the development of arthritis as they go about their duties and responsibilities.

Thursday, 7^th September, was a medical outreach program at the Amasaman market, where market sellers and workers together with buyers were educated on arthritis after which a health screening was conducted. Free consultation with physiotherapy prescriptions where necessary was done for residents in the municipality on Friday, 8^th September.

In all, the week was successful and newer and strengthened collaborations were established between the two institutions. Both institutions further pledged to the advancement of scholarship in their abled capacities towards the good of public health.

#AtPentvars
#TransformationAndService

[pdf-embedder url=”/wp-content/uploads/2023/05/Arthur-Mensah-Jnr_et_al-2023-BMC_Public_Health.pdf” title=”Arthur-Mensah Jnr_et_al-2023-BMC_Public_Health”]

Wellness Tuesday – Health talk series – Non-communicable diseases

Together Wednesday – Health talk on Pentvars radio – Let’s focus on Hypertension

Fun Friday – Health talk series – Mental hygiene for a sound University A+ staff

Workout Saturday – Health walk, gymnastics and outdoor games

The highlight of the week was the health talk series on Mental hygiene for a sound University A+ staff. This presentation was done excellently by Mr Reginald Arthur-Mensah Jnr, a faculty member of the Faculty of Health and Allied Sciences (FHAS). In the presentation, Mr Arthur-Mensah first took us on the journey of how the term “Mental hygiene” was coined and how it lost its application over the years only to regain strong relevance with the onset of COVID-19. An explanation of the term was given, followed up with why it is important to practice mental hygiene. This then proceeded with stressors that threaten our mental health as faculty members. Cardinal in the presentation were the activities or practices that faculty members should do regularly to maintain, improve and sharpen their mental potential. Below are excerpts from the presentation;

What is mental hygiene?

Practices that allow a person to enjoy mental health and be in harmony with their environment (Lotha, 2020). It can also be seen as daily activities that support and maintain mental health (Ramirez-Barrantes et al., 2019).

Why is it important?

Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity (WHO, 1946). As well, it is indicated that 1 in 5 people will develop mental illness in their lifetime (WHO, 2017).

What are the stressors to mental health?

Teaching workload, preparing quizzes, assignments, group work, IAs, examinations, marking, conducting research, further studies, taking care of family and relatives, students’ negative comments, colleagues’ negative comments, and economic pressure.

What are some of the mental hygiene practices?

1. Eat a healthy diet (Eat a variety – Fruits, vegetables, legumes and nuts, animal source foods, healthy oils, whole grains and tubers)
2. Do some physical activity (at least 30 minutes a day)
3. Rest well/Sleep for at least 6-8 hours
4. Have healthy conversations/talk about things that excite you.
5. Sit with your eyes closed and practice deep breathing regularly
6. Find a quiet place to meditate (Phil 4:8). (“Meditate, don’t medicate”)

(Meditation – Focusing attention on any present-moment experience in a non-judgmental way, Kabat-Zinn, 2003).

7. Look in the mirror, make and observe your facial expressions
8. Get a pet(s), observe their behaviour, and play with them
9. Sit or rest in a comfortable position, put on your relaxing music and really listen to it
10. Admire and appreciate nature, take a walk in a green space
11. Be genuinely thankful for things
12. Learn a musical instrument
13. Religious activities e.g., prayer
14. Avoid a lot of noise, stay calm
15. Brainstorm ideas/innovate/critical thinking.
16. Just Dance
17. Join the Royal Mental Hygiene Challenge

Credit: Mr. Reginald Arthur-Mensah Jnr

Regarding the practices, faculty members were encouraged to be intentional with them to reap the utmost benefits for themselves and their work in the University. The Vice-chancellor, Prof. Kwabena Agyapong-Kodua, also contributed an immense wealth of biblical principles and experience to buttress the scientific presentation. Faculty members left the presentation well-informed and energized with a renewed mindset to be mindful to take care of their mental health. The conclusion of the matter is that there is no health without mental health.

#AtPentvars
#PentvarsHealthWeek2023
#TransformationAndService

ĚýBy:

Mr. Reginald Arthur-Mensah Jnr (Department of Nursing and Midwifery, 51¶ŻÂţ)

Barbara Owusu Frempong (Medical Department, Korle Bu Teaching Hospital)

Dr. Mrs. Abigail Agartha Kyei (Department of Nursing and Midwifery, 51¶ŻÂţ)

Download PDF:Ěý SIDE EFFECTS OF CHEMOTHERAPY AMONG WOMEN WITH BREAST CANCER

Introduction

Chemotherapy (chemo) is the use of chemical agents to treat or control disease. Chemo for breast cancer (read /breast-health-among-women-at-eikwe-western-region-ghana-breast-cancer-awareness-month/ on a write-up of breast cancer) uses anti-cancer drugs that may be given intramuscularly (as an injection), intravenously (injected into your vein) or orally (by mouth) to destroy the breast cancer cells. The drugs travel through the bloodstream to reach the cancer cells in the breast. Chemo can be used as the main treatment for women whose breast cancer has spread outside the breast and underarm area to distant organs like the liver or lungs. Chemo has the greatest effect when more than one drug is used at a time. Thus, combinations of 2 or 3 chemo drugs are often used. Chemo is given in cycles, followed by a rest period to allow time to recover from the effects of the drugs. Chemo cycles are usually 2 or 3 weeks long. The schedule varies depending on the drugs used. With some drugs, chemo is given only on the first day of the cycle. With others, it is given one day a week for a few weeks or every other week. At the end of a cycle, rest is allowed and then the cycle begins again.

Side effects of chemotherapy

Chemo drugs can cause side effects, depending on the type of drugs given, dose of drugs given and the length of treatment. Side effects of chemo are grouped into short-term effects (persisting over a limited period) and long-term effects (persisting over a relatively long time). However, some of the common possible side effects include:

• Hair loss
• Nail changes
• Mouth sores
• Loss of appetite or weight changes
• Nausea and vomiting
• Diarrhea
• Fatigue
• Hot flashes and/or vaginal dryness
• Nerve damage
• Increased chance of infections (from reduced white blood cell counts)
• Easy bruising or bleeding (from reduced blood platelet counts)
• Fatigue (from reduced red blood cell counts and other reasons)

Research

A recent study (Unpublished data August, 2022) was carried out by some faculty members and students from the Department of Nursing and Midwifery, 51¶ŻÂţ and Medical Department, Korle Bu Teaching Hospital, to find out the side effects of chemotherapy on female breast cancer patients at the chemotherapy unit of the Korle-Bu Teaching Hospital, Accra, Ghana and to hear about the coping strategies adopted by these women in this difficult time. Female breast cancer patients who had been receiving cycles of chemotherapy for more than a month were sampled. In all, 60 women were sampled.

Results

The youngest woman in our sample diagnosed with breast cancer was 21 years and the oldest woman was 68 years old. The mean age and standard deviation of the women were 44 years (±13.68). The median age was 46 years and the modal age was 49 years. The number of women experiencing short-term and long-term side effects of chemo and the type of short-term and long-term side effects of chemo are shown in Table 1 & 2 below.

Table 1: Short term side effects of chemo

Ěý

Ěý

Table 2: Long term side effects of chemo

The coping strategies adopted by the women included social support which comprised support from family members, children, friends, spouses, church members and breast cancer support groups; spiritual activities which comprised praying and reading the bible; divine intervention which comprised waiting on God for healing and diversional therapy which comprised reading and listening to music.

Way forward

The side effects of breast cancer are real. The corner stone to prevention of breast cancer is early detection through breast self-examination (BSE) (see Figure 1), clinical breast examination (CBE) and mammography. These practices offer women the best opportunity for reducing breast cancer deaths globally.

We send this clarion call to every woman;

1. Be informed
2. Practice regular breast self-examinations
3. Get screened at any nearby health facility

Figure 1: Breast self-examination

Thank you.

Click to download Pdf: Vital Signs

THE VALUE OF REGULAR MONITORING OF YOUR VITAL SIGNS – A QUICK READ

By:

Mr. Reginald Arthur-Mensah Jnr, David Sablah & Dr. Abigail Kyei

Department of Nursing and Midwifery, 51¶ŻÂţ.

Introduction

Vital signs are important biological, biochemical, physiological and hormonal indicators of a person’s general health status. They are the objective measurements of the body’s most basic operations. Their processes perform essential functions for the living body. They are “vital” because they are urgently needed; absolutely necessary; a manifestation and sign of life. Even in triaging patients i.e., assessing or sorting patients according to importance or urgency of clinical presentation, the first set of clinical examinations is an evaluation of the vital signs of the patient.

Traditionally, vital signs include the body’s temperature, blood pressure, pulse rate, respiratory rate and oxygen saturation. Generally, vital signs provide a snapshot of what is going on in the body, if the values are outside the normal range, they may point to a dysfunction in the body.

Below are brief descriptions of the vital signs and the dysfunctions they may point to.

Body temperature

The normal internal body temperature ranges from 36.5 to 37.2 degrees Celsius (Check to verify if you are in this range). Usually, fluctuations in this value indicate there has been a microbial exposure and the body is fighting an infection. When there is a microbial exposure in the body, the immune system sends signals to the hypothalamus to increase the body’s temperature. This process in turn weakens the invading microorganisms and allows the specific body’s immune cells to respond appropriately, halting the pathogenesis of the microorganism. Upon successful victory by the immune cells, the body temperature will return to normal. However, prolong elevated body temperature needs a medical attention.

Blood pressure

The blood pressure is the pressure of the circulating blood against the walls of the blood vessels. Two numbers i.e., a numerator and a denominator are recorded when measuring blood pressure. The numerator (the systolic pressure/higher value) displays the pressure inside the artery when the heart pumps blood to the body. The denominator (the diastolic pressure/lower value) represents artery pressure when the heart is at rest. The blood pressure is considered normal at 120/80 mmHg (millimeters of mercury) (Check to verify if you have this value). Usually, fluctuations in this value indicate a concern for the health of the heart and brain and it associated blood vessels. E.g., coronary heart disease (heart attack), hypertension or stroke (brain attack).

Pulse rate

The pulse rate is the number of times the heart beats in a minute. It ranges from 60 to 100 beats per minute (bpm) (Check to verify if you are in this range). Usually, fluctuations in this value indicate a concern for the health of the heart and its associated blood vessels.

Respiratory rate

The respiratory rate is the number of times anyone breathes in a minute. It ranges from 12 to 20 breaths per minute (bpm). (Check to verify if you are in this range). Usually, fluctuations in this value indicate signs of respiratory illness, signs of a respiratory allergic exposure, respiratory poisoning, heart disease, lung infections, signs of a general infection and emotional changes.

Oxygen saturation

Hemoglobin is a hemoprotein (blood protein) composed of “globin” (colourless protein obtained by removing heme from hemoglobin) and “heme” (the oxygen carrying compound in red blood cells that gives red blood cells their characteristic colour) which functions primarily to transport oxygen from the lungs to body tissues. Oxygen saturation means the amount of oxygen absorbed by the hemoglobin relative to the total hemoglobin in the blood. It ranges from 95 to 100%. (Check to verify if you are in this range). Usually, fluctuations in this value indicate the lack of adequate oxygen rich–hemoglobin reaching the organs of the body. This can compromise various organ functions.

Take note however, that, many sources of internal and external variables affect the scores of these vital signs. E.g., age, external temperature, physical activity, pregnancy etc. Nonetheless, vital signs monitoring is the critical first step for a healthy and long life. Be intentional about monitoring your vital signs and you will save yourself.

Are you ready to monitor your vital signs but do not have the equipment and skill? Visit us at the Department of Nursing and Midwifery, 51¶ŻÂţ and we will be happy to help.

Thank you.

#AtPentvars
#PentvarsNursingMidwifery
#TransformationAndService

“DRIFT” and “SHIFT”, HOW VIRUSES MUTATE

Mr. Reginald Arthur-Mensah Jnr and Dr. Mrs. Abigail Kyei

Department of Nursing and Midwifery, Faculty of Health and Allied Sciences, 51¶ŻÂţ.

Download PDF: Drift and Shift – How Viruses Mutate_January 2022

Introduction

Genetic mutations are fairly normal occurrences for viruses. Viruses change or mutate to form new variants (see Figure 1). Mutations of a virus may result in the recession of the virus or the thriving of the virus.

Figure 1: Viral mutation [observe the spikes (purple colored) and viral genome (green colored)]

Genetic mutations represent any event that changes the genetic structure or any alteration in the inherited nucleic acid sequence of the genotype of an organism (Presterl, Schahawi, & Reilly, 2021).

A virus is a piece of nucleic acid/genome, either a deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), wrapped in a thin coat of protein and an outer envelope (see Figure 1). They can also be defined as ultramicroscopic infectious agent that replicates itself only within cells of living hosts to cause disease (Ward, 2012). For viruses, genetic mutations signify a change in the nucleic acid or genome of the virus that can affect the sequence of its other structures.

Implications of viral mutations include;

1. Enhanced mode/rate of transmission
2. Increased virulence i.e., the capacity of the virus to cause disease resulting in increased infections, hospitalization or death
3. Reduction in the neutralization of viruses by antibodies
4. Reduction in the effectiveness of therapeutics
5. Reduction in detection of virus
6. Ability to cause cancers

Two ways viruses mutate are called “antigenic drift” and “antigenic shift”.

Antigenic drift

As a virus replicates inside a host cell, i.e., when someone gets infected with a virus and the virus is growing/dividing/multiplying/making copies of itself inside the cells of the person, its genome can undergo random replication errors which are sometimes mediated by the virus or due to the replication process. These replication errors can lead to alterations in the viral surface proteins or usually called the antigens. Overtime, these replication errors amass and cause the antigens to drift, meaning, the surface proteins of the new emerging viruses look different than the original virus. Thus, the drift occurs due to small changes overtime in the genes of the genome of the viruses that lead to changes in the surface proteins of the virus.

Antigenic shift

An antigenic shift is a rapid major change in the genome or viral surface proteins or antigens of a virus. Antigenic shift can happen in four ways. They are;

1. Recombination
2. Recombination by independent assortment
3. Recombination of incompletely linked genes
4. Zoonotic transmission

1. Recombination occurs when two different, but related, viruses infect a host cell at the same time. During the process of replication, the genomes of these two viruses interact to generate a new subtype of virus with genome and antigens that are a mixture of the original strains.
2. Usually, the viral genome is a continuous strand. However, some viral genomes are segmented. Recombination by independent assortment occurs when two or more different viruses with segmented genomes infect a host cell. During the process of replication, the segmented genomes of these viruses can interact and assort at random. This can create a new subtype of virus with genome and antigens that are a mixture of the original strains.
3. Recombination of incompletely linked genes occurs when the genes of the genome of viruses interact by combining with other genes at different sites of the viral genomes during replication. This can create a new subtype of virus with genome and antigens that are a mixture of the original strains.
4. Zoonotic transmission occurs when a previously known virus that infects only animals makes a leap to infect humans. The whole process of replication of this virus that infects only animals but now replicating in human host cells creates a new subtype of virus with genome and antigens that are a mixture of the animal-human pair.

Antigenic drift and shift are one of the reasons why people can get viral infection repeatedly. Usually, antigenic shift gives rise to epidemics and pandemics.

COVID-19 and vaccination

We know that the COVID-19 pandemic started as a zoonotic transmission from the source city, Wuhan in China. Thus, it already began as an “antigenic shift” viral infection. So, the good news is that, the vaccines which have been made and continue to be formulated are against a “novel viral strain”. Though, this new strain will undergo mutations as is already been recorded, the vaccines will still be effective at neutralizing the viruses or boosting the immune system to “remember” and “fight” in the event of infection, because, most of the time, the mutations in the viral genome or antigens can be minor that, they do not significantly change how the virus works. They may take time before they drift and these changes also, do not happen at different places in the same time. They often begin as confined infections. Hence, the foundational framework of the virus from which the vaccines were formulated are rendered impotent. Also, even with the discovery of new strains, vaccination substantially, reduces the negative effects of infections or reinfections. As have been recorded around the world, vaccinations have reduced the number of cases that result in serious illnesses, hospitalizations and death.

Nonetheless, there is a cause to remain vigilant for the possibility of near or future antigenic changes in SARS CoV2 and to be prepared for several booster vaccinations if necessary. When viruses drift substantially or shift, therapeutics against the original strain of the virus may no longer work. Thus, therapeutics against viruses must be reviewed periodically.

What must we do?

Many factors contribute to how quickly viruses mutate and spread. One major factor is our human behaviour. To slow further mutations of the current SARS CoV2, we must adhere to the COVID-19 preventive protocols now more than ever. We must;

1. Always wash our hands with soap under running water for at least 30 seconds
2. Avoid touching our face
3. Cough into a handkerchief or a tissue
4. Wear face mask always
5. Avoid crowded places
6. Practice physical distancing
7. Get vaccinated/Get booster vaccinations

This is our new way of living, let us do well.

References

Presterl, E., Schahawi, M., D-L., Reilly, J., S. (2021). Basic Microbiology and Infection Control for Midwives. Springer Nature Switzerland.

Ward, H., (2012). Oxford handbook of Epidemiology for Clinicians. Oxford University Press.

The global medical discourse was on the theme: “Healthcare for all, is it Achievable?”. It sought to raise issues of holistic wellbeing of human beings and discuss the feasible ways to ensure that everyone has access to good healthcare. The thematic focus of the program was enlightening the students on the neglected aspect of mental health.

The panel discussing the subject matter included Richmond Anim Damoah, the moderator (CEO of RAD Communications Limited), Setor Abra Norgbe (First runner up of the 2021 edition’s Ghana Most Beautiful), Nancy Nantwi, (Deputy Regional Training Coordinator), Nana Achiaa Akoto Berhene, (Human Biology student of Kwame Nkrumah University of Science and Technology) and Benedicta Adobea Asare, (Communication student of 51¶ŻÂţ).

Setor Abra Norgbe, a Cuban-trained Medical Doctor, expatiated on health and healthcare, emphasizing on the need to enlighten people on the ignored aspect of mental health.

“We have ignored the importance of mental health in our society and it is affecting people in drastic ways. We cannot afford to neglect our mental health and focus on only the physical aspect of our health. We need feasible plans to achieve holistic healthcare for all. It is very possible to achieve this in our society,” she said.

Nancy Nantwi stressed on the need for sustainable plans to ensure that everybody has access to good healthcare.

“We cannot function in the society without good health and to maintain this for everyone, we have to draw out plans of sustainability to reach everybody in every community. This cannot be achieved in a day but it is a long-term plan that we can very much accomplish,” she said.

Nana Achiaa Akoto Berhene shared ways people can maintain good mental health and prevent any form of psychological breakdown.

“Exercise is very good for releasing stress and maintaining mental stability. Keeping a journal also helps you process your thoughts and identify problems in your life that need to be solved. Avoiding negative thoughts and surrounding yourself with the right kind of people are also important in ensuring good mental health which would improve your general wellbeing,” she said.

Bendedicta Adobea Asare, a Communication student of 51¶ŻÂţ, pointed out social and environmental factors which prevented access to good healthcare.

“People live in remote areas where they have to use roads in deplorable conditions and travel long distances just to get medical attention for their different needs. These places are disadvantaged and as a result, people are unable to get good healthcare. Just as health is not just the mere absence of diseases, healthcare is not solely about hospitals but the state of a community-based holistic focus on general well-being,” she said.

The keynote speaker, Scofray Nana Yaw Yeboah, charged the students to unlearn their comfort zone and create empowering pathways for themselves. The certified global coach said that it was important to build relationships while in school and make positive impressions on people in order to be remembered.

“Someone must recommend you somewhere if you focus on serving others and making impact. Learn to volunteer and use affirmations to psyche your mind for a better future. Your current location is not your final destination. One of the potent ways to create empowering pathways is by reading,” he said.

Francina Mensah, a musician, shared her story and urged the students to network with people and avoid overburdening themselves.

“You need to do away with the inferiority complex and the fear of the unknown to enjoy your youth. This would help you to be healthy mentally,” she said.

At the end of the global medical discourse, the conference host, Sara Nana Yeboah, launched the Danso Abiam Kokroko 1 Foundation, a foundation created to train and nurture young boys in the society. 51¶ŻÂţ was honoured as one of the organisations chosen to oversee the nurturing of the boys and ensuring they are raised to become positive contributors and problem solvers in the world.

#AtPentvars #TransformationAndService

According to Dr. Abigail, the Head of Department of Nursing and Midwifery at 51¶ŻÂţ, theUniversity seeks to offer specialty training for nurses and midwives who want to branch into various specialties within their profession. “But there is a generally a gap when it comes to opportunities for specializing in diabetic care.

That is why we held this workshop to deliberate further on a curriculum that will fill that gap and make nursing and midwifery training at 51¶ŻÂţ stand out. Dr. Kyei added that “the ideas we gather here will help us pay attention to issues that need to be addressed in the curriculum we will be developing to suit our peculiar circumstances when it comes to Diabetic care in our part of the world”.

The lead facilitator Mrs. Angelina Ankomah, an award winning Ghanaian nurse in the UK, threw light on gestational diabetes mellitus which concerns pregnant women and infants. She used her experiences, observations and works at the West Herts NHIS Trust, UK which earned her an award by the Royal College of Nursing. Speaking at the workshop, Mrs. Ankomah said “at the West Herts NHIS Trust, I observed and ensured early screening, diagnosis and management of diabetes among pregnant women.

This resulted to early and successful treatments and increased the hospital’s diabetes patients roll by 135% in 3 months.” Mrs Ankomah, therefore, said she is glad to use these skills and experiences to contribute to developing the curriculum and help make 51¶ŻÂţ a center of excellence in diabetes care education.

Commenting on the workshop, the President of the Ghana Registered Midwives Association Mrs. Netta Ackon, thanked PU for the initiative. She added that the workshop has equipped them with unconventional skills for early detection of gestational diabetes mellitus. Mrs. Ackon also said “we were made to know that the current management regime for diabetes is too basic, and members of my association are willing to undergo more training and therefore, advocate for more attention for diabetes care in the country.”

The workshop was organized by 51¶ŻÂţ with support from The Trio Bridge Foundation, a renown non-governmental health promotion organization in the UK.

Department of Nursing and Midwifery, 51¶ŻÂţ.

Download PDF: Breast Health among women at Eikwe – Breast Cancer Awareness Month October 2021-1

Introduction

Every October marks Breast Cancer Awareness Month (BCAM) to celebrate advances in new research into the detection and diagnosis, prevention, and treatment breakthroughs of breast cancer which could one day lead to a cure for the disease, to highlight the challenges that breast cancer poses and generally to raise awareness about the disease. The Breast Cancer Awareness Month for this year began on Friday, October 1, 2021 and ends on Sunday, October 31, 2021.

Cancer and Breast Cancer

Cancer is a broad term for a class of diseases characterized by abnormal cells that grow and invade healthy cells in the body. Breast cancer starts when the cells of the breast begin to grow out of control. These cancer cells can then invade surrounding body tissues and spread to other parts of the body (NBCF, 2021). According to the World health Organization (WHO), breast cancer is the most common cancer among women worldwide (WHO, 2020).

Every 74 seconds a woman dies of breast cancer. Studies have shown that breast cancer is more frequent in the left breast than in the right breast of women. When breast cancer is detected early, the survival rate is 99%. Globally, breast cancer occurs in less than 1% of men (CDC, 2021). The prevalence of breast cancer in Ghana up to the year 2020 stood at 18.7% (Globocan, 2020).

Risk factors of Breast Cancer

Studies shows that the cause of breast cancer is unknown but there are diverse risks factors that can result in breast cancer. These risks are modifiable (can be prevented) and non-modifiable (cannot be prevented).

Non-modifiable risk factors include;

1. Being a woman
2. Older age (> 50 years)
3. Genetic mutations (BRCA1 or BRCA2 genes)
4. Reproductive history
5. Family history of breast cancer
6. Previous treatment using radiation therapy

Modifiable risk factors include;

1. Physical inactivity
2. Overweight or obesity after menopause
3. Intake of hormones
4. Use of certain oral contraceptives
5. Intake of alcohol
6. Smoking

Symptoms of Breast Cancer

The first noticeable symptom of breast cancer is appearance of a lump (an abnormal thickened enlargement) that feels different from the rest of the breast tissue. Other signs include;

1. Thickening of breast tissue
2. One breast becoming larger or lower
3. A nipple changing position or shape or becoming inverted
4. A rash on or around a nipple
5. Discharge from nipple(s)
6. Constant pain in part of the breast or armpit
7. Peeling, flaking or scaling of the skin of the breast or nipple
8. Swelling beneath the armpit or around the collarbone (NBCF, 2021).

Research

In a recent study (September, 2021) by some faculty members and a student of the Department of Nursing and Midwifery (DoNM), 51¶ŻÂţ (PU) on Breast health practices among women in Eikwe in the Western region of Ghana, results from the study reveal worrisome gaps in the attainment of breast health in Ghana.

Eikwe is a small fishing town in the south east of the Ellembelle district of Nzema in the Western region of Ghana. The town is situated in Axim. It is located after Sanzule-Krisan and is a branch road off the Esiama-Elubo road. It shares boundaries with Krisan and Sanzule to the West and Ngalekpole to the East. It geographical coordinates are 458’00” North, 228’47” West and altitude 15m. (; personal communication).

The study sought to determine the knowledge of breast diseases and the risk factors of developing these breast diseases, to determine the knowledge of breast self-examination (BSE) and to determine the extent of breast screening practices [BSE, clinical breast examination (CBE) and mammography] among a sample of 100 women in Eikwe.

Findings showed that all the women (100%) knew that the breast could be exposed to diseases and more than three-quarters (>75%) were able to mention some breast diseases including fibroadenoma, duct ectasia, breast abscess/infections, mastitis and breast cancer. However, about half of the women (47%) did not know the causes or the risk factors to the diseases they mentioned. Also, about (91%) had heard about BSE but more than (>80%) did not know how to perform BSE. Moreover, regarding the extent of breast screening practices, all the women (100%) had not heard about CBE and (93%) had not done mammography before. Generally, more than half (>50%) of the women were not interested in breast screening practices. The reasons they gave included;

1. Lack of know-how in doing BSE
2. No symptoms of breast diseases
3. Belief that they can never get breast diseases
4. Fear of discovery of the presence of breast diseases
5. No time to do breast screening practices since they had to attend to their livelihoods

It is recommended that intensive education on the importance of breast health should be given to women in the rural communities in Ghana.

Prevention

The corner stone to prevention of Breast Cancer is early detection through breast self-examination (BSE) (see Figure 1), clinical breast examination (CBE) and mammography. These practices offer women the best opportunity for reducing breast cancer deaths globally.

We send this clarion call to every woman;

1. Be informed
2. Practice regular breast self-examinations
3. Get screened at any nearby health facility.

To our men;

1. Help save the boobs
2. Become breastie bestie.

Figure 1: Breast self-examination

Source:

References

American Cancer Society Breast Health Guidelines [ACS] (2021). Breast Cancer. Retrieved from (Accessed October 9, 2021).

Eikwe Map Retrieved from . (Accessed October 7, 2021).

Centers for Disease Control and Prevention [CDC] (2021). Breast Cancer Awareness. Retrieved. (Accessed October 9, 2021).

Globocan (2020). Ghana Cancer Statistics. International Agency for Research on Cancer.

National Breast Cancer Foundation [NBCF] (2021). Breast Cancer Awareness Month. Retrieved from . (Accessed October 9, 2021).

World Health Organization [WHO], (2020). Breast Cancer. Geneva. Author.

Since the emergence of the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in December 2019, the COVID-19 has spread throughout the world, and has been described as occurring in several peaks in waves.

The term “wave” as used in infectious disease cycles, is generally used to describe the rising and declining trends of infections over a prolonged period. Naturally, epidemics and/or pandemic infection cases fluctuate by surging and falling intermittently, with a possibility of rising to a peak or declining and/or never to rise again. The wave phenomenon of epidemics and/or pandemics when presented diagrammatically resembles the frequency curves (see Figures 1&2). Several infections are seasonal in nature, and they recur after fixed time intervals.

Figure 1: Frequency curve

Source: Encyclopedia Britannica, (2021).

Figure 2: COVID-19 infection rates (Canada)

Source: Encyclopedia Britannica, (2021).

The waves of COVID-19

COVID-19 has continued relentlessly for the last eighteen months, but in every geographical area it has affected, there have been periods of surges that have been followed by periods of reduced infections. Infectious disease waves differ across countries, regions, state, and cities and each is distinct in its own science. Concerning the COVID-19 pandemic, some countries have experienced their fourth wave whilst others are yet recovering from their second wave. Typically, such series of waves manifest over different time frames and the epidemics and/or pandemic might not be necessarily over until affected countries, regions, state, and cities have gone through the impact of the wave.

Regarding the COVID-19 pandemic, the first wave referred to the onset of the infection and its primal consequences in populations. It was the period when all clinical cases of infections and diseases, hospital admissions, hospital readmissions, disabilities and deaths were directly linked to COVID-19. Technically, any country that recorded any positive case of COVID-19 experienced the first wave.

The second wave referred to the rise in active cases after the microbiology of the virus and its interaction with man was known and infection prevention and control practices were implemented to limit the spread of the infection. Technically, any country that recorded surges in positive cases of COVID-19 after the implementation of the preventive measures to the virus experienced the second wave.

The third wave is the increase in the number of active cases after the decline in cases from the second wave whose impact is on the social determinants of health. Many factors combine to affect the health of individuals. Whether people are healthy or not, is determined by their individual characteristics and behaviour, their physical environment and their social and economic environment (WHO, 2017). Examples of the physical environment and the social and economic environment of people include their place of residence, state of their environment, income levels, educational levels, unemployment levels, availability of social support services, microeconomic variables, relationships with family and friends etc. However, the major elements include access and use of health care services. The third wave will worsen health inequalities through severe economic injuries. The health impacts caused by this worsening economic recession will be complex especially where health care might just be the benefit of a few. For instance, many hospitals around the globe are already short-staffed and overwhelmed with patients, and some are short on oxygen, forcing a rationing of care. Simply put, the third wave is the increase in infections due to the citizens of a country letting their guard down on the preventive measures of the infections, due to harsh economic situations, which results in pressure and inequalities in health care seeking services where only the able can access health care. Complications of this wave is that, people die not directly from COVID-19, but due to the economic fallout; job losses and other financial pressures that are known from historical recessions to increase physical and mental stress. This wave is not far from many countries.

Based on the ongoing discussion, we ask these questions as a country;

1. How far is Ghana in its second wave and how well is the country coping?
2. Is Ghana in its third wave?
3. Can Ghana experience the third wave and what preparations are in place to meet any such possibilities?

Your response is as good as ours!!!

To prevent the third wave, countries must act now to repair, fix and strengthen their economies. They also need to prioritize access and utilization to basic and specialized health care needs of their citizens else the countries risk continuum into subsequent waves which will impact generations unborn.

The lasting impacts of the COVID-19 pandemic, both positive and negative, can be overwhelming, yet the reality of this pandemic is that: the virus has got into everything about our daily lives.

As scientists work around the clock to eliminate the virus, let us continue to act responsibly and adhere to the precautions and preventive measures using the Swiss Cheese respiratory virus intervention model (see Figure 3).

Figure 3: The Swiss Cheese respiratory virus intervention model

Source:

By:

Mr. Reginald Arthur-Mensah Jnr & Dr. Abigail Kyei

Department of Nursing and Midwifery, 51¶ŻÂţ.

References

Encyclopedia Britannica (Accessed June 17, 2021)

How to stop the COVID-19: The Swiss Cheese model. Retrieved from University of Iowa Health Care. (Accessed June 17, 2021).

WHO, (2017). Determinants of Health. Retrieved from (Accessed June 17, 2021).