By Bannor, Philip A.

Friends, we have all been inundated with what appears to be a purely fabricated story about the health of the flag-bearer of the New Patriotic Party, the Honorable Nana Addo-Danquah Akufo Addo.

A confuted news magazine, AfricaWatch has published an article about the presidential candidate of the NPP as suffering from major health problems including an enlarged weakening heart, an acute kidney injury (possibly causing him to retain urine), inflammatory mucosal dental problems and near demise by metastasizing prostate cancer.

Like most of you, I was quite surprised to read the article but immediately recognized that the Nana Addo's political opponents who may have very little to offer to Ghanaians in the election season, may result to desperate tactics. Desperate people, do desperate things. I began to read the article and right away noticed three key issues of concern.

Before I deal with the issues identified, I need to state from the outset that I am not Nana Addo's personal physician. So I can not speak directly to the state of his health. However, I do know him personally, and he knows me as a practicing physician. My opinions are reflections on the article published by the Steve Malory's AfricaWatch magazine.

The first issue is the accuracy of the information contained in the report. Let me quote a portion of the article below:

"A chest X-ray taken on January 14, 2014, showed him to have acute kidney injury, which kidney experts say is a serious condition that can leave sufferers in considerable pain. "

As a practicing physician, I have never obtained a chest X-ray to diagnose an acute kidney injury. So when I first read the referenced statement above, I did not quite know what to do with it. The usual tests needed to diagnose a suspected acute kidney injury are; Urinalysis (analysis of the patient's urine), CBC (a complete blood count), SED rate ( Westergren sedimentation rate), and CMP (comprehensive metabolic profile).

At the risk of sounding a bit too technical, a UA will give information about spilling or wasting of protein, microalbumin, RBC casts, SG, hematuria, etc., more than what is expected.

A normocytic anemia on CBC may likewise reflect a waning hematopoietin secretion by a diseased kidney. CMP will inform BUN/Creatinine ratio may inform the clinician about pre-renal, intrinsic or post-renal issues. eGFR may be computed to approximate creatinine clearance.

Aberrancy in the Westergren will further guide as to the presence of vasculitis, glomerulonephritis, or glomerulonephropathies. In such case, a needle guided biopsy may be needed.

With respect to imaging one may obtain Ultrasound of the Kidneys, and if further testing is required a non-contrast CT (computed tomography) scan, rather than the gadolinium-enhanced, is preferred to minimize the reported post-study fibrosing of the affected organ.

MRI/A (magnetic resonance imaging/angiography) may be obtained to evaluate the presence of a stenotic RA (renal artery) or delineate other vasculopathies.

The emphasis on Chest X-ray in the article to diagnose acute damage to the kidneys was concerning and raised my suspicion if the entire article may have been written by a hired non-medical personnel to paint a political figure in such a negative light. Notice that the article stated none of the required tests to diagnose the alleged disease.

To further satisfy my curiosity and to make sure that I was current on my information, I checked several reliable and reputable sources to authenticate the use of the chest Xray to diagnose the problem. I checked sources at some of the world-renowned medical centers such as Case Western Hospital, Mayo Clinic, Emory and Vanderbilt University medical centers.

I also checked public sources like WebMD, Medscape, and Merck Manual of Diagnostics -professional edition. I found none to corroborate the use of chest X-ray to make the definitive diagnosis of the alleged disease. None whatsoever. I also called fellow medical colleagues here in the US and the University of Ghana at Legon. All thought the information was spurious or more information was needed.

I asked myself what possible reasons could have prompted the article, if not to malign someone. The symptoms of acute kidney damage range from innocuous nausea and vomiting to the overt seizures and coma. Everyone has had nausea and stomach aches. If the NPP presidential candidate had experienced seizures or slipped into a coma that would have made news in this electronic age.

Nana has never experienced such overt symptoms, and hopefully never in the future. Folks, given all of the above, isn't it fair to ask if the information was possibly cooked to damage Nana politically, given the fast-approaching election on December 7, 2016?

Let me add that a chest Xray may be adjunctive in the event of suspected acute pulmonary edema-i.e. fluid overload in the lungs and evolving cardiac tamponade (fluid around the sac of the heart). But here again, such a patient would be in intensive care (due to rapidly deteriorating medical condition) where a preferable testing would be an echocardiography or catheterization, an invasive instrumentation for exact measurements of cardiac indices and functions.

Such information will then be instructive as to the need for the occasional pericardiocentesis, and other treatment interventions. Notice none of these measures were reported in the AfricaWatch article. Were they mere oversight, or was it because some diseases were conjured from thin air to smear Nana Addo?

If the flag-bearer was ever in such a critical condition in Ghana, United States, United Kingdom, or where ever Steve Malory and his cohorts could think about, do you believe Nana's family would EVER be able to keep such a SECRET about such an admired, well known public figure from the rest of the Ghanaian public? The answer is emphatic no!

In fact, Nana's itinerary are always published in advance of his travels, and Steve Malory and his propaganda phalanx carefully placed Nana's well-published travel dates to coincide with alleged medical treatment.

The article is just a miserably failed veil attempt to taint Nana Addo. Simply stated, I doubt the reported $2.5 million sponsored, Steve Malory's discredited AfricaWatch magazine article, and should be repudiated by ALL, and withdrawn immediately.

The second issue I had with the purported report is the credibility or the authenticity of the information. The maligned publishers placed such a premium on the Wellington Hospital where Nana Addo was reportedly hospitalized. I was curious as to the choice of the medical center and begun to search for information about the hospital.

I was surprised at what I found. Several portions of the AfricaWatch report are PLAGIARIZED from Wikipedia, and other sources. Below are examples;

First plagiarized statement:

The Wellington Hospital, (where Akufo-Addo is receiving treatment), is the largest independent hospital in the UK, famous for its cardiac services, neurosurgery, liver and HPB medicine, rehabilitation, gynaecology, orthopaedics, and other services. (Source is Africa Watch article).

The Wellington Hospital (in St John's Wood, North London) is the largest independent hospital in the United Kingdom, (and part of HCA International hospital group). It is known for its cardiac services, neurosurgery, liver and HPB medicine, rehabilitation, gynaecology, orthopaedics, and other services. (Wikipedia page on Wellington Hospital).

Second plagiarized statement:

The Wellington Hospital has four main sites: North Tower, South Tower, Central Building, and a new Platinum Medical Centre. It is at the Platinum Medical Centre that the diagnostics of the examinations done on Akufo-Addo's ill health were conducted. ( Source AfricaWatch article).

The Wellington Hospital has four main sites: North Building, South Building, Central Building and the new Platinum Medical Centre. The most recent addition to The Wellington Hospital is the new Platinum Medical Centre. ( Source Wikipedia page on Wellington Hospital).

There were several plagiarized statements throughout the article that time will not permit me to reprint them here. The bottom line is simply this, do you believe a plagiarized paid article to smear a political opponent some 100 days before an election? I persuade you not to yield to their insinuations.

Let me touch on the issue of prostate cancer treatment. The publishers conveniently choose a disease that is quite common in all men of Nana's age. What drew my concern is that PSA level is not used to make a diagnosis of prostate cancer.

Let me quote the recommendations from two reliable sources; In 2008, and again in 2012, the U.S. Preventive Services Task Force (USPSTF) concluded that "the evidence was insufficient to assess the balance of benefits and harms of screening for prostate cancer in men younger than age 75 years.

The USPSTF recommended against screening for prostate cancer in men aged 75 years or older using the prostate specific antigen, PSA". Similarly, the Canadian Medical Association stipulates that "available evidence does not conclusively show that using PSA screening will reduce prostate cancer mortality, but it clearly shows an increased risk of harm," when used inappropriately for unnecessary treatment.

The task force recommends that the PSA test should not be used to screen for prostate cancer. There are several non-cancer causes or reasons for increased in OSA including riding a bike, prostatitis (bacterial infection of the prostate organ), urinary tract infection, benign prostate enlargement, prior surgery or instrumentation in the male pelvic floor.

Low PSA levels less than 4 is not indicative of cancer free. High PSA levels are NOT indicative of cancer as alighted in the article. Doctors are increasing, relying on PSA ratio free vs. bound PSA, among PSA density, and velocity (rate of rise in PSA).

The authors dwelled on a high PSA to make claims of prostate cancer. I have patients who have PSA levels higher than the 80 or 90 reported in the AfricaWatch article who do not have cancer. Levels of PSA are not indicative of prostate cancer. The rate of increase in PSA levels may be concerning but not the actual figure per se.

The second issue with the prostate cancer story is the reported modality of treatment with electron beam therapy. The EBT requires daily treatment for several weeks to months. Is anyone aware that Nana Addo has been hospitalized or been seen going to a hospital for months on a DAILY basis?

I strenuously urge readers to dismiss the AfricaWatch story about Nana Addo's health as mere speculative tactics of paid journalists who want to score cheap propaganda points. Lets all pray for the health of ALL our leaders irrespective of our political persuasion.

Philip A. Bannor, MD is a practicing Internal Medicine physician, USA.