Awareness of Ocular Complications of Diabetes Among Diabetic Patients In A Tertiary Hospital In Western, Nigeria

Background:- Diabetes is no longer a disease of affluent and industrialized countries. It affects virtually all ocular structures and can lead to blindness. Routine eye examination is necessary for early detection of ocular involvement and prevention of blindness. Only few diabetics have regular eye examination. Aim:- To study the awareness of ocular complications of diabetes among diabetic patients Methodology:- A cross-sectional prospective study of 148 randomly selected diabetic patients was done. A semi structured questionnaire was administered to these patients by an interviewer who is medical personnel, not below the level of a house-officer. Informed consent was obtained from the patients before filling the questionnaires. The information obtained include the biodata, educational level, duration of diabetes, whether they were aware that diabetes can affect other parts of the body, if yes which parts, which parts of the eye can it affect, how can it affect the eye, whether or not routine eye examination is necessary in diabetics, if yes how often, how did they learn about diabetes and how they think awareness of diabetic complications can be improved. The results were collated and analyzed using SPSS version 13, with chi square done where necessary. Results:- A total of 148 patients were studied. Their ages range between 21years and 82years, with a mean of 58.53 +10.4years. Majority were between 36-60yearrs of age. Eighty-three (56.1%) had educational level within secondary level 40(27 %) tertiary education while 25(16.9 %)) do not have formal education. Most common co morbid factor was hypertension, found in 44.6%. One hundred and twenty three (83.1%) were aware that diabetes could affect other parts of the body, 41% were aware of brain affectation, 54% were aware that it can affect the kidneys, 77.7% were aware that it can affect the eyes, 39.2% blood vessels, 66.2% the legs, 40.5% the skin and 41.9% were aware that it can affect the genitals. Of the 77.7% who were aware that it can affect the eyes, more than half (58.8%) did not know the part of the eye that can be affected. 20.3% knew that it can affect the crystalline lens,4.1% external eye, 13.5% the retina and 3.4% thought it can affect the combination of external eye, lens and the retina. Forty nine respondents (33.1%) did not know that routine eye examination is necessary in diabetics, 16.2% says eye examination should be once, 18.2% twice, 18.9% thrice and 26.4% none. Only 18 (12.2%) respondents got their information of eye complication from eye specialists. Sixty- one respondents (41.2%) do not know how diabetes can affect the eye, 29.7% knew that poor control is the problem, 8.8% think it is due to long duration, 7.4% believe it was a combination of poor control and long duration, 2% claim it is due to infection, 8.8% combination of infection, poor control and long duration and 0.7% erroneously believe thinking too much of DM can result in eye complication. Patients who have been diabetic for more than 10years are more aware that diabetes can affect the eye than those below 5years (92.3% vs. 7.2%, p=0.001). Awareness of diabetic complication is better in those with tertiary education than others (p=0.001). Conclusion:- We conclude that though awareness of ocular complication of diabetes mellitus is high, the level of knowledge is low. Health Practitioners especially eye care specialist need to intensify health education through media, regular health talks in clinics to increase knowledge and increase health seeking behaviours of diabetics in the

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Prevalence of obesity among Nigerian school children

The prevalence of obesity among 457 school children in the age group 6-19 years is 3.2% for males and 5.1% for females based on weight for age. 3.7% males and 3.3% females were classified as obese when triceps skinfold thickness was used as the basis of obesity. Preventable socio-economic factors are responsible for the high prevalence of obesity among, Nigerian school children. This the first study of prevalence of obesity among Nigerian school children.

Ocular B-scan Ultrasound using non-dedicated Ultrasound system: Preliminary Report from Sagamu

Hitherto, opacity of the media precluding view of the retina has prevented ophthalmologists in Sagamu from making definitive diagnosis and decisions on management of some intraocular or orbital lesions. Recently, facility for ocular B-scan ultrasonography has been available in Sagamu. The objective of this study is to assess if ocular B-scan ultrasonography can assist the ophthalmologists in making diagnosis, thereby aiding in management decision of ocular and orbital diseases. We retrospectively review the clinical notes of the 29 patients who underwent ocular B-scan ultrasound of 37 eyes for analysis of age, sex, indications for request, ultrasound findings and subsequent management. The age ranges between 5days and 70years (mean 31years). Male: Female ratio was 2:1. Management decisions were influenced by ultrasound findings in 95% of patients. Keywords: Ocular ultrasound, opaque media, non-dedicated ultrasound system, ophthalmoscopeThe Nigerian Medical Practitioner Vol. 52 (4) 2007: pp. 82-8

Bilateral cataracts post thyroidectemy - a case report

No AbstractThe Nigerian Medical Practitioner Vol. 52 (5&6) 2007: pp. 117-11

Perception of red eye among senior secondary students in Sagamu, Southwest Nigeria

Background: Red eye is a very common presenting complaint in clinical practice among all age groups, including adolescents. Health habits formed during adolescence is carried to adulthood and is often a consequence of their perception. This study, therefore, determined the perception of students toward the red eye. Aim: To determine the perception of red eye and its associated factors among secondary school students in Sagamu. Methods: A cross-sectional descriptive study was carried out among 1082 senior secondary school students in Sagamu local government area, using a semi-structured self-administered questionnaire. Data were analyzed using SPSS Version 20. Relevant descriptive and inferential statistics were calculated. Results: The mean age of respondents was 15.27 ± 1.48 years. There were more females (54.8%) than males. Majority (81%) had heard of red eye, and this was mainly from neighbors; 58.4% felt they could not contact red eye from an infected person. About 35% would instill onion if they had a red eye. About 50.2% felt red eye could lead to blindness. Awareness of red eye was associated with age (P = 0.005), but not with sex and religion. Among respondents, 95.5% and 96.2% had a poor perception as well as a poor attitude toward red eye, respectively. Conclusion: The perception and attitude of senior secondary school students in Sagamu to red eye is poor. Appropriate eye health education and promotional services, including periodic eye examination of students, should be carried out in school health services. Early presentation to eye care centers for its treatment should be encouraged

Knowledge, Attitude, and Health Believes of Glaucoma Patients in a Nigerian Hospital

To find out the knowledge, attitude and health beliefs of glaucoma patients in Sagamu, Nigeria. A Prospective hospital based case series of 90 patients aged 5-87years who has been attending the glaucoma clinic of Olabisi Onabanjo University Teaching hospital (OOUTH) was conducted. Patients were interviewed using a questionnaire and the data obtained analyzed using Epi Info 2002. Overall 15.1% (13) had family history of glaucoma and only 18.1% had heard of glaucoma before their diagnosis was made.93.9% believed that glaucoma is a serious condition which can damage vision and 7.1% believed that they can recover from the illness after treatment. We conclude that glaucoma awareness among glaucoma patients was not high. Majority believed that they can recover from the illness after treatment. Health education programmes may help increase the awareness and knowledge of glaucoma. Nigerian Medical Practitioner Vol. 50 (3&4) 2006: pp. 62-6