Cataract and Retinal Detachment Following Electric Shock Injury in a 28-year-old Nigerian Male: A case report

Aim: To report a case of cataract and retinal detachment following an electrical injury in an adult Nigerian male. C a se report: A 28-year-old man presented with a history of progressive and painless loss of vision in the right eye, three years after an electric shock injury. There was no history of mechanical trauma. Examination and investigations revealed a mature cataract and retinal detachment in the right eye. He subsequently had an uneventful cataract surgery with expected poor prognosis, secondary to the retinal detachment. Conclusion: This case highlights two ocular complications (one common and one uncommon) following an electrical injury. A high index of suspicion and awareness of the likelihood of these complications may increase diagnostic accuracy, especially in cases of presenile cataracts with no apparent cause. Keywords: electrical injury, presenile cataract, retinal detachment Nigerian Journal of Ophthalmology Vol. 16 (1) 2008: pp. 23-2

Poor cataract surgical output: Eye care workers perspective in north central Nigeria

Background: Cataract remains a disease of priority being the leading cause of blindness globally. Although surgically curable, cataract surgical output has remained low in Nigeria, Kwara state inclusive. Astudy was carried out to investigate the perception of eye care workers (ECW) on low surgical output and their adjudged reasons; this has hitherto notbeing evaluated.Materials and Methods: A cross-sectional quantitative survey with the aid of pretested structured questionnaire of all ECW and qualitative survey using in-depth interview on selected workers in Kwara State, Nigeria was done.Results: A total of 142 out of the 157 ECWs (90.5%) working in the 14 surgical eye centers in the state were interviewed with a mean age of 40.37 years, SD ± 8.67. There were 94 (66.2%) females, with a female to male ratio of 2:1. 91 (64.1%) participants were of the opinion that the numbers of cataract surgeries in the state were inadequate. Hospital-basedand human resource efficiency-related issues such as long clinic waiting time, multiple paying and procedural sites, poor staff mix, and gaps in available human resource were the major reasons given for low cataract output. Others reasons were high cost and fear of surgery, distance of eye clinics from patients.Conclusions: Regular operational researches, proper deployment, and efficient use of human and material resources in addition to subsidized cost and appropriate health education to allay fear of surgery are steps that could enhance cataract surgical output

Challenges in the management of glaucoma in a developing country; a qualitative study of providers' perspectives

Background: Glaucoma management is challenging to patients as well as to the eye care providers.The study is aimed at describing the challenges faced by providers using qualitative methods.Methods: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services.The discussions were recorded with the aid of a microcassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified.Quotes that reflect the themes and sub-themes were then identified in the data.Results: In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burdenconstituting about 35% of outpatient visits. Identified patient related challenges include;late presentation,lack of glaucoma awareness,delay in referral from optometrists,and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting ofdrugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant.Some respondents considered the current number of glaucoma surgeries as adequate, while somethink otherwise.Reasons put forward for reluctance to offer glaucoma surgery include;late presentation, lack of patient satisfaction,complications of surgery,and negative publicity.Conclusion: Even though the challenges in the management of glaucoma indeveloping countries are many, they are not insurmountable.There is need for concerted and integrated efforts involving all cadres of eye care practitioners, patients, institutions and governments to address this important eye disease. Improved awareness, provision of adequate equipment,availability and affordability of medications,need for training and retraining of eye care providers are all important measures that can lead to better management of the glaucoma patient

Assessment of pre and postoperative psychiatric comorbidity among patients scheduled for elective cataract surgery in Lagos, Nigeria

Objective: Comorbid psychiatric disorders have been reported to be associated with pre and postoperative periods. Studies on pre and postoperative comorbid psychiatric disorders among ophthalmological patients are scanty in Nigeria and other sub-Saharan countries. This study was aimed at determining pre and postoperative comorbid psychiatric disorders among patients scheduled for elective cataract surgery in Lagos, Nigeria.Methods: Seventy-seven adult patients scheduled for elective cataract surgery at the ophthalmology clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria were recruited and assessed 24 hours pre and 24 hours postoperatively for psychiatric morbidity by asking them to complete the twentieth version of the Self-rating Questionnaire and the Hospital Anxiety and Depression Scale.Results: The findings of this study showed that only 5.2% of the participants experience preoperative mental illness and anxiety respectively while the 9.1% experienced depression. Post-operative assessments revealed that none of the participants experienced any mental illness or depression apart from 1.3% who experienced anxiety postoperatively. There were no statistically significant findings between the sociodemographic variables and anxiety, depression and mental illness.Conclusions: The findings of this study indicated that there were comorbid psychiatric disorders among ophthalmological patients scheduled for cataract surgery in Lagos, Nigeria. Therefore, patients who are to undergo surgery should be screened for psychiatric morbidity. Likewise, adequate and appropriate surgical information should be given to patients to reduce associated comorbid psychiatric disorders.Keywords: Psychiatric morbidity, preoperative, postoperative, anxiety, depression, catarac

Malignant Glaucoma: Report of a Presumed Bilateral Spontaneous Case

Background: Malignant glaucoma is an ocular emergency and may lead to blindness if not promptly recognized and treated effectively. It is usually reported after trabeculectomy, and spontaneous or bilateral cases are not common in the literature.Case report: This article reports the case of a Nigerian woman who  developed spontaneous bilateral malignant glaucoma with resultant visual impairment. A literature review on the subject is also undertaken. Possible etiology and management challenges of the case are also discussed.Conclusion: This study is aimed at drawing attention to this potentially blinding eye disease, and ultimately improves knowledge on its diagnosis and management, to reduce the visual morbidity.Key words: Malignant glaucoma, closed angle glaucoma, blindness, visual impairment, aqueous misdirection, vitrectom

Pattern of Eye Diseases among Commercial Intercity Vehicle Drivers in Nigeria

Objective: To determine the pattern of eye diseases among commercial intercity vehicle drivers (CIVDs) in Ilorin, Nigeria.Design: A cross-sectional descriptive study.Methodology: Out of the estimated 450 drivers operating inthe five major motor parks for CIVDs in Ilorin, 399 consecutive drivers participated in the study. Structured questionnaires were administered and ocular examinations were done.Results: The common ocular conditions seen were presbyopia(28.3%), allergic conjunctivitis (22.6%), pingueculae (18.0%), ocular hypertension (8.8%), pterygium (8.3%), cataract (7.8%), and uncorrected refractive error (6.0%). Visual impairment, based on legally required standard for commercial drivers in Nigeria, was found in 11.5% of theparticipants, while 3.3% of them had monocular blindness with a visual acuity (VA) of less than 3/60 in one eye. Cataract and glaucoma were the major causes of visual impairment.Conclusion: Ensuring that all prospective drivers undergo basic vision tests, followed by prompt referral of those with visual impairment to ophthalmologists could serve as a good case detection outlet. Blinding ocular conditions could be detected early and treated appropriately. This will ultimately prevent unnecessary loss of lives and property

Uncommon complications of Otitis media in a tertiary center: A Case Series

Background: The aim is to report cases of unusual and infrequent complication of otitis media in North-central Nigeria, as well as evaluate their outcome. We present 7 case reports of patients with unusual complications from otitis media in our setting.Case 1: A fifteen year old Yoruba girl presented at the Accident and emergency of our hospital with a 2 week history of left sided ear ache, 10 day history of left sided ear discharge and 3 day history of jaw and neck stiffness. There was a positive history of use of ‘Turari’ locally prepared perfume and application of an ear drop from a local chemist. Caregiver said patient was fully immunized. Examination revealed a young girl, conscious and alert, not pale, anicteric with stiff neck, positive and rigid joints on movement.Case 2: An 8 year old Yoruba girl presented first to the eye clinic with 2 days history of swelling of the right eye, associated pain, reduction in vision and eyelid swelling without eye discharge or itch. There was a of purulent ear discharge 8 days prior to eye symptoms. No history of trauma was obtained. Examination revealed proptosis with zygomatic abscess extending to the post-auricular. She had incision and drainage with systemic and topical antibiotics for ear dressing. Outcome was uneventful.Conclusion: The unusual complication of otitis media still occurs in our environment usually due to late presentation and contamination of wound. Prevention is still the best option.  Keywords: Otitis Media, Complications, Otogenic Tetanus, Ophthalmic, Proptosi

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Presumed Fuchs' uveitis syndrome – a case report and review of literature

Fuchs' uveitis syndrome (FUS) is an uncommon form of uveitis. A case of presumed FUS seen in a patient at the eye clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria is presented. An update on FUS is provided. A high index of suspicion is advocated for cases of asymptomatic, unilateral uveitis associated with cataract. Cataract surgery in these types of patients is not associated with a fulminant post-operative inflammation common with other forms of uveitis. Nigerian Journal of Ophthalmology Vol. 14(1) 2006: 31-3

Pattern of Seat Belt and Mobile Phone use while driving in an Urban Population of Commercial Drivers

Objective: Human error contributes significantly to the occurrence of road traffic accidents (RTAs) and their attendant morbidity and mortality. While driving, distractions such as the use of mobile phones and poor compliance with the use of seat belts play different roles in the occurrence of RTAs and possible injuries arising from them. This study aimed at evaluating the pattern of seat belt and mobile phone use (while driving) in an urban population of commercial drivers It also investigated the relationship between mobile phone use and recorded accidents.Methods: Commercial intercity vehicle drivers were interviewed face to face at the five major motor parks in Ilorin-Nigeria about mobile phone and seat belt use while driving.Results: Three hundred and ninety nine (399) commercial intercity vehicle drivers (CIVDs) participated in the study. All were male. Eighty-three drivers (20.8%) had been involved in RTA over the last 10 years and common causes were faulty vehicles 44 (42.7%) and driving errors 22 (21.4%). Two hundred and thirteen (53.4%) of the drivers engaged their seat belts regularly, 151 (37.8%) did so occasionally, and 35 (8.8%) never did. In addition, 155 (38.8%) drivers believed it was always necessary to use their seat belts, while 111 (27.8%) had a contrary opinion. 105 (26.3%) drivers admitted that the seat belts in the vehicles they drove had malfunctioned. Twenty-nine (11.5%) out of 253 mobile phones owners used these devices when driving, while twenty-five (96.9%) out of the 29 drivers who made or received calls in transit did not use hands-free devices. There was no statistically significant association between calls while driving and involvement in RTA (p&gt; 0.05).Conclusion: The use of mobile phones and poor compliance with the use of seat belts while driving are common among commercial drivers in Ilorin, Nigeria. There is a need for improved education, monitoring, and enforcement of existing laws against these vices to curb these risky habits.Key words: Commercial drivers, seat belt, mobile phone, road traffic acciden