OCULAR FINDINGS IN CHILDREN WITH CEREBRAL PALSY ATTENDING A TERTIARY HOSPITAL IN NORTH CENTRAL NIGERIA

Cerebral palsy is commonly associated with ocular abnormalities which often impact on their development and education. There is paucity of studies on this in Nigeria.   We decided to study/ determine the prevalence of ocular abnormalities among children with cerebral palsy that attended the neurology clinic of University of Ilorin Teaching Hospital, Nigeria (UITH). A cross sectional survey of children with cerebral palsy presenting at Pediatric neurology clinic of UITH between January and December 2012 was done. Age appropriate visual acuities were checked, ocular examination was done with hand held Slit Lamp and Cycloplegic refraction and fundoscopy done with indirect Ophthalmoscope. Thirty - seven (42.5%) of 87 subjects seen within that period presented for ocular assessment. There were 24 males (64.9%) and 13 females (35.1%) with a male female ratio of 1.8:1. The age ranged between 6-168months with a mean of 50.11+ 46.51months. Thirty- three (89.2%) were delivered full term while 4(10.8%) were preterm. Spastic cerebral palsy accounted for 45.9% of all the cases seen.  Strabismus was found in thirteen subjects (35.1%). This was esotropia in 7(54%) and exotropia in 6 (46%) subjects. Refractive error was found in 32(86.5%) subjects and Cortical Visual Impairment (CVI) in 28(75.7%) subjects    CVI, refractive errors and strabismus are the most common ocular findings in children with Cerebral Palsy in Nigeria. Early detection and early intervention is important to achieve best developmental and educational attainment. Multidisciplinary approach involving Neurologists, Ophthalmologists, and Physiotherapist is paramount in managing these children from the time of diagnosis.

Eye Injuries among Road Traffic Accident Victims in Ogun State, Nigeria

Aim: To investigate the types of eye injuries seen among road traffic accident (RTA) victims managed at a referral hospital in Ogun State, Nigeria.Materials and Method: All RTA victims who presented at Olabisi Onabanjo University Teaching Hospital (OOUTH) between July 2004 and June 2005; their eyes were examined by an ophthalmologist for any form of injury. The biodata, cause and type of eye injury, cause of accident, position ofvictim in the vehicle, use of seat belt by victim, and treatment offered were documented using a questionnaire.Results: Thirty-five (2.7%) of the RTA victims (1314) during the study period had various forms of eye injury. The majority were male (65.7%); 80% were between 20 and 40 years. The victims included 7 technical workers (20%); 6 students (17.1%); 5 traders (14.3%); 5 office workers (14.3%); and 5 drivers (14.3%). Only 24% of the drivers and 8% of frontseat passengers had used a seat belt. The majority of the victims, 23 (65.7%), had a combination of extraocular and anterior segment injuries . Lid injury was the most common extraocular injury 29 (90.6%), followed by laceration (34.4%), oedema (30.2%) and bruising (25%); while themost common injury of the anterior segment was subconjunctival haemorrhage 23 (85.2%). Most of the patients, 28(80%), presented within 24 hours of injury.Conclusions: The majority of eye injuries from RTAs seen at OOUTH, Sagamu were mild and mainly found in the extraocular and anterior segments of the eye.Key words: eye injury, road traffic accidents, anterior segment, extraocular segment, posterior segmen

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

Disability and its Predictors among Glaucoma Patients in a Nigeria City

This study estimates disability and its predictors among adult Nigerians with glaucoma. Cross-sectional design, recruiting consecutive glaucoma patients attending a glaucoma clinic. Disability was assessed using WHO Disability Assessment Schedule. Poisson regression was used to assess predicting factors. 123 (male 70, 56.9%) glaucoma patients with mean age 62.8±15.1 years participated in the study. Mild to moderate disability was reported (108, 87.8%) with overall level of 18 and 56% reported moderate/severe degree of their disability. This was high in mobility and life activities domains such as walking outside home and community participation. Sex, marital status, religion, age, left intraocular pressure and diastolic blood pressure significantly predicted disability. Male participants compared with females and participants who professed belief in Christianity/Islam compared with traditional belief were 14% and 50% respectively less likely to report disability. The singles were 4 times more likely to report disability compared with widow/widower. Participants with less than tertiary education were more likely to be 34% disabled. With increase in age, the participants were more likely to be 0.02% disabled and with a decrease in diastolic blood pressure, there is 0.6% decrease in disability. In conclusion, moderate disability was reported especially in mobility and participation domains with 56% expressing moderate/severe degree of it. Older age impact upon disability and is a good predictor of it whereas being religious is less so. Keywords: Glaucoma, Disability, Prevalence, Predictor, Nigeri

Perception and practice of food hygiene and safety among youth and women of child-bearing age in Ikenne Local Government, Ogun State, South West, Nigeria: a qualitative study

Food borne diseases remain public health issue in the developing countries as outbreaks often result in devastating health and economic outcomes. The significant morbidity resulting from its toll on the socio-economic status of the country makes it imperative that an urgent need to stem the disease and prevent further transmission is proffered. Inappropriate knowledge and perception of the disease may perpetuate the disease condition. This study thus sets out to determine the level of awareness of causes of food borne disease and practices as they relate to food hygiene in a local government in Nigeria Focus group discussion involving only the available nine of the ten wards in Ikenne Local government area of Ogun State, Nigeria and Independent observation of food safety and hygienic practices in nine roadside eateries (one eatery in each of the available wards) in the local government were carried out. Data analysis was by systematic thematic analysis. The awareness of food borne diseases amongst the discussants was very limited. Perception about the means of transmission of these diseases was very poor. The following were mainly mentioned as diseases that could be acquired by eating food from street vendors; Cholera, typhoid, HIV/AIDS, others were malaria, epilepsy and asthma. Hygienic practices among the food handlers were generally poor. There was a huge knowledge gap on food safety and hygiene, food borne diseases and infectious diseases within the community. It is therefore recommended that an urgent programme of health education of the masses coupled with training of food handlers on Food Hygiene is embarked upon in the community