Prevalence and severity of pterygium among commercial motorcycle riders in south eastern Nigeria

Background: Pterygium is common among outdoor workers who are daily exposed to sunlight and dust due to repeated conjunctival /corneal drying and microtrauma especially in the tropics. Commercial motorcyclistsin Nigeria are outdoor workers who spend the greater part of the day outdoors under the intense heat and dust characteristic of this part of the world and would therefore be largely predisposed to developingthis conjunctival disorder.Objective: The aim of this study is to determine the prevalence and severity of pterygium among these workers and relate these findings to their duration of work.Methods: A cross sectional study with a multi stage random sampling design was used to choose the 615 subjects enrolled in the study.Results: The prevalence for pterygium was 19.3% (206 eyes) with stage 1 occurring mostly (52%) followed by stage 2(46%). Pterygium was commonamong riders who had been riding for 5 years or less. The relationship between duration of riding and pterygium severity was significant (p=0.009). This prevalence was unaffected by the use of regular sun glasses (p=0.188).Conclusion: A strong relationship exists between commercial motorcycle riding and development of pterygium not affected by using regular sunglasses. We recommend that helmets with full face shields and/orproper UV protected riding goggles where the helmets have no face shield be enforced by the regulation bodies so as to reduce the prevalence of these disorders.Keywords: Pterygium, Prevalence, Commercial motorcyclists, work duration

The Distribution of Presbyopia in the Eye Clinic of the Eastern Nigeria Medical Centre, Enugu

Objective: As few data on presbyopia among Nigerians is available, it was decided to review the distribution and characteristics of presbyopia in a Nigerian private eye clinic population. Methods: Patients presenting for the first time with symptoms of presbyopia in the eye clinic of the Eastern Nigeria Medical Center, Enugu were recruited. Standard methods of assessment of the refraction for both distance and near were used to arrive at each patient's presbyopic correction. Results: The mean age at first presentation with symptoms of presbyopia was found to be 39 ± 0.5 years; slightly earlier in females (34.9 ± 0.8 years) than for the males(42.0 ± 0.7 years); and a wide range of ages (25 to 78 years) at first presentation. The mean power of plus lens required by the patients was found to be 2.1 ± 0.1D (males 2.1 ± 0.2D and females 1.8 ± 0.2D) with a wide range of individual variation (1.0 ± 0.6D to 3.0 ±1.7D). Conclusion: Nigerian presbyopes at first presentation require higher power plus lenses than Caucasians of comparable age. There is a need for a study of a larger series to establish the Nigerian standards as results obtained from other populations may be inappropriate. The wide variation of required lens power noted emphasizes the need for the individualization of presbyopic correction rather than prescription based on assumed changes with age. Key Words: Presbyopia, Refraction, Presentation of presbyopia, Age at presbyopia Orient Journal of Medicine Vol.15(1&2) 2003: 32-3

Post Operative pain following Ocular Surgery: Relevant Preventitive Management in the University of Nigeria Teaching Hospital, Enugu

Objective: To determine the optimal time and mode of administration of postoperative analgesics following ocular surgery. Background: Most elective ocular surgery are said to be accompanied by onlymild pain. This knowledge, however, is not available to the prospective patientand this usually results in undue fear of eye surgery. This often results in failureto keep surgery appointments. Post operative pain relief should therefore beproperly targeted and analgesic agents timely administered for greatest effect. Method: A prospective study of the post operative experience of twenty patientswho had different types of ocular surgery. Results: The onset of post operative pain was influenced by the form ofanaesthesia (local or general). When surgery was done under generalanaesthesia, onset of pain was delayed for up to 19 hours whereas in casesdone under local anaesthesia onset of pain was within 2-3 hours. The severity ofpostoperative pain depended on the pain threshold of the patient and type ofanaesthesia. Conclusion: Post operative pain management should start from the timeinformed consent is being sought. A careful explanation of the nature andintensity of pain expected and what could be done to alleviate it should be madeavailable to the patient preoperatively. In the absence of Patient ControlledAnalgesia (PCA) machines, forms of pre-emptive analgesia not dependent onhigh technology should be considered. The advantages of preoperative use ofNon-steroidal Anti-Inflammatory Drugs (NSAIDs) should be explored. Key Words: Post-operative pain, analgesia in ophthalmology Jnl of Medical Investigation and Practice Vol.1 2000: 41-4

Factors affecting the utilization of safety devices by commercial motorcyclists in South- East Nigeria

Background: Motorcycle crashes are common causes of morbidity and mortality for both riders and passengers. To prevent and reduce the severity of injuries sustained through road traffic accidents (RTA) many countries enforce the use of safety devices while riding. Certain factors including non-enforcement of the existing road safety laws have been implicated as causing the poor utilization of safety devices by motorcycle riders in the developing countries. This study seeks to determine the prevalence of use of safety devices, and the reasons for non-utilization of these devices among the commercial motorcyclists in south eastern Nigeria.Methodology: This was a cross sectional survey conducted among commercial motorcycle riders in the three local government areas in Enugu metropolis, the capital of Enugu State.Results: The prevalence of safety device use (goggles/helmets) in this study was 82.1% (505 motorcyclists). Four hundred and fifty three (73.7%) use goggles while 131 motorcyclists (21.3%) use helmets alone. The major determinants of non-utilization of helmets noted were cost among 52.1% of the riders and discomfort as 25.7% found the use of helmets uncomfortable. Age (>40 years) and marital status were significantly associated with use of safety devices while formal school education did not positively influence their use.Conclusion: The prevalence for use of safety helmets is low and the reasons for the poor utilization of this safety device are trivial when compared with the overall safety of the motorcyclists.Keywords: Determinants, prevalence, protective wears, rider

Ocular features seen in children with hydrocephalus at University of Nigeria Teaching Hospital Enugu: a case series

Background: Hydrocephalus has been known since antiquity. It has beendefined as an increase in size of the ventricular system of the brain, resulting from raised cerebrospinal fluid volume.Objective: The purpose of this study is to determine the various ocular disorders that may be associated with hydrocephalus in children seen in the University of Nigeria Teaching Hospital (UNTH) Enugu.Patients and Methods: This study was carried out on 15 patients attending the neurosurgical outpatient clinic of the University of Nigeria Teaching Hospital Enugu. All patients who met the criteria for inclusion in the study of hydrocephalus, aged less than two years and attended the neurosurgicaloutpatient clinic between January and December 1998 were included. The diagnosis of hydrocephalus was made based on the history, clinical examination and brain ultrasonography. The data was analysed with a scientific calculator Casio FX-82 Lb and Epi info version 6 software.Results: Fifteen children with un-operated hydrocephalus confirmed bytransfontanelle ultrasonography were examined at presentation for ocularcomplications of hydrocephalus. The mean age at presentation was 29.8 weeks. The peak age group of presentation was 11-20 weeks. The male/female ratio was 1:1. Ocular complications of hydrocephalus included setting sun appearance, nystagmus, optic disc palor and hyperaemia.Conclusion: The Ophthalmologist has a well established role to play in assisting the paediatric neurosurgeon in the long term management of children with hydrocephalus if the risk of blindness is not to be added to their other physical disabilities.Keywords: Children, features, hydrocephalus, ocula

Cataract Extraction With Intraocular Lens Implant: Early Experience In University Of Nigeria Teaching Hospital (U.N.T.H.), Enugu, South-Eastern Nigeria

Objectives: To audit our early experience of cataract surgery with intraocular lens implant, in the University of Nigeria Teaching Hospital (U.N.T.H.), Enugu. Methods: In a retrospective, non-comparative case-series study, the records of all patients who had cataract extraction with intraocular lens implant between January 2001 and October 2002 and were followed up for at least eight weeks were analyzed. Information on age, sex, type of cataract, co-existing ocular and systemic disease, pre- and postoperative visual acuity and postoperative complications was collected. Results: Forty four eyes of 40 patients were studied; mean age of the patients was 52.2 years (range: 8-87 years). Thirty seven eyes had age-related (senile) cataract; 2 post-uveitis cataract and 5 traumatic cataract. Associated systemic diseases were diabetes mellitus (4); hypertension (4); asthma (1); rheumatism (1) and diabetes and hypertension (1). Preoperative visual acuity was /=6/18. With refraction those with visual acuity of >/= 6/18 increased to 14 out of the 18 who had refraction (77.8%). Cause of persistent poor visual acuity was ascertained in only 1 eye and was endophthalmitis. Postoperative complications included corneal oedema/striae (91%); astigmatism (18.2%); poor wound apposition (18.2%) and endophthalmitis (2.3%). Conclusion: The final visual outcome in 77.8% of patients who had refraction post-surgery was good (>/= 6/18.) confirming that Cataract surgery with IOL implant is safe and effective in restoring vision to the cataract blind in this part of the world. Most of the cases of postoperative astigmatism were corrected with refraction. Key Words: cataract extraction; intraocular lens implant Orient Journal of Medicine Vol.15(3&4) 2003: 31-3

Eye disease in leprosy patients in Abakaliki, Nigeria

…………………. Ebonyi Medical Journal Vol. 3 (1&2) 2004: pp. 14-2

Causes of visual impairment among commercial motor vehicle drivers in Uyo metropolis, Akwa Ibom State, Nigeria

Background: Commercial motor vehicles are a very important means oftransport in Nigeria where most people do not own personal vehicles and the railway system is not functioning.Aims and Objectives: The aim of the study is to assess the ocular health status of commercial motor vehicle drivers in Uyo metropolis and to determine the causes of visual impairment amongst them.Materials and Methods: Uyo is the capital city of Akwa Ibom State in theSouth-South geo-political zone of Nigeria with a population of 305,961according to 2006 National population census. This is a cross sectional survey of commercial motor vehicle drivers in all the eleven functional motor parks in Uyo as at the time of the study. A total of two hundred and ninety-one (291) drivers who consented to the study were recruited, interviewed with a standardized questionnaire and examined. Examination included distant visual acuity with Snellen’s Chart and near visual acuity with near chart, tonometry using Schiotz’s tonometer; penlight and magnifying loupe were used to examine the anterior segment, color vision test was with Ishihara chart, funduscopy with direct ophthalmoscope and visual field assessment by confrontation amongst other tests. Data were analysed with SPSS10 soft ware package.Results: Mean age of drivers was found to be ±41.5 years. Prevalence of road traffic accident (RTA) in the study was 24.7%. Human factor contributed 27.7% to the cause of accidents. Causes of visual impairment included refractive error, glaucoma and cataract.Conclusion: There was no statistically significant association between RTA and visual impairment but there was statistically significant association between RTA and visual field defect (P=0.037).Recommendation: Visual field assessment at least by confrontation should be made a requirement before issuance of motor vehicle driving licence and proper visual field assessment of suspected drivers be done by an ophthalmologist before issuance of license. A State-wide survey of visual status of commercial motor vehicle drivers is recommended.Keywords: Cataract, drivers, refractive error, road, transportation

Factors that affect medical students’ performance in Anatomy in the University of Nigeria

Background: Much attention has been drawn to the area of medical education in contemporary times with the aim of developing effectiveteaching strategies in our medical schools.Objectives: To identify the problems encountered by students in the study of Anatomy and suggest ways of enhancing their performance in the subject.Materials and Methods: Three hundred structured, pretested self administered questionnaires were applied to medical students of theFaculty of Medical Sciences, University of Nigeria Enugu Campus (UNEC), who had spent at least two years in the medical school. Data analysis was by SPSS version 15.Results: Of the 300 questionnaires, 201(67.0%) were correctly filled and analysed. One hundred and three (51.2%) of the respondents were females, 163 (81.1%) were aged 21 to 30 years and 105(52.3%) hadspent more than two years in the medical school. One hundred and eleven (55.2%) believed that dissection followed by audio-visual aids 101(50.3%) offered students adequate exposure to the learning of anatomy. One hundred and eleven, (55.2%) also implicated overcrowding as a major cause of students’ aversion for dissection leading to inadequate exposure to the subject and the resultant poor performance. One hundred and seven (53.2%) believed that the preparatory period for 2nd MBBS exams should be extended so as to offer students adequate exposure to laboratory specimens.Conclusion: Over-population causes inadequate exposure of students to anatomical specimens and thus affects their performance negatively.Keywords: Anatomy, factors, problems, students’ performanc

Central nervous system affecting drugs and road traffic accidents among commercial motorcyclists

Background: Commercial motorcyclists are popular due to the convenience associated with their use especially in areas where taxis do not ply. The financial benefits to the operators caused a boom but indirectly resulted in a lot of carnage on our roads. These accidents (RTA) have been attributed to various causes including driving under the influence of drugs that affect the central nervous system (CNS).Objective: This study was aimed at determining the role of CNS affecting drugs in the causation of RTA among these motorcyclists and also to make recommendations based on the result.Methodology: This is a cross-sectional survey with a multi-stage random sampling used to select 615 commercial motorcyclists in Enugu metropolis. A structured questionnaire was administered after obtaining consent from the respondents. Data were analysed with the Statistical Package for Social Sciences (SPSS) version 11.5 and variables were tested using the Chi square. A p-value of <0.05% was considered significant.Results: Amongst the motorcyclists 78% were using CNS affecting drugs while 57.7% had been involved in RTA. These were mostly in the 31-40 and 21-30year age groups. The use of CNS affecting drugs, as well as inexperience in riding, was significantly associated with RTA. Visual impairment was not a significant cause of RTA.Conclusion: The use of CNS affecting drugs is common among commercial motorcyclists. Majority of commercial motorcyclists involved in RTA use these drugs. The government of Nigeria through its agencies should enforce laws regulating motorcycle riding under the influence of drugs.Keywords: Brain, influence, riders, substance