School eye health screening in Kaduna-Northern Nigeria

Background: Five public primary schools referred to as Local Education Authority (L.E.A.) primary schools, were identified for this study. The aim was to find out the pattern of eye disorders affecting primary school children in Kaduna North metropolis and to offer treatment to those with treatable disorders. Method: A total of 2,397 pupils whose classes ranged from primary one to six and aged between five to eighteen years were examined. Results: Of this number, 1,232 (51.57%) were males and 1,161 (48.43%). The commonest causes of eye disorders were allergic conjunctivitis (14.5%), refractive error (1.7%), and infective conjunctivitis (1.4%). Conclusion: School eye screening visits should be at least once a year and should involve screening of all nursery one and primary one pupils. School teachers can be trained to measure visual acuity. Primary eye care workers may be trained and utilised to carrying out school screening in schools, while basic eye health classes can be taught in ante-natal classes to enlighten mothers who are the primary care givers. Early detection of eye conditions in children is an advantage for management. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 191–19

Cross-sectional and longitudinal associations between psychotic and depressive symptoms in depressed adolescents

Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11–17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response

Cancer Biomarker Discovery: The Entropic Hallmark

Background: It is a commonly accepted belief that cancer cells modify their transcriptional state during the progression of the disease. We propose that the progression of cancer cells towards malignant phenotypes can be efficiently tracked using high-throughput technologies that follow the gradual changes observed in the gene expression profiles by employing Shannon's mathematical theory of communication. Methods based on Information Theory can then quantify the divergence of cancer cells' transcriptional profiles from those of normally appearing cells of the originating tissues. The relevance of the proposed methods can be evaluated using microarray datasets available in the public domain but the method is in principle applicable to other high-throughput methods. Methodology/Principal Findings: Using melanoma and prostate cancer datasets we illustrate how it is possible to employ Shannon Entropy and the Jensen-Shannon divergence to trace the transcriptional changes progression of the disease. We establish how the variations of these two measures correlate with established biomarkers of cancer progression. The Information Theory measures allow us to identify novel biomarkers for both progressive and relatively more sudden transcriptional changes leading to malignant phenotypes. At the same time, the methodology was able to validate a large number of genes and processes that seem to be implicated in the progression of melanoma and prostate cancer. Conclusions/Significance: We thus present a quantitative guiding rule, a new unifying hallmark of cancer: the cancer cell's transcriptome changes lead to measurable observed transitions of Normalized Shannon Entropy values (as measured by high-throughput technologies). At the same time, tumor cells increment their divergence from the normal tissue profile increasing their disorder via creation of states that we might not directly measure. This unifying hallmark allows, via the the Jensen-Shannon divergence, to identify the arrow of time of the processes from the gene expression profiles, and helps to map the phenotypical and molecular hallmarks of specific cancer subtypes. The deep mathematical basis of the approach allows us to suggest that this principle is, hopefully, of general applicability for other diseases

Ocular aids: experience at the Guinness Ophthalmic unit, Kaduna , Nigeria

Objective: To determine the pattern of presentation of ocular manifestations in HIV/AIDS and the modes of management employed. Method: This collaborative, hospital based retrospective study between the Ophthalmology and Immunology units covered the period between January-December, 2004. Results: 1020 new patients were seen during this period with HIV/AIDS, of whom 125(12.3%) cases presented with some form of ocular complications, made up of 74 females (59.2%) and 51 males (40.8%). Herpes Zoster Ophthalmicus (HZO), was the commonest form of presentation in 87 (69.6%) patients, followed by ocular tumours in 17 (13.6%) patients and cotton-wool spots in 5 (4%) patients. Conclusion: There is still a great need for the definitive diagnoses of ocular lesions, and retinal lesions in particular as well as appropriate treatment of ocular HIV/AIDS. Keywords: ocular HIV/AIDS, Guinness Ophthalmic Kaduna Nigerian Journal of Surgical Research Vol. 7(3&4) 2005: 305-30

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Background: Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment. Objective: To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru. Design: A pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and≤6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures. Results: A total sample of 364 children aged 3–11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital. Conclusion: Prevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research