Pattern of Presentation and Outcome of Surgical Management of Primary Open Angle Glaucoma in Kano, Northern Nigeria

Background: Primary open angle glaucoma (POAG) is one of the leading causes of avoidable blindness. Unlike blindness from cataracts, glaucomatous optic nerve damage is irreversible, and prevention ofglaucoma is one of the priorities of World Health Organization (WHO) Vision 2020 program. POAG is the commonest type of glaucoma and affects about 33.1 million people worldwide. This study is a fiveyear review of 71 eyes of 63 patients who had trabeculectomy. The study evaluates the pattern of presentation and modality of surgical treatment in our environment.Methods: Records of all patients with primary open angle glaucoma operated over a five year period was retrieved. Information extracted included patients bio data, visual acuity, gonioscopic findings, intraocular pressure as measured with applanation tonometer before and after surgery, and recorded in mmHg. Perimetry was done with 2 m tangent screen and recorded in a perimetry chart. All the patientshad trabeculectomy with application of anti metabolite (5fluorouracil). Extra capsular cataract extraction with or, without posterior chamber intra ocular lens implantation was done on 13 patients. Biometry wasnot done on patients with cataract. Surgery was done on better eye first in all patients.Results: There were 71 eyes of 63 patients. The male to female ratio was 3:1. The age ranged between 18 to 75 years. 8 patients were below the age of 30 years. One third of the patients were between the ages of50 to 59 years. At presentation 12 patients (19%) had normal vision (WHO vision category O), 26 patients (41%) were visually impaired, 12 patients (19%) were severely visually impaired and 13 patients(21%) were blind (from co existing cataracts). The cup disc(c: d) ratio assessed before surgery was 0.5 in 9 eyes (13%), 31 eyes (53%) had c: d ratio 0.6 to 0.8 and 18 eyes had c: d ratio of 0.9. All the patientshad open anterior chamber angles (Schafer grade 3 and 4). Perimetric changes were; mild peripheral constriction in 5 eyes (8%), peripheral constriction with arcuate scotoma in 19 eyes (26%), constrictedfields of 30° or less in 34 eyes (48%), and in 13 eyes there was inability to fixate on target. IOP before surgery was 21 to 30 mm Hg in 12 eyes (17%), and above 31 mm Hg in 69 eyes (83%). Post operativeIOP of 10 to 15 mm Hg was obtained in 58 eyes (82%) and 11 eyes (15%) had IOP of 16 to 20 mm Hg. Only 2 eyes (3%) had IOP in the lower twenties.Conclusion: Primary open angle glaucoma is characterized by late presentation. Trabeculectomy with application of 5FU is the surgical treatment of choice in our environment and give good intra ocularpressure control. There is need to increase public awareness on glaucoma to limit this type of avoidable blindnes

Towards improving the security of low-interaction honeypots: insights from a comparative analysis

The recent increase in the number of security attacks by cyber-criminals on small businesses meant that security remained a concern for such organizations. In many such cases, detecting the attackers remained a challenge. A common tool to augment existing attack detection mechanisms within networks involves the use of honeypot systems. A fundamental feature of low-interaction honeypots is to be able to lure intruders, but the effectiveness of such systems has nevertheless been affected by various constraints. To be able to secure honeypots systems, it is important to firstly determine its requirements, before taking appropriate actions to ensure that the identified requirements have been achieved. This paper critically examines how existing low-interaction honeypot systems abide to major requirements before recommending how their security could be improved

A hybrid three-phased approach in requirement elicitation

Requirement elicitation is one of the most important activities in requirement engineering and allocating limited amount of time in this activity is considered to significantly contribute towards failure of software projects. Having quality requirements is also greatly influenced by the techniques utilized during requirement elicitation process. The adoption of a single requirement elicitation technique within software development projects has various drawbacks. As solution, hybrid techniques are being considered as the way towards comprehensive requirements engineering. This paper investigates the hybrid requirement elicitation technique to tackle the challenges developers are facing in the process of software development. In this paper, the combination of 3 requirement elicitation techniques, namely use of questionnaire, interview and prototyping in a unified framework is investigated during the implementation of an online educational system

Arrow injuries to the eye

Two male siblings aged 10 and 17 years, respectively, presented to our hospital with two days history of being shot in the right eyes with arrows. The patients presented with severe pains, bleeding, swelling, discharge and loss of vision. There was positive history of application of traditional eye medicine and an unsuccessful attempt was made to remove the arrows. Both patients presented with panophthalmitis. X-rays of the orbits and para nasal sinuses indicated the tip of the arrow was lodged to the apex of the orbit in the younger patient, and the arrow vertically traverses the eye/ orbit and lodged in the roof of the maxillary sinus in the other patient with fluid level in the lower third of the sinus. The patients were placed on broad-spectrum systemic antibiotics, had base line investigations and prepared for exploration. The patients had evisceration with removal of the arrows

Pattern of diabetic retinopathy in Kano, Nigeria

Background: The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria.Materials and Methods: Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient’s bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS).Results: A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23%) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77%) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X2=29.77 {95% CI}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X2= 65.85, {95% CI} P= 0.000]. Based on ICDRDSS scale, 136 patients (64%) had no retinopathy and 78 patients (36%) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8%). Cataract and glaucoma were the cause in 6 patients (2.8%).Conclusion: Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment

DEVELOPED PROBABILISTIC REDUCTION FACTORS FOR LOPHIRA ALATA (EKKI) TIMBER JOISTS SUBJECTED TO CREEP-RUPTURE

Wood experiences a significant loss of strength and stiffness when loaded over period of time. This phenomenon is known as creep-rupture. Several models were developed for the estimation of the reduction of load carrying capacity of timber with time. In this paper, the results of time dependent structural reliability analysis of timber joist produced with Lophiraalata (Ekki) timber specie was presented. Three load duration models were considered in the study, namely: The Model proposed by Wood, Gerhards model, and Nielsen. The timber joist was designed in accordance with the Eurocode 5. The uncertainties in all the basic design variables were fully accommodated in the time dependent reliability analysis. The entire process was implemented using a developed MATLAB program employing First Order Reliability Method (FORM). Time dependent mathematical models for modification of safety index to account for the effect of load duration were proposed. The use of both Gerhards and Nielsen model, for the design of Lophiraalata timber members was recommended.  http://dx.doi.org/10.4314/njt.v36i1.

Effect of nanosilica on the mechanical and microstructural properties of a normal strength concrete produced in Nigeria

The failure of conventional concrete to have classical mechanical properties, reduced permeability and lead to sustainability in concrete production called for the use of supplementary Cementitious Materials (SCM) in concrete to improve its performance. This study investigates the effect of adding optimal dosage of an SCM called nanosilica (nS) on the tensile and compressive strengths, microstructural properties and cement hydration reaction for grade 30 concrete. The optimal dosage of the nS was determined to be 1.5% by weight of cement using compressive strength test. The influence of optimal nS dosage on the concrete properties was investigated using compressive strength test, splitting tensile strength test, Scanning Electron Microscopy (SEM) and Energy Dispersion Spectroscopy (EDS). Results revealed that optimal nS addition led to 30% and 23.3% respective increase in compressive and tensile strengths of conventional concrete at 7days of curing. SEM micrographs show better packing density in the nano-concrete at 90days of curing. EDS shows that addition of optimal nS dosage in concrete led to formation of more C-S-H gels at 90days curing period, and a corresponding reduction in Ca/Si ratio of the nano-concrete to 0.89; a ratio that is very close to that of 14Ǻ tobermorite reported in literature. The optimal nano-concrete can be used where strength improvement, especially at early age and reduction in concrete permeability are requirements. Keywords: Compressive strength, Tensile strength, Normal strength nano-concrete, SEM, EDS

Effects of ground granulated blast furnace slag and pulverized fuel ash on rheology of concrete

The rheology of concrete containing Pulverized Fuel Ash (PFA) and Ground Granulated Blast Furnace Slag (GGBS) has been scarcely studied and reported, despite their increase application as Supplementary Cementitious Materials (SCM) that drives improvement of sustainability of the construction industry. This work studied the effect of these SCMs and Superplasticizer proportions on rheological properties of concrete using rate controlled concrete rheometer. Two groups of mixes containing replacement or addition on mass basis using either PFA or GGBS or their combinations were derived from the control mix. The dynamic yield stress, plastic viscosity and 28 day compressive strength of the control mix are 1258 Pa, 6 PaS, and 40.5 MPa respectively. The results of the rheology tests of the various binary mixes (PFA and Portland cement) and ternary mixes (Portland cement, PFA and GGBS) structural concrete shows wide disparity in the measured rheological parameters. The results show that the decrease in dynamic yield stress of the ternary mix containing 20% GGBS is 4.1%, whereas the decrease in dynamic stress of the ternary mix containing 20% PFA is 35.9% compared to the control ternary mix. The high volume Portland cement replaced ternary concrete can therefore be effectively characterized as a workable and pumpable concrete. Keywords: Rheology, PFA, GGBS, superplasticizer, concrete

Refractive errors in presbyopic patients in Kano, Nigeria

Background: The study is a retrospective review of the pattern of refractive errors in presbyopic patients seen in the eye clinic from January to December, 2009.Patients and Methods: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient’s age, sex, and types of refractive error. Unaidedand pin hole visual acuity was done with Snellen’s or “E” Charts and near vision with Jaeger’s chart in English or Hausa. All patients had basic eye examination and streak retinoscopy at two third meter working distance. The final subjective refractive correction given to the patients was used to categorize the type of refractive error.Results: There were 5893 patients, 1584 had refractive error and 644 were presbyopic. There were 289 males and 355 females (M:F= 1:1.2). Presbyopia accounted for 10.9% of clinic attendance and 40% of patients with refractive error. Presbyopia was seen in 17%, the remaining 83% required distance correction; astigmatism was seen in 41%, hypermetropia 29%, myopia 9% and aphakia 4%. Refractive error was commoner in females than males and the relationship was statistically significant (P-value = 0.017; P < 0.05 considered significant).Conclusion: Presbyopia is common and most of the patients had other refractive errors. Full refraction is advised for all patients.Keywords: Presbyopia, pattern, correctio

Schistosomiasis presenting as colonic polypoid masses in a Nigerian patient

Intestinal Schistosomiasis is a serious disease and is commonly produced by S. mansoni and japonicum . The presence of viable ova of the organism in the colon elicits inflammation, formation of granuloma, ulcers, haemorrhage and colonic fibrosis with subsequent longterm sequelae. Schistosoma mansoni is endemic in the Middle East, Africa, Central and South America. This is a case of a Nigerian with colonic polypoid masses which turned out to be Schistosomal mansoni infection.Keywords: Colonic polypoid masses, Schistosoma mansoni, Nigerian patien