Blindness and visual impairment in a rural community in Ogun State, South West Nigeria

Objectives: This is a community-based study in which residents of Coker-Ilepa ward of Ifo Local Government Area of Ogun State, South-West Nigeria were examined to determine the prevalence of blindness and visual impairment serving as a screening exercise contributing to primary eye care programme of the community. The study aims to find out the prevalence and pattern of blindness and visual impairment in this community and to compare and contrast with other studies.Methods: Five hundred and four (504) residents from 8 villages selected via multi-stage random sampling were interviewed and examined over a 15 day period and results analyzed with WHO Epi-Info 2002 software.Results: Prevalence of blindness was 2.2% (95% CI 0.89 – 3.50, n=504) while that of visual impairment was 8.9% (95% CI 6.36 – 11.44, n=504). Blindness was also higher in the elderly (8.8% in those above 60 years compared to 1.4% in those between 40-49 years and 0% in those less than 40 years) and in females (3.5%) as against males (0.81%). Cataract is the commonest cause of blindness and visual impairment – 72.7% and 46.7% respectively followed by corneal scarring for blindness (18.2%) with refractive error being the second cause of visual impairment (26.7%). Glaucoma is the third most common cause of blindness (9.1%) and visual impairment (11.1%) respectively.Conclusion: - The study shows a very high prevalence of blindness and with cataract responsible. The provision of adequate modern eye care facilities with surgical capabilities in the rural area in order to achieve the goals of Vision 2020 in the country is therefore recommended.Key Words: - Blindness, Visual, impairment, rural

Couching Techniques for Cataract Treatment in Osogbo, South West Nigeria

Background: Couching is still being practised in developing countries including Nigeria despite its adverse effects on vision.Objectives: To find out the different techniques of couching, highlight the unacceptable poor visual sequelae and assess knowledge, attitudes, and practices of subjects.Settings and Design: Clinic based and prospective observational study.Methods and Material: Structured interview and clinical examination of consecutive patients was used to obtain information.Results: Fifteen subjects and 20 eyes of 9(60%) males and 6(40%) females were studied. Age range 60 -90 years and mean 72.4±8.0. Commonest presenting complaints were “I cannot see properly/clearly” 4(26.7%) and “I want to do my second eye so I can see better” 3(20%). Presenting Versus (vs.) Corrected visual acuity (VA) was75% vs 60% blind, 55% vs 45% low vision, and 0% vs 10% normal vision, p= 0.032. Friends and neighbours mostly introduced subjects tocouching (26.7% each). Commonest methods involved using sharp objects/needling 45% and blunt/grooving/rocking methods (30%). Subjects assumed “supine” position 75% of time. Eighty five percent of eyes were done at the coucher’s. Procedure was painful in 73.3%. Only 5 eyes (25%) maintained vision for >10years. Thirteen (86.7%) said “no” to a repeat procedure and 93.4% would advice against couching.Conclusions: Couching methods used were very crude and archaic with attendant poor quality of vision and dissatisfaction. Public education, affordable and accessible cataract surgical services taken to the rural communities could gradually phase out couching.Keywords: Couching, Methods, Visual sequelae, Nigeri

Patterns of presentations at a free eye clinic in an urban state hospital

Background: Provision of affordable eye care is one of the cardinal programs of the Osun State Government of Nigeria.Objective: The objective of this study was to assess the pattern of eye diseases presenting in a secondary health care facility based at Osogbo the State Capital.Materials and Methods: We reviewed the hospital records of all patients that were cared for at the eye clinic of the State Hospital, Osogbo, Osun State, Nigeria from January 2009 to December 2010.Results: A total of 1018 patients were attended to at the eye clinic during the period of review. Mean age of these patients was 49.4 ± 23.2 years. There were 408 (40.1%) males and 610 (59.9%) females with a female-male ratio of 1.5 : 1. Most of them were traders (28.1%) and married (32.1%). Vernal conjunctivitis (21.1%), cataract (14%), glaucoma(11.1%), and refractive errors (20.7%) were the main eye diagnoses.Conclusion: Preventable causes of blindness were quite common among the patients. There is a need for community education to reduce the prevalence of these diseases in the general population.Key words: Eye clinic, free, pattern, urba

Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

Background. Acute kidney injury (AKI) is a relatively common clinical condition, associated with high rates of mortality. Although there is extensive literature on the nature and consequence of AKI in the developed world, much less is known in the developing world and more specifically in sub-Saharan Africa (SSA).Objectives. To describe the demographics, histological diagnosis and clinical course of patients presenting with AKI to a single centre in Sudan.Methods. Retrospective data were collected on 100 consecutive patients with AKI and an active urinary sediment, who underwent diagnostic native percutaneous renal biopsy.Results. The mean (standard deviation) age of those biopsied was 33.6 (14.1) years of age, with a preponderance (58%) of females. The most common clinical  indications for biopsy were AKI associated with haematuria and proteinuria (72%), AKI and proteinuria (22.5%) or AKI and haematuria (5%). The frequencies of the most common primary glomerulonephritides (GN) were focal segmental GN (15%) and mesangiocapillary GN (8%). Lupus nephritis was the most frequent secondary GN associated with AKI (31%) and the most common overall histological diagnosis. Peak creatinine, but not oliguria, at presentation predicted likelihood of remaining dialysis-dependent. Age at presentation but not baseline renal function by  estimated glomerular filtration rate (eGFR), was associated with the likelihood of having residual chronic kidney disease following an episode of AKI.Conclusions. The data suggested differences in the pattern of intrinsic  renal/glomerular disease leading to AKI to those published and mainly derived from the developed world and patients in SSA

Sexual assault against women at Osogbo Southwestern Nigeria

Background: Sexual assault against women is common all over the world. However, reliable data on the subject in developing countries including Nigeria is not available.Objective: To review the patterns of sexual violence against women treated at the hospital over a 7‑year period.Materials and Methods: Review of hospital records of victims of sexual assault who presented at the hospital from 1 January 2003 to 31 December 2009. Data obtained were analyzed using descriptive statistics and Chi squire test.Results: Sexual assault cases constituted 2.1% of female consultation outside pregnancy during the period under study while proportion of cases increased over the years under review. Mean age of the victims was 15.8 (SD 8.1) years ranging from 5 to 48 years. Most (73.7%) were less than 18 years while 93.2% were single (never married). About 81% of the victims less than 18 years were sexually abused in the day time. Majority (79.6%) knew their assailant. About 40% of the victims presented within 24 h of sexual abuse but none had postexposure prophylaxis.Conclusion: Sexual assault among women is an important health problem in this environment. There is need for hospital based management protocol.&#160

Rapid Development of Intestinal Type Gastric Adenocarcinoma

Intestinal type gastric adenocarcinoma is felt to develop over a protracted time period through a series of defined steps. Several potential risk factors for the development of gastric cancer have been identified, including a family history of gastric cancer and Helicobacter pylori infection. We present the case of a patient with neither risk factor who progressed in a 14 month time frame from histologically normal gastric mucosa to early stage intestinal type gastric adenocarcinoma in the setting of diffuse gastric intestinal metaplasia and atrophic gastritis. This patient's presentation conflicts with our current understanding of the development of intestinal type gastric adenocarcinoma

Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria

EO Asekun-Olarinmoye,1 PO Akinwusi,2 WO Adebimpe,1 MA Isawumi,3 MB Hassan,3 OA Olowe,4 OB Makanjuola,4 CO Alebiosu,2 TA Adewole51Department of Community Medicine, 2Department of Medicine, 3Department of Surgery, 4Department of Microbiology, 5Department of Chemical Pathology, College of Health Sciences, Osun State University, Osogbo, Osun State, NigeriaBackground: The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria.Methods: A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17.Results: The mean age of the respondents was 49.7 &plusmn; 1.6 years, 100 (38.6%) were males, 84 (32.4%) were farmers, and 111 (42.9%) were traders. The prevalence of hypertension was 13.16% (present in 34 respondents). Seventeen (6.6%) had isolated systolic hypertension, while 11 (4.2%) had isolated diastolic hypertension. Two hundred and thirty-six (91.1%) undertook daily exercise lasting at least 30 minutes and 48 (18.5%) had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6%) claimed a family history of hypertension. The average body mass index (BMI) among respondents was 23.4 &plusmn; 4.9 kg/m2, 51 (19.6%) had a BMI of 25.0&ndash;29.9, and 30 (11.5%) had a BMI &ge; 30. A significant association existed between age older than 40 years and having hypertension (P < 0.05), while no relationship existed between age and BMI or between gender and hypertension (P > 0.05). Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI < 25 had at least a three times greater likelihood of developing hypertension than those with BMI < 25 (odds ratio 2.9, 95% confidence interval 0.007&ndash;0.056, P = 0.011).Conclusion: The prevalence of hypertension is high in this study population and we recommend scaling up primary prevention efforts to reduce this in Nigerian communities.Keywords: prevalence, hypertension, anthropometry, body mass index, rural communit

Effect of Vocal Anesthesia on Adult Dental Patients during Covid-19 pandemic period

BACKGROUND: Pain is as a major concern with dental patients. The dentist-patient interaction can reveal the presence of anxiety and fear, which may result in rise of pain. This study aimed to assess vocabulary communication as support to dental anesthesia on the adult dental patient. MATERIALS AND METHODS: This is a prospective, randomized clinical study, conducted from February 2020 through March 2021. Two hundred individuals (112 males, 88 females) of the age range (16 to 84 years) were separated into two groups for testing the level of pain during dental local anesthesia, with vocal communication and without vocal communication. RESULTS: While the control group showed no difference between males and females, there was a difference between the sexes in the experimental group with past dental visits, VAS and injection type having less anxiety (p=0.0001) while with education/VAS having (p£0.01) as appear in sex to age (p£0.05). There was no difference when data were compared by age, or type of anesthesia (inferior alveolar nerve block or infiltration technique). CONCLUSION: Dental anxiety can be alleviated by talking to the patients before the procedure, which could reduce the amount of pain

Ramond-Ramond Cohomology and O(D,D) T-duality

In the name of supersymmetric double field theory, superstring effective actions can be reformulated into simple forms. They feature a pair of vielbeins corresponding to the same spacetime metric, and hence enjoy double local Lorentz symmetries. In a manifestly covariant manner --with regard to O(D,D) T-duality, diffeomorphism, B-field gauge symmetry and the pair of local Lorentz symmetries-- we incorporate R-R potentials into double field theory. We take them as a single object which is in a bi-fundamental spinorial representation of the double Lorentz groups. We identify cohomological structure relevant to the field strength. A priori, the R-R sector as well as all the fermions are O(D,D) singlet. Yet, gauge fixing the two vielbeins equal to each other modifies the O(D,D) transformation rule to call for a compensating local Lorentz rotation, such that the R-R potential may turn into an O(D,D) spinor and T-duality can flip the chirality exchanging type IIA and IIB supergravities.Comment: 1+37 pages, no figure; Structure reorganized, References added, To appear in JHEP. cf. Gong Show of Strings 2012 (http://wwwth.mpp.mpg.de/members/strings/strings2012/strings_files/program/Talks/Thursday/Gongshow/Lee.pdf