Ophthalmology Ward Research Articles

Aqueous Extract Analysis of Lens Epithelial Cells: Unraveling the Link between Oxidative DNA Damage and Malondialdehyde in Senile Cataract

Background and Aims: The purpose of this study was to examine the level of oxidative stress in people with cataracts, based on previous studies that indicated its role in causing DNA damage and cataract formation. The study also sought to determine the correlation between the degree of DNA damage and the concentration of malondialdehyde, a marker of lipid peroxidation, in patients with senile cataracts. Methods: The study involved 30 senile cataract patients aged 50-80 years and 12 cadaveric donors of corneal tissue who died in road accidents. They were selected from the ophthalmology ward of Acharya Vinoba Bhave Hospital. The aim was to measure DNA damage in human lens epithelial cells (HLECs) by Comet assay and malondialdehyde levels in the aqueous extract of HLECs. Results: The study found that the oxidative DNA damage level of human lens epithelial cells is not correlated with the malondialdehyde levels in the aqueous extract of HLECs in senile cataract patients. Conclusions: The study did not support the hypothesis that oxidative stress is a major factor in the development of cataracts. The results suggest that other mechanisms, such as genetic factors, environmental factors may be more relevant in the pathogenesis of cataracts.

Point Prevalence of Type 2 Diabetes Mellitus Patients among Different Specialties at MTI Khyber Teaching Hospital in Peshawar

OBJECTIVE: The main goal of this research study was to analyze the profile and prevalence of type 2 diabetic patients admitted to the MTI Khyber Teaching Hospital, Peshawar. METHODOLOGY: A hospital-based point prevalence cross-sectional descriptive study was carried out as a pilot project in November 2022 at MTI Khyber Teaching Hospital, Peshawar, Pakistan. Patients satisfying the inclusion and exclusion criteria enrolled in the study, and a non-probability consecutive sampling technique was used. RESULTS: A total of 850 patients were admitted during the study period; out of them, 24.7% had type II diabetes mellitus (T2DM). The mean length of hospital stay was significantly high among T2DM patients (p <0.01). Moreover, there were statistically significant differences χ2(2) = 94.67, p <0.01, in the mode of admission among the T2DM patients, with fewer cases shifted from other units compared to ER and OPD. The antidiabetic regimen prescribed during the hospitalization included an oral antidiabetic regimen (36.9%), oral plus twice-daily insulin regimen (19.63%), and basal-bolus insulin (15.07%). CCU and ophthalmology ward had the highest proportion of admissions of T2DM patients (40% each). Patients were admitted for various indications; 11.0% were admitted due to diabetic foot ulcer, 9.5% for elective surgery, 9.55% had acute coronary syndrome (ACS), and 9.0% had diabetic kidney disease. CONCLUSION: Patients admitted exhibited a high prevalence of T2DM. We highlighted some of the substantial characteristics of these patients attending various specialties. KEYWORDS: Point Prevalence, Type 2 Diabetes Mellitus, Indications, Admission Rate, Treatment Regimen.

Evaluation of operations and causes of corneal transplantation in patients referred to the ophthalmology ward of Imam Khomeini Hospital in Ahvaz 2003 to 2019

Introduction: Corneal transplantation is one of the most common eye surgeries and the most common and successful tissue transplant in the world. The aim of this study was to determine the frequency of causes and types of corneal transplantation in patients referred to the ophthalmology ward of Imam Khomeini Hospital in Ahvaz from 2003 to 2018. Methods: This descriptive study was performed on the records of the patients who underwent corneal transplantation. The information included age, sex, cause of transplantation, sex and age of the donor, need for re-transplantation, reason for re-transplantation, laterality of cornea and the type of operation. Results: The mean age of patients receiving cornea was 50.93 years and included 491 (49.3%) male and 505 (50.7%) female. 51.7% of corneal transplant operations were related to the right eye and 47.9% of the operations were related to the left eye respectively. PBK was the most cause of corneal transplantation. Most patients underwent corneal transplantation by PK and then DSAEK. Conclusion: Frequency of PBK was increased in this study as compare to other previous studies which may be due to significant increase in the rate of phacoemulsification surgeries. DSEAK and DMEAK have become more accepted and favorable surgeries in the case of corneal endothelial disease. Based on new surgical techniques and advances in post of management we suggest, new meta-analysis study to evaluate associated diseases , comparison of the regraft rate in different surgical techniques and post op management of them.

The Outcome of Concurrent Intracameral Fluconazole Injection with Amniotic Membrane Transplantation for Fungal Keratitis in Dr. M. Djamil General Hospital: A Case Series

Background: Fungal keratitis is often difficult to eradicate and requires long treatment. Antifungal agents have lower efficacy because of low tissue penetration and the indolent nature of the infection. Fluconazole has effective ocular penetration ability, reaching aqueous concentration as same as plasm concentration. Multilayer amniotic membrane transplantation (MLAMT) has been shown to be a promising surgical procedure to reconstruct the ocular surface by supporting the epithelialization of the cornea and having protective antimicrobial properties. This study aims to report the outcome of concurrent intracameral fluconazole injection with amniotic membrane transplantation for fungal keratitis in Dr. M. Djamil General Hospital.
 Case presentation: Four inpatients in the ophthalmology ward of Dr. M. Djamil General Hospital with moderate to severe fungal keratitis. All patients were first treated with medications. Because the patients did not show clinical improvement after getting maximum therapy, they underwent intracameral fluconazole injection concurrent with MLAMT. MLAMT was performed with multilayered amniotic membranes to fill and cover the defect. The bandage contact lens was placed to protect and keep the MLAMT in place and for patients’ comfort. Patients were then observed for signs of inflammatory reaction and epithelialization. All patients showed reduced inflammation and improved epithelization after surgery.
 Conclusion: Concurrent intracameral fluconazole injection with MLAMT can be considered an alternative treatment for refractory fungal keratitis as it decreases the rate of inflammation and improves epithelization.

Rhinocerebral Mucormycosis Following COVID-19 Infection in Iran.

Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage. In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and facial nerve dysfunction; they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining methods to rule out mucormycosis. In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy; also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago). COVID-19 infection might be a predisposing factor for many opportunistic infections, such as fungal elements); thus, the physician should be aware of the dosage and duration of corticosteroid therapy to prevent the development of these infections.

A case–control study of drinking beverages and the risk of multiple sclerosis in Iran

BackgroundThere is no study in the world on the relationship between consuming black and green tea as beverages containing polyphenols and the risk of MS. This study aimed to determine the association between the consumption of green and black tea, coffee, non-alcoholic beer, milk, fruit juices and carbonated beverages with the risk of MS.Methods and materialsThis case–control study was performed on 150 patients with MS and 300 healthy individuals as a control group among patients who were referred to the ophthalmology ward of a referral hospital in Ahvaz with the groups matching for age. The data collection tool was a researcher-made questionnaire including demographic information and beverage consumption. Analysis was performed using univariate and multiple logistic regression models.ResultsThe mean age of patients at the time of diagnosis was 38.55 ± 8.88 years. The results showed that drinking milk (OR = 5.46), natural juice (OR = 2.49), and carbonated beverages (OR = 16.17) were associated with an increased chance of developing MS. However, drinking non-alcoholic beer (OR = 0.48), black tea (OR = 0.20), green tea (OR = 0.29) and coffee (OR = 0.07) were associated with a reduced chance of developing MS.ConclusionThe results show that drinking black and green tea, non-alcoholic beer, and coffee are associated with a decrease in the chance of developing MS. The results of this study can be used to design interventional research and to change people's lifestyles to prevent MS.

Relationships between Cataract Surgery Patient-Perceived Discharge Teaching Quality, Discharge Readiness, and Post-Discharge Outcomes: A Cross-Sectional Study Based on Regression Modeling Analysis

Introduction: A short hospital stay makes discharge planning services especially critical for patients undergoing cataract surgery. Studies on discharge teaching quality, discharge readiness, and post-discharge outcomes for patients with cataracts are lacking. Our study aimed to explore the relationships between the perceived discharge teaching quality, discharge readiness, and post-discharge outcomes of cataract surgery patients and to conduct a differential analysis between inpatient and day ward patients. Methods: We recruited 387 patients from the ophthalmology ward of a top-tier hospital in western China through convenience sampling. Data were collected on the day of discharge and at 2 weeks post-discharge. Statistical methods included multiple linear regression analysis, χ2 test, and the Mann-Whitney U test. Results: Regression models indicated that discharge teaching quality was the key factor of discharge readiness, while post-discharge outcomes were influenced by discharge readiness and discharge teaching quality. Further, inpatients’ discharge teaching quality, discharge readiness, and post-discharge subjective feelings were better than those of day ward patients. Conclusions: The effect of discharge planning services on patients undergoing cataract surgery was generally satisfactory. High-quality discharge teaching can enhance patients’ discharge readiness, further improving their post-discharge outcomes. When conducting discharge teaching, day ward medical staff should pay more attention to patients’ demands and explore a more effective teaching delivery method.

Tobacco and other risk factors for esophageal squamous cell carcinoma in Lilongwe Malawi: Results from the Lilongwe esophageal cancer case: Control study.

Esophageal cancer is the second commonest cancer in Malawi, and 95% of all cases are esophageal squamous cell carcinoma (ESCC). Very little is known about the epidemiology of ESCC in Malawi including risk factors. The main objective of the study was to evaluate and describe risk factors of ESCC in Malawi. We conducted a case-control study from 2017 to 2020 at two hospitals in Lilongwe, Malawi and consenting adults were eligible for inclusion. Endoscopy was conducted on all cases and biopsies were obtained for histological confirmation. Controls were selected from patients or their guardians in orthopedic, dental and ophthalmology wards and they were frequency matched by sex, age, and region of origin to cases. An electronic structured questionnaire was delivered by a trained interviewer. Multivariate conditional logistic regression models were used to assess the associations between subject characteristics, habits, and medical history and risk of ESCC. During the study period, 300 cases and 300 controls were enrolled into the study. Median age of cases and controls was 56 years and 62% of the cases were male. Among cases, 30% were ever cigarette smokers as were 22% of controls. Smoking cigarettes had an adjusted odds ratio of 2.4 (95% CI 1.4-4.2 p = 0.003). HIV+ status was present in 11% of cases and 4% controls, which resulted in an adjusted odds ratio was 4.0 (95% CI 1.8-9.0 p = 0.001). Drinking hot tea was associated with an adjusted odd ratio of 2.9 (95% CI 1.3-6.3 p = 0.007). Mold on stored grain has an adjusted odd ratio of 1.6 (95% CI 1.1-2.5 p = 0.021). Reducing smoking cigarettes, consumption of scalding hot tea, and consumption of contaminated grain, could potentially help reduce the burden of ESCC in Malawi. Further investigation of the association between HIV status and ESCC are warranted.

Ocular Morbidities in Indoor Pediatric Patients in the Ophthalmology Ward at a Tertiary Care Hospital

Ocular Morbidities in Indoor Pediatric Patients in the Ophthalmology Ward at a Tertiary Care Hospital

Different Patterns of Ocular Trauma Presentation in Nishtar Hospital Multan

Objective: The objective of this study was to determine the frequency of ocular trauma among gender and different age groups. And to determine various causative factors and the impact of trauma on ocular structures and visual acuity. Methods: This cross-sectional study was carried out in Ophthalmology department of Nishtar Medical University and Hospital, Multan, Pakistan from May 2021 to August 2021. Data were collected from 142 patients. A questionnaire was devised. Data were analyzed using SPSS V26. Results: Out of 142 patients that were admitted in Ophthalmology ward, 36 (25.40%) were female patients and 106 (74.60%) were male patients with mean age of 15.9 years with standard deviation of 14.5. There was no statistically significant difference between male and female patients (p value=0.2). Cornea was most commonly injured structure and mechanical factors were the most common cause of ocular trauma. Out of 142 patients, 4 (2.80%) got just medical management and 138 (97.20%) patients required surgical intervention while they were also given topical and oral antibiotics and anti-inflammatory drugs. Conclusion: Ocular Trauma is most prevalent among children. Males were affected more than females. The cornea was the most commonly affected structure. Ocular Trauma is one of the leading causes of monocular blindness. Most of the ocular traumas were due to some mechanical factors. Keywords: Ocular Trauma, Multan, Nishtar Hospital, South Punjab

FREQUENCY OF RAISED BLOOD PRESSURE / RAISED MEAN ARTERIAL PRESSURE ABNORMALITIES IN PATIENTS WITH PRIMARY OPEN-ANGLE GLAUCOMA

ABSTRACT
 Objectives 
 To find out the frequency of impaired blood pressure and mean arterial pressure in our patients presenting with primary open angle glaucoma.
 Material and Methods
 This prospective cohort study was conducted in Khyber Teaching Hospital Peshawar from July 2020 to December 2020. All patients having primary open angle glaucoma, were included. Those having high blood pressure (BP) on admission or history of high blood pressure or using anti-hypertensive drugs, were admitted to the ophthalmology ward of Khyber Teaching Hospital. Blood Pressure/ Mean Arterial Pressure and Intra ocular pressure (IOP) phasing were done. Mean Arterial Pressure, MOPP and peak IOP were determined. Patients having secondary types of glaucoma, primary angle closure glaucoma and those patients who declined concent were excluded. Data was collected on a already prepared standard proforma and analysed by spss 23.
 Results
 A total of 375 patients were diagnosed to have Primary open angle glaucoma (POAG), out of which 200 (65%) patients had impaired blood pressure, so rest of 70 (35%) patients had Normal Tension Glaucoma (NTG). Out of 200 cases with primary open angle glaucoma, 175 patients (87.5%) had hypertension, while 25 patients (12.5%) had low blood pressure. Amongst the hypertensive patients, the mean arterial pressure (MAP) was raised in 70(35%) patients, while the Mean Occular Perfussion Pressure (MOPP) was raised in 15 patients ie 7.5% .
 Conclusion
 Sixty five percent of our patients with primary open angle glaucoma had impaired blood presure, out of which 87.5% of patients had high blood pressure and the rest had low blood pressure.
 Keywords Primary open angle glaucoma (POAG), impaired blood pressure, impaired mean arterial pressure.

Penetrating Keratoplasty a boon in different corneal diseases to improve social life

PKP can visually rehabilitate many of those who suffer from visual impairment due to corneal diseases so the primary objective of this study was to report treatment results of patients, who received a total penetrating Keratoplasty for various corneal diseases. Purpose: Review the surgical treatment, anatomical and functional results, and complications of treatment in this group of patients at our institution in terms of graft survival and visual acuity.Methods: This was a hospital based prospective study done in 70 patients admitted in ophthalmology ward, department of Ophthalmology, Basaveshwar teaching general hospital, M.R. Medical college, Kalaburagi over a period of two years. Patients diagnosed with non-healing corneal ulcer, corneal perforation, bullous keratopathy, infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders were indicated for total penetrating Keratoplasty After a complete ocular examination, total penetrating Keratoplasty (diameter ≥ 10.0 mm) was performed. The surgical technique involved dissection of affected tissues with a margin of minimum 1.0 mm of non-affected tissue. The size of the corneal graft ranged from 10.0 to 14.0 mm,Results: This group consisted of 36 females, whose mean age was 66.13 ± 9.94 (range 39 to 80 years), and 34 males, whose mean age was 63.69 ± 14.48 (range 32 to 92 years). There was no statistically significant difference with respect to gender and age between both groups. The main cause of surgical treatment failure was persistent epithelial defect, observed in 28 (40%) operated eyes, resulting from decreased corneal sensitivity and impaired tear production. Conclusion: Our study confirms that Full Thickness Penetrating Keratoplasty: Surgical boon and effective tool in management of chronic non-healing microbial corneal ulcer refractory to medical therapy, corneal dystrophy and degenerations and various other corneal diseases at my geographical area. It not only eliminates infection but also maintain globe integrity and improve visual acuity and thus improving social life

Serum concentrations of 25-hydroxyvitamin D and different subtypes of age-related cataract; a case-control study

Introduction: Age-related cataract (ARC) is the principal causes of low vision and also the most prevalent type of cataract among the elderly population, particularly women. Objectives: To evaluate the association between serum concentration of vitamin D and risk of different subtypes of senile cataract. Patients and Methods: A total of 200 controls and 1241 patients with newly recognized ARC attending the ophthalmology ward of a major teaching hospital in Urmia, Iran, were included in this investigation. All included subjects aged 40 to 85 years. Cataracts were classified as pure nuclear cataract (NC) (n=216), pure cortical cataract (CC) (n=336), pure posterior sub-capsular cataract (PSC) (n=140) and mixed cataracts (549). Serum concentration of 25-hydroxyvitamin D was obtained from blood samples. All participants were administered by a questionnaires to collect data on demographic variables and risk factors. Results: On multivariate analysis, a marked negative association (P < 0.05) was found between vitamin D serum levels and the risk of NC (OR = 0.20; 95% CI: 0.09-0.75) or CC (OR = 0.25; 95% CI: 0.12-0.96) in females only. Other significant predictors of pure NC in women were higher education (OR = 0.51) and serum calcium levels (OR = 0.35). Apart from serum concentrations of vitamin D, postmenopausal status (OR = 2.26) was the other predisposing factor for pure cortical opacity in women. Conclusion: Our finding does not endorse a role for vitamin D in cataractogenesis among men. In women, however, serum levels of 25(OH)D were only inversely associated with the risk of NC and CC and not with PSC or mixed cataract. Providing sufficient vitamin D is possibly helpful in preventing senile cataract formation in females.

A model of cognitive evaluation battery for diagnosis of mild cognitive impairment and dementia in educated and illiterate Egyptian elderly people

BackgroundThe high illiteracy rates in the North African and Middle Eastern region make direct cognitive testing challenging. Validated instruments for dementia in Arabic language are lacking specially those targeting low-educated subjects.ObjectivesThe aim of this study was to develop a cognitive evaluation battery suitable for both educated and illiterate Egyptian elderly people.DesignA cross-sectional study was conducted. Setting: Ain-Shams University geriatric and ophthalmology wards, geriatrics outpatient clinic, and geriatric clubs. Participants: 159 male and female participants aged ≥ 60 years were recruited.MeasurementsCut-off points were determined according to DSM-IV criteria for dementia and MMSE scores which divided the participants into 3 quadrants as normal, having mild cognitive impairment and having dementia then application of the new battery test was done.ResultsTest re-test reliability ranged from adequate to high in most of its tests with r ≥ 0.7. There was a statistical significance between all battery tests when divided into normal and dementia according to DSM IV criteria except in digit span forward length, digit span backward length, stimulus cue of confrontation naming and judgment. Means and standard deviations were calculated for each battery subset, for the whole sample, for low-educated group and group with > 9 years education according to three quadrants of MMSE.ConclusionA new valid and reliable neurocognitive evaluation battery that can differentiate between normal, mild cognitive impairment, and dementia in both educated and illiterate subjects under the name of Ain Shams Cognitive Assessment (ASCA) scale is now available.

Process mining as support to simulation modeling: A hospital-based case study

The purpose of this paper is to show how the knowledge of Process Mining techniques can provide a robust premise to build a Discrete Event Simulation (DES) model of a healthcare process. In order to analyze some specific processes of an ophthalmology ward of a large Italian hospital, ProM6 framework was implemented, which supports process mining techniques in form of plug-ins; the plug-ins process data, in form of Event Log, in order to extract information about the process. The DES model based on such information was run via a commercial tool, Simul8, which allows building sophisticated process models. A timely algorithm was then deployed to adapt the ProM6 information to the DES model. Following, a conformance analysis was conducted by comparing the original Event Log, and the Simulation tool data, taking into account the main case-related model attributes (routing probabilities profile, time perspective, and resources perspective). The paper aims at developing the line of inquiry for what concerns the deployment of approaches to set forth the link between Process mining and Simulation modeling.

Eye-related Emergency Department Visits with Ophthalmology Consultation in Taiwan: Visual Acuity as an Indicator of Ocular Emergency

To investigate the epidemiology of eye-related emergency department (ED) visits and to determine if visual acuity (VA) could be an indicator for determining the timing for managing ocular emergencies, we have conducted the retrospective study which included patients visited the ED for eye-related reasons and had received ophthalmology consultations at a referral center in Taiwan in 2015. Among 46,514 consultations, 5,493 were ophthalmology consultations (11.8%). After exclusion, 5,422 were eligible for analysis. Among them, 1,165 (21.5%) had not likely emergent diagnoses, 4,048 (74.7%) had likely emergent diagnoses, and 209 patients (3.9%) could not be determined. The logMAR VA was 0.31 ± 0.48, 0.66 ± 0.78, and 1.00 ± 0.94 in groups with not likely emergent, likely emergent, and undetermined diagnoses, respectively. Among all eye-related ED visits, 10.3% of patients received ophthalmologic intervention or were admitted to the ophthalmology ward. A LogMAR VA score of 0.45 (decimal equivalent of 0.4) had the highest discrimination power for identifying whether a patient needed ophthalmology intervention or admission to ophthalmology ward (area under the curve: 0.802, sensitivity: 0.800, specificity: 0.672). In our study, we found VA could be an indicator for determining the priority and time of ocular emergencies requiring ophthalmic intervention in patients visiting the ED for eye-related reasons.

Diabetic retinopathy and age-related macular degeneration: a survey of pharmacoutilization and cost in Calabria, Italy.

The aged population is constantly growing, thus fostering an increase in age-dependent diseases. Among these, diabetic retinopathy (DR) along with age-related macular degeneration entails progressive vision loss. Since such conditions are associated with the proliferation of novel vessels, their pharmacotherapeutic management consists of the intravitreal injection of anti-vascular endothelial growth factor drugs, able to hinder the driving of vascular proliferation prompted by vascular endothelial growth factor. The humanized anti-vascular endothelial growth factor monoclonal antibody ranibizumab provided evidence for efficacy in several trials, hence earning approval by the US Food and Drug Administration for therapeutic use in all the stages of DR. Due to the lack of epidemiologic and pharmacoeconomic evaluation in the local Calabria Region context, the present retrospective observational study focused on prevalence of DR and age-related macular degeneration, treatment and cost of therapy with ranibizumab in 870 patients arriving to clinical observation at the “Mater Domini” University Hospital in Calabria, Italy from January 2014 to June 2017. Data were extracted from the database of ophthalmology ward and subjected to statistical analysis. The results suggest that the most frequent retinal diseases are age-related macular degeneration and DR and that the use of ranibizumab has been decreasing over the 4-year study period together with the associated cost per patient which was similar for both disorders. Therefore, appropriateness of treatment with drugs other than ranibizumab needs to be assessed in this setting and deep monitoring of pharmacologic treatment for retinal diseases is necessary to prevent or delay visual acuity decrease and complete vision loss. Study procedures were performed in accordance with the “Mater Domini” University Hospital ethical standards of the responsible committee on human experimentation

Application effects of humanistic nursing in ophthalmology ward

Objective To explore the effects of humanized nursing service in ophthalmology ward. Methods Between May 2016 to February 2018, a total of 200 patients in the ophthalmology ward of Shaoxing People's Hospital of Zhejiang Province were selected as the research subjects by convenience sampling method. According to the sequence of admission, the subjects were divided into control group and intervention group, with 100 cases in each group. The patients in both groups received routine ophthalmic care. The intervention group received humanistic nursing service at the same time. The scores of Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) , patient satisfaction, nursing complaints and disputes were compared between the two groups. Results Before the intervention, there were no statistical differences in the scores of SAS and SDS between the two groups (P>0.05) . After the intervention, the scores of SAS and SDS in the intervention group were both lower than those in the control group, and the differences were statistically significant (P<0.05) . The satisfaction rate of the intervention group was higher than that of the control group, and the difference was statistically significant (P<0.01) . Conclusions Humanistic nursing service can improve the patient's anxiety and depression level, improve the patient's satisfaction, and reduce the nursing complaints and disputes. Key words: Anxiety; Depression; Patient satisfaction; Humanistic nursing; Ophthalmology

Household, Moderate Physical Activity and the Risk of Breast Cancer Among Nigerian Women: An Epidemiological Study

Background: Breast cancer incidence in Nigeria has risen by &gt;120% since 2000. The mortality rate (25.9/100,000/yr) ranks highest in Africa. Inverse associations between household physical activities (PA) as well as moderate PA, and breast cancer risk have been suggested in literature. However, the roles of these activities in breast cancer risk have not been widely studied in Africa. As the socioeconomic status of many Nigerian women improves, their household and daily routines are expected to change. These have implications for their level of physical activity. Aim: The aim of this study was to investigate if there is an association between household, as well as moderate PA and breast cancer risk among Nigerian women. Methods: The study was a multisite hospital based case-control design involving 379 histologically confirmed breast cancer cases and 403 controls. The participants aged ≥ 20 years were interviewed in-person between October 2016 and May 2017 using a pretested questionnaire. Cases were selected from oncology wards and controls from ophthalmology wards. Self-reported household and moderate PA were summarized as both hours per week and metabolic equivalents (MET) hours per week (met-hr/wk). Data were analyzed using multivariable logistic regression, adjusting for known confounders. SPSS version 23 was used for all analyses. Results: The odd of having breast cancer (based on MET-hr/wk) was 40% less among women in the upper tertile of household PA than those in the lowest tertile (95% CI, 0.39-0.94). This was stronger among younger (OR: 0.50, 95% CI, 0.26-0.94), premenopausal (OR: 0.46; 95% CI, 0.24-0.89) and lean women (OR: 39, 95% CI, 0.16-0.87). Moderate PA was also associated with reduced breast cancer risk ( P = 0.04). Conclusion: The study suggested that household and moderate physical activities were protective of breast cancer among Nigerian women. Household chores and other routine moderate activities could provide opportunities for breast cancer prevention in Nigeria. Future studies could consider the use of community controls to authenticate the findings.

Kératites fongiques : étude rétrospective monocentrique sur 5 ans à l’île de la Réunion

Fungal keratitis is rare in France, but could be a severe sight-threatening condition. Here, we aimed to describe the epidemiology of fungal keratitis in Réunion Island. In a retrospective study, we analyzed 13 culture-proven keratitis episodes, occurred between January 2013 and July 2017 in the ophthalmology ward of a University Hospital, Saint-Pierre. Twelve isolates were genotyped and antifungal susceptibility testing was performed. Corneal abrasion caused by vegetable matter was the main predisposing factor. Stromal infiltration was observed in 12 patients. Six patients did not response to medical treatment, requiring surgical care, including two enucleations surgery. Fusarium solani (n=6) and Fusarium dimerum (n=4) were the main fungal species involved in fungal keratitis. Clinical failures were more prevalent with F.solani infections. The lowest minimal inhibitory concentrations for Fusarium sp. were observed with voriconazole and amphotericin B. In Reunion Island, the epidemiology of fungal keratitis is characterized by the predominance of Fusarium species, potentially involved in visual loss. This pattern is consistent with the epidemiology usually observed in tropical areas.