The study showed an unacceptably high rate of stillbirth in rural Nigeria. Early recognition of complications and prompt referral may reduce stillbirth rate.
Introduction: The non-communicable eye diseases such as diabetic retinopathy have become significant threats to vision and require lifelong management. The development of ocular complications of diabetes has been associated with longstanding and/or poorly controlled disease. Early detection and prevention are keys to reduce this scourge, but this largely depends on the existing knowledge. Objective: This study is aimed at determining the knowledge, attitude and practice regarding eye care among patients living with diabetes with a view to making recommendations for a multidisciplinary patient-centered approach to ophthalmic care. Methods: One hundred and three respondents were interviewed using a structured questionnaire in a cross sectional study carried out in the Endocrinology Clinic of Federal Medical Centre, Owerri, Imo State, Nigeria. Results: There was a female preponderance with a male to female ratio of 1:1.3. Of these respondents, 68.9% had been diabetic for 5 years or less; 56.4% could define diabetes; but only 40.77% could mention some ocular complications of diabetes. Only 31.1% had had their eyes examined; the rest had not been to an eye clinic due to lack of funds, time, no ocular problems and not having been referred to an eye doctor. This attitude and practice were not significantly associated with age, sex, occupation or duration of illness. Conclusion: Though more than half of the respondents could define diabetes, there is still a poor knowledge of the ocular complications of diabetes and a poor attitude and practice regarding eye care among these patients. An interdisciplinary patient-centred approach to the management of diabetic eye diseases is recommended so as to reduce the burden of visual impairment from diabetes.
Background. Sickle cell nephropathy (SCN) is a serious complication of sickle cell anaemia (SCA) with asymptomatic onset in childhood and possible progression to chronic kidney disease (CKD). In Southeast Nigeria, few studies have evaluated renal function in paediatric SCA patients for early detection of renal impairment and early intervention to reduce morbidity and mortality. Therefore, this study evaluated the renal function of paediatric SCA patients in a steady state based on glomerular filtration rate and urinalysis findings (proteinuria and haematuria). Methods. A cross-sectional study of consecutively recruited sixty haemoglobin SS (HbSS) children in a steady state and sixty age- and sex-matched haemoglobin AA (HbAA) controls aged 2–18 years was done. Renal function of HbSS subjects was evaluated using estimated glomerular filtration rate (eGFR) which was compared with healthy HbAA subjects. The prevalence of significant proteinuria and haematuria, its association with eGFR, and the effect of past sickle cell crisis (in the preceding 24 months) on renal function were also evaluated. Results. Mean eGFR was significantly higher in HbSS subjects than in the HbAA subjects (p=0.001) and decreased with age. Significant proteinuria and haematuria were more prevalent in the HbSS group (3.4% and 6.7%, respectively) compared to the HbAA subjects (0% and 0%, respectively) (p=0.496 and 0.119, respectively). No significant association was observed between eGFR and proteinuria (p=1.000) or haematuria (p=1.000). There was a positive correlation between eGFR and frequency of past painful crisis that required hospitalization (r=0.138, p=0.295) and between eGFR and frequency of blood transfusion (r=0.679, p≤0.001). Conclusions. Asymptomatic paediatric HbSS (SCA) patients had higher mean eGFR indicating an increased risk of nephropathy. There was no association between eGFR and proteinuria or haematuria. Frequent sickle cell crises especially one requiring transfusion were positively correlated with hyperfiltration.
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