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Table of Contents
October-December 2016
Volume 11 | Issue 4
Page Nos. 109-140
Online since Thursday, March 16, 2017
Accessed 1,743 times.
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ORIGINAL ARTICLES
Cataract prevalence, etiology, and systemic association in children attending EI walidain Charity Eye Hospital from April to July 2015
p. 109
Atif A. M Saad, Hind M. M Abusnina, Karimeldin M. A Salih
DOI
:10.4103/1858-5000.202358
Background:
Childhood cataracts are responsible for 5%–20% of blindness in children worldwide and for an even higher percentage of childhood visual impairment in developing countries. This study is an attempt to evaluate the prevalence, etiology, and systemic association of cataract in Sudanese children attending El walidain Charity Eye Hospital.
Materials and Methods:
this is a cross-sectional, observational prospective study in the period between April and July 2015. Out of 783 children were enrolled in this study, 52 children aged ≤18 years presented with cataract to El walidain Charity Eye Hospital in Khartoum state in the period between April and July 2015. Diagnosis of cataract was made based on history and clinical examination using ophthalmoscope and slit lamp.
Results:
Prevalence was 6.6%. Nearly 63% of the patients were male, mostly were male, usually idiopathic and juvenile in nature, corneal opacity and photophobia in addition to lens opacity manifested were the usual presentation. Trauma, steroid therapy, congenital, Down syndrome, and other systemic diseases found to be a risk factor.
Conclusion:
The prevalence of cataract in children in El walidain Charity Eye Hospital was more than that of a hospital-based study done in Tanzania. The mean age of patients was 6.1 years. Corneal opacity and lens opacity were the most common symptoms and signs, respectively. Idiopathic cataract was the most common type and decreased vision was the most common complication.
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Prevalence of diabetes mellitus in a tertiary health institution in Gombe Metropolis, Nigeria
p. 113
Mela Danjin, Nafisa Umar Usman, Danladi Adamu
DOI
:10.4103/1858-5000.202357
Aim:
This study was aimed at determining the prevalence of diabetes mellitus (DM) among adult patients attending Specialist Hospital Gombe, Northern Nigeria.
Materials and Methods:
A 5-year (2010–2014) retrospective descriptive survey of cases of DM was conducted, using hospital record retrieved from the Record Department of Specialist Hospital Gombe. Diagnosed adult cases of DM were carefully identified and sorted from the general outpatient department morbidity register. Relevant data were then harvested on a specially designed data collection template.
Results:
A total of 40,083 medical cases were counted, out of which 2069 cases of DM were identified. This implies an overall prevalence rate of 5.16%. However, the yearly prevalence of the disease revealed as high as 12.55% in the year 2012 and a least value of 1.22% in the year 2010. Age-specific case count of the disease was found to be highest (1288; 62.25%) within the uppermost age range of 65–75, while the lowest age range of 25–34 was least affected (33, 1.60%). Overall, more females (1491; 72.06%) suffered from the disease than males (578, 27.94%). The sex difference was found to be significant (
χ
2
= 449.15521,
P
= 0.000). Furthermore, the case burden of the disease was found to be significantly (
χ
2
= 39.02524,
P
= 0.000) highest among individuals living in urban areas, 663 (80.38%) than those living in rural areas, 406 (19.62%).
Conclusion:
The disproportionately high case burdens of DM among females, urban dwellers, and the aged are useful information for the design of targeted diabetes prevention programs by government and other stakeholders.
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REVIEW ARTICLES
Fixed pass mark: Time for change
p. 119
Assad Ali Rezigalla
DOI
:10.4103/summ.summ_13_16
Pass mark is a score that forms a limit between enough competent candidates and those who are not competent. There are two types of pass marks: relative and absolute. Fixed pass mark can be determined by either asking judges or arbitrary figure. The internationalization, globalization, and cross-border education driven by the development of information and communication technology need global standards for medical education. Thus, there is need for evidence-based standards. In the presence of remarkable evidence against the use of fixed pass mark, continuing its use becomes unjustifiable.
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Ventral abdominal hernias in adults
p. 121
Ismat Mohamed Mutwali
DOI
:10.4103/1858-5000.202361
Ventral abdominal hernias (VAHs) are distinguishable from incisional hernias (IHs) and warrant a separate research and studies from IHs for better practice and interpretation of the outcomes. There are significant differences between IH and primary ventral hernia (PVH), in regard to etiology, mode of treatment, and different techniques employed for repairing, as well as complications and postoperative adverse results. Ventral hernias could be primary and these include umbilical hernia, epigastric hernia, spigelian hernia, and lumbar hernia, and secondary ventral hernias include IH. The aim of the present article is to review the risk factors, incidence, pathogenesis, prevention, complication, and management of the PVHs and to draw attention to the less common primary VAH, for those who need to acquire the knowledge about the topic, namely, under- and post-graduate medical students, surgical trainees, and junior surgeons in practice. A database search was performed using a combination of the search terms: primary ventral hernia, umbilical hernia, epigastric hernia, spigelian hernia and lumbar hernia risk factors, incidence, pathogenesis, prevention, and complications. Some of the relevant reference lists were searched manually to obtain more relevant literature.
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Anesthesia and assisted reproductive technology: A literature review
p. 129
Gamal A. M Ejaimi, Mohamed Elamin Alhindi, Sittelnissa Saeed
DOI
:10.4103/1858-5000.202360
Assisted reproductive technology or
in vitro
fertilization (IVF) is a method used to achieve pregnancy by artificial methods. It includes four steps which are: Induction of ovulation, picking up of mature ovum, injection of sperm microscopically into the mature ovum, and then transferring of fertilized ovum, as embryo, to the uterus. The procedure of IVF demonstrates pain during ovum pickup through aspiration technique using vaginal ultrasound probe which supersedes the laparoscopic retrieval oocyte. The bulk of cases present with anxiety and other psychological disorders related to their infertility. These factors perpetuate pain associated with the procedure. Consequence of this, the role of anesthetist will be of great importance to deal with these challenges. Different modalities and methods of anesthesia could be used during IVF. Clinician should adapt to familiar one. Counseling of patients has a major role. However, written guidelines and protocol may be helpful and of great benefit.
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CASE REPORTS
Fracture of medial pole of right condyle and symphysis of mandible in a 6-year-old male: A conservative approach
p. 133
Karthik Shunmugavelu, Kumaravel Subramaniam
DOI
:10.4103/1858-5000.202356
Much importance has to be emphasized on the fractures of mandibular condyle and symphysis in children due to the growth center status. Risk involving this region might lead to facial asymmetry and growth retardation. Most common etiology includes trauma, fall, sports, occupational hazard, and interpersonal violence. Moreover, in the mandible, condyle is the foremost anatomical site to fracture. In this presentation, we highlight a case of a 6-year-old male witnessed with a fracture of unilateral medial pole of the right condylar head and mandibular symphysis. Clinical examination revealed limited mouth opening, edema, and deviation of mandible to the right side. Computed facial tomography revealed fractured right condylar head. Treatment plan included conservative approaches such as closed reduction and nonrigid mandibular splint. The main concept of this approach is to emphasize that nonsurgical and functional approach plays a crucial role in the management of mandible symphysis and condyle fractures in pediatric population thereby avoiding growth inhibition.
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Pyrexia of unknown origin: A diagnosis and treatment challenge in a resource-limited setting
p. 137
Ibrahim Aliyu, Zainab F Ibrahim
DOI
:10.4103/1858-5000.202359
The term pyrexia of unknown origin (PUO) was first described by Petersdorf and Beeson in 1961. It is characterized by a temperature of more than 38.3°C on several occasions lasting for more than 3 weeks or for more than 1 week of inpatient investigation. The etiology of PUO is extensive but could be broadly classified into infectious and noninfectious causes. Infection accounts for 34% of cases; the case of a 6-month-old boy who presented with fever of 2 months duration is reported. He had series of investigations without the etiology identified. Furthermore, he was placed on empiric antibiotics on admission but the fever persisted; however, he was discharged after 3 weeks; and while on follow-up visit, the fever resolved. This report highlights how bizarre PUO may present.
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