Quantitative and qualitative assessment on individual perception and self-care practice of refractive error in a rural community in Enugu, South East Nigeria

Background

Globally, uncorrected refractive errors have been identified as the most common cause of visual impairment and the second leading cause of treatable blindness.

Aim

This study quantitatively and qualitatively assessed individual perception and self-care practice of refractive error (RE) in a rural community in Enugu State.

Subjects and Methods

A descriptive, cross-sectional, population-based survey was done in Amorji community, Enugu State. A pretested, researcher-administered questionnaire was used to interview the respondents on knowledge of causes, features and treatment of RE, their self-care practices, and attitudes toward RE. Focus group discussions (FGDs) and in-depth interviews (IDIs) were also carried out to qualitatively assess these parameters. Data was analyzed using SPSS version 20.

Results

A total of 522 adults, 307 (58.8%) males, and 215 (41.2%) females aged 43 ± 31.6 (range 18-83) years participated in the study. Of the participants, 235 (45.0%) had good knowledge of RE; 272 (52.1%) had positive attitude toward RE, while only 51 (9.8%) had good self-care practice. Educational status was significantly (p = 0.02) associated with participants' knowledge, attitude, and self-care practices. Good knowledge significantly (p = 0.001) influenced attitude and self-care practices among the participants. Results from FGDs and IDIs were in agreement with those obtained from the questionnaire-based part of the study.

Conclusion

The participants from Amorji community had good knowledge of the features of RE but poor knowledge of its causes and treatment. They also exhibited positive attitude, but poor self-care practices toward refractive errors.

ECG abnormalities among HIV infected children placed on ART at Enugu, South East of Nigeria

Background

Cardiovascular abnormalities are not much reported among human immunodeficiency virus (HIV) infected children especially in Africa where there is high HIV disease. In addition, the use of highly active antiretroviral therapy (HAART) in such children may have a protective effect on the cardiovascular system.

Methods

Cross-sectional study of randomly selected eighty HIV infected and 80 aged matched non- HIV-infected children were used. HIV-infected children were on HAART for more than 5years and had steadily received the treatment for 6 months prior to the time of the tests. Heights and weights were measured and body mass index calculated. Cardiac indices evaluated were heart rate (HR), PR interval, QRS duration, QT/QTC Interval, P/QRS/T Axis, RV5/SV1 voltage and RV5+SV1 voltage.

Results

The average heart rate was significantly higher among HIV infected children on HAART than their non-infected counterparts (P= 0.019). At 0.05 significance level, their PR interval was significantly higher than those in the control group (P=0.050). The average QRS duration result also showed a significant difference between that of test and control subjects (P = 0.022)

Conclusion

The HAART usage possibly improved the cardiovascular functioning in the infected children but the protective effects diminish with increase age and longer exposure

Factors associated with depression and anxiety among glaucoma patients in a tertiary hospital South-East Nigeria

OBJECTIVE

To explore the factors associated with depression and anxiety among glaucoma patients.

SUBJECTS AND METHODS

This was a cross-sectional study involving adult glaucoma patients, who attended the eye clinic of Enugu State University Teaching Hospital, Parklane, Enugu, from April to September 2018. In total, 182 glaucoma patients with no other significant ophthalmic or medical conditions were recruited. Information on their socio-demographic and clinical characteristics was obtained using a close-ended, interviewer-administered questionnaire. Detailed ophthalmic evaluation to characterize the glaucoma was done. Depression and anxiety were assessed using the hospital anxiety and depression scale. Data were analyzed using SPSS version 21. Bivariate analysis was done to identify factors associated with depression and anxiety. The level of significance was at P < 0.05.

RESULTS

The participants were mainly females, 108 (59.3%), married, civil servants with tertiary education and mean age of 59.7 ± 13.3 SD years. Majority of them had advanced stage of primary open angle glaucoma. Eighty (44%) of the participants had anxiety, while 76 (41.8%) had depression. Severe/blind stage of glaucoma and reduced visual acuity were significantly associated with anxiety and depression; occupation (trading) and intraocular pressure of <21 mmHg also significantly associated with depression.

CONCLUSION

The prevalence of anxiety and depression among glaucoma patients in Enugu was high. Severe/blind stage of glaucoma and reduced visual acuity were the most important factors that associated with both anxiety and depression. Incorporating a psychological health approach to glaucoma care especially in patients with severe glaucoma and reduced visual acuity may promote effective communication between clinicians and patients and treatment adherence.

Relationship between corneal biomechanical properties among pregnant women in a tertiary hospital in Nigeria

Objective

In Nigeria, many pregnant women as well as health-care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them.

Materials and Methods

A prospective longitudinal study was used. One hundred and thirty-four pregnant women attending the Obstetric Clinic of the University of Nigeria Teaching Hospital, Enugu, were consecutively recruited in their second trimester for the study. Changes in CCT, CS, and IOP were monitored at the second and third trimesters and 6-week postpartum. Data obtained were analyzed using Statistical Package for the Social Sciences version 20. The effect of duration of pregnancy on these variables was determined using simple linear regression and further analysis was done using Bonferroni's post hoc test.

Results

The women were aged 18-48 years, with a mean age of 30.81(±5.49) years and majority of them (61.2%) were multigravida. The duration of pregnancy varied inversely and significantly with CS (P < 0.05) and IOP (P < 0.000) with the least values recorded in the third trimester, while it varied directly and also significantly with CCT (P < 0.000) with the highest value obtained in the third trimester. A negative correlation that was significant only in third trimester was found between CCT and IOP (P < 0.02) and CS (P < 0.03).

Conclusion

There was a progressive increase in CCT with a corresponding decrease in CS and IOP across the trimesters of pregnancy, but these changes reversed 6-week postpartum.

Does consumption of an aqueous extract of Hibscus sabdariffa affect renal function in subjects with mild to moderate hypertension?

Hibiscus sabdariffa (HS) has been traditionally used as a herbal medicine in Nigeria mainly because of its antihypertensive action. In view of the recent increase in the prevalence of renal failure, we have investigated the effect of HS consumption on renal function in Nigerians with mild to moderate hypertension. A total of 78 newly diagnosed but untreated subjects with mild to moderate hypertension attending the medical outpatients unit of Enugu State University Teaching Hospital (Enugu, Nigeria) were recruited for the study. These subjects were randomly divided into three equally sized groups that received HS or lisinopril (treatment groups) or placebo (control group), once daily for 4 weeks. Indices of renal function (urine volume and creatinine clearance) were measured at baseline and weekly throughout the study period. HS and lisinopril significantly increased (P < 0.001) urine volume compared to placebo, and HS significantly (P < 0.001) increased urine volume more than lisinopril. HS significantly increased (P < 0.001) creatinine clearance compared to placebo whereas lisinopril did not. These results indicate that HS consumption improved indices of renal function in our study population of Nigerians with mild to moderate hypertension.

Effects of aqueous extract of Hibiscus sabdariffa on the renin-angiotensin-aldosterone system of Nigerians with mild to moderate essential hypertension: A comparative study with lisinopril

Objectives:

The present study investigated the effects of aqueous extract of Hibiscus sabdariffa (HS) on the three basic components of renin-angiotensin-aldosterone system: Plasma renin, serum angiotensin-converting enzyme (ACE), and plasma aldosterone (PA) in mild to moderate essential hypertensive Nigerians and compared with that of lisinopril, an ACE inhibitor.

Materials and Methods:

A double-blind controlled randomized clinical study was used. Seventy-eight newly diagnosed but untreated mild to moderate hypertensive subjects attending Medical Outpatients Clinic of Enugu State University Teaching Hospital, Enugu were recruited for the study. Those in Group A received placebo (150 mg/kg/day), Group B were given lisinopril (10 mg once daily) while those in Group C received aqueous extract of HS (150 mg/kg/day). After 4 weeks of treatment, the levels of plasma renin, serum ACE, and PA were determined.

Results:

HS and lisinopril significantly (P < 0.001) reduced PA compared to placebo by 32.06% and 30.01%, respectively. Their effects on serum ACE and plasma renin activity (PRA) were not significant compared to placebo; they reduced ACE by 6.63% and 5.67% but increased plasma PRA by 2.77% and 5.36%, respectively.

Conclusion:

HS reduced serum ACE and PA in mild to moderate hypertensive Nigerians with equal efficacy as lisinopril. These actions are possibly due to the presence of anthocyanins in the extract.

Assessment of body mass index and blood pressure among university students in, Enugu, South East, Nigeria

BACKGROUND

Body Mass Index (BMI) has been described as a significant predictor of Blood Pressure (B.P) but few studies have demonstrated this association in our environment. The study aims to determine the pattern of relationship between BMI and blood pressure in our environment.

METHODOLOGY

Two thousand and ninety six (2096) students in two Universities located in Enugu, South East Nigeria completed the study. The blood pressure, weight and height were measured. Body mass index was calculated as weight in Kilograms divided by height in meters square (kg/m2).

RESULTS

More females than males were underweight (9.4% versus 4.7%). More males than females were overweight (8% versus 4%).Obesity occurred more in males than females (7% versus 0.9%). Blood pressure parameters increased significantly with BMI (p < 0.0001) with higher values in males than in females; (the mean systolic blood pressure 124.88 +/- 10.97 mmHg versus 114.93 +/- 6.82 mmHg, P < 0.0001; the mean diastolic blood pressure was 80.1 +/- 7.2 mmHg versus 73.36 +/- 6.82 mmHg, p = 0.035 and the mean arterial Pressure (MAP) 95.02 +/- 7.78 mmHg versus 87.2 +/- 9.58 mmHg, p < 0.0001).

CONCLUSION

A significant relationship between BMI and Blood pressure was demonstrated among university students in South East Nigeria.