Prevalence of Dry Eye Disease in Type 2 Diabetic and Non-Diabetics: A Cross-Sectional Hospital-Based Study.

Aims and Objectives: Dry eye disease (DED) is a common condition that affects the quality of life of may individuals. This study aims to estimate the prevalence of DED and identify potential risk factors in adult patients seeking care at Lagos State University Teaching Hospital., Nigeria. Materials and Methods: This was a cross-sectional, hospital-based study that aimed to determine the prevalence of DED in type 2 diabetic and non-diabetic patients. A total of 200 adult participants-100 with type 2 diabetes and 100 non-diabetic patients, were recruited into the study. A symptom screening standard patient evaluation for dryness questionnaire was administered and a fluorescein break-up time test was done to diagnose DED. Results: The mean age was 61.4 years (±11.7 SD) and most were females (146, 72.86%). Using the standard patient evaluation for dryness questionnaire, 87.31% of the study participants had symptom(s) of DED. The proportion of DED in diabetics was 63.95% while in the non-diabetics was 68.37%, and this was significantly higher in the non-diabetic group (proportion difference of 16.47%, P = 0.006).The prevalence of DED as measured by the fluorescein break-up time was 55.81% (95% CI: 48.39-63.24). There was no significant difference in prevalence between diabetic and non-diabetic participants. Logistic regression analysis showed that increased duration of diabetes and age were significant predictors of DED in diabetic and non-diabetic groups, respectively. Conclusion: The prevalence of DED was high in our study population with increasing duration of diabetes in diabetics and older age in non-diabetics significantly associated with DED.

Orbito-oculoplastic diseases in lagos: a 4-year prospective study.

AIMS: To determine the prevalence of orbito-oculoplastic diseases and thereby contributing a data base to the emerging orbito-oculoplastics subspecialty in the sub-Saharan region. SETTINGS AND DESIGN: A tertiary eye care centre. MATERIALS AND METHODS: A descriptive prospective study was done in a tertiary eye care center. Demographic and clinico-pathological diagnoses of 269 patients presenting to the oculoplastics clinic over a 4-year period (January 2008 -December 2011) were collected at entry and during follow-up visits. These were patients referred from the general ophthalmology clinics of the study center, secondary eye care centers within and from neighboring states. Patients were categorized based on the primary diagnosis after examination by the oculoplastics surgeon. Ethical issues were considered though data collection did not involve direct patient participation. STATISTICAL ANALYSIS USED: Microsoft Excel 2007 software. RESULTS: Two hundred and sixty-nine patients were seen with 141 (52.4%) females. Leading etiological factors were trauma; 81 (30.0%), congenital anomalies 55 (21.0%) and tumors 44 (16.0%). Eyelid diseases were the most frequent 115 (42.8%), with ectropion 36 (31.0%) and ptosis 33 (29.0%) being the most common. Orbital and peri-orbital lesions 44 (16.4%) were mainly dermoids 12 (27.3%) and capillary heamangioma 4 (9.1%) in the pediatric age while thyroid orbitopathy 11 (25.0%) was predominant in adults. Ocular and degenerative diseases were retinoblastoma in 4 (16.7%) and phthisis bulbi in 10 (33.3%). Contracted socket was 22 (84.0%) of socket pathologies. Primary conjunctival diseases occurred less often, rather Stevens-Johnson syndrome in 9 (30.0%) and its ocular complications were more frequent. CONCLUSIONS: It is expected that this survey will provide a database for oculoplastics surgeons and ophthalmologists in an emerging subspecialty and thus enhance training focus and equipment acquisition.

Ectropion and entropion in sub-Saharan Africa: how do we differ?

AIMS: To study the etiopathophysiology of ectropion and entropion in a sub-Saharan tertiary eye care center and examine how it differs from reports elsewhere. METHODS AND MATERIALS: This was a retrospective audit of all consecutive patients who presented with ectropion or entropion to the oculoplastics clinic of a tertiary eye care unit. We reviewed the medical records of all such patients and data extracted include age, gender, etiopathology, and diagnosis. The primary oculoplastic disease was used in classifying the patients. The study period covered January 2008-June 2012. RESULTS: A total of 53 patients were identified constituting 37.3% of all eyelid diseases. Thirty-three (62.3%) were males. Forty-eight (90.6%) had ectropion, 43(89.6%) of which were cicatricial ectropion. Five (9.4%) had entropion. The median age group affected was 30-39 years (26.4%). There were no cases of congenital ectropion or entropion. The leading etiological factor was trauma in 36 cases (67.9%), which was mostly due to road traffic accidents (50.9%). CONCLUSIONS: This study highlights a difference in etiopathophysiology of ectropion and entropion in a sub-Saharan region when compared to reported data from developed countries. In Nigeria, ectropion (which is often cicatricial) is usually secondary to trauma whereas senile involution is the common cause in many developed countries. This finding has implications in appropriate planning and skill acquisition for surgical correction in this group of patients.

Ectropion and Entropion in Sub-Saharan Africa: How do we Differ?

Aims: To study the etiopathophysiology of ectropion and entropion in a sub-Saharan tertiary eye care center and examine how it differs from reports elsewhere. Methods and Materials: This was a retrospective audit of all consecutive patients who presented with ectropion or entropion to the oculoplastics clinic of a tertiary eye care unit. We reviewed the medical records of all such patients and data extracted include age; gender; etiopathology; and diagnosis. The primary oculoplastic disease was used in classifying the patients. The study period covered January 2008-June 2012. Results: A total of 53 patients were identified constituting 37.3 of all eyelid diseases. Thirty-three (62.3) were males. Forty-eight (90.6) had ectropion; 43(89.6) of which were cicatricial ectropion. Five (9.4) had entropion. The median age group affected was 30-39 years (26.4). There were no cases of congenital ectropion or entropion. The leading etiological factor was trauma in 36 cases (67.9); which was mostly due to road traffic accidents (50.9). Conclusions: This study highlights a difference in etiopathophysiology of ectropion and entropion in a sub-Saharan region when compared to reported data from developed countries. In Nigeria; ectropion (which is often cicatricial) is usually secondary to trauma whereas senile involution is the common cause in many developed countries. This finding has implications in appropriate planning and skill acquisition for surgical correction in this group of patients

Protein kinase D1 maintains the epithelial phenotype by inducing a DNA-bound, inactive SNAI1 transcriptional repressor complex.

BACKGROUND: Protein kinase D1 is downregulated in its expression in invasive ductal carcinoma of the breast and in invasive breast cancer cells, but its functions in normal breast epithelial cells is largely unknown. The epithelial phenotype is maintained by cell-cell junctions formed by E-cadherin. In cancer cells loss of E-cadherin expression contributes to an invasive phenotype. This can be mediated by SNAI1, a transcriptional repressor for E-cadherin that contributes to epithelial-to-mesenchymal transition (EMT). METHODOLOGY/PRINCIPAL FINDINGS: Here we show that PKD1 in normal murine mammary gland (NMuMG) epithelial cells is constitutively-active in its basal state and prevents a transition to a mesenchymal phenotype. Investigation of the involved mechanism suggested that PKD1 regulates the expression of E-cadherin at the promoter level through direct phosphorylation of the transcriptional repressor SNAI1. PKD1-mediated phosphorylation of SNAI1 occurs in the nucleus and generates a nuclear, inactive DNA/SNAI1 complex that shows decreased interaction with its co-repressor Ajuba. Analysis of human tissue samples with a newly-generated phosphospecific antibody for PKD1-phosphorylated SNAI1 showed that regulation of SNAI1 through PKD1 occurs in vivo in normal breast ductal tissue and is decreased or lost in invasive ductal carcinoma. CONCLUSIONS/SIGNIFICANCE: Our data describe a mechanism of how PKD1 maintains the breast epithelial phenotype. Moreover, they suggest, that the analysis of breast tissue for PKD-mediated phosphorylation of SNAI1 using our novel phosphoS11-SNAI1-specific antibody may allow predicting the invasive potential of breast cancer cells.

Orbital cellulitis: clinical course and management challenges. the Lagos State University Teaching Hospital experience.

BACKGROUND: Orbital cellulitis is a devastating acute infection of orbital soft tissues located posterior to the orbital septum. It is both vision and life-threatening. It is an ocular emergency which most often present in childhood. OBJECTIVE: This article reviewed cases presenting during the study period with the view of examining the pattern of presentation, clinical course and management challenges. METHODS: A retrospective study was conducted on patients presenting with orbital cellulitis between January 2008 and June 2011. Socio-demographic data, entry and discharge visual acuity, presenting complaints, predisposing factors, duration of complaints, admission period and complications were extracted from clinical records and analyzed. RESULTS: Seventeen (17) patients presented with orbital cellulitis constituting 6.2% of ocular emergency admissions during the study period. Twelve (70.6%) were males. Thirteen (76.5%) were children. The major predisposing factors were upper respiratory tract infections, and facial and globe injuries in five (22.7%) cases respectively. Only five (29.4%), presented within three days of disease onset. Average duration of admission was 10.6 days. Complications during the course of disease were category 4 and 5 blindness in five (23.5%), orbital abscess four (23.5%), cavernous sinus thrombosis two (11.8%), contralateral preseptal cellulitis two (11.8%) and exposure keratopathy in one (5.9%). CONCLUSION: Orbital cellulitis has remained a disease with high ocular morbidity. The major management challenges were poor financial status of patients precluding necessary diagnostic laboratory and imaging studies. Early recognition, diagnosis and treatment are crucial to the preservation of vision and reduced occurrence of complications. The importance of record keeping is also highlighted.