ABSTRACT
A baby born at home 14 hours earlier was brought to the neonatology department with bilateral upper palpebral chemosis with purulent secretions and pseudomembranes, with no general signs of infection. The gram staining of a secretion sample shows the presence of Neisseria gonorrhoeae. Intramuscular ceftriaxone treatment was initiated, combined with topical application of rifamycin, dexamethasone, and oxytetracycline. Complete healing without sequelae was obtained after two weeks. This case presents an opportunity to review this preventable pathology and its treatment. The only effective way to prevent it is to raise the awareness of disadvantaged population about the value of antenatal care.
Subject(s)
Ophthalmia Neonatorum/drug therapy , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Dexamethasone/therapeutic use , Female , Glucocorticoids/therapeutic use , Humans , Infant, Newborn , Oxytetracycline/therapeutic use , Rifamycins/therapeutic useABSTRACT
INTRODUCTION: Retinopathy is a chronic complication with severe functional consequences in patients with sickle cell disease. Its prevalence is not well known in sub-Saharan Africa because of the absence of screening. We report here the results of a routine screening for sickle retinopathy in a Comprehensive Sickle Cell Center in Sub-Saharan Africa. METHODS: Screening of sickle retinopathy was carried out in all sickle cell patients aged 10 and over, followed between 2010 and 2012. Retinopathy was screened by dilated indirect fundoscopic examination and retinal angiography, if necessary. The gender, age and hematological parameters of patients with sickle retinopathy were compared with those of controls randomly selected from the cohort of sickle cell patients without retinopathy followed during the same period. RESULTS: The overall prevalence of sickle cell retinopathy was 8.8% (142/1604): 12.4% (91/731) in SC, 5.2% (38/734) in SS, 9.4% (5/53) in Sß°-thalassemia patients and 9.3% (8/86) in Sß+-thalassemia patients. Proliferative retinopathy was more common in SC patients (P<0.01). High levels of hemoglobin or of hematocrit were associated with retinopathy in all patients and with proliferative retinopathy in SC patients. In SS or Sß0thalassemia patients, high leukocyte count was associated with proliferative retinopathy. Low fetal hemoglobin level was associated with retinopathy in all groups. CONCLUSION: The prevalence of sickle cell retinopathy is high and negatively associated to the level of fetal hemoglobin. The efficiency of a routine screening for sickle cell retinopathy must be assessed in Africa as well as the benefit of phlebotomy and hydroxyurea therapy as a preventive treatments.
Subject(s)
Anemia, Sickle Cell/complications , Anemia, Sickle Cell/epidemiology , Retinal Diseases/epidemiology , Retinal Diseases/etiology , Adolescent , Adult , Africa South of the Sahara/epidemiology , Female , Hospitals, Special , Humans , Male , Prevalence , Risk Factors , Young AdultABSTRACT
INTRODUCTION: Treatment of cataract blindness is surgical to restore vision. The aim of this work was to compare the PKA to the classic EEC in the surgical treatment of adult cataract in terms of anatomical and functional results in our institute. MATERIALS AND METHODS: This was a cross-sectional study of 333 operated eyes of cataract of the adult and followed for one month. The postoperative functional data and the causes of poor results were specified. RESULT: A total of 172 men (51.7%) and 161 women (48.3%) underwent cataract surgery. The mean age was 64.2 years. 61.26% of patients had visual acuity (≥3 / 10) in EEC compared with 65.28% in PKA. (21%) for EEC, and (15%) for PKA had poor visual acuity (<1/10). The proportion of patients with good results increases with the best correction to 77.3% for EEC and 91.5% for PKA. The poor results close to those of the WHO in both techniques (6.7%). EEC and (5.3%) PKA. The poor results were mainly related to pre-existing pathologies (6.6%) and astigmatism related to surgery (7.1%). CONCLUSION: In order to achieve the objectives of "Vision 2020", within the framework of the fight against blindness, it is imperative to facilitate the popularization of the PKA throughout the African subregion.
INTRODUCTION: Le traitement de la cécité par cataracte est chirurgical permettant ainsi de restaurer la vision. Le but de ce travail était de comparer la phacomanuelle sans suture (PKA) à l'extraction extra capsulaire (EEC) classique dans le traitement chirurgical de la cataracte de l'adulte en terme de résultats anatomiques et fonctionnels dans notre institut. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale sur 333 yeux opérés de cataracte de l'adulte et suivis pendant un mois. Les données fonctionnelles postopératoires et les causes de mauvais résultats ont été précisées. RÉSULTATS: Au total 172 hommes (51,7%) et 161 femmes (48,3%) ont subi une chirurgie de la cataracte. L'âge moyen était de 64,2 ans. L'acuité visuelle était bonne (≥3/10) chez (61,26 %) de nos patients en EEC contre (65,28%) en PKA. En EEC, (21%) et (15%) pour la PKA avaient une mauvaise acuité visuelle (<1/10). La proportion des patients avec de bons résultats augmente avec la meilleure correction à (77,3%) pour EEC et (91,5%) pour la PKA. Les mauvais résultats avoisinent ceux de l'OMS dans les deux techniques (6,7%) EEC et (5,3%) PKA. Les mauvais résultats étaient principalement liés aux pathologies préexistantes (6,6%) et astigmatismes liés à la chirurgie (7,1%). CONCLUSION: Pour atteindre les objectifs de la « vision 2020 ¼, dans le cadre de la lutte contre la cécité, il est impératif de faciliter la vulgarisation de la PKA dans toute la sous-région africaine.
ABSTRACT
INTRODUCTION: The treatment of cataract blindness is surgical, allowing restored vision. The purpose of this study was to evaluate the functional results of cataract surgery in adults in a tertiary care referral center. PATIENTS AND METHODS: Prospective study of 2012 eyes operated for adult cataract from September 1, 2009 to August 31, 2010 (12 months). The results were analyzed by the Monitoring Cataract Surgical Outcomes software (MCSO). The postoperative functional data and the causes of poor outcomes were identified. RESULTS: A total of 1044 women (51.9%) and 968 men (48.1%) underwent cataract surgery. Mean age was 65 years. Extracapsular cataract extraction (ECCE), and manual sutureless small incision cataract surgery (SICS) with posterior chamber IOL implantation in 98%, were the main surgical techniques. Functional results indicated that 45.5% of our patients had good visual acuity (≥3/10) with current spectacles, 33% had limited visual acuity (1/10-2/10), and 21.6% had poor visual acuity (<1/10). The proportion of patients with good results improved with best spectacle correction to 63%, vs. 22.9% with limited visual acuity and 14.1% with poor outcomes. The causes of poor outcomes were mainly related to surgical complications (42.1%) and refractive errors (34.8%). DISCUSSION: These results are inferior to WHO standards, which recommend a rate greater than or equal to 80% for good outcomes and a rate below 5% for bad outcomes. CONCLUSION: The identification of the causes of poor outcomes underscores the importance of improving surgical skills and the need for postoperative refraction.
