Pseudoexfoliation in a rural Burmese population: the Meiktila Eye Study.

AIMS: The aim of this study was to report on the prevalence and correlates of pseudoexfoliation syndrome (PXF) in a rural Burmese population. METHODS: The study was a cross-sectional, population-based survey of the inhabitants > or =40 years in the Meiktila District. Ophthalmic examination included Snellen visual acuity, slit lamp examination, tonometry, gonioscopy, dilated fundus examination and frequency doubling perimetry. RESULTS: In a population of 2076 subjects (4016 eyes) the prevalence of PXF was 3.4% (95% CI 2.14 to 4.67%; 78 eyes). Twelve eyes with PXF were blind. In the univariate analysis, PXF was associated with: increasing age, blindness (odds ratio (OR) 4, 95% CI 1.84 to 8.68; p<0.0004), increasing intraocular pressure (IOP) (OR 1.08, 95% CI 1.04 to 1.11; p<0.00001), nuclear cataract (OR 6.92, 95% CI 2.89 to 16.59; p<0.00001), cortical cataract (OR 4.78, 95% CI 2.37 to 9.65; p<0.00001) and the presence of an occludable angle (OR 3.05, 95% CI 1.52 to 6.13; p<0.002). In the multivariate analysis, only increasing age and IOP remained significantly associated with PXF. CONCLUSIONS: The prevalence of PXF in the Burmese population is greater than previously reported in other East Asian populations. Increasing age and IOP are the strongest predictors of PXF, and it is associated with cataract, occludable angles and blindness.

Correlation of some biochemical parameters with clinical features of protein energy malnutrition.

The authors report on a study correlating the laboratory findings of children with protein energy malnutrition (PEM) with their clinical presentations. Forty-nine cases of marasmus, 17 of kwashiorkor and 28 of marasmic-kwashiorkor, as well as 20 controls, were studied and monitored in hospital. Fasting plasma samples obtained on days 2, 14 and 21 were analyzed for total proteins, albumin, triglycerides and cholesterol. Blood glucose and haemoglobin were also determined. The total plasma proteins and albumin were significantly lower in all the malnourished cases compared to the controls, with marked hypoproteinaemia among those cases with kwashiorkor. Plasma triglycerides were significantly lower in the malnourished group, when compared to controls. With dietary treatment, plasma triglycerides rose significantly accompanied with regression in liver size. Four out of the 17 children with kwashiorkor, had died; they had the lowest serum albumin concentrations of all the cases studied. The mean haemoglobin concentration of those who died was also significantly lower than that of the survivors.

Glycosylated hemoglobin levels in Sudanese sickle cell anemia patients.

Glycosylated hemoglobin was measured, by a colorimetric method, in 49 patients with sickle cell anemia attending Khartoum Teaching Hospital. The level obtained (4.9%, SD 1.3) was significantly lower than the control value (5.6%, SD 0.2; p less than 0.0025). Expressed as percentage of the control value, the glycosylated hemoglobin level in these patients was 81%. This falls midway between the 90% reported in a benign form of sickle cell anemia in Saudi Arabia and the 58% reported in a severe form in an American Black group, which gives support to the observed heterogeneity of sickle cell anemia. Alternatively, glycosylated hemoglobin level in 27 subjects with sickle cell trait (5.6%, SD 0.2) was identical to that of the controls. The state of hemolysis in the sickle cell anemia patients, as indicated by bilirubin levels, did not correlate with the glycosylated hemoglobin values. Although glycosylated hemoglobin measurement is affected by red cell survival, it does not reflect the state of ongoing hemolysis.

Tumors of the brain in the Sudan.

One hundred twenty-three cases of tumors of the brain encountered in patients admitted over a 10-year period (1971-1981) at the Neurosurgical Section, Shaab Teaching Hospital, Khartoum, Sudan are presented. Special emphasis is directed at the high incidence (45.5%) of meningiomas. Clinical and pathological findings are reported.

Fibromuscular dysplasia of the cervico-cephalic arteries.

Six cases of fibromuscular dysplasia of the cervical and cephalic portions of the internal carotid arteries, including their intracranial branches are reported. It should perhaps be pointed out that one of the cases was from the Sudan. As far as we know, the condition has never before been reported in a male African. The condition was associated with an intracranial aneurysm in four of our cases. To our knowledge only three autopsied cases of fibromuscular dysplasia involving intracranial arteries are on record. In our six cases the diagnosis was based on angiographic evidence, and three of the cases, two with intracranial involvement, were verified post mortem.