Retinopathy among Adult Diabetics and Its Predictors in Northwest Ethiopia.

BACKGROUND: Diabetic retinopathy is the leading cause of blindness among working-aged adults worldwide, including developing countries such as Ethiopia, and the burden of diabetes-related blindness is undeniably posing a massive challenge to the health care system. Diabetes and its micro- and macrovascular complications are becoming more prevalent among Ethiopian diabetics. For that reason, the purpose of this study was to assess the incidence of diabetic retinopathy and its predictors among diabetics in Ethiopia. METHODS: A hospital-based retrospective cohort study was conducted using 494 randomly selected diabetics aged above 18 years at Felege Hiwot Comprehensive Specialized Hospital from 2011 through 2014 and was followed until December 2019. The preliminary and longitudinal data was abstracted into demographics, clinical, and physiological attributes using a standardized structured questionnaire. The collected data was entered into the system using EpiData version 4.2 and analyzed using STATA version 14.0. The survival experience of the patients was assessed using the Kaplan-Meier survivor function. The predictors of diabetic retinopathy were identified by the Cox proportional hazard model. Bivariable and multivariable Cox proportional hazard models were computed, and variables having a P value of < 0.05 in the multivariable Cox proportional hazard model were declared as significant predictors of diabetic retinopathy. RESULTS: During the follow-up, the overall incidence rate of diabetic retinopathy was 48 per 1000 person-years (95% CI: 40.0-57.0). Age in years (AHR 1.02; 95% CI: 1.00-1.04), fasting blood sugar level (AHR 1.02; 1.00-1.04), hypertension (AHR 2.61; 95% CI: 1.47-4.63), DM patients who had LDL > 100 mg/dl (AHR 2.73; 95% CI: 1.32-5.64), total cholesterol > 200 mg/dl (AHR 2.22; 95% CI: 1.08-4.55), and positive proteinuria (AHR 1.74; 95% CI: 1.10 -2.73) were found to be the significant predictors of diabetic retinopathy. CONCLUSION: The overall incidence rate of diabetic retinopathy was found to be high in both type 1 and type 2 DM. Age, fasting blood sugar levels, hypertension, proteinuria, dyslipidemia, and high systolic blood pressure were all predictors of the development of diabetic retinopathy. Controlling glycemia, dyslipidemia, proteinuria, and blood pressure is critical for halting the progression of diabetic retinopathy.

Kartagener's syndrome: a case report.

BACKGROUND: Kartagener's syndrome is a subset of primary ciliary dyskinesia, an autosomal recessive inherited disorder characterized by the clinical triad of chronic sinusitis, bronchiectasis, and situs inversus. Abnormal ciliary structure or function leading to impaired ciliary motility is the main pathophysiologic problem in Kartagener's syndrome. CASE PRESENTATION: A 24-year-old man from Gondar town, North-West Ethiopia, presented to University of Gondar Hospital with recurrent episodes of nasal congestion with itching and paranasal discomfort, and productive cough for more than a decade. Clinical and imaging findings revealed chronic sinusitis, bronchiectasis, dextrocardia, and situs inversus. He was treated with orally administered antibiotics, mucolytic, and chest physiotherapy. He was symptomatically better with the above therapy, and started on a long-term low-dose prophylactic antibiotic. CONCLUSIONS: Patients with Kartagener's syndrome exist in Ethiopia as cases of chronic recurrent sinopulmonary infections. As there is no easy, reliable non-invasive diagnostic test for Kartagener's syndrome and the correct diagnosis is often delayed by years, it may cause chronic respiratory problems with reduced quality of life. Genetic counseling and fertility issues should be addressed once Kartagener's syndrome is diagnosed.