scholarly journals Prevalence and predictors of ocular complications among children with nephrotic syndrome in a resource-limited setting

2020 ◽  
Author(s):  
Faith Nakubulwa ◽  
Rebecca Claire Lusobya ◽  
Anthony Batte ◽  
Bashir Ssuna ◽  
Damalie Nakanjako ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
High Dose ◽  
Renal Unit ◽  
Ocular Complications ◽  
Cross Sectional ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children with nephrotic syndrome receiving care at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three (3) months at pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71%(95%CI 61.1–79.6) and 56%(95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) P = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

scholarly journals Prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment in a resource-limited setting

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Faith Nakubulwa ◽  
Rebecca Claire Lusobya ◽  
Anthony Batte ◽  
Bashir Ssuna ◽  
Damalie Nakanjako ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
High Dose ◽  
Renal Unit ◽  
Ocular Complications ◽  
Cross Sectional ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Abstract Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three [3] months at the pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71% (95%CI 61.1–79.6) and 56% (95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) p = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist.

scholarly journals Ocular and extra-ocular complications following long-term steroid consumption in children with idiopathic nephrotic syndrome

2020 ◽  
Vol 11 (1) ◽  
pp. 7-10
Author(s):  
Gulshan Nigar Chaudhury ◽  
Tarannum Khandaker ◽  
Tahmina Ferdous ◽  
Rifat Asma Chowdhury ◽  
Shireen Afroz ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Intraocular Pressure ◽  
Bone Pain ◽  
Idiopathic Nephrotic Syndrome ◽  
Epigastric Pain ◽  
Cross Sectional Study ◽  
High Dose ◽  
Ocular Complications ◽  
Cross Sectional ◽  
The Mean

Background: High dose of corticosteroids are required by patients with idiopathic nephrotic syndrome for long duration due to repeated relapse. The aims of this study were to analyze the ocular and extra-ocular complications of steroids on children with nephrotic syndrome. Methods: This cross-sectional study was conducted at Dhaka Shishu (Children) Hospital from September 2017 to September 2019. Children with nephrotic syndrome between 1-16 years of age, who received steroid for at least three months, participated in this study. Total 70 children were enrolled. Detailed history was taken from parents regarding initial episode, drug history, visual problem, headache, hypertension, weight gain, psychosis, bone pain, epigastric pain and excessive growth of body hair. Comprehensive opthalmologic assessment including visual acquity, intraocular pressure and cataract were performed. Detail of renal histopathology and treatment regimen in each patient was noted. Results: A total of 70 patients were included, 61.4% were male and 38.6% were female. Median age at the time of examination was 60 months (range 17 to 216 months). The mean duration of disease was 33.71±21.12 months. The mean cumulative steroid dose at the time of examination was 8485.91±7326.83 mg. Fourteen (20%) patients had posterior subcapsular cataract. Among 70 patients, we could do visual acuity for 25 (35.7%) patients, intraocular pressure (IOP) in mm for 51 (72.85%) patients. Among them raised IOP was found in five (9.8%) patients. In right eye mean IOP was 14.16±3.57 and for left eye 14.77±3.55 mm. Renal biopsy was performed in 15 (21.43%) cases. Among the biopsy report, it was found that mesangial proliferative glomerulonephritis (MPGN) in 8 (53.33%), focal segmental glomerulonephritis (FSGS) in 2 (13.33%) and minimal change in 5 (33.34%) cases. Among all cases, 12 (17.14%) patients developed Cushingoid facies, 3 (4.2%) patients had hypertrichosis, 3 (4.2%) patients had central obesity and 4 (5.7%) patients had buffalo hump but none had hypertension, diabetes mellitus, epigastric pain, bone pain or psychosis. Conclusion: Cataract formation was the most frequent ocular complication after large dose of oral corticosteroid therapy. The present study emphasizes the need for regular eye screening. Cushingoid facies was the most frequent among extra-ocular complications. Birdem Med J 2021; 11(1): 7-10

Midwives' practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda

2020 ◽  
Vol 14 (1) ◽  
pp. 1-12
Author(s):  
Ziidah Namwaya ◽  
Imelda Namagembe ◽  
Dan Kaye ◽  
Gorrette Nalwadda ◽  
Grace Edwards ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Current Practice ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Mulago Hospital ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
Mulago National Referral Hospital ◽  
Perception Of Care ◽  
National Referral Hospital

Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Conclusions Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.

scholarly journals Factors associated with delayed uptake of cataract surgery among adult patients at Mulago National Referral Hospital, Uganda

2021 ◽  
Vol 21 (3) ◽  
pp. 1259-1265
Author(s):  
Francis O Sebabi ◽  
Walter O Okello ◽  
Faith Nakubulwa ◽  
Rogers Sempindu ◽  
Catherine Driciru ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Adult Patients ◽  
Sub Saharan Africa ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Mulago National Referral Hospital ◽  
National Referral Hospital

Background: Cataract is the leading cause of blindness globally. Many patients with cataract in developing countries delay to come for cataract surgery. Objectives: This study aimed to determine the factors associated with delayed uptake of cataract surgery among adult pa- tients seen at Mulago National Referral Hospital eye clinic in Uganda. Methods: Employing a hospital based cross-sectional study, adult patients with cataract and having moderate visual impair- ment or blindness were recruited. Patient-related factors for delayed surgery were assessed using a predetermined question- naire. Data was analyzed using stata version 14.2. Logistic regressions were used to determine the factors associated with delayed uptake of cataract surgery among these patients. Results: Eighty two participants with operable cataract were evaluated. Females were 44 (54%) and the mean age of partic- ipants was 67 years. Fifty three (65%) had delayed uptake of cataract surgery. The factors associated with delayed uptake of cataract surgery among patients with cataract were financial constraint, felt no need for surgery and good unilateral vision. Conclusions: Financial constraints, no felt need for cataract surgery and having good unilateral vision are the factors asso- ciated with delayed uptake of cataract surgery among cataract patients. We recommend cataract surgical outreach to remote areas and health education. Keywords: Risk factors; operable cataract; cataract; surgery; Uganda; sub-Saharan Africa.

scholarly journals Pterygium and associated factors among adults: a hospital-based prospective study

2020 ◽  
Vol 6 (1) ◽  
pp. 32-37
Author(s):  
Chhimi Wangmo ◽  
Nor Tshering Lepcha
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Adult Patients ◽  
Age Group ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
High Prevalence ◽  
Grade 3 ◽  
National Referral Hospital

Introduction: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium wasmost common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusion: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium

scholarly journals Bacterial profile of meconium of neonates born at National Referral Hospital Cipto Mangunkusumo, Jakarta, Indonesia

2020 ◽  
Vol 2 (7A) ◽  
Author(s):  
Amarila Malik ◽  
Grasella Ong ◽  
Firsty Amanah Prasetyaningsih ◽  
Kristien Juni ◽  
Radhian Amandito ◽  
...  
Keyword(s):  
Bacterial Diversity ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Microbial Colonization ◽  
Feeding Patterns ◽  
Cross Sectional ◽  
Cultivable Bacteria ◽  
16S Rdna Pcr ◽  
National Referral Hospital

Microbial colonization of a neonate’s gastrointestinal tract has significant perinatal and lifetime health consequences, with some clinical outcomes that have been linked to differences in the diversity and composition of gut microbiota. The effort to engineer intestinal ecosystem has led us to preserve the cultivable commensal microbiota. Here we investigated the association of cultivable bacterial diversity of neonates meconium from Indonesian National Referral Hospital Cipto Mangunkusumo (NRHCM) with mode of delivery and feeding patterns, as well as hyperbilirubinemia. We performed a cross-sectional study of meconium and clinical data collected from 14 Indonesian neonates born at NRHCM. Culture-dependent identification of bacterial isolates was conducted by performing simultaneous microbiological and molecular 16S rDNA PCR-Sanger sequencing methods. Phylogenetic tree and principal components analysis were employed to determine the bacterial profile and their association with clinical characteristics and outcomes. Cultivable bacterial profile indicates the predominance of Firmicutes (84,41%), with an abundant population of Staphylococcus (53.24%) with top three most significant population present are, i.e. S. hominis (12.99%), S. epidermidis (11.68%), and S. haemolyticus (10.39%). Bacterial diversity was associated with mode of delivery which showed that vaginal route populated by lower diversity of cultivable bacteria but by fewer opportunistics one than that of cesarean, with Staphylococcus hominis dominates the population, whereas with feeding patterns showed that the exclusive breast-fed was most populated by Staphylococcus, whereas non-exclusive one shared the same proportion of Staphylococcus and Bacterioides. While, non-hyperbilirubinemia group showed more abundant and diverse Staphylococcus than that of the opposite group.

Sign in / Sign up

Export Citation Format

Share Document