Must we remain blind to the need for clinical ethics support services in Africa? Eyes on Nigeria.

Hospitals and healthcare workers in Africa, and Nigeria specifically, are increasingly being confronted by complex situations, in which decision-making becomes more troublesome in the presence of conflicting goals, values, and preferences among the respective stakeholders. Given that all healthcare decision-making requires ethical considerations, and there is a noted absence or paucity of documentation of institutionalized mechanisms for addressing any associated concern or dilemma in Nigeria, it is thus unclear how most hospitals, healthcare workers, and the public handle the ethical dimensions of patients' care and hospital practice, while also generating possibilities for improvement in care quality. This paper is an attempt to heighten awareness of the need for clinical ethics support services (CESS) in Nigeria and encourage thought, reflection and dialogue over the issues raised.

Comparing the Use of Smartphone and Vernier Calipers for Corneal Diameter Measurement in Nigerian Term Neonates.

Background: Corneal diameter (CD) measurement in newborns is essential for the detection of blinding ocular pathologies. It requires specially trained personnel, contact techniques, and the use of anesthesia. Smartphone use may obviate these challenges.

Spectacle design preferences among school children in Enugu State, Nigeria.

Background: Uncorrected refractive error has profound effects on children's educational and social development and spectacles are cost-effective in correcting this. However, the cosmetic appearance of spectacles may affect compliance to prescribed spectacles.

Aims: This study explored spectacle design preferences of school children in Enugu State, Nigeria and any associated sociodemographic factors.

Current pattern of ocular trauma as seen in tertiary institutions in south-eastern Nigeria.

Background: Ocular trauma is a leading cause of monocular blindness worldwide and in developing countries, are not only more common but also more severe. Industrialization and urbanization may alter or modify prevalent aetiological factors and the presentation of ocular trauma.

Objective: To determine the current pattern of eye injuries in Teaching Hospitals in Enugu State.

Utilizing Telemedicine for Delivery of Postoperative Care Following Minimally Invasive Gynecologic Surgery: A Randomized Controlled Trial.

Objectives: Determine if patient satisfaction is greater after delivering postoperative care via telemedicine following minimally invasive gynecologic surgery.

Materials And Methods: University-based outpatient clinic; Randomized controlled trial (Canadian Task Force classification I). Females between 18 and 60 years of age scheduled to undergo laparoscopic hysterectomy or laparoscopic excision of endometriosis were invited to participate.

Refractive Error and Visual Impairment Among School Children: Result of a South-Eastern Nigerian Regional Survey.

Purpose: To determine the prevalence refractive errors and causes of visual impairment in school children in the south-eastern region of Nigeria.

Methods: School-based cross-sectional samples of children 5 to 15 of age in both urban and rural areas were profiled through cluster sampling. The main outcome measures were presenting, uncorrected, and best-corrected visual acuity using the Refractive Error in School-age Children (RESC) protocol.

Technical capacities needed to implement the WHO's primary eye care package for Africa: results of a Delphi process.

Objective: The aim of the study was to establish the technical capacities needed to deliver the WHO African Region's primary eye care package in primary healthcare facilities.

Design: A two-round Delphi exercise was used to obtain expert consensus on the technical complexity of each component of the package and the technical capacities needed to deliver them using Gericke's framework of technical feasibility. The panel comprised nine eyecare experts in primary eyecare in sub-Saharan Africa.

Prevalence of refractive errors and visual impairment in school children in Enugu South-East Nigeria.

Aims: To determine the prevalence of refractive errors and causes of visual impairment in school children in Enugu State, South-eastern Nigeria.

Methods: A descriptive cross-sectional, school-based survey in children aged 5-15 years from selected primary and junior secondary schools (public and private) in both urban and rural communities of Enugu State was carried out. Ocular examinations were performed on them according to the Refractive Error in School-age Children (RESC) protocol.

Conjunctival bacterial flora and their antibiotic sensitivity among patients scheduled for cataract surgery in a tertiary hospital in south-east Nigeria.

Purpose: To determine the pre-operative conjunctival bacteria flora and their antibiotic susceptibility among patients scheduled for cataract surgery.

Methods: A descriptive, cross-sectional, hospital-based study design was adopted. It involved 104 consecutive, consented patients scheduled for cataract surgery at the University of Nigeria Teaching Hospital Enugu, from June to September 2017.

Relationship between corneal biomechanical properties among pregnant women in a tertiary hospital in Nigeria.

Objective: In Nigeria, many pregnant women as well as health-care providers are unaware of the effect of pregnancy on the eye. The present study investigated the changes in central corneal thickness (CCT), corneal sensitivity (CS), and intraocular pressure (IOP) among pregnant women in a tertiary hospital in Nigeria and the relationship between them.

Materials And Methods: A prospective longitudinal study was used.

Dermoid of the Posterior Fossa in Chiari II Malformation: The First Reported Case.

Dermoid cysts are rare lesions, particularly in children. Chiari II malformations are seen in patients with myelomeningocele. Here, we present a child with Chiari II malformation who, during a Chiari II decompression, was found to have a dermoid cyst.

Giant Arachnoid Granulation Associated with Anomalous Draining Vein: A Case Report.

Giant arachnoid granulations (AG) can mimic intracranial lesions. Knowledge of these structures can help avoid misdiagnosis when interpreting imaging. Here, we report a child who presented with a mass within the superior sagittal sinus and an anomalous draining vein.

Unusual Manifestation of Superior Mesenteric Artery Syndrome in a Female Patient: A Case Presentation.

Superior mesenteric artery (SMA) syndrome is a rare clinical entity. We report a female patient presenting with abdominopelvic pain and diagnosed with superior mesenteric artery syndrome. Direct venography revealed a large ovarian varix that was treated with hysterectomy and unilateral oophorectomy.

Ectopic arachnoid granulation involving a rare intracranial venous sinus variant.

Arachnoid granulations are hypertrophied arachnoid villi, which extend from the subarachnoid space into the venous system and aid in the passive filtration and reabsorption of cerebrospinal fluid. These macroscopic structures have been described in various locations, with the transverse and sigmoid sinuses seen as normal variants on imaging. Here we present the occurrence of an enlarged arachnoid granulation at the foramen rotundum where a variant intracranial venous sinus was identified during routine dissection.

Dry Eye Disease: Concordance Between the Diagnostic Tests in African Eyes.

Objective: To assess the concordance between the diagnostic tests for dry eye disease (DED) in a Nigerian hospital population.

Methods: The study was a hospital-based cross-sectional survey of adults (≥18 years) presenting at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu; September-December, 2011. Participants' socio-demographic data were collected.

Herpes Simplex Encephalitis of the Parietal Lobe: A Rare Presentation.

A 69-year-old female with a history of breast cancer and hypertension presented with a rare case of herpes simplex encephalitis (HSE) isolated to her left parietal lobe. The patient's first biopsy was negative for herpes simplex virus (HSV) I/II antigens, but less than two weeks later, the patient tested positive on repeat biopsy. This initial failure to detect the virus and the similarities between HSE and symptoms of intracranial hemorrhage (ICH) suggests repeat testing for HSV in the presence of ICH.

Transforaminal Ligaments of the Lumbar Spine: A Comprehensive Review.

Once considered anomalous structures, transforaminal ligaments are not widely known and the criteria for identifying and classifying them are not universal. They are, however, of potential importance during neurological procedures, as their entrapment might lead to radicular pain. Transforaminal ligaments are not present in all patients, but when they are, the incidence of all types of ligaments is significantly higher, with the most common type being the superior corporotransverse ligament.

Eye Injuries Among Primary School Children in Enugu, Nigeria: Rural vs Urban.

A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope.

The performance evaluation of a urine malaria test (UMT) kit for the diagnosis of malaria in individuals with fever in south-east Nigeria: cross-sectional analytical study.

Background: Accurate rapid diagnosis is one of the important steps in the effort to reduce morbidity and mortality of malaria. Blood-specific malaria rapid diagnostic tests (RDTs) are currently in use but other body fluid specific diagnostic test kits are being developed. The aim of the present study was to evaluate the performance characteristics of a one-step Urine Malaria Test™ (UMT) dipstick in detecting Plasmodium falciparum HRP2, a poly-histidine antigen in urine of febrile patients for malaria diagnosis.

Prevalence of presbyopia in a rural African community.

Introduction: When presbyopia (loss of accommodation of the crystalline lens with increasing age) sets in, doing near work becomes associated with headache and eye strain. Reading and writing become a challenge. Literacy levels may be low in rural communities; nevertheless some work other than reading, like sewing, sorting stone from grain and operating mobile phones, is done with dissatisfaction.

Immunogenicity and safety of the candidate RTS,S/AS01 vaccine in young Nigerian children: a randomized, double-blind, lot-to-lot consistency trial.

Background: For regulatory approval, consistency in manufacturing of vaccine lots is expected to be demonstrated in confirmatory immunogenicity studies using two-sided equivalence trials. This randomized, double-blind study (NCT01323972) assessed consistency of three RTS,S/AS01 malaria vaccine batches formulated from commercial-scale purified antigen bulk lots in terms of anti-CS-responses induced.

Methods: Healthy children aged 5-17 months were randomized (1:1:1:1) to receive RTS,S/AS01 at 0-1-2 months from one of three commercial-scale purified antigen bulk lots (1600 litres-fermentation scale; commercial-scale lots), or a comparator vaccine batch made from pilot-scale purified antigen bulk lot (20 litres-fermentation scale; pilot-scale lot).

Prevalence and profile of ophthalmic disorders in oculocutaneous albinism: a field report from South-Eastern Nigeria.

To assess the burden and spectrum of refractive and non-refractive ophthalmic disorders in south-eastern Nigerians with oculocutaneous albinism. In a population-based survey in Enugu state, between August, 2011 and January, 2012, albinos were identified using the database of the Enugu state's Albino Foundation, and mass media-based mobilisation. The participants were enrolled at the Eye Clinics of the University of Nigeria Teaching Hospital and Enugu State University of Science and Technology Teaching Hospital using a defined protocol.

Oculocutaneous albinism: identifying and overcoming barriers to vision care in a Nigerian population.

To assess eye care service utilization, and identify access barriers in a south-eastern Nigerian albino population. The study was a population-based, cross-sectional survey conducted in Enugu state between August, 2011 and January, 2012. Using the data base of the state's Albino Foundation and tailored awareness creation, persons living with albinism were identified and recruited at two study centres.

Dry eye disease: prevalence, distribution and determinants in a hospital-based population.

Objectives: To determine the prevalence, distribution and risk factors for dry eye disease (DED) in a tertiary ophthalmic outpatient population.

Methods: The study was a cross-sectional descriptive hospital-based survey conducted at the Eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between September and December, 2011. The participants comprised adult ophthalmic outpatients aged 18 years or older.

Prevalence of eye diseases among school children in a rural south-eastern Nigerian community.

Introduction: Vision has an essential role in a child's development, and visual deficit is a risk factor not only for altered visio-sensory development, but also for overall socioeconomic status throughout life. Early detection provides the best opportunity for effective treatment of eye and vision problems in children. Therefore, timely screening is vital to avoid lifelong visual impairment.