Patient Education and Medication Adherence among Hypertensives in a Tertiary Hospital, South Western Nigeria

Background

Hypertension is a global health issue among the adult population with high morbidity and mortality rates. Poor adherence to medication is associated with bad outcome of the disease and wastage of health resources. Therefore, this study aims to determine the role of patient education in medication adherence among hypertensives attending tertiary hospitals in Ekiti State, South Western, Nigeria.

Methods

This is a descriptive cross-sectional study involving 420 participants attending Family Medicine Department Clinic of Federal Medical Centre (FMC), Ido-Ekiti. Relevant data were collected using semi-structured questionnaire.

Results

The mean age of respondents was 60.97 ± 11.28 years, and a slight female preponderance (male: female = 1:1.7 over male). Three hundred and forty nine (83.1%) were married, 273(65.0%) were from a monogamous family and 375(89.2%) had family sizes of more than 4. Ninety four (22.4%) had good knowledge about hypertension, and 257(61.2%) were adherent to their medication. Increased medication adherence proportion was observed as knowledge about hypertension improves. The odds of adherence to treatment among subjects with good knowledge is 2 times (OR = 2.320, 95%CI = 1.164, 4.626) higher than among subjects with poor knowledge.

Conclusion

The proportion of respondents with good knowledge about hypertension is low. However, the adherence among them to medication is higher and statistically significant. Patient education about the disease and its treatment by primary care physicians can help to improve adherence to medication.

Syringocystadenoma Papilliferum of Eye Lid: A Case Report and Review of Literature in a Tertiary Eye Hospital, Nigeria

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TRAUMATIC CORNEAL LACERATION IN NORTHWESTERN NIGERIA

BACKGROUND

Corneal laceration is a partial or full thickness corneal injury resulting from direct or indirect ocular trauma. Cornea laceration generally leads to the development of corneal opacity which is a significant cause of blindness worldwide, particularly in developing countries where facility for corneal transplant is not readily available. Clinical outcomes depend on causes, the part of cornea involved, and availability of skilled human resource and presence of corneal transplant services.

AIM

To assess the presentation, causes, and outcome of management of traumatic cornea laceration among patients at Federal Medical Centre (FMC), Birnin Kebbi, Kebbi, Nigeria.

METHODOLOGY

A one-year, retrospective review of all patients with traumatic corneal laceration who presented to eye clinic of Federal Medical Centre (FMC) Birnin Kebbi, Nigeria between November 2013 and October 2014. Information retrieved from the patient records included patient's bio data, clinical features, presenting visual acuity (VA), agents of injury, surgical intervention and visual outcome after treatment. The data obtained were analyzed with SPSS version 16.

RESULTS

Thirty two cases of traumatic corneal laceration presented during the study period. The age of study participants ranged from 2 years to 47 years with a mean of 15.28+12.46. 16 (50%) were children less than ten years old. There were 21(65.6%) males and 11(34.4%) females with male/female ratio of 1.9:1 and 20 (62%) cases of corneal lacerations occurred at home. Majority of injuries were inflicted with sticks in 9 (28.1%) cases followed by motor bike accidents in 6(18.8%). The left eye was mostly affected 18 (56.2%). Thirteen patients (40%) presented within 24 hours of injury while 16 (50%) presented within a week while one (3.1%) reported after two weeks. Presenting visual acuities in 28(90.6%) ranged from 6/12 to hand movement and no light perception in 3(9.4%). Associated injuries included uveal prolapsed 28(87.5), cataract 15(46.9%), vitreous haemorrhage 6(18.8%) and retinal detachment 1(3.1%). All the patients had examination under anesthesia and cornea repair carried out within 36-48 hours of admission in 28(87.5%) cases and within 7 days in the remaining 4 (12.5%) patients. One (3.2%) patient developed endophthalmitis. After 6weeks follow up, visual accuity of 6/60 and better were achieved in 9 eyes. There was a statistically significant correlation between the presenting visual acuity and visual outcome. However, no relationships exist statistically between age, sex, and agent of injury. The site of injury also shows statistical association with the visual acuity at six weeks follow up.

CONCLUSION

from this study, we observed that traumatic corneal lacerations were significant causes of ocular morbidity especially in children; public eye-health education is recommended as a preventive measure.

Blindness and scalp haematoma in a child following a snakebite

BACKGROUND

Snake envenomation is a major public health problem of the Savannah regions of West Africa. Ocular manifestations of snakebites are rare with few reports documenting blindness as a complication.

OBJECTIVE

To highlight an unusual manifestation of snake bites and its attendant problems.

METHODS

A report of scalp haematoma and blindness in a 10 year old child presenting 2 weeks after a snake bite (presumably carpet viper) is a rare manifestation. Local swelling, epistaxis, bilateral proptosis, exposure keratopathy and use of traditional eye medications were associated findings. Anti-venom though administered late saved the child's life but blindness could not be reversed.

RESULTS

Ocular ultrasonography revealed layered retrobulbar collection in the left eye, presumably due to hemorrhage. The skull x-ray showed a soft tissue swelling and aspirate from scalp swelling was bloody. Cranial Computed Tomography (CT) scan done late detected no abnormalities.

CONCLUSION

Snakebite is associated with lifelong morbidity. Ocular manifestations must be treated as emergency. This case highlights the effect of ignorance and poverty in a setting of a common medical emergency leading to blindness and reduced quality of life.

Indications for destructive ocular surgeries in Nigeria

INTRODUCTION

Destructive ocular surgery (DOS) means eye loss. An audit of its indications would be useful in reducing its incidence.

OBJECTIVE

To determine indications for destructive ocular surgeries.

MATERIALS AND METHODS

The case records (files) of all the patients who had DOS in a tertiary health facility in Nigeria from January 2004 to December 2011 were reviewed retrospectively. The information extracted include the bio data, indication for DOS, type of surgery performed and history of the use of traditional eye medications (TEM) and willingness to use an artificial eye (AE).

RESULTS

Thirty-seven patients had DOS. The mean age of the patients was 35.51years (SD 21.6) and the male to female ratio was 2.1:1. Evisceration was the commonest DOS performed , in 30 eyes (81.1 %). The most common indication for DOS was intraocular infection, in 15 eyes (40.5 %), followed, among others, by trauma in 13 (35.1 %) and malignant ocular tumours in 4 (10.8 %). There was association between age and indication for DOS (P = 0.032). Many patients, 15 (40.5%), used TEM and most, 34 (91.9%), refused an artificial eye (AE) after surgery.

CONCLUSIONS

The most common indication for DOS in this study was intraocular infection. Evisceration was the commonest destructive eye surgery offered.