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Biomedical subjects

A Foster

Publications and source records attributed to A Foster.

At least 109 records · Page 6Linked to original sources
PubMed1994

With an eye to good practice: traditional healers in rural communities.

In Africa, certain traditional treatments for eye diseases can produce ocular damage and visual loss. However, many practices do not cause harm, and some may be beneficial. Traditional healers are often valuable resource persons, helping to provide an understanding of cultural beliefs and practices relating to eye disease, and delivering eye care at community level. These matters are discussed below with special reference to conditions in Zimbabwe.

Eye Diseases↗
PubMed1994

Traditional eye medicines and corneal ulceration in Tanzania.

A one-year prospective study into the aetiology of corneal ulceration in 103 patients attending Mvumi hospital, Tanzania, showed 25% (95% CL 16.5-33.5%) of ulcers to be associated with the use of traditional eye medicines (TEM) within the previous 7 days. There was no statistically significant difference between TEM users and non-users in terms of sex of the patients, season of presentation or age at presentation. Of 26 corneal ulcers in TEM users, 58% (n = 15) had no other identified cause of ulceration apart from TEM use. Of the remaining 11, eight showed the appearances of HSV keratitis, and three others had bacterial infection, two with Neisseria gonococcus. TEM use was associated with hypopyon at presentation (19.3 vs 2.6% in non-TEM users (P = 0.004)), and there was a trend to more central and dense corneal scarring in the TEM users group (42 vs 23%, P = 0.06). Secondary infection is an important cause of corneal scarring following TEM use, and all patients who have a TEM-associated corneal ulcer should have intensive antimicrobial treatment. TEM use will continue so long as primary eye care continues to be unavailable to the majority of the population of Africa.

Adolescent↗
PubMed1993

Methods for evaluation of anti-asthma drugs in the primate.

Use of the primate is gaining popularity in the definition of anti-asthma drugs. The present report describes three novel tests of (1) bronchodilatation, (2) hyperreactivity and (3) anti-inflammatory activity in the rhesus monkey. All tests are based on standard clinical techniques and the relevance and application of the tests to subsequent clinical evaluation is addressed.

Animals↗
PubMed1993

Causes of blindness in children attending four schools for the blind in Thailand and the Philippines. A comparison between urban and rural blind school populations.

Using WHO definitions of visual loss and a standardised methodology, 256 children were examined in schools for the blind in Thailand (1 school) and the Philippines (3 schools). 244 (95%) were blind (BL) or severely visually impaired (SVI). Causes of SVI and blindness were classified anatomically and aetiologically, and avoidable causes identified. Causes of visual loss in Khon Kaen, Thailand (n = 65) and Manila, Philippines, (n = 113) were similar, with conditions of the whole globe accounting for 27.7 and 27.4% of SVI/BL; retinal disease 29.2 and 23.0%; cataract 16.9 and 16.8%; corneal disease 12.3 and 13.4%; and optic nerve disease and glaucoma 6.2 and 8.8%. Perinatal factors accounted for 20.0 and 23.0% of SVI/BL; hereditary disease 13.8 and 17.7%; and 12.3 and 15.0% was due to events occurring during childhood. The underlying aetiology could not be determined in 50.8 and 41.6% of cases, respectively. In the two schools together twenty six children (15%) were blind from retinopathy of prematurity (ROP) and 16 (9%) from corneal scarring attributed to Vitamin A deficiency. 103 of 178 (58%) children had avoidable causes of visual loss. In the Filipino towns of Baguio and Davao (n = 66), the causes of visual loss were different from those in Khon Kaen and Manila, with 54.8 and 42.9% of SVI/BL being due to corneal disease, and only 3.2 and 8.5% to retinal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Causes of childhood blindness: results from west Africa, south India and Chile.

Using World Health Organization definitions of visual loss and a standardised methodology, 905 children were examined in Chile, West Africa and South India. Of these 806 (89%) suffered from blindness (BL) or severe visual impairment (SVI). Causes of SVI and BL were classified anatomically and aetiologically, and avoidable causes identified. In W. Africa (n = 284) the major anatomical cause of SVI/BL was corneal scar/phthisis bulbi (35.9%). Retinal disease accounted for 20.4%, cataract 15.5% and glaucoma 13.0%. Aetiologically 33.8% of SVI/BL was due to childhood factors and 21.1% to hereditary disease. In S. India (n = 305) the major anatomical cause of SVI/BL was corneal scar/phthisis bulbi (38.4%). Retinal disease accounted for 22.6%, cataract 7.4% and glaucoma 3%. Aetiologically 37.0% of SVI/BL was due to childhood factors and 29.8% to hereditary disease. In Chile (n = 217) the major anatomical cause of SVI/BL was retinal disease (47.0%). Cataract accounted for 9.2%, glaucoma 8.3% and 6.9% was due to corneal pathology. Aetiologically 30.4% of SVI/BL was due to hereditary factors, and 20.8% to perinatal factors of which four-fifths (16.6%) was due to retinopathy of prematurity. Avoidable conditions accounted for 70%, 47% and 54% of cases in W. Africa, S. India and Chile respectively.

Adolescent↗
PubMed1993

Visual loss in an onchocerciasis endemic community in Sierra Leone.

The visual acuities of 1625 individuals recruited to a community-based clinical trial of ivermectin in southern Sierra Leone were measured, and the prevalence of visual loss in this rural population where onchocerciasis is hyperendemic was determined. Ocular examination was performed before treatment to establish the cause of visual loss. Using WHO definitions, 1.3% were blind (less than 3/60 in both eyes), 4.3% were visually impaired (between 6/24 and 3/60 in the better eye), and a further 3.4% were uniocularly blind (less than 3/60 in one eye and better than 6/24 in the other). Cataract and onchocerciasis were the major causes of visual loss in this population. More than half of the ocular morbidity was preventable or treatable by public health measures or basic curative medicine. These findings are discussed in the light of the available health and eye care services.

Blindness↗
PubMed1993

Results of community-based eyelid surgery for trichiasis due to trachoma.

In many parts of Africa patients with upper-lid trichiasis due to trachoma have very limited access to ophthalmologists or hospital facilities. In order to reach these patients it is necessary for trained paramedical eye workers to operate on patients close to where they live. The results of trichiasis surgery performed by an ophthalmic nurse in Tanzania were evaluated. A total of 156 operations were performed on 94 patients over a 2 year period by an eye nurse in central Tanzania. One hundred and forty four eyes in 86 patients were followed for a minimum of 9 months (range 9-36; mean 25.5 months). One eye developed a wound infection and nine eyes developed minimal central notching of the upper eyelid, but without corneal exposure. Survival time analysis showed a probability of survival without recurrent trichiasis of 81% at 24 months (95% CI 74% to 88%) and 79% at 36 months (95% CI 71% to 87%). It is concluded that trichiasis surgery may be safely and effectively performed in the community by a trained ophthalmic nurse.

Blindness↗
PubMed1993

Childhood blindness: a new form for recording causes of visual loss in children.

The new standardized form for recording the causes of visual loss in children is accompanied by coding instructions and by a database for statistical analysis. The aim is to record the causes of childhood visual loss, with an emphasis on preventable and treatable causes, so that appropriate control measures can be planned. With this standardized methodology, it will be possible to monitor the changing patterns of childhood blindness over a period of time in response to changes in health care services, specific interventions, and socioeconomic development.

Abstracting and Indexing↗
PubMed1992

Older widow mortality in rural Bangladesh.

Prospective data from rural Bangladesh are used to explore the adverse impact of widowhood on old age female mortality. The results indicate that widows aged 45 and above have significantly higher mortality than their currently married counterparts. Controlling for age and disability status, much of this excess mortality risk can be accounted for by patterns of living arrangements and household assets. An analysis of older widows suggests that the presence of adult male kin in the household (primarily sons), and to a lesser extent household headship (both of which may be interpreted as reflecting individual access to resources in this society) have a substantial impact on mortality risks for this group of women.

Aged↗
PubMed1992

Results and evaluation of high volume intracapsular cataract surgery in Nepal.

One thousand intracapsular cataract extractions were performed by two ophthalmologists over a 57-day period at Lahan Eye Hospital in Nepal. Ninety-nine per cent of eyes had a visual acuity of less than 3/60 at surgery. Ninety-eight per cent of eyes achieved a visual acuity of 3/60 or better with aphakic spherical correction at discharge, of which 69% had a visual acuity of 6/36 or better. In 314 eyes seen at 1-month follow-up, 88% achieved 6/18 or better with full aphakic correction. The surgical time averaged less than 10 min and the cost of disposables less than pounds 1 per operation.

Adolescent↗
PubMed1992

Acceptability of aphakic correction. Results from Karnali eye camps in Nepal.

Of 235 aphakic patients followed for 1-10 years in Karnali, Nepal, 23% were wearing aphakic spectacles in good condition, 25% had lost or broken their spectacles, 31% were wearing scratched or repaired spectacles, 5% never received spectacles and 16% were dissatisfied, of which 84% still had good phakic vision in the fellow eye. Of 303 aphakic eyes, 89% had a visual acuity of 6/60 or better with +10 spherical correction and 7.3% (22 eyes) were blind (V/A less than 3/60); of which the major causes were pre-existing posterior segment disease unrelated to the cataract operation.

Aphakia, Postcataract↗
PubMed1992

Herpetic keratitis in Tanzania: association with malaria.

Of 103 patients who presented to a rural clinic in Africa with corneal ulceration, 62 (60.2%) had corneal ulcers which on clinical diagnosis were attributable to herpes simplex virus. There was a strong association between herpetic ulceration and a history of recent malaria; 37 of 62 (59.7%) herpetic ulcers occurred in the 3 month period from April to June which corresponds to the end of the peak season for malaria compared with 14 of 41 (34%) of the non-herpetic ulcers. Fifty per cent of herpetic ulcers had a geographic morphology, 27.4% were dendritic, and 22.6% presumed herpetic ulcers were stromal: 38.7% of herpetic ulcers occurred in children under 5 years of age. Bilateral herpetic ulcers occurred in 16.1% of patients but were more common in children under 2 years of age. Geographic and stromal ulcers tended to heal more slowly than dendritic ulcers (mean time to healing 12.6, 12.2, and 6.6 days respectively), and were more likely to result in severe corneal scarring (45%, 29%, and 0% respectively). Herpes simplex keratitis is a major cause of corneal scarring in Africa. It is often seen in children, may be bilateral, commonly is geographic in morphology, and has a strong association with malaria infection. Because it is not easily preventable, more effort must be made to ensure early diagnosis and prompt, effective treatment in order to prevent severe scarring and visual loss.

Adolescent↗