Confirmatory factor analysis of latent constructs for measuring social well-being in African migrant samples.

The present study contributes to psychology and well-being literature by investigating social well-being in minority contexts. The factor structure of the Keyes' long format 33-item social well-being measure was investigated among African migrant samples. A cross-sectional survey methodology was used to collect data from a total of 404 African migrants living in South Africa (n = 146), Uganda (n = 158) and Kenya (n = 100). They were 202 (50%) males, 195 (48.3%) females, and 7 (1.7%) of the samples did not disclose their gender. They were aged from 14 to 70 with a Mean age of 32.21 (standard deviation = 7.696). Data collected were analysed using CFA in AMOS (version 29). We found an unstable four-factor emic solution for African migrants in Sub-Sahara Africa. We could not replicate the theoretical social well-being model of Keyes (1998) among African migrant samples in Sub-Saharan Africa. Insights from the study will be critical to designing culturally appropriate indigenous measures that accurately reflect the social realities and well-being constructs of African migrants. Our findings will also help policymakers and service providers to identify areas of need, develop appropriate socio-cultural programmes, and allocate resources more effectively to support the integration and well-being of migrants within African societies.

Assessment of Macular Pigment Optical Density Using Fundus Reflectometry in Diabetic Patients.

PURPOSE: Diabetic retinopathy (DR) is a major cause of visual disability and may be associated with reduction in macular pigment (MP) density and insufficient data are available. We present MP optical density (MPOD) measured by fundus reflectometry in eyes with and without early and moderate DR. SUBJECTS AND METHODS: This was a cross-sectional study conducted in the year 2014-2015. Participants were divided into three groups: the normal individuals without diabetes constituted Group I, while diabetic patients without DR and the patients with mild-to-moderate DR constituted Group II and Group III, respectively. MPOD and maximum optical density (Max OD) were measured using a Visucam 500 fundus camera (Carl Zeiss Meditec AG, Jena, Germany). RESULTS: Fifty diabetic patients without DR, 50 with mild and moderate DR, and 50 healthy individuals underwent MPOD and Max OD measurements. The mean pigment density was the same in all the three groups (0.12). HbA1c levels were inversely correlated with MPOD (P = 0.01) and Max OD (P = 0.002). There was no relationship between MP density and age (P = 0.66), gender (P = 0.24), or duration of diabetes (P = 0.85). The duration of diabetes was compared between the two groups of diabetic patients with and without DR. CONCLUSIONS: The mean pigment density assessed by fundus reflectometry was 0.12 in each of the three groups studied. Higher HbA1c levels in diabetic patients correlated with decreased MPOD and Max OD. Better glycemic control may influence macular health in diabetic patients.

The association of severity of retinal vascular changes and cardiac remodelling in systemic hypertension.

OBJECTIVES: The aim of the study was to explore the association between hypertensive retinopathy, grades of retinopathy and cardiac remodelling. METHODS: This was a cross-sectional observational study. A total of 500 consecutive hypertensive adults from the in-patient population were studied for the presence of hypertensive retinopathy by dilated fundoscopy. The presence of cardiac remodelling due to hypertension was studied both by electrocardiography (ECG) and echocardiography. Hypertensive target organ damage in other organs was also screened. In addition, the association of grades of hypertensive retinopathy with target organ damage was also analyzed. RESULTS: Systolic blood pressure (BP) at presentation and duration of hypertension showed no relationship with markers of hypertensive heart disease. However, diastolic BP was significantly higher in patients with retinopathy. Hypertensive retinopathy was diagnosed in 324 subjects of whom 90 had grades 3 and 4 retinopathy. Patients with grades 3 and 4 retinopathy had significant associations with ECG evidence of left ventricular (LV) strain pattern and left atrial enlargement, and a weaker association with left ventricular hypertrophy (LVH) using QRS voltage criteria (Sokolov-Lyon). On echocardiography, grades 3 and 4 retinopathy were significantly associated with LVH, left atrial enlargement and reduced left ventricular ejection fraction (LVEF), as well as with higher creatinine values. A large number of these patients presented with heart failure. Cardiac remodelling was not seen in patients without retinopathy and was uncommon in patients with grades 1 and 2 retinopathy. CONCLUSION: Grades 3 and 4 retinopathy demonstrated a significant association with LV strain pattern and left atrial enlargement on ECG, LVH and reduced LVEF on echocardiography as well as with heart failure. There was no relationship with systolic BP and duration of hypertension, while diastolic BP showed a significant positive correlation. Signs of hypertensive heart disease were practically absent in patients without hypertensive retinopathy and uncommon in those with grade 1-2 alterations.

Pseudotumor of ciliary body.

Orbital pseudotumor is a benign disease involving the orbital structures. Pseudotumor of the ciliary body is rare. We present a case of a 27-year-old male who presented with gradual visual loss, pain, and redness in his left eye. On examination he was found to have a yellowish white mass at the periphery of anterior chamber in his left eye and ultrasound biomicroscopy (UBM) revealed a ciliary body mass in the same eye. He was treated with systemic steroids, which was tapered over a period of 8 weeks. His symptoms improved and the ciliary body mass disappeared with no recurrence over the next 6 months. UBM is an important diagnostic tool for diagnosing ciliary body mass. Early diagnosis and prompt treatment with systemic steroids may help resolve pseudotumor of the ciliary body.

Wound infiltration with plain bupivacaine as compared with bupivacaine fentanyl mixture for postoperative pain relief after abdominal surgery.

AIM: To compare the efficacy of wound infiltration with Bupivacaine or Bupivacaine with fentanyl for post operative analgesia. BACKGROUND: The role of Bupivacaine and fentanyl mixture as wound infiltration for post operative analgesia is less explored in human subjects. MATERIALS AND METHODS: This prospective, randomized included 60 ASA grade I, II, and III patients in the age group of 20-75 years of age. The patients were randomized into two groups of 30 patients each: Group A received wound infiltration with a solution containing 0.5% bupivacaine (2 mg/kg), while, Group B received infiltration with a solution containing fentanyl 25 µg added to 0.5% bupivacaine (2 mg/kg). RESULTS: None of the patients in both groups had unbearable incisional pain but addition of fentanyl to 0.5% bupivacaine reduced analgesic consumption in the postoperative period (P<0.05). CONCLUSION: Addition of opioids to local anesthetics results in better postoperative analgesia and reduced opioid requirement post operatively.