KNOWLEDGE OF ANTIMICROBIAL DRUG RESISTANCE (AMR) AMONG PATIENTS IN A GENERAL OUTPATIENT CLINIC IN ABUJA MUNICIPAL AREA COUNCIL (AMAC), FEDERAL CAPITAL TERRITORY, NIGERIA.

Introduction: Antimicrobial resistance (AMR) is currently prevalent and has the potential to affect everyone, of any age, in any country. In humans, animals, and the environment, antimicrobial-resistant microbes are quickly emerging and spreading. This study aims to assess the knowledge of Antimicrobial Drug Resistance (AMR) among patients in a General Outpatient Clinic in Abuja Municipal Area Council (AMAC), Federal Capital Territory, Nigeria. Methodology: This was a descriptive cross-sectional study among 400 clients in a district hospital done in 2022 using a multistage sampling technique. Data was collected using a self-administered structured questionnaire and analyzed and presented as tables, proportions, and percentages using the IBM SPSS 28 Statistical Package for the Social Sciences. Ethical approval was granted by Bingham University Teaching Hospital Ethical Research Committee, Jos, and Plateau State. Results: The study revealed that 8.5% of female respondents had good knowledge, 20.75% had fair knowledge while 27.75% had poor knowledge. Of all the male respondents, 8.5% had good knowledge, 13% had fair knowledge and 21.5% had poor knowledge. Summarily, only 68 (17.0%) of participants had good knowledge of antimicrobial resistance, 135 (33.75%) had fair knowledge of antimicrobial resistance, and 197 (49.25%) had poor knowledge of antimicrobial resistance. Test of association between knowledge of antimicrobial resistance and socio-demographics showed that marital status (χ² = 44.28, p < 0.045), Education (χ²= 123.80, p < 0.001), and Age (χ² = 112.95, p < 0.001) were statistically significant. Conclusion: The Federal, State, and Local governments, health care providers, and community health workers should focus on increasing awareness of AMR risk factors through health campaigns and programs that will aid behavioral change.

Pediatric Multiple Endocrine Neoplasia Type 2B: Clinicopathological Correlation of Perilimbal Mucosal Neuromas and Treatment of Secondary Open-Angle Glaucoma.

Ocular findings of multiple endocrine neoplasia type 2B (MEN 2B) include prominent corneal nerves, mucosal neuromas of the conjunctiva, glaucoma, and dry eyes. A 15-year-old girl with MEN 2B presents with advanced secondary open-angle glaucoma and bilateral perilimbal masses. High-resolution optical coherence tomography (HR-OCT) of the perilimbal lesions showed normal epithelial thickness and subepithelial lobular areas of mixed reflectivity, which correlates well with histopathologic findings of benign mucosal neuromas. The patient underwent bilateral gonioscopy-assisted transluminal trabeculotomy (GATT) in both eyes, which achieved adequate intraocular pressure control at short-term follow-up. To the authors' knowledge, this is the first report correlating HR-OCT and histopathologic findings in benign mucosal neuroma associated with MEN 2B, and the first description of secondary open-angle glaucoma associated with MEN 2B treated with GATT.

Consequences of Puberty on Efficacy of Intraocular Pressure-Lowering Drugs in Male Dutch-Belted Rabbits.

PURPOSE: To investigate the changes in intraocular pressure (IOP), aqueous flow, and outflow facility, as well as efficacy of IOP-lowering drugs before and after sexual development in rabbits. METHODS: Male Dutch-belted rabbits were studied at night between the ages of 8 and 44 weeks. During these times, body weight, testicular volume, and serum testosterone were measured to monitor sexual maturity. Ocular measurements included anterior chamber depth, central corneal thickness, IOP, aqueous flow, and outflow facility. Systemic acetazolamide or topical timolol, latanoprost, or saline were administered pre- and postpuberty to assess drug effects on these parameters. RESULTS: Body weight, testicular volume, and serum testosterone increased until 28 weeks of age. IOP increased during prepuberty (R2 = 0.49, P = 0.003), dropped significantly during puberty, rising again immediate postpuberty, and changing little thereafter. Postpuberty compared with prepuberty found higher IOP (P < 0.0001), slower aqueous flow (P = 0.008), lower outflow facility (not statistically significant, P = 0.07), increased central cornea thickness, and increased anterior chamber volume. Timolol lowered IOP both pre- and postpuberty, whereas, latanoprost and acetazolamide decreased IOP postpuberty only. CONCLUSIONS: As male rabbits mature, the cornea thickens and the anterior chamber volume increases. At the same time, aqueous flow slows, yet, IOP increases. This suggests that decreased outflow facility and/or increased episcleral venous pressure might contribute to the puberty-related changes in IOP. Underdevelopment of tissues of the outflow pathways may contribute to the differences in drug efficacy in rabbits when young compared with after sexual maturity.

Acute Retinal Necrosis Presenting in Developmentally-delayed Patients with Neonatal Encephalitis: A Case Series and Literature Review.

We report three cases of patients with developmental-delay from neonatal herpetic encephalitis and/or meningitis who presented years later with acute retinal necrosis due to herpes simplex virus. The diagnosis was delayed in all cases due to the patients' inability to verbalize their ocular complaints and cooperate with eye examinations. This case series documents the clinical course, pathophysiologic mechanism, and treatment of acute retinal necrosis in this patient population. Clinicians should understand the importance of prudent consideration of acute retinal necrosis in patients with a history of neonatal herpetic encephalitis and/or meningitis presenting with a red eye.

Update on pigment dispersion syndrome and pigmentary glaucoma.

PURPOSE OF REVIEW: The present article reviews the clinical features and pathogenesis of pigment dispersion syndrome and pigmentary glaucoma and provides an update regarding their diagnosis and management. RECENT FINDINGS: Newer imaging modalities including ultrasound biomicroscopy and anterior segment optical coherence tomography facilitate visualization of the iris concavity characteristic of eyes with pigment dispersion syndrome and pigmentary glaucoma. Patients with pigmentary glaucoma may be distinguished from those with other glaucoma types by the presence of typical symptoms, personality type, and patterns of diurnal intraocular pressure fluctuation. Although laser iridotomy has been shown to alter iris anatomy in pigmentary glaucoma, it is not proven to slow visual field progression. Multiple trials have validated the safety and efficacy of filtering surgery in treating pigmentary glaucoma, with fewer studies published on the role of micro-invasive glaucoma surgery. SUMMARY: Literature from the review period has further defined the unique clinical characteristics of pigment dispersion syndrome and pigmentary glaucoma. Laser surgery has a limited role in the management of these entities, whereas trabeculectomy remains an acceptable first-line surgical treatment. Further studies are needed to define the potential application of the newer micro-invasive glaucoma procedures in pigmentary glaucoma.

Measuring intraocular pressure.

PURPOSE OF REVIEW: Tonometry is undergoing a long-overdue renaissance. Goldmann applanation tonometry (GAT) is 50-year-old technology. Although GAT is considered a 'reference standard', it has many limitations and confounders. This review compares GAT to some of the newer technologies that have recently been commercialized or are in development. RECENT FINDINGS: Dynamic contour tonometry is fairly cornea-independent, but requires technical skill to carry out. Rebound tonometry requires no anesthetic and is particularly useful in children. The ocular response analyzer quantifies corneal biomechanical factors and provides other useful measures relevant to glaucoma risk. A transpalpebral tonometer that claims to measure intraocular pressure (IOP) through the closed eyelid has been introduced, but studies comparing it to conventional tonometers suggest it is too unreliable for routine use. Various new technologies including IOP-sensing contact lenses and implantable sensors are in clinical evaluation. SUMMARY: There is no perfect tonometer, and clinicians must choose which to use in their daily practice, balancing accuracy, precision, convenience, and cost. Clinicians should recognize that a single IOP measurement is but an often error-prone snapshot of a widely varying physiologic parameter. IOP data should only be used in the context of the overall clinical picture.

Smoking in young adult African Americans.

AIM: The aim of this study was to describe factors that influence decisions of young African Americans to start smoking. BACKGROUND: Young adult African Americans have a high risk for becoming regular smokers, but little is understood about their smoking. This knowledge is needed because understanding young adults' smokers will help develop effective tobacco cessation and prevention strategies. DESIGN: Qualitative study. METHOD: The study consisted of 22 in-depth interviews with African Americans between the ages of 19-25. Data were collected between 2009-2010. Smokers, former smokers and non-smokers were included. RESULTS/FINDINGS: Results indicated that smoking identity of young adults was influenced by their limited and discounted knowledge of health risks and the stigma associated with the type of tobacco smoked. The importance of cost was discussed as was the effect of smoking on relationships and vice versa. Marijuana was the primary reason they started smoking tobacco. Their transition into adulthood and views of smoking, adulthood and success all influenced smoking. Additionally, self-reflection on personal choices around smoking was important and may be useful in effective smoking cessation programmes for this group. CONCLUSION: Nurses are in an ideal position to promote effective smoking cessation in young adults. Direct, culturally relevant messages are needed that fit into the context of the young adults' lives by addressing concurrent use of marijuana, self-esteem and success in life.