Knowledge, attitude, and practice pattern towards diabetic retinopathy screening among general practitioners in primary health centres in Jakarta, the capital of Indonesia.

BACKGROUND: Diabetic retinopathy (DR) is an emerging cause of visual impairment and blindness and is often detected in the irreversible stage. General practitioners (GPs) play an essential role in the prevention of DR through diabetes control, early detection of retinal changes, and timely referral to ophthalmologists. This study aimed to determine the knowledge, attitude, and practice (KAP) towards DR screening among GPs in the district primary health centres (PHCs) in Jakarta, Indonesia. METHODS: A cross-sectional study was conducted between April 2021 and February 2022 in 17 randomly selected district PHCs. A validated online questionnaire was then distributed. Good knowledge was defined when the correct response rate was > 75%, positive attitude was indicated when desired attitudes were found in more than half of the items (> 50%), and good practice was defined when more than half of the practice items (> 50%) were performed. RESULTS: A total of 92 GPs, with a response rate of 60.1%, completed the questionnaire. Seventy-nine respondents (85.9%) were female with a median (range) age of 32 (24-58) years. Among the respondents, 82 (89.1%) had good knowledge and all showed positive attitude on DR screening. However, only four (4.3%) demonstrated good practices. We found a weak positive correlation (rs = 0.298, p = 0.004) between attitude and practices. CONCLUSION: GPs in Jakarta showed good knowledge and positive attitude on DR screening. However, they did not show good practice. There was a positive correlation between attitude and practice.

Comparative Analysis of Treatment Outcomes in Patients with Neuromyelitis Optica Spectrum Disorder Treated with Rituximab, Azathioprine, and Mycophenolate Mofetil: A Systematic Review and Meta-analysis.

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a neurological condition consisting of relapse-related disability. Treatment options are limited. This systematic review and meta-analysis aimed to evaluate the effectiveness and tolerability of rituximab (RTX) in comparison to azathioprine (AZT) and mycophenolate mofetil (MMF) for the treatment of NMOSD. Methods: A systematic search was conducted among electronic databases, including PubMed, Scopus, EBSCO, and Cochrane, for relevant studies. We included randomized, controlled trials and prospective and retrospective studies evaluating the efficacy and safety of RTX compared to AZT and/or MMF in adult and pediatric patients with NMOSD. The Newcastle-Ottawa Scale (NOS) and Cochrane Collaboration tool were used to determine the risk of bias. Results: Eleven studies involving 1,086 patients were included in our study. Treatment with RTX generally yielded favorable annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS) results in comparison to AZT and MMF, despite its variable statistical significance. RTX treatment reduced the relapse rate and hazard risk for relapse (HRR). Patients in the RTX group experienced significantly fewer adverse events, among which the most common were allergies, infections, and leukopenia. Conclusion: In this study, RTX appeared to be superior to AZT and MMF in improving disability and reducing relapse in patients with NMOSD. RTX is also associated with fewer adverse events based on pooled analysis. Future randomized clinical trials are needed to establish the efficacy and safety of RTX in patients with NMOSD.