Background: There is a global epidemic of refractive error with myopia being the most prevalent cause of correctable visual impairment. However there is little data on refractive error in sub-Saharan Africa. This study assesses the prevalence and pattern of refractive errors (RE) in urban public high school students in Nairobi County, Kenya. Methods: This was a cross-section based survey of among1376 teenage high school students in Nairobi County, Kenya. Eleven out of 80 schools were selected and all the students in selected schools were invited to participate. All the students had their visual acuity taken using logMAR charts and those with a visual acuity of 6/12 or less in the better eye were invited for objective then subjective refraction. The data was analysed using SPSS 20.0. Chi-square test was used compare means and proportions. Results: The total participation rate was 84.8% (1376/1622). Of the 1376 students who participated 751 (54%) were boys and 639 (46%) were girls. The prevalence of refractive error was 15.5% (209/1348) with a preponderance of myopia at 14.4% [194/1348, OR= 0.7(95% CI= 0.4-0.9)], followed by astigmatism at 7.6% [103/1348, OR= 0.9, (95% CI= 0.6-1.3)] and lastly at 0.7% [10/1348, OR= 0.6 (95% CI=0.2-2.0)] hyperopia. Boys were less likely than girls to have both refractive error (OR= 0.7, 95% CI= 0.5-0.9) and myopia (O.R= 0.7, 95% C.I= 0.4-0.9).Congruous low myopia, i.e. occurring in both eyes (75.4%, 153/209) was the commonest form of refractive error among students with refractive error. Conclusions: There was a high prevalence of refractive error among teenagers attending high school in Nairobi Kenya with a predominance of myopia especially amongst girls.

SUMMARY: Foramen ovale is a surgically important aperture of the skull since it allows approach to and manipulation of the trigeminal ganglion as it lies in the Meckel's cave. This transfacial approach, Hartel's approach, requires two anatomical points for accurate cannulation; the zygomatic point and the pupil point. This study describes the morphology and location of foramen ovale and describes the pupil point in relation to the medial canthus in the Kenyan population. Department of Human Anatomy departmental review board approved the study. Two hundred dry skulls from the Department of Human Anatomy were studied using a digital calliper with help of a measuring frame. The results were analysed using SPSS version 20. The results showed the length and width of right foramen ovale was 7.69 mm mean (SD ±1.31) and 4.24 mm (±0.64) respectively while the left foramen ovale was 7.68 mm (±1.23) and 4.28 mm (±0.74). The distance of the zygomatic point from the external auditory meatus on the right was 23.54 mm (±2.26) and the left was 23.49 mm (±2.16). The median distances of the pupil point in relation to the medial canthus was 9.5mm on the right and 8.1 mm on the left. These results were significantly different from other population data. Neuronavigational aids to foramen ovale in Kenyans should take this into consideration.

HighlightsDuring tumescence the nutritive function is carried out by the dorsal artery running in the normal pressure zone outside the tunica albuginea.Penile rings disrupt the nutritive function thus causing pathology.Removal of penile rings can be effected under local anaesthesia.

Background: Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs in the elderly population. This is because of physiological atrophy of the brain parenchyma and frailty which leads to higher risk of falls. CSDH is unusual in the younger population but can be seen in the context of impact injuries in the younger population and mostly in males. Case Reports: We describe CSDH in 4 young postpartum mothers with no history of trauma. All had cesarean section births under spinal anaesthesia. The 4 mothers' ages range from 24 years to 32 years. They presented with persistent post-dural puncture headaches with 2 of the mothers having focal neurological deficits. They presented between 4 weeks and 6 weeks after cesarean section. Three mothers underwent burrhole evacuation with one mother having a craniotomy. All recovered after surgery. Conclusion: Spinal anaesthesia and disruption of the CSF dynamics is the only identifiable risk factors in these young mothers. A longitudinal follow-up of mothers undergoing spinal anaesthesia should be done to document the incidence of CSDH in postpartum mothers.

No abstract