Factors associated with delayed uptake of cataract surgery among adult patients at Mulago National Referral Hospital,Uganda

BackgroundCataract is the leading cause of blindness globally. Many patients with cataract in developing countries delay to come for cataract surgery.ObjectivesThis study aimed to determine the factors associated with delayed uptake of cataract surgery among adult patients seen at Mulago National Referral Hospital eye clinic in Uganda.MethodsEmploying a hospital based cross-sectional study, adult patients with cataract and having moderate visual impairment or blindness were recruited. Patient-related factors for delayed surgery were assessed using a predetermined questionnaire. Data was analyzed using stata version 14.2. Logistic regressions were used to determine the factors associated with delayed uptake of cataract surgery among these patients.ResultsEighty two participants with operable cataract were evaluated. Females were 44 (54%) and the mean age of participants was 67 years. Fifty three (65%) had delayed uptake of cataract surgery. The factors associated with delayed uptake of cataract surgery among patients with cataract were financial constraint, felt no need for surgery and good unilateral vision.ConclusionsFinancial constraints, no felt need for cataract surgery and having good unilateral vision are the factors associated with delayed uptake of cataract surgery among cataract patients. We recommend cataract surgical outreach to remote areas and health education.     

Detection of clinical progression through plasma ctDNA in metastatic melanoma patients: a comparison to radiological progression

Background The validity of circulating tumour DNA (ctDNA) as an indicator of disease progression compared to medical imaging in patients with metastatic melanoma requires detailed evaluation.Methods Here, we carried out a retrospective ctDNA analysis of 108 plasma samples collected at the time of disease progression. We also analysed a validation cohort of 66 metastatic melanoma patients monitored prospectively after response to systemic therapy.Results ctDNA was detected in 62% of patients at the time of disease progression. For 67 patients that responded to treatment, the mean ctDNA level at progressive disease was significantly higher than at the time of response (P < 0.0001). However, only 30 of these 67 (45%) patients had a statistically significant increase in ctDNA by Poisson test. A validation cohort of 66 metastatic melanoma patients monitored prospectively indicated a 56% detection rate of ctDNA at progression, with only two cases showing increased ctDNA prior to radiological progression. Finally, a correlation between ctDNA levels and metabolic tumour burden was only observed in treatment naïve patients but not at the time of progression in a subgroup of patients failing BRAF inhibition (N = 15).Conclusions These results highlight the low efficacy of ctDNA to detect disease progression in melanoma when compared mainly to standard positron emission tomography imaging.Subject terms: Tumour biomarkers, Biomarkers     

The impact of body weight trajectory from childhood on chronic inflammation in adulthood: The Bogalusa Heart Study

Importance::The impact of long-term burden of excessive body weight, beginning in childhood, on inflammatory status in adulthood has been poorly described.Objec...