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9%, n = 176). Moderate and high intensity PA decreased over the course of pregnancy in both groups. Women in group 2 had significantly higher risk of GDM in two of the estimated logistic models. In all models, significant associations between PA trajectories and GDM were only observed among women with excessive gestational weight gain in the second trimester.

Women with high sedentary behavior were significantly at higher risk of GDM despite high PA levels by intensity and this association was significant only among women with excessive GWG in the second trimester. Participation in high sedentary behavior may outweigh the benefit of engaging in high PA to mitigate the risk of GDM.

Women with high sedentary behavior were significantly at higher risk of GDM despite high PA levels by intensity and this association was significant only among women with excessive GWG in the second trimester. Participation in high sedentary behavior may outweigh the benefit of engaging in high PA to mitigate the risk of GDM.

The quality of life can be impacted negatively by blindness arising from cataract. The total prevalence of blindness in Kenya is estimated at 0.7%, however cataract contributes almost half (43%) of the total blindness in Kenya. Optometrists are well placed to assess and refer cataract patients. However, little is known on optometrists' skills, practice and knowledge. Therefore, this study was designed to assess optometrists' knowledge, skill and practice on cataract in Kisumu, Kenya.

A cross-sectional study design was used. The study was conducted from June 2019 to August 219 using self-administered questionnaire. Basic socio-demographic characteristics were collected and participants' knowledge, skills and practice on cataract were investigated. The primary outcome measure was the proportions of participants who identified the questions related to knowledge, skills and practice on cataract. Chi-square analysis was performed to assess the association between demographic characteristics of participants wit for more clinical based activities among optometrists. This will eases diagnosis of cataract and its management with an aim to reduce the burden in Kenya.

The study established that despite the good level of knowledge among optometrist on cataract, there exist a gap on skills and practice. The results of this study calls for more clinical based activities among optometrists. This will eases diagnosis of cataract and its management with an aim to reduce the burden in Kenya.

Optimal management strategies for clinically localised prostate cancer are debated. Using median 10-year data from the largest randomised controlled trial to date (ProtecT), the lifetime cost-effectiveness of three major treatments (radical radiotherapy, radical prostatectomy and active monitoring) was explored according to age and risk subgroups.

A decision-analytic (Markov) model was developed and informed by clinical input. The economic evaluation adopted a UK NHS perspective and the outcome was cost per Quality-Adjusted Life Year (QALY) gained (reported in UK£), estimated using EQ-5D-3L.

Costs and QALYs extrapolated over the lifetime were mostly similar between the three randomised strategies and their subgroups, but with some important differences. Across all analyses, active monitoring was associated with higher costs, probably associated with higher rates of metastatic disease and changes to radical treatments. When comparing the value of the strategies (QALY gains and costs) in monetary terms, fcT trial, radical radiotherapy and prostatectomy appeared to be cost-effective for low risk prostate cancer, and radical prostatectomy for intermediate/high risk prostate cancer, but there was uncertainty in some estimates. Longer ProtecT trial follow-up is required to reduce uncertainty in the model.

Current Controlled Trials number, ISRCTN20141297 http//isrctn.org (14/10/2002); ClinicalTrials.gov number, NCT02044172 http//www.clinicaltrials.gov (23/01/2014).

Current Controlled Trials number, ISRCTN20141297 http//isrctn.org (14/10/2002); ClinicalTrials.gov number, NCT02044172 http//www.clinicaltrials.gov (23/01/2014).

Paclitaxel (PTX) is an antineoplastic drug widely used in treatments for ovarian, breast, and small-cell lung cancer. Although ocular effects associated with PTX have been previously described, very few studies have specifically reported systemic PTX as a contributing factor for limbal stem cell deficiency (LSCD), which is characterized by the loss of stem cell and barrier function of the limbus leading to progressive pain and reduction in visual acuity. Described here is a unique case where a patient was diagnosed with LSCD secondary to PTX use for the treatment of breast cancer, at doses of PTX far lower than what is reported in current literature.

A 73-year-old woman with a previous diagnosis of breast cancer with liver metastasis presented with a complaint of increasing pain in the left eye more than the right, along with decreasing visual acuity in both eyes following 3months of PTX therapy for recurrent liver metastases. Upon examination, best-corrected visual acuity was 20/100 in the right eye and xicities that may result in their use. Ophthalmology review is recommended for patients after starting PTX therapy to assess for signs of LSCD, particularly in patients where drug toxicity can be aggravated due to impaired hepatic function.

Visual impairment is the partial or complete loss of vision in which the presenting visual acuity lie between 6/18-no perceptions of light. In Kenya, little attention has been directed towards children vision and causes of visual impairment. Therefore, this study was designed to investigate the prevalence and causes of visual impairment in the children population of Kenya.

This cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5-16 years). Visual acuity was taken using Snellens chart at 6 m. Anterior and posterior segment was assessed using slit lamp and indirect ophthalmoscope. The World Health Organization definition formed the baseline for calculating the mean prevalence of visual impairment.

Visual acuity measurements were available for 3240 (95.3%) participants. AZ-33 solubility dmso The mean prevalence of visual impairment based on pin-hole value was 1.7 ± 0.3% using World Health Organization definition. The prevalence of visual impairment based on presenting visual acuity value was 2.