Objective:To assess the Knowledge, Attitude and Practices (KAP) towards diabetes and diabetic retinopathy in the general population of Bin Qasim Town (BQ), Karachi.Methods:An observational, cross-sectional study was approved by Research Ethical Committee of Al-Ibrahim Eye Hospital. It included every third household by stratified sampling in each Union Council of (BQ) Town, in the months of May to July 2013. The interview Questionnaire included 43 questions, of qualitative and quantitative aspects, which were awarded 56 scoring points. SPSS version 20.0 was used to analyze the data.Results: Six hundred ninety two adults one from each household were interviewed. Of the total respondents, 271 (39.2%) had diabetes. Lowest mean knowledge score (5.28 ± 6.09) was seen in illiterate respondents. Male’s Mean Knowledge score (7.61 ± 6.600) was better than female’s (5.46 ± 6.21) with P <0.001. Over all mean score of Attitudes towards diabetes was 5.43 ± 2.57. It was higher (6.62 ± 2.03) in diabetic respondents as compared with non-diabetic respondents (4.70 ± 2.59) with p < 0.000. In Practice module majority of the respondents (69.9%) did not exercise, 49% took high caloric snacks between meals and 87% ate outside home once a month, 56.8% diabetics visited ophthalmologist for routine eye examination; but only 9.2% asked for retinal examination.Conclusion:Lack of knowledge of diabetes was found in the surveyed community, more marked in females, illiterate and the individuals not having diabetes.

Objectives:Primary aim was to review the literature on the prevalence of diabetic retinopathy (DR) and Vision threatening diabetic retinopathy (VTDR) in Pakistan.Methods:A search of the bibliographic databases (Medline, Pub med, and Google scholar) was conducted from 1990 to March 2017. Articles about prevalence of DR and VTDR in Pakistan were retrieved and scrutinized. The studies satisfying the inclusion/exclusion criteria were considered for detail review.Results:Forty one articles on prevalence of DR were traced out. Exclusion and inclusion criteria were met in 29 studies. In selected studies (29), pooled Prevalence of DR was found to be 28.78% with a variation of 10.6% to 91.3%. Out of 29 studies, DR was classified in 19 studies. Pooled Prevalence of VTDR in these 19 studies was found to be 28.2% (variation of 4% to 46.3%) of patient with retinopathy and 8.6% of all diabetics.Conclusion:A great variation in the values of DR and VTDR was observed in this study. Researchers suggest a community based study with uniform methodology to find out a comparable value of prevalence of DR and VTDR in all provinces of Pakistan.

There is a good deal of consensus in the literature about the key role of leadership-especially that of the headteacher-in facilitating school improvement. Yet much of the research in this area has taken place in Western industrialised countries. This article explores the issue of headship in the context of schools in a specific developing country context, that of Pakistan. Drawing on 2 studies of the experience of headteachers in Karachi, the article identifies and explores the key variables that may contribute to a sense of personal efficacy for these heads, namely the expectations generated by the national or community culture, the powers and accountabilities generated by the school system in which they work, and their own individual personalities and histories.

Relatively little systematic research has been undertaken on the role of the principal/headteacher in developing countries. In this study six headteachers of government and non-government secondary schools in Karachi were interviewed in depth and five completed diaries of their activities for one week. The study drew upon Rosemary Stewart's analysis of management roles in terms of the demands and constraints which are placed upon managers and the ways in which available choices are exercised by them. Significant differences were found both between and within government and non-government sectors. This paper describes these findings and explores their implications for educational change.

No abstract

BackgroundCholera is an important infectious cause of secretory diarrhea. The primary symptom of infection is the sudden onset of watery diarrhea with subsequent volume depletion causing renal insufficiency. The objective of this research is to study the level of dehydration at presentation and subsequent fluid management in patients with cholera.MethodsThis study was conducted on 191 patients of Cholera admitted at a tertiary care hospital in Karachi, Pakistan during the period of 5 years. Medical charts were evaluated retrospectively for initial hydration status, baseline lab investigations on admission and discharge and fluid therapy given to all the patients while their stay in the hospital and the data was analyzed on SPSS 15.0.ResultsOut of the 191 patients, 83(43%) were males and 108 (57%) were females with mean age of 42.3 years (SD±18.34). The average duration of symptoms was 3.75 days (SD±2.04). Of 191 patients, 175 (92.1%) presented with dehydration, 80 (42.3%) were given Ringer's Lactate (R/L) + Normal Saline (N/S), 45 (24%) patients were given R/L + N/S + Oral Rehydration Therapy (ORS), 27 (14.3%) of the patients were kept on R/L only and remaining were given various combinations of R/L, N/S, ORS and Dextrose Saline (D/S). On admission mean Blood Urea Nitrogen (BUN) was 24.54 (SD±16.6), mean creatinine was 2.47 (SD±2.35) and mean BUN/Creatinine ratio was 11.63 (SD±5.7).ConclusionAggressive fluid rehydration remains the cornerstone of management of cholera. Instead of presenting with a classical BUN/Creatinine ratio of >20∶1, patients with pre-renal failure in cholera may present with a BUN/Creatinine ratio of <15∶1.

Objective:To compare the visual outcomes of phacoemulsification surgery with intraocular lens (IOL) in persons with and without diabetes at end of follow-up.Methods:This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from “Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups. Group A consisted of 48 diabetics and group B consisted of 44 non- diabetics with or without diabetes in the age group ≥ 30 years were included. Patients with small Pupil, Pseudo exfoliation Syndrome, Diabetic Retinopathy, and positive history of Uveitis, Glaucoma, and Macular Degeneration were excluded. Data analysis was performed by SPSS Version 20.0.Results:Best Corrected Visual Acuity (BCVA) in diabetic patients improved from 0.813 ± 0.181 Log MAR pre operatively to 0.183 ± 0.143 after the period of six months post-operatively. Corresponding results in non-diabetics were 0.66 ± 0.31 and 0.08 ± 0.092 Log Mar (P value = 0.001). If WHO criteria was considered, 87.5% diabetics and 92% non-diabetics achieved normal vision (Log Mar 0 to 0.5; ≥ 6/12,) on the first post-operative day. Remaining 12.5% diabetics and 8% non-diabetics achieved moderate vision (0.6 to 1 Log MAR) on first post-operative day improving to normal vision within a week.Conclusion:Visual outcomes in diabetics after phacoemulsification with intra ocular lens implant is almost as good as that in non-diabetic patient if the diabetics have no retinopathy and have good glycemic control.

No abstract