Objective: To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy. Methods: This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy. Results: The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia. Conclusion: Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy. How to cite this:Anwar SB, Asif N, Naqvi SAH, Malik S. Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.279 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective:To determine the etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan.Methods:This cross sectional study was conducted at the Department of Ophthalmology, Combined Military Hospital, Peshawar over four years period from June 2012 through March 2016, Two hundred ten consecutive soldiers who presented with ocular war injuries were included for analysis after taking written informed consent. A predesigned proforma was used to record patient’s demographic details along with the cause, side, type and severity of injury, ocular trauma score was also recorded at presentation.Results:The mean age of the patients was 29.34±5.35 years. All of them were males. Left side was more frequently involved (n=126, 60.0%) and the most frequent underlying cause was IED blast injury (n=114, 54.3%). Closed globe injuries were more frequent and were recorded in 120 (57.1%) patients. Upon assigning Ocular Trauma Score, Grade-V (28.6%) injuries were the most frequent followed by Grade-I (25.7%), Grade III (25.7%), Grade II (11.4%) and Grade IV (8.6%). When stratified for the type of injury, OTS Grade I injuries were highest (60.0%) among patients with open globe injuries, hence poorer prognosis, while OTS Grade V injuries were highest (50.0%) among patients with closed globe injuries (p=0.000).Conclusion:IED blast injuries are most frequently encountered ocular war injuries often involving soldiers in the age group 20-30 years. These open globe injuries had worst clinical presentation to begin with and poorer prognosis than closed globe injuries.
Objective:To analyze desire for sons/daughters among ladies of Peshawar, Pakistan, with a view to rule out son preference and to study impact of various demographic characteristics on the subject.Methods:Cross-sectional descriptive study conducted at Combined Military Hospital, Peshawar, from August 2015 - January 2016; sampling technique was random/probability/non-purposive. Self-designed questionnaire was utilized; carrying questions pertinent to desire for sons/daughters during marital life, and demographic details. Data analyzed via descriptive analysis (SPSS-21), expressed as frequencies/percentages and mean ± standard deviation(minimum/maximum). Sons and daughters desired (dependent variables) were cross-tabulated with independent variables.Results:Response rate was 63.25% (n-506). Data revealed following: Sons desired 3.05±2.061(1/12); Daughters desired 1.15±0.767(0/4); 6.1%(n-31) and 0.6%(n-3) desired infinite number of sons and daughters respectively, 18.2%(n-92) did not desire to have even one daughter, while 2.2%(n-11) considered it immaterial to have daughters or sons. There was a significant relation between sons desired and client’s education (p<0.001), husband’s education (p<0.001) and socioeconomic class (p<0.001). There was no significant impact of religion (p-0.142) on desire for sons. Impact of independent variables on daughters desired was similar but less pronounced.Conclusion:There was candid son preference among the respondents. Gender discrimination can be attenuated by adequately addressing son preference at all tiers.
Objective: To evaluate whether steroids or immunomodulator is a better mode of treatment in long term management of vernal keratoconjunctivitis.Study Design: A quasi experimental study. Place and Duration of Study: Armed Forces institute of Ophthalmology, Rawalpindi, from Feb 2019 to Oct 2019. Methodology: Ninety-two patients in between ages of 5-20 years were divided into two equal groups of 46 patients each. After instillation of 0.1% Fluoromethalone (steroid) into both eyes of patients of vernal keratoconjunctivitis, in group A and outcomes were compared with those of 0.05% Cyclosporine (immunomodulator) administered in the same manner in group B. All the patients were followed up regularly after 1, 3, and 6 weeks, 3 months, and 6 months and data recorded for inference. Results: Both the drugs were found to effectively reduce the foreign body sensation but had no or minimal effect on visual acuity and intraocular pressure (p-vale<0.001). Few patients in steroid group showed noticeable rise of intraocular pressure. (p=0.02). Cyclosporine was found to markedly reduce the mucoid discharge and photophobia without any adverse side effects (p-value=0.02). Conclusion: Cyclosporine appears to be more effective in control of mucous discharge and inflammation than steroids in vernal keratoconjunctivitis with minimal or no side effects and hence was found to be a safe alternative to steroid usage in long-term treatment groups.
Objective: To study epidemiology, presentation and management of cases with unilateral proptosis presenting at a tertiary care hospital. Study Design: Case series. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jan 2016 to Dec 2017. Methodology: Retrospective analysis of hospital record of patients with unilateral proptosis was carried out. Data was entered and analyzed in SPSS version 22. Chi square test was used for statistical analysis. Results: Thirty-three cases of unilateral proptosis with a mean age of 41.79 ± 3.87 years were included in the study. Pain was the most common association. Proptosis was mild in 42.4%, moderate in 48.5% and severe in 9.1% cases. In 61% cases, diagnosis was made on excisional or incisional biopsy and on the basis of radio imaging in 39% cases. Most common cause of proptosis found was pleomorphic adenoma (12%). Patients with axial and non-axial proptosis were 48.5% and 51.5% respectively. Fourteen cases (42.5%) were managed surgically and 2 cases (6%) were observed. Total of 22 cases (67%) improved after treatment, 8 cases (24%) went into remission, 2 (6%) deteriorated, and 1 (3%) died in the study period. Conclusion: Unilateral proptosis is a diagnostic challenge. Pertinent history taking and detail examination is the key, but associated signs or symptoms not always point towards correct diagnosis. Tissue biopsy provides a conclusive diagnosis especially where radio imaging is doubtful.
Objective: To determine the success rate of Endonasal Endoscopic Dacryocystorhinostomy (Endo-DCR) in cases of chronic dacryocystitis secondary to primary acquired nasolacrimal duct obstruction (NLDO). Study Design: Quasi-experimental study. Place and Duration of Study: Department of Oculoplastic Surgery, Armed Forces Institute of Ophthalmology Rawalpindi, from Sep 2018 to Nov 2019. Methodology: Endo-DCR under General Anaesthesia was performed on 100 patients of primary acquired nasolacrimal duct obstruction causing chronic dacryocystitis. Post-operatively these patients were checked on first post-op day, then on one week and finally four months after surgery. We removed silicone tubes of all the patients four months after surgery. To ensure patency of lacrimal passage, we did syringing and irrigation of lacrimal system of all cases, at conclusion of the study. We chose absence of epiphora and patent lacrimal system on syringing as indicators of successful procedure. Results: Hundred patients (males 37; females 63) were recruited for this study. Mean age of our sample population was 51.1 ± 29 years. Right nasolacrimal duct obstruction cases were 56 whereas left nasolacrimal duct obstruction cases were 44. Subjective improvement i.e., absence of epiphora was found in 90% patients. We got successful irrigation of lacrimal passages (objective improvement) in 94% of patients. Conclusion: Endo-DCR yields comparable results to external Dacryocystorhinostomy (Ex DCR). It offers additional benefits of esthetically better outcome, lesser complication rate and short surgery and patient recovery time.
Objective: To evaluate the success rate of Transcanalicular Diode laser assisted Dacryocystorhinostomy (TC-DCR) in cases of acquired nasolacrimal duct obstruction (NLDO). Methods: This Quasi-Experimental study was conducted in Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from July 2018 to April 2019. In this study, 73 patients of chronic dacryocystitis secondary to acquired NLDO were treated by TC-DCR under general anaesthesia. Follow up examination was done after one day, one week and three months. Silicone tubes were removed three months after surgery and syringing of lacrimal system done to confirm patency of lacrimal passages. Success of the procedure was documented as absence of epiphora and patent nasolacrimal duct on syringing. Results: Seventy three patients (males 27; females 46) were included in this study. Mean age of these patients was 51.6±21 years. On completion of this study which was three months after surgery, we found subjective improvement (absence of epiphora) in 86.3% patients and objective improvement (successful irrigation of lacrimal passages) in 93.2% patients. Conclusion: TC- DCR is a minimally invasive technique of doing Dacryocystorhinostomy and imparts more than 90% success rate. It has additional advantages of good cosmetic results, low complication rate and short surgery and convalescence time. doi: https://doi.org/10.12669/pjms.36.4.1906 How to cite this:Awais M, Naqvi SAH, Akram A, Shahid M. Transcanalicular diode laser assisted dacryocystorhinostomy: A breakthrough in the treatment of acquired nasolacrimal duct obstruction. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1906 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To determine the frequency of sino-orbital mucormycosis outcomes in diagnosed patients of COVID-19 and its association with the duration of the disease. Study Design: Case series. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Pak Emirates Military Hospital, Rawalpindi, from Feb to Jul 2021. Methodology: A sample size of 20 was calculated using WHO calculator. Diagnosed patients of COVID-19 who fulfilled the inclusion criteria were selected through consecutive sampling technique. The mode of presentation, in-depth imaging findings, associated co-morbidities and management/follow up details were collected. Results: Total 20 patients were included in study. There were 12 (60%) male and 8 (40%) female. Mean age of patients was 60.4 ± 9.8 years. Outcomes of study were treatment, still of follow up, mortality and mortality with sepsis, survival and exenteration (15%, 15%, 25%, 5%, 25% 15% respectively). Among all the patients, 2(10%) patients showed intraconal and extraconal orbital involvement, 9 (45%) showed left, 8 (40%) showed right and 1(5%) showed both orbits involvement. Outcomes of sino-orbital mucormycosis showed significant association with COVID-19 duration (p=0.03). Conclusion: Sino-Orbital mucormycosis is a common and potentially life-threatening complication of COVID-19. Early initiation of anti-fungal treatment as well as surgical intervention are key to decrease both the mortality and morbidity associated with the disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.