Prevalence of diabetic retinopathy in newly diagnosed type 2 diabetes mellitus patients

To determine the prevalence of diabetic retinopathy in patients with newly diagnosed type 2 diabetes mellitus. This study was conducted at Royal Medical Services hospitals between March 200 1 and March 2004. A total of 583 patients with newly diagnosed type 2 diabetes mellitus were referred to ophthalmology clinics by their treating physicians for ophthalmologic assessment. The prevalence of diabetic retinopathy was 22.6%. The commonest presenting diabetic retinopathy was mild non-proliferative diabetic retinopathy [3 1 .5%], and the least common was severe non-proliferative diabetic retinopathy [17.3%].Diabetic retinopathy is a common finding in patients with newly diagnosed type 2 diabetes mellitus. Being a preventable and treatable complication if diagnosed and treated at earlier stages, a national strategy should be implemented to achieve this goal

Comparison between remifentanil, propofol or both for sedation during retrobulbar nerve block

To compare between the efficacy of remifentanil and propofol and combination of both for analgesia during retrobulbar nerve block in cataract surgery. A prospective randomised double blind study conducted in King Hussein Medical Center in Royal Medical Services during the period between September 2004 and August 2005. 160 patients undergoing extra capsular cataract extraction surgery under retrobulbar anaesthesia were enrolled in the study. Patients were randomly divided into four groups [40 patients in each group] and received different drug combinations by the same anaesthetist as follows: remifentanil 0.3 microgram/kg [group 1], propofol 0.5 mg/kg [group 2], remifentanil 0.3 microgram/kg and propofol 0.5 mg/kg [group 3] and saline 0.1 ml/kg as a placebo [group 4]. Patient's movement and pain were observed during the injection. Heart rate, respiratory rate and haemoglobin oxygen saturation were observed every minute for 10 minutes after the block. No significant movement occurred in group 3 during the placement of the block compared to half of the patients in the control group. The mean visual analogue score was 2.3 in group 3 compared to 6.7 in group 4. There was no significant change in mean heart and respiratory rates and haemoglobin oxygen saturation among the three study groups. Patients undergoing cataract surgery under retrobulbar anaesthesia, a combination of remifentanil 0.3 microgram/kg and propofol 0.5 mg/kg is considered to provide excellent relief of pain with least patient movement and minimal respiratory and cardiac side effects

Steroid - induced glaucoma in myopia

Objectives: This is a prospective study for the effects of local steroids on the intraocular pressure in patients with different degrees of myopia

Methods: 60 patients underwent cataract extraction with or without posterior chamber implant, 9 of these patients had extracapsular cataract extraction without implant due to high degree of myopia. All the cases were done by the same surgeons and same technique

Results: The outcome of this study showed that, myopes are more susceptible to high intraocular pressure by local steroid than emmetropes or hypermetropes

Conclusion: Myopes who are in need for local steroids should be closely observed for induced high intraocular pressure and be given a drug, which counteracts the induced high intraocular pressure when necessary. We strongly recommend that one should keep an eye on intraocular pressure especially in myopes who need long term period of local steroid or after cataract extraction +/- implant, keratoplasty, uveitis and vernal catararrh. The higher the degree of myopia, the higher the induced rise in intraocular pressure