ABSTRACT
Objective: To determine the visual outcome of laser treatment in clinically significant macular edema
Methods:This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan [DAP] during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with "Clinical Significant macular edema" [CSME], treated with laser photocoagulation were analyzed. Bestcorrected visual acuity [BCVA] at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data
Results:Diabetic retinopathy was found in 20.3% [1777] of 8742 diabetic attending DAP Hospital" amongst whom 39.6% [705] had Sight threatening diabetic retinopathy. Laser was advised in 96.4% [680] individuals, accepted by 70.5% [480] individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes [99%] and focal laser was done in 12 eyes [1%]. After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% [22] eyes, stabilized in 67% [619] eyes and improved in 30.7% [284] eyes. One line improvement on Snellen's chart was fond in 21.3% [197] eyes, 2 lines in 8% [74] eyes, 3 lines in 1.2% [12] eyes and 4 lines in one [0.1%] eye with p-value of 0.000
Conclusion:Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist
ABSTRACT
To assess the Knowledge, Attitude and Practices [KAP] towards diabetes and diabetic retinopathy in the general population of Bin Qasim Town [BQ], Karachi. 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. 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. Lack of knowledge of diabetes was found in the surveyed community, more marked in females, illiterate and the individuals not having diabetes
ABSTRACT
To find out the pattern of different congenital malformation [CM] and to compare the proportion of congenital malformations between consanguineous and non-consanguineous parents. This observational study was done in Countess of Dufferin Fund Hospital, [CDF] Hyderabad from July 2006 to June 2008. All newborns with congenital anomaly at birth were included. Complete examination of the newborn after birth and relevant investigations were done. Babies with malformations whose parents were consanguineous were compared with babies having CM whose parents were non-consanguineous. Maternal age, parity, singletons, multiple births, still births and neonatal death were also recorded. Overall prevalence of congenital malformations was 15.7 / 1000 births. Central nervous system anomalies were the commonest [51%]. Congenital malformations in the newborns of consanguineous parents were significantly higher than in the newborns of non-consanguineous parents. Still births and neonatal deaths were commoner in the newborns of consanguineous parents. The results of this study show that parental consanguinity is associated with increased congenital malformations; neural tube defect is the most common anomaly seen
Subject(s)
Humans , Male , Female , Congenital Abnormalities/genetics , Congenital Abnormalities/epidemiology , Neural Tube Defects/genetics , Infant, Newborn , Fetal Death/geneticsABSTRACT
Cesarean Section [C-S] is one of the most commonly performed operations in the world.1 Diet and nutrition play a vital role in post operative recovery. The objective of the study was to assess the trends and practices about "Early Initiation of Oral Maternal Feeding after Cesarean Section [C-S] under Regional Anesthesia [RA]" and to analyze it in the context of evidence based medicine [EBM]. The study was a multi center cross sectional survey conducted from August 2009-September 2010. Closed ended self administered questionnaires were filled in by 398 respondents of obstetric specialty. In response to the questionnaire 31.3% of the study participants were in favor of early initiation of maternal feeding 2-4 hours; while 84.6% preferred to delay it up to 6-12 hours; 61.6% had the perception that early start of solid diet may lead to ileus and wound dehiscence; whereas 3.4% feared burst abdomen; while only 35.1% said that it would have no effect on wound. About 57% respondents said that early maternal ambulation after an uncomplicated C-S can help in early recovery, while 43% participants thought that it may lead to hypotension, giddiness and spinal headache. The responses of the participants regarding early initiation of maternal oral feeding after C-S under RA illustrate fears and old conventional trends rather than practices based on scientific evidence. Awareness programs and multi center clinical trials in the local context may change this practice and give them enough experience and confidence. The evidence shows that initiation of early oral maternal feeding [MF] results in greater maternal satisfaction, less gastro intestinal and wound complications and is also cost effective