Visual hygiene in adult myopes

Objective: The purpose of this study was to evaluate. 1. The importance of visual hygiene in adult myopes. 2. To find out the association of myopia with posture and visual environment. Main outcome measures were to evaluate role of visual hygiene, to evaluate the effects of posture in developing myopia and to evaluate the effects of visual environment in developing myopia

Methods: This was an institutional based cross sectional study conducted at College of Ophthalmology and Allied Vision Sciences in the main OPD of Eye Department, Mayo Hospital, Lahore, during the months of July to September 2016. Total of 100 subjects of both genders aged between 5-15 years, having Myopia of -1D to -5D were included in the study by using nonprobability convenient sampling technique. All the subjects were asked to fill the questionnaire containing questions regarding academic performance with and without spectacles. Data was collected through a self designed questionnaire and analyzed on SPSS software [Version 20.00] and p value was calculated by one sample t-test and ANOVA

Results: A total of 100 subjects were checked having myopia of varying degree [1.00- 5.00diopters].The results showed that there was greater degree of myopia in subjects having poor visual hygiene. The results showed that out of 100 subjects, 98 were into the habit of cleaning their glasses before wearing them. Positive relationship between myopia development and reading distance was found. Those who watched TV on daily basis for 3 hours had myopia in the range of -4.25 to -5.0 D. It was also found that most of the subjects study under bright light. Higher degree of myopia was found in subjects who were also computer users. Positive association between posture and myopia development was also found

Conclusion: The results concludes that poor posture, dim light while studying and excessive use of computer is significantly related to the degradation of naked vision. This data and whole study support the assumption that visual hygiene improvement could be useful in minimizing the myopia development

Astigmatism and early academic readiness in school children

Background: Astigmatism may effect schooling among children

Objective: To determine the effect of uncorrected astigmatism on the readiness of child to go to school

Methodology: This cross-sectional study was conducted on 61 children and vision screening was performed on these children admitted in nursery and prep class of Government Paisa and Akhbar School Lahore from 1 October to 30 November 2015. A questionnaire was asked from the in-charge of each class. The questions represented the different scales of academic readiness. These questions included physical health, personal and social development, academic performance, reluctance while coming to school, attention, language and literacy. The children with astigmatism [defined as >o.5 or equal to 0.5 in either eye] were compared with children who had no astigmatism. Association between the astigmatism and each scale of academic readiness was measured by applying qualitative chi square test. The effect of age and spherical refractive error was ignored. The data was entered and analyzed by using SPSS version 13

Results: A total of 61 students participated in this study. 21 students were of age 4 years and 40 children were of age 5 years. 35 children were non-astigmatic and 25 children were astigmatic. There was no significant effect of uncorrected astigmatism on health and development [P=0.2], reluctance to go to school [p=0.08] and school attendance [p=0.3]. This may be due to the fact that our schools are not that efficient to record theacademic performance across the developing years. There was a significant effect of astigmatism on academic readiness [p=0.02], language and literacy [0.05]

Conclusion: The study showed that there was significant effect of astigmatism on academic readiness, language and literacy whereas there was no significant effect on health and development, reluctance to go to school and school attendance. This study emphasized on the importance of early vision screening in preschoolers so that children can see clearly in early years of their visual development and academic learning

Fundus findings and visual functions in Pathological Myopia

Background: Visual function is a group of specific properties of eye which are essential for comprehensive vision of an individual. Pathological myopia is the condition of eye in which axial length of eye is more than 24mm and refractive error is more than -6 D

Objectives: To evaluate the visual functions in patients with high myopia and to find the most common finding of fundus in pathological myopia

Methodology: This was a descriptive cross sectional study which was conducted on seventy five subjects. Samples were selected by using non probability purposive sampling technique. Visual functions were assessed by using i.e visual acuity by Snellen chart, contrast sensitivity by lea numbers, visual field by confrontation method, color vision by D-15, glare by BAT [brightness acuity test], funds finding by indirect ophthalmoscope. Results: Study was conducted on 75 subjects [150] eyes. Best corrected visual acuity [BCV] was 6/6 to 6/9, 6/9 to 6/12 and 6/9 to 6/18 in myopes with -6.00DS to -8.00DS, - 8.00DS to - 10.00DS,-11.00DS and in -15.00DS respectively. Visual field in myopes from -6.00DS to -8.00DS was normal, it was constricted in myopes more than -9.00DS. Contrast sensitivity [CS] of Myopes having refractive error of -6.00DS to -8.0DS, - 9.00DS to -14.00DS and ? -14.00 DS had 1.25%, 1.25%-2.50% and 5% contrast respectively. 55 subjects having refractive errors from -6.00 DS to -12.00 DS had normal color vision for more than -12.00DS refractive errors. Color vision was defective in 45% subjects specially for blue color. Glare was present in 15 myopes with refractive error more than -14.00DS. The most common fundus findings in pathological myopes were myopic crescent, temporal tilting of optic disc and posterior staphyloma in severe pathological myopes. Conclusion: Visual functions were reduced in high degree of myopia. Myopic crescent, temporal displacement of disc and posterior staphyloma are most common fundus findings in pathological myopes

metabolic syndrome and inflammation: role of insulin resistance and increased adiposity

We sought to determine the role of obesity and insulin resistance [IR] in the pathogenesis of inflammation in metabolic syndrome [MetS]. Our study included 100 patients with MetS and 100 age and gender matched control patients who attended a tertiary care laboratory in Rawalpindi, Pakistan. Anthropometric data was obtained including height and weight to calculate body mass index. A record of patient's blood pressure [BP], waist circumference [WC] and hip circumference [HC] was made. Biochemical analysis included measurements of fasting glucose, triglycerides [TG], high-density lipoprotein cholesterol [HDL-c], insulin, and high-sensitivity C reactive protein [hsCRP]. IR was determined by the homeostasis mode assessment insulin resistance [HOMA-IR] method. The levels of hs-CRP were found to be elevated in all patients with MetS where it correlated significantly with all its components including measures of obesity, fasting insulin and glucose levels, IR, TG and HDL-c. However, on linear regression analysis only WC, fasting insulin, and HOMA-IR remained significantly correlated with hs-CRP. MetS is a condition characterized by chronic low-grade inflammation, which arises because of increased abdominal adiposity and IR. Large multicenter studies are needed to gain insight into its pathogenesis and derive treatment strategies

Frequency of visual disorders in school children of district Rahim Yar Khan

Background: Low vision is defined as visual acuity of less than 6/18, but equal to or better than 3/60, or a corresponding visual field loss to less than 20 degrees in the better eye with best possible correction

Objective: To determine the frequency of visual disorders in school children

Subjects and Methods: In this cross sectional study, 5360 students of different age groups and of both sexes from the urban and rural government schools of all the tehsils of district Rahim Yar Khan, were selected and screened out. Schools were selected in clusters through random sampling. Visual acuity of all the children was checked by using Snellen's Chart and children with refractive errors were refracted at the same place and prescribed the required number for glasses. The children with organic lesion or not improved with refraction were referred to Sh. Zayed Hospital, Rahim Yar Khan [SZH] for thorough assessment and management. The data was entered and analyzed by using SPSS 15

Results: Out of total 5360 children 256 [4.77%] have refractive errors and 33 subjects [0.61%] comprising 23 [69.69%] males and 10 [30.30%] females have low vision. The major cause of low vision was found to be Retinitis Pigmentosa [RP] which accounted 13 cases [39.39%] of the total low vision patients while 7 cases [21.21%] of congenital cataract, 4 [12.12%] Buphthalmos, 3 [9.09%] Optic Atrophy, 3 [9.09%] Albinism, 2 [6.06%] Maculopathy and 1 [3.03%] high Myopia [Chorioretinal degeneration]

Conclusion: Hereditary diseases have been found to be the major cause of low vision leading to blindness. The study also revealed that low vision is more common in males. There is high prevalence of refractive errors found in this study, giving the picture of the increased burden of eye problems in district Rahim yar Khan

Primary angiosarcoma of breast

Primary breast sarcomas, except for phyllodes tumour, are very rare entities, accounting for < 0.1% of all malignant neoplasms. Angiosarcoma of breast is infrequent malignancy and differential diagnosis from other sarcomatous and angiomatous breast tumours holds importance. Two cases of primary angiosarcoma of breast were encountered. One involved a 32 years lady who was treated by wide local excision and six cycles of chemotherapy. The other occurred in a 54 years old lady who was treated with mastectomy, did not receive any radiation or chemotherapy and was later lost to follow-up. Neither of the patient had history of previous breast surgery, chemotherapy or radiotherapy

Gestational trophobiastic diseases; a tertiary care experience

The study was carried out to evaluate the frequency and types of gestational. Trophoblastic diseases [GTD] in endometrial curettings received for histopathology examination. Data Source: Pathology Department, Shifa Naval Hospital Karachi. It was a Retrospective Descriptive Observational study. Department of Pathology, Pakistan Naval Ship; Shifa Naval Hospital Karachi. Period: From 2009 till 2010. A total of 170 cases of endometrial curettage were examined. All specimens received with a diagnosis of product of conceptions [POC] or with the clinical suspicion of a gestational trophoblastic disease were included. It was observed that partial mole identified in 57.1% cases followed by complete mole 21.4%, choriocarcinoma 14.2% and placental site Trophoblastic disease 7.1% cases. Nearly half of the cases were diagnosed as having a gestational trophoblastic disease; these were from the age groups of 26-30 years followed by 21-25 years. Hydatidiform mole is the commonest gestational trophoblastic disease, Most complete moles are detected clinically but partial moles are misdiagnosed as abortions therefore all cases of abortions should be sent for histopathological examinations

Microbiological isolates in body fluids and secretions

To assess the spectrum of microbes isolated from body fluids and secretions. It is a Descriptive: Observational study which was carried out from January 2010 at Taj Medical Complex Karachi. Pakistan. A total of three thousand and fifty six [3056] samples received in the laboratory of the Taj Medical Complex [both from indoor as well as outdoor patients] were included from both sexes satisfying the inclusion criteria. Included patients had a mean age of 40.5 years with female predominance. Nearly a third of included samples yielded any growth by microbial agents. Most commonly isolated pathogen was Klebsiella spp. followed by the Escherichia coli and Staphylococcus spp. The regular and meticulous monitoring of the pattern and distribution of microbial isolates can guide our choices in terms of empirical antibiotic therapies. Our study is a snapshot of the current microbiological occurrence

Central nervous system tumors: a hospital based analysis

To assess the spectrum of CNS tumors and provide benchmark data for future studies assessing data in continuum. Descriptive study. This study was carried out from Jan 2003 till Jan 2009 at Pakistan Naval Ship Shifa [Naval Hospital] Karachi, Pakistan. One hundred cases fulfilling the inclusion criteria were included between the ages of 1-85 years belonging to both genders. Majority of the cases were seen in the year 2008 with the most commonly encountered lesion being the glial tumors followed by the meningiothelial neoplasms. Our findings were similar to previous similar studies in our setup with little change in trends. Glial tumors appear to be more common in our setup whereas the popularly believed Meningiothelial tumors though common came next. Our study can form the benchmark data upon which future studies can be conducted