Profile of patients attending eye OPD Shahina Jamil teaching hospital Abbottabad in year 2008 / 2009

The aim of our study was to collect relevant information about patients attending out patient department [OPD] of Ophthalmology in Shahina Jamil Hospital Abbottabad in year 2008/2009. A comprehensive proforma was designed which contained all relevant information about the patients. It was completed for each patient attending eye OPD from March 2008 to February 2009. At the end of the year all record was analyzed. The total number of patients attending eye OPD from March 2008 to February 2009 was 10,000. These patients were analyzed on the basis of age, sex and demography. Patients with different diseases were also analyzed. This study gave us an idea about the demographic and other details including diagnosis of the patients attending Eye OPD. Such studies are needed to tailor our health services according to the needs of the patients and their total quality management

Blunt non-perforating ocular trauma patterns of ocular damage and final visual outcome

To study the causes of blunt ocular trauma in a closed-globe, its various clinical signs on presentation and final visual outcome. A prospective analytic study of one hundred cases of the blunt ocular trauma conducted in the Department of Ophthalmology, Ayub Teaching Hospital, Abbottabad. In one hundred cases. Seventy-nine [79%] were males and twenty-one [21%] were females. Hyphacma occurred in sixty-two cases [93.9%], mydriasis in twenty-nine cases [43.9%], traumatic iritis/uveitis fifty three [80.3%], and seventeen [25.8%] patients developed traumatic cataract. Traumatic Glaucoma occurred in 3% cases. Vitreous haemorrhage occurred in nineteen [63.3%] and seventeen [56.7%] cases were with retinal heamorrhages, commotio retinae was seen in ten [33.3%] post-traumatic optic atrophy occurred in eight [26.7%] and retinal detachment in six cases. Anterior segment involvement have better visual prognoses 89.4%, compared to posterior segment trauma which is 26.7%. A high percentage of youth and children suffered eye injuries, home setting and sports-related injuries were more common. Hyphaemas and lens injuries have relative little affect on the final visual outcome as compared to the posterior segments injuries

Dual thyroid ectopy in an old woman

Very few cases with dual thyroid ectopy and a normally located thyroid gland have been reported. A 65 years old woman presented with hemoptysis and mild dysphagia 5 years after thyroidectomy. On direct laryngoscopy a supraglotic mass was detected and removed; which on histopathology turned to be an ectopic thyroid tissue. On barium swallow lateral view of the neck demonstrated a mass between trachea and esophagus at C4-6 level. CT scan confirmed a high attenuation, mass posterior to trachea in sub-cricoid area. Suspecting another ectopic thyroid here, Technetium-99 scans were done, while on thyroxine and 4 weeks without it: earlier was inconclusive but the later confirmed another ectopic thyroid in thyroid bed on left side with a tail on right. The diagnosis was dual ectopic thyroid tissue in supraglottic area and the thyroid area [laterally and to the left] extending between trachea and esophagus at C4-6 level producing difficulty in breathing and mild dysphagia. This was a case of dual ectopic thyroid. It emphasizes that thyroid scan should be routinely performed in all thyroid cases and all the suspicious areas studied

Corneal complications of spring catarrh

To look for signs of corneal complications in cases of spring catarrh. A descriptive case series study of 200 patients of spring catarrh was conducted in the department of ophthalmology Ayub Teaching Hospital, Abbottabad. The most common complication of spring catarrh seen was superficial punctate keratitis [24%], [6%] were having vernal ulcer and [0.5%] had association with keratoconus. Spring was more common in people above 12 years; males were more affected common corneal complication turned out to be superficial punctate keratitis

Status of children in blind schools in the Northern Areas of Pakistan

Prevalence of blindness in Pakistan is estimated to be 0.9%, which comes to about 1.25 million persons. A significant number of these are persons under 20 years of age. To make these children useful citizens in future, special facilities are to be provided to these children for their education and training. A study was done to find out the visual status of the students studying in a blind school in Abbottabad, Pakistan, the only such facility in the region. A total of 50 patients were examined during our visit to the blind school in Abbottabad. Age of the patients ranged from 6 to 27 years [mean: 12.32 years]. All the students, who were otherwise healthy, were included in the study. The most common disorder identified was malformed globe or traumatic eyes [16 cases, 32%], in most of the cases, leading to phthisis bulbi. Other conditions noticed were Retinitis Pigmentosa [10 cases, 20%], Keratoconus, Optic atrophy, Buphthalmos [6 cases each, 12%], corneal opacity [4 cases, 8%] and retinal detachment [2 cases 4%]. We should work towards betterment of these schools by providing them with more funds, equipment and manpower. Regular visits of Ophthalmologists to these schools may be helpful. Genetic counselling should be arranged for the families

Relation of smoking and elevated homocysteine in patients presenting with acute coronary syndrome

Elevated plasma homocysteine levels. homocysteine levels are risk factor for coronary artery disease. Smoking is known to be Other risk factors like diabetes mellitus, associated with an increased plasmafamily history, obesity and dyslipidemia were homocysteine level and both with increased riskalso studied. of cardiovascular disease. To investigate the relation ship between smoking, plasma homocysteine and other conventional risk factors with coronary artery disease in relatively younger population of patients presenting with acute coronary syndrome in emergency room of Cardiology Department, Allied Hospital Faisalabad. Among 586 patients of ACS under 50 years, 221[38%] patients were found to be smokers. Smoking habit showed significant difference between male and female patients as 177 [80%] male and 44 [20%] female. Homocysteine level of 22.4% patients among all was high and was found associated [63.5% of smokers] with smoking habit Out of 1852 consecutive patients[P<0.01]. Hypertension was not among admitted in emergency room of Cardiologysignificant factors for smokers as 421 [65%] Department, Allied Hospital Faisalabad overwere not suffering from hypertension. There one year, 1375 [74%] presented with acute chestwere 93 obese among smokers and these two pain, 586 were under 50 year. 384 [66%] wererisk factors collectively posed insignificant males 202 [34%]. 200 [34%] were under 40effect [P<0.05]. years. 386 [66%] patients were in age range 41 - 50 years. The demographic details, history and clinical examination of patients were recorded and their blood was collected in fasting state for estimation of serum total cholesterol, plasma glucose and serum total It was concluded that smokers were more prone to have coronary heart disease due to increased levels of homocysteine, its association with abnormal lipid profile and especially when some other risk factor combines with smoking greatly increases the risk of cardiovascular disease and should therefore be offered intensive advice to help them cease smoking also have reduced levels of homocysteine

unusual case of bloody tears

Conjunctival bleeding is usually caused by non accidental or accidental conjunctival laceration, conjunctival tumors and nasolacrimal sac tumors. We report here a rare case of conjunctival bleeding which was self induced using cinnamon bark

Recurrent episcleritis in children-less than 5 years of age

Episcleritis, though common in adults, is a rare disease in children. Episcleritis is associated with systemic diseases in a third of cases in adults. Here we describe systemic diseases associated with recurrent episcleritis in children less than five years of age. This Retrospective Observational case series study was conducted at the Department of Ophthalmology of Ayub Teaching Hospital, Abbottabad, from March 1995 till February, 2006. Six children diagnosed clinically with recurrent episcleritis were included in this study. Complete ophthalmologic as well as systemic evaluation was done in each case. This study was conducted on 6 children with a diagnosis of recurrent episcleritis. There were four boys and two girls, with an age range of 35-52 months. Right eye was involved in three cases, left eye in two cases while one case had a bilateral disease. Recurrence occurred in the same eye in all cases, with one bilateral involvement. Four children [66%] had a history of upper respiratory tract infection in the recent past. No other systemic abnormality was detected in any case. Two cases had a history of contact with a pet animal. Recurrent episcleritis in young children is a benign condition. Upper respiratory tract infection is the most common systemic association. Pet animals may be a contributory factor

Writing a scientific paper

Scientific paper is the outcome of hard labour done over a period of months on a certain topic by scientists or students for their postgraduate degree. A good paper should leave an impact on the reader. It should describe the significance of the project, objectives of the study, methodology employed and the results. This paper describes various components of a research article, and when and how each section should be written.

Eclipse retinopathy: Follow up of 36 cases after April 1995 solar eclipse in Pakistan

A study was carried out at the Department of Ophthalmology Ayub Medical College, Abbottabad from April 1995 to April 2002 to study the visual acuity changes in patients of solar eclipse retinopathy. Thirty-six patients with solar eclipse retinopathy were seen. Examination included assessment of Visual Acuity [VA], Slit Lamp examination, Fundoscopy, Fundus Photography and Fundus Fluorescein Angiography where the VA was 6/60. The patients were seen at weekly intervals then at monthly interval and later annually. Poor visual acuity was seen in all patients, after images in 28 patients, Erythopsia in 25 patients and Central Scotoma in 23 patients. Eye involvement was unilateral in 27 cases and bilateral in 9 cases. Twenty-nine patients were male and 7 patients were female. The commonest age group was between 10'30 years. Conclusions: Complete recovery was seen in 26 patients, 7 made partial recovery while in three patients the visual acuity remained poor. Maximum recovery occurred between two weeks to six months. After six months, no changes in the visual acuity or macular lesion were noticed

Frequency of ocular complications of leprosy in institutionalized patients in NWFP Pakistan

There is no systemic disease, which so frequently gives rise to disorders of the eye as leprosy does. The study was conducted to determine the prevalence and gravity of ocular complications in institutionalized leprosy patients in NWFP. It is important to provide necessary information to leprosy health workers and general physicians in order to sensitize them to early detection and treatment or referral to appropriate centre. A prospective study of ocular complications of leprosy patients was conducted at the leprosy centre of Lady Reading Hospital Peshawar and the Leprosy Hospital Balakot, district Mansehra. The study included a record of the name, age, sex, type, duration of disease and completion of multi-drug therapy [MDT]. Classification of the patients was done according to Ridley and Jopling 5-group system. Visual acuity was tested by Snellen chart and those patients having a vision of less than 3/60 were labelled as blind. Ocular adnexa were examined by naked eye and lacrimal sac regurgitation test was done. Slit lamp biomicroscopy was done for anterior segment examination and direct ophthalmoscope was used for fundoscopy. The authors studied 143 patients in the above mentioned leprosy centres. Out of these, 59 had lepromatous leprosy, 39 borderline tuberculoid leprosy, 9 tuberculoid leprosy, 33 borderline lepromatous leprosy, and 33 borderline leprosy. The majority of patients came from the northern districts of NWFP, including Malakand division and district Mansehra. The male to female ratio was 4:1. The age of the patients ranged from 14 to 80 years and the duration of the disease ranged from 1 year to 48 years. Ocular complications were found in 73% of the patients. These complications included loss of eyebrows in 57 patients, loss of eyelashes in 37, corneal changes [including opacity, ulceration, and/or anaesthesia] in 44, iridocyclitis in 31, lagophthalmos in 36, ectropion in 13, and chronic dacryocystitis in 3. Of the total of 15 [11%] patients who went blind from ocular complications, 16 eyes did so due to corneal opacities, 6 eyes due to cataract, 5 eyes due to chronic anterior uveitis and one eye due to corneal ulcer, panophthalmitis and phthisis bulbi each. Conclusions: A significant number of leprosy patients [73%] have ocular complications. The frequency of ocular complications increases with the increasing age and duration of disease of the patients

study of posterior chamber intraocular lens implantation

200 cases of extracapsular extraction with Posterior Chamber intra-ocular lens implantation were studied between February, 1988 to April, 1994 at DHQ Teaching Hospital, Abbottabad and were followed up, with a view to measure post-op refractive errors and complications. The procedure was performed either under GA or under Peribulbar anaesthesia using operating microscope, IOL were inserted with the help of air bubble or methyl cellulose. Michol or acetylcholine were used in selected cases. [21% of the patients had visual acuity of 6/6 without any glasses. 72.6% had visual acuity of 6/9 or more with spherical correction of +2D/-2D. 7.8% of the patients developed after cataract which needed yag Laser or capsulotomy] The procedure is treatment of choice for unilateral and senile cataract without any additional complication then seen in routine E.C.C.E. No extra risk of post operative complications is experienced

Refractive error and squint in primary school children

1306 school children were screened for refractive errors and squint between September 1991 and September 1994. 2.60% of the children had abnormal cover test. 7.04% of the children were found to have refractive error. Only 36.95% of the children were aware of their refractive error and using glasses. Myopia was the commonest refractive error amounting to 6.12%. Many of the children examined were not aware of their ocular disease