Prevalence of diabetic retinopathy in central region of the Mongolia / Шинэ санаа Шинэ нээлт

Background@#As a leading cause of blindness in working-aged people, diabetic retinopathy is a serious threat to quality of life. There is limited information on prevalence of Diabetic Retinopathy among diabetic subjects and its associated factors in a rural setting in developing countries including Mongolia.@*Methods@#Population based cross sectional study included either type 1 or 2 diabetic patients from Selenge province, Darkhan-Uul province, Tuv province and Dundgovi province, and done complete eye examination to detect any diabetic retinopathy including fundus examination. We classified diabetic retinopathy according to the severity and assessed risk factors.@*Results@#Totally 1443 persons participated in this study, the overall prevalence of any diabetic retinopathy was 16.3%, the overall prevalence of macular edema was 2.7%, and the overall prevalence of vision-threatening retinopathy was 2.2%. In persons with detected diabetic retinopathy, 85.8% has mild to moderate nonproliferative diabetic retinopathy. Selenge province has the most diabetic retinopathy (22.5%) compared to Darkhan-Uul, Tuv, and Dundgovi provinces (15.3%, p=0.01; 15.1%, p=0.03; 5.5%, p<0.001) respectively. Independent risk factor for any retinopathy were longer diabetes duration (p<0.001), high systolic blood pressure (p<0.001), high level of HbA1c (p<0.001), and smoking (p<0.001).@*Conclusions@#In this study overall prevalence of diabetic retinopathy was 16.3%, and our result is lower than other studies in Asia. Longer the duration of diabetes, and higher the systolic blood pressure, HbA1c are related to the development of diabetic retinopathy. We need better control of the hypertension and diabetes mellitus in the future.

Neuroleptic malignant syndrome in a diabetic patient with eye complication and acute psychosis.

Neuroleptic malignant syndrome is a life-threatenting complica-tion of antipsychotic treatment. The prevalence is estimated to be 0.02 to 2.4 percent of patients exposed to dopamine receptor antagonists. Mortality rates are reported to be 10-20 percent. The important clinical signs and symptoms are severe muscle rigidity and fever. Other features are changes in level of consciousness ranging from confusion to coma, autonomic instability and laboratory evidence of muscle injury (eg, elevated CPK). We report a diabetic patient with eye complications and acute psychosis, developing neuroleptic malignant syndrome four days after receiving haloperidol 15 mg/day. The patient recovered well within 5 days after discontinuation of haloperidol and symptomatic treatment and had undergone an eye operation which yielded good result.