Frequency and Risk Factors of Diabetic Retinopathy among Patients with Type 2 Diabetes Mellitus: A Single-Center Study from Bangladesh.

Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus (DM). DR remains a leading cause of blindness, currently accounting for 4.8% of the world's 37 million blindness cases. DR is one of the critical preventable causes of blindness. In Bangladesh, the number of studies reporting the prevalence and risk factors of DR in type 2 DM (T2DM) is limited. We conducted this cross-sectional study in a tertiary hospital in Bangladesh from March 2017 to August 2019 among 200 patients with T2DM for the presence and severity of DR by using color fundus photography in a dilated pupil. The diagnosis and grading of DR were made using the Early Treatment of Diabetic Retinopathy Study (ETDRS) Chart. Out of 200 subjects with T2DM, 35.5% had DR; the frequencies of NPDR and PDR were 19.0% and 16.5%, respectively. The mean age, diabetes duration, FPG, HbA1c, TG, TC, LDL-C, and serum creatinine were statistically higher, and eGFR was lower in the study subjects with DR than those without DR; BMI and HDL-C were indifferent in the two groups. The frequencies of males, subjects having monthly income of 10,000 Bangladeshi Taka (BDT) or more, smokers, hypertensives, and subjects having uncontrolled diabetes (HbA1c ≥7%), were higher in the DR group than the no DR group. Higher age (≥50 years), higher monthly income (≥10,000 BDT), urban residence, smoking, uncontrolled diabetes, and high LDL-C (≥100mg/dL) were found to be independent risk factors of DR in the study subjects. A large-scale nationwide study is needed to find out the actual prevalence of DR in Bangladesh.

Outcome of Transcanalicular Endolaser and External Dacryocystorhinostomy in Chronic Dacryocystitis.

Nasolacrimal duct obstruction due to chronic dacryocystitis is the most common cause of epiphora. Dacryocystorhinostomy (DCR) is the treatment of choice for chronic dacryocystitis. This can be carried out by external, endoscopic and endolaser surgical approach. Though external DCR is still a gold standard and most popular method, the latest procedure of less traumatic DCR is transcanalicular approach. The study was done to evaluate the outcome of Transcanalicular Endolaser DCR regarding epiphora and surgery related complications by measuring anatomical success rate (patency assessed by irrigation), functional success rate (symptom free) and complication rate and to compare with External DCR (Ext-DCR). This prospective interventional study was conducted from October 2011 to September 2012 in Ophthalmology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Total 62 patients included in the study as per inclusion and exclusion criteria of them 31 for TCEL-DCR and 31 for Ext-DCR. But during follow-up one patient was dropped from each group and finally outcome of 30 patients analyzed in each group. Mean age of the patients TCEL-DCR was 38.3±11.54 and of Ext-DCR was 38.4±14.01. In both groups females were the most sufferer (female: male = 1.5: 1). Functional and anatomical success rate of TCEL-DCR showed 93.3% and 83.3% after 3 months; 83.3% and 76.7% after 6 months respectively. Statistically non-significant difference was observed about success rate in comparison between groups. Per-operative complications were pain excessive bleeding. In TCEL-DCR pain complained 13.3% and excessive bleeding occurred in 3.3%. Where as in Ext-DCR pain complained 16.7% and excessive bleeding occurred in 20%; difference was statistically significant (p=0.001). Post-operative complications were bleeding and scar formation. Bleeding occurred in TCEL-DCR 6.67% and in Ext-DCR 10%. So, TCEL-DCR could be an alternative option for the treatment of chronic dacryocystitis especially for those patients who are conscious about scar formation and afraid about Ext-DCR technique.

Evaluation of ophthalmic manifestations in patients with intracranial tumours.

The present study was done to observe the ophthalmic manifestations in patients with intracranial tumor. This was a prospective, purposive, consecutive, observational study conducted in patients with radiologically proven intracranial tumors in the department of Ophthalmology with collaboration of Department of Neuro-surgery of Bangabandhu Sheikh Mujib Medical University from January 2006 to December 2010. All cases had tissue histopathology confirmation post-operatively. The most common type of intracranial tumor was pituitary adenoma (58.04%), followed by craniopharyngioma (20.53%), posterior fossa tumour (12.50%) [medulloblestoma, ependymoma], meningioma (8.04%) [sphenoidalwing meningioma, petroclavel meningioma, oligodendroglioma] and others (0.89%) [nasopharyngial carcinoma, esthesio - astrocytoma]. Common neuro-ophthalmological findings were visual blur (91.07%), visual field defect (71.42%), optic disc changes (50%), pupillary light reaction defect (48.21%) and colour vision defect (46.42%). The study shows, pituitary adenoma is the most common tumor that impairs the visual pathway structures followed by craniopharyngioma, posterior fossa tumour & meningioma. Furthermore, decreased visual acuity, visual field defect, abnormal optic discs, relative afferent pupillary defect and ophthalmoplegia etc. are the common neuro-ophthalmic features that should be carefully examined for early detection of intracranial tumors.

In vitro antioxidant potential study of some synthetic quinoxalines.

In continuation of our study the in vitro antioxidant activity of some novel quinoxaline derivatives was investigated by 1,1-diphenyl-2-picrylhydrazyl (DPPH) method with respect to ascorbic acid. To determine the antioxidant activity, a number of substituted indoxyls (3A-G), cyclic ketones (2A-G), and quinoxalines (1A-G) were synthesized by both microwave and conventional heating methods. The present findings revealed that some quinoxalines and their precursors (1D, 1F, 1G and 2E) exhibited a marked scavenging effect on DPPH radical.

Treatment of myasthenia gravis: a surgical profile.

Twenty three cases of thymectomy were performed in Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2004-2006 for myasthenia gravis, age ranging from 18 to 65 years, male were 16 and female 07. Out of these cases 09 had thymoma of which 03 have shown features of malignancy. There was no pre-operative or post operative mortality. Thymectomy in myasthenia gravis was considered when there was clinical feature of drooping eye lids, difficulty in deglutition, nasal voice, generalized weakness etc. All patients received medical treatment before and after surgery. Medical treatment usually given at BSMMU anticholinesterase such as mastinon, if the patient is improved and well tolerated, this regime is continued. Although, role of steroid and immunosuppressive agents for the treatment of myasthenia gravis is controversial, steroid used in few cases of type II & type III. No steroid used in ocular variety. Patients were followed for one year and showed significant improvement after surgery.

Corneal ulcer disease in Bangladesh.

The problem of acute infectious corneal disease in Bangladesh is discussed. Environmental situations combined with socioeconomic conditions create significant blindness due to this disease in this country. Clinical differentiation into bacterial and fungal ulcers was usually impossible in the advanced stages of ulceration with which the patients presented. Serious logistical problems hinder therapy. Fungal ulcers fared worse than bacterial ulcers. Conjunctival flaps were unsuccessful in alleviating the former. Critical shortage of medication as well as corneal tissue for therapeutic transplantation added to the difficulties. Large-scale public health and educational measures are indicated for effective, long-term solution.