ABSTRACT
INTRODUCTION: The objective of this study is to evaluate diabetic patients with either normal fundus or non-proliferative diabetic retinopathy (NPDR) changes, examine retinal alterations during follow-up, and propose follow-up guidelines within a tertiary eye care setting. METHODS: A five-year prospective longitudinal study is being conducted at the Diabetic Clinic of Al Ibrahim Eye Hospital/Isra Postgraduate Institute of Ophthalmology, Karachi. Induction for the research took place from October 2021 to March 2022, and a two-year preliminary report is presented here. Newly diagnosed type II diabetic patients with normal fundus or NPDR of any stage, irrespective of age, gender, or glycemic status, who were willing to participate and agreed to follow-ups, were included. Patients with proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), fundus non-visibility, or systemic complications of diabetes were excluded. RESULTS: A total of 251 patients were enrolled, consisting of 80 individuals with a normal fundus and 171 with different stages of NPDR, including mild (N=59), moderate (N=91), and severe (N=21) retinopathy. The incidence of progression from mild to moderate NPDR was noted to be 52.5%, with a median time of 3.5 months. Progression from moderate to severe NPDR occurred in 37.1% of cases, with a median time of 4.5 months. Similarly, DME developed in 5% of patients with mild NPDR over eight months, in 22.2% with moderate NPDR over seven months, and in 37.5% with severe NPDR over 4.4 months. CONCLUSION: This study emphasizes the urgent need to revise diabetic retinopathy (DR) monitoring protocols for our Pakistani (Southeast Asian) population. The rapid progression of NPDR and the high rates of DME development demand more frequent screenings. Current guidelines recommending annual screenings are inadequate. Biannual screenings for patients with a normal fundus or mild NPDR, and quarterly assessments for those with moderate or severe NPDR, are necessary.
ABSTRACT
OBJECTIVE: To determine the frequency of type-II Diabetes mellitus (DM) in the endogenous population of Gaddap town and also to evaluate the status of Diabetic retinopathy (DR) in this group. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi, from January 2006 till December 2008. METHODOLOGY: This community based study of subjects of either gender was carried out in the Gaddap town. Three primary eye care centres were established in the existing primary health care (PHC) facilities, to screen the target Population aged 30 years and above, and who met other inclusion criteria for DM and DR respectively. Patients requiring intervention were managed accordingly. Data was entered and analyzed using Microsoft Visual Basic 6 and Microsoft Access. RESULTS: Out of the cohort of 19211 subjects, 1677 patients were found Diabetic, giving the prevalence of DM in Gaddap town at 8.73%, with 1258 (6.55%) known and 419 (2.18%) newly diagnosed cases. DR was seen in 460 (27.43%) of the Diabetic cases with 126 (7.51%) patients requiring urgent intervention for vision threatening complications. CONCLUSION: The result validates the importance of early screening of DR in people suffering from DM for possible management and prevention of sight threatening complications in the early stage of the disease and advocates the inclusion of primary eye care as a part of PHC system.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Diabetic Retinopathy/epidemiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pakistan/epidemiology , PrevalenceABSTRACT
Present study was performed to determined the changes in the blood picture of the brown rats Rattus norvegicus naturally infected with intestinal cestodes. The results are based on the examination of 82 brown rats captured at random from Hyderabad city and its adjacent areas. Blood profiling of cestode (Hymenolepis diminuta and Hymenolepis nana) infected male and female rats showed significantly lower values of Total Erythrocyte Count (TEC), Haemoglobin (Hb) concentration, Haematocrit (Hct), Mean Corpuscular Haemoglobin (MCH) and Mean Corpuscular Haemoglobin Concentration (MCHC) as compared to their control (non-infected) rats of both sexes. The Mean Corpuscular Volume (MCV) value for infected male and female rats was found significantly higher than those of their control rats. A significantly higher Total Leukocyte Count (TLC) in male and female infected rats was noted as against the non-infected (control) rats of both sexes. The Differential Leukocyte Count (DLC) revealed significant increase in absolute number of each type of cell in cestode infected male and female rats. However, lymphocyte and basophil counts recorded from male infected rats were similar to the counts of their control rats. Conspicuous changes in the blood picture of cestode infected male and female rats indicate host-parasite interaction as well as the triggering of defense mechanism in the host against infection.