Clinical Profile of Low Vision Patients Attending in Low Vision Clinic in a Tertiary Care Hospital.

The purpose of the study was to determine the disease profile of patients attending the low vision clinic of a tertiary eye care hospital at National Institute of Ophthalmology & Hospital (NIO&H), Dhaka, Bangladesh July 2016 to June 2017. Low vision and blindness are major causes of morbidity and an economic burden on the individual, family and the country. Low vision service has emerged as a major challenge faced by the developing countries .so prompt diagnosis; early treatment and early use of low vision devices can improve the quality of life. It was a prospective observational study conducted in low vision clinic at a tertiary care hospital in Bangladesh for one year. A total 419 patient, aged 6-60 years among them 267(63.7%) were male and 152(36.3%) were female. The leading causes of low vision in patient attending the low vision clinic were Retinitis pigmentosa (31.3%) macular dystrophy/stargards diseases & maculopathy (20.3%) and myopia with macular degeneration (14.8%). The percentage of visual impaired (6/18-6/60) were 38.3%, severely visual impaired (<6/60-3/60) were 24.4% & (<3/60) 37.3%. Almost all the patient was prescribed spectacles and Telescope for distant vision, Hand held magnifier and video magnifier were prescribed for near vision. Vision improved with low vision devices (6/18 or better) in 49.5%, (6/18-6/60) in 47.3%, (<6/60-3/60) in 2.8%, (<3/60) in 0.3% patient. Vision with low vision devices were significantly changes (p=0.001). The present study shows that hereditary ocular anomalies (Retinitis pigmentosa, macular dystrophy, myopic degeneration) and amblyopia were more common causes of low vision in this part of world.

Depo-Provera -- proving its innocence.

PIP: Family planning programs are needed to address the most significant problem in India today--the population explosion. The contraceptive injectable Depo-Provera contains the synthetic progesterone depot-medroxyprogesterone acetate (DMPA) that suppresses ovulation. Considerable controversy surrounds it. Early studies on beagle dogs suggested that DMPA increased the risk of cancer. Reviews by the World Health Organization [WHO] and the International Planned Parenthood Federation show that DMPA is safe. The US Food and Drug Administration approved Depo-Provera as a contraceptive. Political controversies and misperceptions still limit women's access to Depo-Provera. The media focused on the misinformed controversies and opposition by nonmedical women's groups when Max-India launched Depo-Provera in India. The medical community has kept silent on Depo-Provera. The women's groups and other Depo-Provera critics do not follow the scientific approach to dispute its efficacy and safety. These groups believe, because of the legacy of colonial domination, that the West is forcing low-quality products into India. They also think that it increases the incidence of cancer, but the increase in a WHO study was statistically insignificant. Depo-Provera's contraceptive effectiveness is 99.7%. Demographic factors do not affect tolerance. Menstrual irregularities comprise the most common side effect but are replaced by amenorrhea after 12 months use in 50% of cases. Beneficial effects of Depo-Provera are improvement of hemoglobin levels, protection against uterine cancer, and relief of premenstrual syndrome and dysmenorrhea. It is reversible (93% pregnancy rate 18 months after discontinuation). The Health Ministry has not approved Depo-Provera for the national family planning program but has for private physicians. The Indian Council for Medical Research has conducted clinical trials of Depo-Provera and their results will determine whether or not it will be approved for the national program.^ieng