Dr. Jamshed Ahmed | Dow University of Health Sciences (original) (raw)

Papers by Dr. Jamshed Ahmed

Rawal Medical Journal, 2019

Objective: To determine if Key Feature questions are reliable for Pakistani medical universities.... more Objective: To determine if Key Feature questions are reliable for Pakistani medical universities. Methodology: In this cross sectional survey, convenient sampling technique was used and was conducted March 2016 to March 2017 and included 135 medical students. All fourth year students who had completed one month of clinical rotation in the ENT ward were asked to sit for the test after being briefed about the study. The tests were in two parts; the first was of 25 BCQ’s which are taken as a regular feature after completion of the clinical rotation. They were given a time of 30 minutes each. Data were analyzed using SPSS version 16.0. Result: Cronbach’s alpha for 25 BCQ’s was 0.605 where as the Cronbach’s alpha for 13 key feature component was 0.560. Conclusion: Ideally, 0.07 and above Cronbach’s alpha is considered significant and our results do not. Our results did not come up to the level of significance.

Many thanks to the patients and families affected with retinitis pigmentosa who provided valuable... more Many thanks to the patients and families affected with retinitis pigmentosa who provided valuable insight for the content and layout of this booklet. Retinitis pigmentosa RP is an inherited retinal dystrophy caused by the loss of. Retinitis pigmentosa RP belongs to the group of pig. Retinitis pigmentosa: understanding the clinical presentation, mechanisms and treatment options. Erica L Fletcher.Retinitis Pigmentosa and Allied Disorders.

Objectives: To study the clinical picture and staging of retinoblastoma at the time of first pres... more Objectives: To study the clinical picture and staging of retinoblastoma at the time of first presentation. Methodology: This prospective study of consecutive case series was conducted in the department of ophthalmology,

Pak J Med Sci, 2008

Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabeti... more Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. Methodology: We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio (using Mantel-Haenszel technique) and 95% confidence interval to assess association between the variables. Results: Among the 16507 subjects (95.3% response rate) 660 (4%) were found to be diabetic. Out of these, one hundred one (15.3%) had diabetic retinopathy. We found a low prevalence of diabetic retinopathy (0.6%) among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects (OR 2.7, with 95% CI 1.08-4.1) as compared to rural areas of Sindh. In addition it was higher in hypertensive (OR 2.77 with 95% CI 1.0-4.1) and in obese (OR 2.2 with 95% CI 1.7-4.2) as compared to subjects with normal body mass index (BMI). The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four (52%) subjects with diabetes with normal vision, 149(22%) subjects were with moderate visual impairment, thirty six (5.9%) subjects were blind and twenty two (3.3%) subjects were with severe visual impairment. About 214 diabetics have hypertension (32.4%), one hundred forty one (21.3%) diabetics are obese. Conclusion: Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan.

Pak J Med Sci July- …, 2010

Pak J Med Sci 2010 Vol. 26 No. 3 www.pjms.com.pk 567 ... Sorath Noorani 1, Jamshed Ahmed 2, Auran... more Pak J Med Sci 2010 Vol. 26 No. 3 www.pjms.com.pk 567 ... Sorath Noorani 1, Jamshed Ahmed 2, Aurangzeb Shaikh 3, Ziauddin Ahmed Shaikh4 ... ABSTRACT Objective: To assess the etiological factors and circumstances associated with the occurrence of eye injuries in children ...

OBJECTIVE To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pse... more OBJECTIVE To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic adults. METHODS This prospective interventional case series was conducted at Sindh Govt Lyari General Hospital Karachi and Al- Noor Eye Hospital Karachi from June 2006 to May 2008. Complete ophthalmic examination of anterior and posterior segment was performed including assessment of type of posterior capsular opacification, measurement of intraocular pressure. Visual acuity, measurement of intraocular pressure and any unwanted complications were analyzed. RESULTS Seventy six (43.18%) patients were operated on both eyes. Mean age was 62.01 +/- 13.02 years. There were 104 (59.1%) females and 72 (40.9%) males. Visual acuity at presentation was found to be 6/9 to 6/18 in 130 (59.1%)eyes, 6/18 to 6/60 in 81(36.8%) and below 6/60 in 9 (4.1%) eyes. A significant reduction in intraocular pressure (13.8, +/- 1.4, P = 0.000) was noted on second post operative day. Intraoperative complic...

Objective: To study the efficacy and safety of trabeculectomy augmented with intra-operative appl... more Objective: To study the efficacy and safety of trabeculectomy augmented with intra-operative application of MitomycinC (MMC) in various types of refractory glaucomas. Design & Duration: Quasi experimental study from Jan. 2002 to Dec. 2007. Setting: Department of Ophthalmology, Unit-I, Civil Hospital and Dow University of Health Sciences, Karachi. Patients: Forty patients with a number of refractory glaucomas who underwent trabeculectomies with MMC. Methodology: MMC 0.02% (0.2mg/ml) was applied to 52 eyes of 40 patients being operated for trabeculectomies under the partial thickness scleral flap with an exposure time of three minutes. Visual outcome, control of intraocular pressure (IOP) and complications were evaluated. Results: There were 25 males and 15 females in the study with an average age of 41.3(range 1-65) years and an average follow up of 26.4 months (range 12-60 months). The average preoperative IOP was 32.5mm Hg (range 2452 mmHg) on an average of 1.34 medications, and th...

OBJECTIVE To assess the outcome of irrigating Akahoshi/Wahab pars plana levitator for posterior a... more OBJECTIVE To assess the outcome of irrigating Akahoshi/Wahab pars plana levitator for posterior assisted levitation in dropped nucleus during phacoemulsification. STUDY DESIGN A case series. PLACE AND DURATION OF STUDY Ophthalmology Unit-III, Dow University of Health Sciences at Sindh Government Lyari General Hospital and Al-Noor Eye Hospital, Karachi, from January 2008 to December 2009. METHODOLOGY Cases of dropped nucleus during phacoemulsification were recruited. Predisposing factors and stage of phacoemulsification at which dropped nucleus were recognized. Levitator was inserted through pars plana after vitrectomy around nucleus and levitation was carried out. Follow-up was done till 6 months. RESULTS Thirty two patients including 18 males (56.3%) and 14 females (43.8%) underwent pars plana levitation. Predisposing factors were pupillary miosis in 9 cases, Brunescent cataract in 7 cases, pseudoexfoliation in another 7 cases, hypermature cataract in 5 cases and extended capsulorr...

OBJECTIVE To determine the anatomical and functional improvement in eyes with diffuse macular oed... more OBJECTIVE To determine the anatomical and functional improvement in eyes with diffuse macular oedema after modified mild macular grid laser. METHODS The prospective study was conducted at the Department of Ophthalmology Unit II, Civil Hospital Karachi, and the Department of Ophthalmology, Dow International Medical College, Karachi, from June 2011 to May 2014. We used neodymium-doped yttrium aluminium garnet 532nm frequency-doubled green laser to treat all eligible patients. Treatment variables were a spot size of 50 microns, exposure duration of 0.1 seconds, and power sufficient to produce barely visible burns in a grid pattern. We treated the thickened retina and non-thickened area of the macula excluding central 500 micron. Microaneurysms within the macular areas were treated by focal application of laser shots sufficient to bleach them. RESULTS The study comprised 86 eyes of 52 patients who were treated by applying 180 to 360 burns with a mean of 275±51. Mean macular thickness di...

To study the visual outcome in patients subjected to cataract extraction with prior grid laser an... more To study the visual outcome in patients subjected to cataract extraction with prior grid laser and intraoperative intravitreal bevacizumab injection. This prospective case series comprised of 38 patients subjected to phacoemulsification and in the bag intraocular lens implantation at Al-Noor Eye Hospital and Sindh Govt Lyari General Hospital Karachi from January 2007 to December 2008. All the patients had prior macular grid treatment and intra-operative injection of intra-vitreal Avastin. Diabetes mellitus duration, preoperative glycosylated haemoglobin (HbA1c) level and other systemic and local complications of diabetes were recorded. The patients were clinically assessed with biomicroscopic examination preoperatively, and postoperatively on day 1, week 1, and in months 1, 2, 3 and 6 respectively. Visual acuity and state of macular oedema was clinically assessed and documented. Out of thirty-eight patients, eighteen were males and 20 were females. Mean duration of diabetes was 9.92 +/- 5.5 years (Range 4-16) while that of hypertension was 7.87 +/- 3.66 years (Range = 2-15). HbAlc level was 8.36% +/- 1.93% (range 6.3 - 12.3). Thirty-one (81.5%) patients had HbA1c level 8.0% or above indicating a poor control. At 6 months of follow up best corrected distant visual acuity of 6/6 to 6/9 was achieved in 23(60.5 %), 6/12 in 11(28.9%) and 6/24 in 4(10.5%) cases while best corrected near acuity of N/6 was achieved in 22 (57.8%) N/8 in 12 (31.4%) and N/12 in 4 (10.5%) cases. At 6 months follow up visual acuity declined in two cases because of uncontrolled diabetes and hypertension. Cataract surgery in diabetic patients with macular oedema and hypertension has a good visual outcome if prior macular grid laser is performed and intra-vitreal anti VEGF is injected during surgery.

JPMA. The Journal of the Pakistan Medical Association, 2016

To determine the anatomical and functional improvement in eyes with diffuse macular oedema after ... more To determine the anatomical and functional improvement in eyes with diffuse macular oedema after modified mild macular grid laser. The prospective study was conducted at the Department of Ophthalmology Unit II, Civil Hospital Karachi, and the Department of Ophthalmology, Dow International Medical College, Karachi, from June 2011 to May 2014. We used neodymium-doped yttrium aluminium garnet 532nm frequency-doubled green laser to treat all eligible patients. Treatment variables were a spot size of 50 microns, exposure duration of 0.1 seconds, and power sufficient to produce barely visible burns in a grid pattern. We treated the thickened retina and non-thickened area of the macula excluding central 500 micron. Microaneurysms within the macular areas were treated by focal application of laser shots sufficient to bleach them. The study comprised 86 eyes of 52 patients who were treated by applying 180 to 360 burns with a mean of 275±51. Mean macular thickness differed significantly betwe...

Journal of the Pakistan Medical Association, 2011

To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic ... more To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic adults. This prospective interventional case series was conducted at Sindh Govt Lyari General Hospital Karachi and Al- Noor Eye Hospital Karachi from June 2006 to May 2008. Complete ophthalmic examination of anterior and posterior segment was performed including assessment of type of posterior capsular opacification, measurement of intraocular pressure. Visual acuity, measurement of intraocular pressure and any unwanted complications were analyzed. Seventy six (43.18%) patients were operated on both eyes. Mean age was 62.01 +/- 13.02 years. There were 104 (59.1%) females and 72 (40.9%) males. Visual acuity at presentation was found to be 6/9 to 6/18 in 130 (59.1%)eyes, 6/18 to 6/60 in 81(36.8%) and below 6/60 in 9 (4.1%) eyes. A significant reduction in intraocular pressure (13.8, +/- 1.4, P = 0.000) was noted on second post operative day. Intraoperative complication included subconjuctival haemorrhage in 22 (10%) eyes, pin head haematoma at the entry site in 7 (3.2%) eyes, pea head haematoma at the entry site in 8 (3.6%) eyes, minor grade of vitreous haemorrhage in 9 (4.1%) cases. Insufficient capsular opening was noted in 8 (3.6%) eyes. Clinically evident macular oedema in 4 (1.8%) eyes. We found no case of endophthalmitis or retinal detachment. Surgical posterior capsulotomy is a safe and effective procedure in experienced hands and could be adopted in place of YAG laser.

Journal of the College of Physicians and Surgeons Pakistan Jcpsp, Sep 1, 2009

Total hyphaema means blood in the anterior chamber totally filling it. Hypertensive traumatic tot... more Total hyphaema means blood in the anterior chamber totally filling it. Hypertensive traumatic total hyphaema means a hyphaema with raised intraocular pressure (IOP) above 21 mm of Hg caused by blunt trauma. Traumatic hyphaema usually occurs in young man. Incidence ...

Pakistan Journal of Medical Sciences Online

Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabeti... more Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. Methodology: We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio (using Mantel-Haenszel technique) and 95% confidence interval to assess association between the variables. Results: Among the 16507 subjects (95.3% response rate) 660 (4%) were found to be diabetic. Out of these, one hundred one (15.3%) had diabetic retinopathy. We found a low prevalence of diabetic retinopathy (0.6%) among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects (OR 2.7, with 95% CI 1.08-4.1) as compared to rural areas of Sindh. In addition it was higher in hypertensive (OR 2.77 with 95% CI 1.0-4.1) and in obese (OR 2.2 with 95% CI 1.7-4.2) as compared to subjects with normal body mass index (BMI). The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four (52%) subjects with diabetes with normal vision, 149(22%) subjects were with moderate visual impairment, thirty six (5.9%) subjects were blind and twenty two (3.3%) subjects were with severe visual impairment. About 214 diabetics have hypertension (32.4%), one hundred forty one (21.3%) diabetics are obese. Conclusion: Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

2004 to May 2008. Non probability deliberate purposive method of sampling was used for patient se... more 2004 to May 2008. Non probability deliberate purposive method of sampling was used for patient selection. We included patients of all ages with corneal blood staining having total hyphaema with an intraocular pressure of 50 mmHg or more for five days or hyphaema that was initially total and did not resolve below 50% in 6 days with intraocular pressures of 25 mmHg or more or hyphaema that remained unresolved for 9 days. Patients without visual potential, rubeosis

from October 2002 to March 2008. Ophthalmic examination was performed on 112 patients and their f... more from October 2002 to March 2008. Ophthalmic examination was performed on 112 patients and their family members to identify affected individuals and to characterize the disease phenotype. Family pedigree was obtained. Some family members also had fundus photographs and fluorescein angiography. Results: Legal blindness at the time of presentation was found in 104(46.4%) eyes while 76 (33.9 %) eyes have visual impairment. Visual field was constricted on confrontation in 44 (39.3%) cases. Regarding modes of inheritance, autosomal dominant was found in 5 (4.5%) autosomal recessive in 78(69.6%) and X-Linked in 7 (6.3%). Twenty two (19.6%) cases were sporadic. Typical retinitis pigmentosa picture was found in 97 (86.6%) while 15 (13.3 %) patients showed atypical picture in which 6 (5.35%) cases of pericenteric RP, 5(4.46%) cases of Usher's syndrome and 2(1.78%) cases of retinitis punctata albescence. One case of Bardet-Biedl syndrome and one case of Cockayne's syndrome was found. Conclusions: There is a high prevalence of blindness among patients of retinitis pigmentosa. Autosomal recessive mode of inheritance is the most common.

To evaluate the surgical outcome difficulties and complications of managing radial tear in contin... more To evaluate the surgical outcome difficulties and complications of managing radial tear in continuous curvilinear capsulorrhexis by using lunar punch.

Medical Channel

who underwent ND. YAG laser posterior capsulotomy in a Racquet shaped pattern. Abraham capsulotom... more who underwent ND. YAG laser posterior capsulotomy in a Racquet shaped pattern. Abraham capsulotomy contact lens(Ocular instruments) was placed onto the eye. The aiming beam was focused on the superior capsule 1 mm inside the IOL edge. Nd:YAG laser was applied to create a racquet shaped opening in the posterior capsule. Result: In this study there were 419 males and 311 females with mean age of 61.4 year. The mean duration between cataract surgery and capsulotomy was 1.4 years. At last follow up the visual acuity improved in 86.3 % cases. Mean laser shots applied were 22.3 (SD=6.5) with a mean power 1.3 mJ SD(.04). Acute complications in first week included bleeding from iris, pitting to the IOL, hanging flap, transient rise in intraocular pressure, transient anterior chamber reaction, cystoid macular edema which resolved over a period of six months. Retinal detachment was noted in six cases after a period of at least three year follow up. Conclusion: Racquet shaped Nd:YAG laser post...

Medical Channel

ABSTRACT Objective: To correlate the strength of motivation, of medical students of Dow Medical C... more ABSTRACT Objective: To correlate the strength of motivation, of medical students of Dow Medical College, with their academic achievements. Students and Methods: This study was conducted at department of Ophthalmology Unit-II Dow University of Health Sciences and Civil Hospital Karachi, from January 2013 to December 2013. Professional students during rotation in Ophthalmology were included after taking their consent. A total of 116 students were selected. Strength of motivation was measured on 16 items Strength of motivation for medical students (SMMS) questionnaires. Their complete data including FSC marks, aptitude test marks were recorded. Correlation between academic achievements and strength of motivation was measures by Pearson’s correlation constant on SPSS Version 15 for Windows. Results: A total of 116 students were recruited. Males were more motivated then females. No significant correlation was found between marks obtained in FSC and SMMS. There was no correlation between ...

Rawal Medical Journal, 2019

Objective: To determine if Key Feature questions are reliable for Pakistani medical universities.... more Objective: To determine if Key Feature questions are reliable for Pakistani medical universities. Methodology: In this cross sectional survey, convenient sampling technique was used and was conducted March 2016 to March 2017 and included 135 medical students. All fourth year students who had completed one month of clinical rotation in the ENT ward were asked to sit for the test after being briefed about the study. The tests were in two parts; the first was of 25 BCQ’s which are taken as a regular feature after completion of the clinical rotation. They were given a time of 30 minutes each. Data were analyzed using SPSS version 16.0. Result: Cronbach’s alpha for 25 BCQ’s was 0.605 where as the Cronbach’s alpha for 13 key feature component was 0.560. Conclusion: Ideally, 0.07 and above Cronbach’s alpha is considered significant and our results do not. Our results did not come up to the level of significance.

Many thanks to the patients and families affected with retinitis pigmentosa who provided valuable... more Many thanks to the patients and families affected with retinitis pigmentosa who provided valuable insight for the content and layout of this booklet. Retinitis pigmentosa RP is an inherited retinal dystrophy caused by the loss of. Retinitis pigmentosa RP belongs to the group of pig. Retinitis pigmentosa: understanding the clinical presentation, mechanisms and treatment options. Erica L Fletcher.Retinitis Pigmentosa and Allied Disorders.

Objectives: To study the clinical picture and staging of retinoblastoma at the time of first pres... more Objectives: To study the clinical picture and staging of retinoblastoma at the time of first presentation. Methodology: This prospective study of consecutive case series was conducted in the department of ophthalmology,

Pak J Med Sci, 2008

Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabeti... more Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. Methodology: We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio (using Mantel-Haenszel technique) and 95% confidence interval to assess association between the variables. Results: Among the 16507 subjects (95.3% response rate) 660 (4%) were found to be diabetic. Out of these, one hundred one (15.3%) had diabetic retinopathy. We found a low prevalence of diabetic retinopathy (0.6%) among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects (OR 2.7, with 95% CI 1.08-4.1) as compared to rural areas of Sindh. In addition it was higher in hypertensive (OR 2.77 with 95% CI 1.0-4.1) and in obese (OR 2.2 with 95% CI 1.7-4.2) as compared to subjects with normal body mass index (BMI). The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four (52%) subjects with diabetes with normal vision, 149(22%) subjects were with moderate visual impairment, thirty six (5.9%) subjects were blind and twenty two (3.3%) subjects were with severe visual impairment. About 214 diabetics have hypertension (32.4%), one hundred forty one (21.3%) diabetics are obese. Conclusion: Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan.

Pak J Med Sci July- …, 2010

Pak J Med Sci 2010 Vol. 26 No. 3 www.pjms.com.pk 567 ... Sorath Noorani 1, Jamshed Ahmed 2, Auran... more Pak J Med Sci 2010 Vol. 26 No. 3 www.pjms.com.pk 567 ... Sorath Noorani 1, Jamshed Ahmed 2, Aurangzeb Shaikh 3, Ziauddin Ahmed Shaikh4 ... ABSTRACT Objective: To assess the etiological factors and circumstances associated with the occurrence of eye injuries in children ...

OBJECTIVE To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pse... more OBJECTIVE To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic adults. METHODS This prospective interventional case series was conducted at Sindh Govt Lyari General Hospital Karachi and Al- Noor Eye Hospital Karachi from June 2006 to May 2008. Complete ophthalmic examination of anterior and posterior segment was performed including assessment of type of posterior capsular opacification, measurement of intraocular pressure. Visual acuity, measurement of intraocular pressure and any unwanted complications were analyzed. RESULTS Seventy six (43.18%) patients were operated on both eyes. Mean age was 62.01 +/- 13.02 years. There were 104 (59.1%) females and 72 (40.9%) males. Visual acuity at presentation was found to be 6/9 to 6/18 in 130 (59.1%)eyes, 6/18 to 6/60 in 81(36.8%) and below 6/60 in 9 (4.1%) eyes. A significant reduction in intraocular pressure (13.8, +/- 1.4, P = 0.000) was noted on second post operative day. Intraoperative complic...

Objective: To study the efficacy and safety of trabeculectomy augmented with intra-operative appl... more Objective: To study the efficacy and safety of trabeculectomy augmented with intra-operative application of MitomycinC (MMC) in various types of refractory glaucomas. Design & Duration: Quasi experimental study from Jan. 2002 to Dec. 2007. Setting: Department of Ophthalmology, Unit-I, Civil Hospital and Dow University of Health Sciences, Karachi. Patients: Forty patients with a number of refractory glaucomas who underwent trabeculectomies with MMC. Methodology: MMC 0.02% (0.2mg/ml) was applied to 52 eyes of 40 patients being operated for trabeculectomies under the partial thickness scleral flap with an exposure time of three minutes. Visual outcome, control of intraocular pressure (IOP) and complications were evaluated. Results: There were 25 males and 15 females in the study with an average age of 41.3(range 1-65) years and an average follow up of 26.4 months (range 12-60 months). The average preoperative IOP was 32.5mm Hg (range 2452 mmHg) on an average of 1.34 medications, and th...

OBJECTIVE To assess the outcome of irrigating Akahoshi/Wahab pars plana levitator for posterior a... more OBJECTIVE To assess the outcome of irrigating Akahoshi/Wahab pars plana levitator for posterior assisted levitation in dropped nucleus during phacoemulsification. STUDY DESIGN A case series. PLACE AND DURATION OF STUDY Ophthalmology Unit-III, Dow University of Health Sciences at Sindh Government Lyari General Hospital and Al-Noor Eye Hospital, Karachi, from January 2008 to December 2009. METHODOLOGY Cases of dropped nucleus during phacoemulsification were recruited. Predisposing factors and stage of phacoemulsification at which dropped nucleus were recognized. Levitator was inserted through pars plana after vitrectomy around nucleus and levitation was carried out. Follow-up was done till 6 months. RESULTS Thirty two patients including 18 males (56.3%) and 14 females (43.8%) underwent pars plana levitation. Predisposing factors were pupillary miosis in 9 cases, Brunescent cataract in 7 cases, pseudoexfoliation in another 7 cases, hypermature cataract in 5 cases and extended capsulorr...

OBJECTIVE To determine the anatomical and functional improvement in eyes with diffuse macular oed... more OBJECTIVE To determine the anatomical and functional improvement in eyes with diffuse macular oedema after modified mild macular grid laser. METHODS The prospective study was conducted at the Department of Ophthalmology Unit II, Civil Hospital Karachi, and the Department of Ophthalmology, Dow International Medical College, Karachi, from June 2011 to May 2014. We used neodymium-doped yttrium aluminium garnet 532nm frequency-doubled green laser to treat all eligible patients. Treatment variables were a spot size of 50 microns, exposure duration of 0.1 seconds, and power sufficient to produce barely visible burns in a grid pattern. We treated the thickened retina and non-thickened area of the macula excluding central 500 micron. Microaneurysms within the macular areas were treated by focal application of laser shots sufficient to bleach them. RESULTS The study comprised 86 eyes of 52 patients who were treated by applying 180 to 360 burns with a mean of 275±51. Mean macular thickness di...

To study the visual outcome in patients subjected to cataract extraction with prior grid laser an... more To study the visual outcome in patients subjected to cataract extraction with prior grid laser and intraoperative intravitreal bevacizumab injection. This prospective case series comprised of 38 patients subjected to phacoemulsification and in the bag intraocular lens implantation at Al-Noor Eye Hospital and Sindh Govt Lyari General Hospital Karachi from January 2007 to December 2008. All the patients had prior macular grid treatment and intra-operative injection of intra-vitreal Avastin. Diabetes mellitus duration, preoperative glycosylated haemoglobin (HbA1c) level and other systemic and local complications of diabetes were recorded. The patients were clinically assessed with biomicroscopic examination preoperatively, and postoperatively on day 1, week 1, and in months 1, 2, 3 and 6 respectively. Visual acuity and state of macular oedema was clinically assessed and documented. Out of thirty-eight patients, eighteen were males and 20 were females. Mean duration of diabetes was 9.92 +/- 5.5 years (Range 4-16) while that of hypertension was 7.87 +/- 3.66 years (Range = 2-15). HbAlc level was 8.36% +/- 1.93% (range 6.3 - 12.3). Thirty-one (81.5%) patients had HbA1c level 8.0% or above indicating a poor control. At 6 months of follow up best corrected distant visual acuity of 6/6 to 6/9 was achieved in 23(60.5 %), 6/12 in 11(28.9%) and 6/24 in 4(10.5%) cases while best corrected near acuity of N/6 was achieved in 22 (57.8%) N/8 in 12 (31.4%) and N/12 in 4 (10.5%) cases. At 6 months follow up visual acuity declined in two cases because of uncontrolled diabetes and hypertension. Cataract surgery in diabetic patients with macular oedema and hypertension has a good visual outcome if prior macular grid laser is performed and intra-vitreal anti VEGF is injected during surgery.

JPMA. The Journal of the Pakistan Medical Association, 2016

To determine the anatomical and functional improvement in eyes with diffuse macular oedema after ... more To determine the anatomical and functional improvement in eyes with diffuse macular oedema after modified mild macular grid laser. The prospective study was conducted at the Department of Ophthalmology Unit II, Civil Hospital Karachi, and the Department of Ophthalmology, Dow International Medical College, Karachi, from June 2011 to May 2014. We used neodymium-doped yttrium aluminium garnet 532nm frequency-doubled green laser to treat all eligible patients. Treatment variables were a spot size of 50 microns, exposure duration of 0.1 seconds, and power sufficient to produce barely visible burns in a grid pattern. We treated the thickened retina and non-thickened area of the macula excluding central 500 micron. Microaneurysms within the macular areas were treated by focal application of laser shots sufficient to bleach them. The study comprised 86 eyes of 52 patients who were treated by applying 180 to 360 burns with a mean of 275±51. Mean macular thickness differed significantly betwe...

Journal of the Pakistan Medical Association, 2011

To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic ... more To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic adults. This prospective interventional case series was conducted at Sindh Govt Lyari General Hospital Karachi and Al- Noor Eye Hospital Karachi from June 2006 to May 2008. Complete ophthalmic examination of anterior and posterior segment was performed including assessment of type of posterior capsular opacification, measurement of intraocular pressure. Visual acuity, measurement of intraocular pressure and any unwanted complications were analyzed. Seventy six (43.18%) patients were operated on both eyes. Mean age was 62.01 +/- 13.02 years. There were 104 (59.1%) females and 72 (40.9%) males. Visual acuity at presentation was found to be 6/9 to 6/18 in 130 (59.1%)eyes, 6/18 to 6/60 in 81(36.8%) and below 6/60 in 9 (4.1%) eyes. A significant reduction in intraocular pressure (13.8, +/- 1.4, P = 0.000) was noted on second post operative day. Intraoperative complication included subconjuctival haemorrhage in 22 (10%) eyes, pin head haematoma at the entry site in 7 (3.2%) eyes, pea head haematoma at the entry site in 8 (3.6%) eyes, minor grade of vitreous haemorrhage in 9 (4.1%) cases. Insufficient capsular opening was noted in 8 (3.6%) eyes. Clinically evident macular oedema in 4 (1.8%) eyes. We found no case of endophthalmitis or retinal detachment. Surgical posterior capsulotomy is a safe and effective procedure in experienced hands and could be adopted in place of YAG laser.

Journal of the College of Physicians and Surgeons Pakistan Jcpsp, Sep 1, 2009

Total hyphaema means blood in the anterior chamber totally filling it. Hypertensive traumatic tot... more Total hyphaema means blood in the anterior chamber totally filling it. Hypertensive traumatic total hyphaema means a hyphaema with raised intraocular pressure (IOP) above 21 mm of Hg caused by blunt trauma. Traumatic hyphaema usually occurs in young man. Incidence ...

Pakistan Journal of Medical Sciences Online

Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabeti... more Objective: To estimate the prevalence of diabetic retinopathy among newly diagnosed adult diabetics from the data set of Pakistan National Blindness survey 2003. Methodology: We analyzed the data collected from the Pakistan National Blindness Survey, a population based survey with regards to diabetic retinopathy and its risk factors. Descriptive information for each of the variable was derived and distribution was assessed by simple tabulation and cross tabulation. We used Odds Ratio (using Mantel-Haenszel technique) and 95% confidence interval to assess association between the variables. Results: Among the 16507 subjects (95.3% response rate) 660 (4%) were found to be diabetic. Out of these, one hundred one (15.3%) had diabetic retinopathy. We found a low prevalence of diabetic retinopathy (0.6%) among the subjects aged 30 and above. The risk of diabetic retinopathy was higher in urban diabetic subjects (OR 2.7, with 95% CI 1.08-4.1) as compared to rural areas of Sindh. In addition it was higher in hypertensive (OR 2.77 with 95% CI 1.0-4.1) and in obese (OR 2.2 with 95% CI 1.7-4.2) as compared to subjects with normal body mass index (BMI). The prevalence of blindness in diabetic subjects was 5.9%. There were three hundred forty four (52%) subjects with diabetes with normal vision, 149(22%) subjects were with moderate visual impairment, thirty six (5.9%) subjects were blind and twenty two (3.3%) subjects were with severe visual impairment. About 214 diabetics have hypertension (32.4%), one hundred forty one (21.3%) diabetics are obese. Conclusion: Our study data suggests lower prevalence of Diabetic Retinopathy as compared to other part of the region. There is great need to collect and monitor epidemiological data at district hospital level in order to develop a national annual retinal screening program for diabetic patients in Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

2004 to May 2008. Non probability deliberate purposive method of sampling was used for patient se... more 2004 to May 2008. Non probability deliberate purposive method of sampling was used for patient selection. We included patients of all ages with corneal blood staining having total hyphaema with an intraocular pressure of 50 mmHg or more for five days or hyphaema that was initially total and did not resolve below 50% in 6 days with intraocular pressures of 25 mmHg or more or hyphaema that remained unresolved for 9 days. Patients without visual potential, rubeosis

from October 2002 to March 2008. Ophthalmic examination was performed on 112 patients and their f... more from October 2002 to March 2008. Ophthalmic examination was performed on 112 patients and their family members to identify affected individuals and to characterize the disease phenotype. Family pedigree was obtained. Some family members also had fundus photographs and fluorescein angiography. Results: Legal blindness at the time of presentation was found in 104(46.4%) eyes while 76 (33.9 %) eyes have visual impairment. Visual field was constricted on confrontation in 44 (39.3%) cases. Regarding modes of inheritance, autosomal dominant was found in 5 (4.5%) autosomal recessive in 78(69.6%) and X-Linked in 7 (6.3%). Twenty two (19.6%) cases were sporadic. Typical retinitis pigmentosa picture was found in 97 (86.6%) while 15 (13.3 %) patients showed atypical picture in which 6 (5.35%) cases of pericenteric RP, 5(4.46%) cases of Usher's syndrome and 2(1.78%) cases of retinitis punctata albescence. One case of Bardet-Biedl syndrome and one case of Cockayne's syndrome was found. Conclusions: There is a high prevalence of blindness among patients of retinitis pigmentosa. Autosomal recessive mode of inheritance is the most common.

To evaluate the surgical outcome difficulties and complications of managing radial tear in contin... more To evaluate the surgical outcome difficulties and complications of managing radial tear in continuous curvilinear capsulorrhexis by using lunar punch.

Medical Channel

who underwent ND. YAG laser posterior capsulotomy in a Racquet shaped pattern. Abraham capsulotom... more who underwent ND. YAG laser posterior capsulotomy in a Racquet shaped pattern. Abraham capsulotomy contact lens(Ocular instruments) was placed onto the eye. The aiming beam was focused on the superior capsule 1 mm inside the IOL edge. Nd:YAG laser was applied to create a racquet shaped opening in the posterior capsule. Result: In this study there were 419 males and 311 females with mean age of 61.4 year. The mean duration between cataract surgery and capsulotomy was 1.4 years. At last follow up the visual acuity improved in 86.3 % cases. Mean laser shots applied were 22.3 (SD=6.5) with a mean power 1.3 mJ SD(.04). Acute complications in first week included bleeding from iris, pitting to the IOL, hanging flap, transient rise in intraocular pressure, transient anterior chamber reaction, cystoid macular edema which resolved over a period of six months. Retinal detachment was noted in six cases after a period of at least three year follow up. Conclusion: Racquet shaped Nd:YAG laser post...

Medical Channel

ABSTRACT Objective: To correlate the strength of motivation, of medical students of Dow Medical C... more ABSTRACT Objective: To correlate the strength of motivation, of medical students of Dow Medical College, with their academic achievements. Students and Methods: This study was conducted at department of Ophthalmology Unit-II Dow University of Health Sciences and Civil Hospital Karachi, from January 2013 to December 2013. Professional students during rotation in Ophthalmology were included after taking their consent. A total of 116 students were selected. Strength of motivation was measured on 16 items Strength of motivation for medical students (SMMS) questionnaires. Their complete data including FSC marks, aptitude test marks were recorded. Correlation between academic achievements and strength of motivation was measures by Pearson’s correlation constant on SPSS Version 15 for Windows. Results: A total of 116 students were recruited. Males were more motivated then females. No significant correlation was found between marks obtained in FSC and SMMS. There was no correlation between ...