Purpose: To evaluate the role of cycloplegic agents in diagnosis and management of accommodative spasms. Methods: Prospective cohort study included patients with recent onset ocular strain. All patients underwent comprehensive eye examination and objective refraction. Then patients were randomized to receive either atropine or cyclopentolate for cycloplegia. And objective refraction was recorded again. Patients were randomly assigned to one of the two treatments i.e.full cycloplegic correction or 0.001% atropine and reviewed at 1-, 2- and 3-month follow-ups. Results: Total 52 patients, mean age16.1±4.7 were evaluated. 33 patients (63.5%) received atropine and 19 (36.5%) received cyclopentolate. There was significant difference between precycloplegic and post cycloplegic refraction however, the difference between cyclopentolate and atropine was not significant. None of the patients, whether treated with glasses or low dose atropine experienced any ocular strain till the end of study. Conclusion: Both cyclopentolate and atropine are equally effective in achieving adequate cycloplegia in patients with accommodative spasm. Plus corrective wear or low dose atropine are equally effective in relieving the symptoms of patients. Keywords: Cycloplegic agents, Post-cycloplegic refraction, Accommodative spasm

The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during or immediate post-recovery of systemic disease were evaluated. Demographic, clinical characteristics, effect of age, and hospitalization on the disease course were studied. The disease course was evaluated every month for 3 months period. All, except 2, patients had complete resolution of lid myokymia within 3 months of onset. Median [IQR] myokymia recovery time was 42 [31,60] days. Age and duration of hospitalization had a significant linear relationship with myokymia recovery time. Recovery was delayed by 2.64 days with every 1-year increment in age and by 6.19 days with every additional day of hospital stay. Recovery time was independent of severity of systemic disease ( P = .055) and gender ( P = 0.2). Eyelid myokymia can be a possible manifestation of COVID-19 recovery phase. While myokymia recovers gradually in all these patients, older age and a longer duration of hospitalization are associated with slower recovery.

Ranked amongst the top five milk-producing countries globally, the Pakistan dairy industry can help to overcome food shortage and hunger, alleviate poverty and positively impact economic growth. This influencing role could potentially be more significant while the COVID-19 pandemic severely affects humanity, challenges the economy and increases the risk of global food shortage. However, its large national population of dairy livestock contrasts with Pakistan's top-five ranking, indeed, four to five Pakistani cows produce milk equivalent to one dairy cow of countries with a well-developed dairy industry. Low milk yield per cow negatively impacts the national production and compromises the development of an efficient processing sector, such that consumers are very often forced to use adulterated milk sold by local ‘milkmen.’ As a consequence, while committed to alleviating global hunger, Pakistan imports in excess of half a million tons of milk and milk-based products annually. Many studies have identified unproductive, inefficient and imprecise management issues combined with poor genetics and imbalanced nutrition as the leading barriers to improvement in the Pakistani dairy livestock sector. At an individual level, lack of awareness, affordability issues, illiteracy and low ambition of a large percentile of dairy farmers creates additional significant barriers. To address low productivity and poor genetics, Pakistani corporate farms and wealthier individual farmers import genetically improved breeds to attain high milk yields. However, they are then faced with the challenge of managing such breeds to attain sustainable and persistent milk yields under Pakistani climatic conditions, often risking excessive culling even to the point of business liquidation. In developed dairy industries, automated sensor-based livestock management systems are now available to help monitor, compute, and optimize procedures in real-time and are proven to increase productivity and profitability. The term precision livestock farming (PLF) is used to describe systems that monitor individual animals or groups of animals to overcome management deficiencies and optimize productivity. My stance in this Opinion Paper is that adopting and utilizing such precision technologies may support Pakistan in raising its livestock resources toward greater productivity, thereby helping to overcome the global food shortage.

Aim: To survey eye-care professionals in Pakistan, including optometrists, ophthalmologists, and residents from either, on their knowledge, opinions, and clinical practice patterns. We also looked to see if their myopia-related practice habits were in accordance with current standards of care and guidelines. Methods: An online survey was created and shared with eyecare providers from all provinces in Pakistan. The responses were collected over a span of 8 weeks. Results: 173 professionals took part in the survey and 146 were able to complete the survey (based on their response to specific questions). Most common method of refraction was cycloplegic refraction, and most tended to under-correct myopia. Only 1/4th of clinicians were measuring axial length and 21% never performed binocular testing and checked lag of accommodation in myopes. Most common method of myopic fundus examination was dilated fundus biomicroscopy and criteria for peripheral fundus examination was myopia greater than 6 diopters. Almost half have not attended a course/ workshop on myopia (control) in past 6 months and 1/4th tended to rarely read a myopia related journal article. Progression of more than 1 diopter a year was criteria for initiation of control strategies for most clinicians and 0.01% atropine was the preferred initial concentration and almost half of them believed the control strategies to be moderately effective. Conclusion: A substantial proportion of eyecare providers do not appear to be aware of current concepts and do not incorporate recent guidelines into their practices regarding myopia management. Keywords: Practice patterns, Eye care providers, Myopia

In the last twenty years’ Pakistani media have experienced remarkable progress and transformation in its role. There have been serious setbacks in current years. Almost more than one hundred private TV channels are currently broadcasting. Pakistan is one of the unsafe counties of the world for journalists as per the 2020 report of the International Federation of Journalists Pakistan. Pakistan has been a war zone for almost forty years, where 140 journalists were killed in Pakistan from 2000 to 2020 but still, Pakistani law does not guarantee journalists' safety. Are they feeling safe and secure and which steps will be important for journalists’ security and safety? This researcher is qualitative. The data have been collected by conducting interviews and applying the social responsibility theory to investigate, what is about the freedom of speech because this theory describes the claims that the journalist always plays a responsible role of passing the information with freedom and the task of the press is to make journalism better.