Objective: To determine the frequency, severity and risk indicators of diabetic retinopathy (DR) in patients with diabetes attending a primary care diabetes centre. Methods: This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale. Results: Of total registered diabetic patients (n=11,158), 10,768 (96.5 %) were screened for DR. Overall DR was found in 2661 (24.7%) patients. DR was found in decreasing order of frequency in patients with type 2 (n= 2555, 23.7%) followed by patients with type 1 diabetes (n=101, 0.93% ) and patients with gestational diabetes mellitus (GDM) (n=5, 0.46%). Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency. Conclusion: Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes.

Objectives: Female sexual dysfunction (FSD) with chronic diseases such as diabetes has received little attention globally. The aim of this study is to assess the frequency of sexual dysfunction (SD) in women with diabetes; an aspect of female health that has not been explored in our population. Materials and Methods: This cross-sectional observational study using non-probability convenient purposive sampling technique was carried out at three health facilities of Karachi, for a duration of 1 year. One hundred women with diabetes who consented to participate in the study were included. Pregnant, divorced, widowed, and unmarried females were excluded. Modified female sexual function index (FSFI) was used to gather information. Results: Out of 100 women, 88 women with diabetes completed the interviewer-based modified FSFI survey questionnaire. Among 88 women, 38 (43.2%) reported to have SD, whereas 50 (56.8%) were found to have no significant sexual issues. Partner's age and occupation were significantly associated with FSD. All parameters of modified FSFI, i.e., sexual desire, arousal, lubrication, orgasm, and dyspareunia, were significantly associated (P < 0.001) with diabetes. Conclusion: Women with diabetes are at increased risk of SD and often do not volunteer information about their sexual issues. The most common cause of SD was dyspareunia, followed by lubrication, orgasm, lack of sexual arousal, and sexual desire. The healthcare providers should be aware to initiate and facilitate the discussion and need to develop their own comfort to talk about sexual issues.

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Objective:To study the outcomes of intravitreal injection of Bevacizumab and laser photocoagulation in the treatment of diabetic macular edema (DME).Methods:Seventy-two eyes of 59 patients with diabetic macular edema were divided into two groups of 41 eyes (Group-A) and 31 eyes (Group-B). Subjects in group-A were treated with three intravitreal injections of Bevacizumab (IVB), and that of group-B with macular photocoagulation. Duration of study was 9 months. Follow up pattern for both groups was1, 2, 3 and 6 months. Best Corrected Visual acuity on log MAR (BCVA) for distance as well as near in each visitwas recorded. Retinal OCT for central macular thickness (CMT) was performed on baseline. SPSS version 20.0 was used to analyze the data.Results:Mean age of the patients was 53.76 ± 8.82 ranging to 36-71 years. Out of 59 patients, 40 (67.8%) were male and 19 (32.2%) female. It was observed that the difference of results among both groups was not significant. Fig.2 documents visual acuity recorded as Improved; Stable and Worse.Conclusion:The improvement in BCVA was significant at 6 months in both treatments. The final improvements in BCVA has been almost similar between both the treatment groups although it was noted that IVB group showed early improvement in BCVA at follow-ups of 1 and 3 months. A long term follow-up is required in these cases to see the effect of both these treatment strategies.

Background: In Pakistan age related vision disturbances are mainly due to cataract. Various studies have reported relationship of ocular lesion with senile changes and diabetes mellitus resulting in reduced quality of life due to vision. Oxidative stress is an important factor in the process of cataractogenesis. The pathogenesis of the cataract may involve decreased activity of antioxidant scavenging system which includes non-enzymatic natural antioxidants as biomolecules such as carotenoids and vitamins. So, it is planned to investigate the level of serum antioxidant vitamins in diabetic cataract patients and in non-diabetic cataract patients.Methods: The study was conducted at Biochemistry department, Al-Tibri Medical College Karachi from October 2016 to October 2017. Ninety pre diagnosed cataract patients were selected from Al-Ibrahim Eye Hospital Karachi 40 normal control subjects were selected from the same population with same socioeconomic group. The demographic data was analyzed. The random blood sugar, antioxidant vitamins (C, A and E) and malondialdehyde were analyzed in the blood sample of control and cataract patients. The data was analyzed by SPSS version 20.Results: There was no significant difference in the level of vitamin C, A, E and MDA between diabetic and non-diabetic cataract patients, but the blood levels of vitamins of control are higher as compared to the cataract patients. The level of MDA is significantly high in cataract patients as compared to control. Antioxidant vitamin E was negatively correlated with serum malondialdehyde in cataract patients.Conclusions: It is concluded that in diabetic and non-diabetic cataract low level of serum antioxidant vitamins may be a contributory factor for cataractogenesis.