Diabetic retinopathy is a disease involving microangiopathic changes in response to chronic hyperglycaemia and pan retinal photocoagulation (PRP) is currently the mainstay of treatment for proliferative retinopathy. In the present study, we evaluated the effect of pan retinal photocoagulation (PRP) on retinal nerve fibre layer (RNFL) thickness in patients with diabetic retinopathy using optical coherence tomography (OCT). This was a prospective longitudinal study. Patients with Type 2 diabetes mellitus with proliferative diabetic retinopathy (PDR) or very severe non- (N)PDR requiring laser treatment were included in the study. PRP was performed by a single trained personnel. Peripapillary RNFL located 3.4 mm around the optic disc was evaluated using time-domain OCT. Examination was performed before treatment, and 2 and 4 months after laser treatment. In total, 39 subjects (39 eyes) were recruited into this study. Twenty-nine patients had PDR and 10 had very severe NPDR. Mean age was 54.97 ± 8.38 years. Male and female genders were almost equally distributed with 18 males and 21 females. Median thickness of average RNFL at baseline was 108.8 um (interquartile range [IQR] 35.3). At two months post-procedure, average RNFL thickness significantly increased to 117.4 (IQR 28.6; P = 0.006). Although, other quadrants revealed a similar trend of increasing thickness at two months but it was not significant. At 4 months post-laser treatment, RNFL thickness in all quadrants reduced to baseline levels with insignificant changes of thickness compared to prior to laser treatment. There was also no significant association between changes in RNFL thickness and HbA1c levels (P = 0.77). In conclusion, PRP causes transient thickening of the RNFL which recovers within 4 months post-laser treatment. At the same time, poor sugar control has no direct influence on the RNFL changes after PRP.
Diabetic Retinopathy

Background: Oral lichen planus (OLP) which belongs to the spectrum of LP, is a commonly encounteredoral mucosal problem among patients seeking treatment in the Oral Medicine clinic. Its counterpart, orallichenoid reaction (OLR), which resembled OLP clinically and microscopically, is often encountered inthese patients as well. Although the various clinical forms of OLP/OLR are well-recognized, the diseasepattern in regards to lesion-active and lesion-free periods in these patients remains poorly characterized.Thus the aim of this study was to determine the clinical and demographic profile of those patients withactive OLP/OLR lesions and compare them with those patients who are clinically lesion-free.Materials and methods: The study subjects comprised 20 patients who attended the Oral MedicineClinic at the Faculty of Dentistry, University of Malaya for follow-up appointments/management. Theywere interviewed according to a pre-designed questionnaire, and clinical examination was carried out. Allthese were conducted under the supervision of Oral Medicine specialists. OLP was diagnosed accordingto the internationally accepted criteria.Results: The cohort consisted of predominantly female (n=14; 70%) and Chinese (n=9; 45%) patients,with an overall age range of 26-79 years (median, 56 years). Fifteen (75%) patients presented withactive OLP/OLR lesions and the remaining 5 (25%) were lesion-free. The lesion-active group comprised3 (15%) males and 12 (60%) females whereas the lesion-free had 3 (15%) males and 2 (10%) females.Reticular LP was the most common type (n=21/35; 60%) and the gingiva was the most prevalent site(n=21/46; 45.65%). Social habits, medical histories and medications were not significantly differentbetween lesion-active and lesion-free OLP patients.Conclusions: Findings suggest that demographic parameters, lifestyle and systemic diseases do notappear to influence the disease pattern and lesion severity in OLP.

This study aims to determine the prevalence of lower urinary tract symptoms (LUTS) and level of awareness among male outpatients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A questionnaire consisting of demographic data, questions related to knowledge, attitude and practice on BPH and the International Prostate Symptom Score (IPSS) was used for this study. Uroflowmetry and bladder scan were used to evaluate the function of the urinary tract and severity of BPH. Urine dipstick was done for glycosuria, proteinuria and haematuria. A total of 220 respondents were surveyed. The prevalence of moderately and severely symptomatic LUTS was 42.7%. The most commonly reported LUTS were nocturia (78.2%), frequency (58.2%) and incomplete emptying (44.6%). The prevalence of glycosuria, proteinuria and haematuria were 23.6%, 11.4% and 1.8% respectively. There was a significant association between increasing age with the severity of LUTS (p=0.005). Out of 102 respondents with voided urine volume greater than 150 mL, there was a significant decrease in maximum (Qmax) (p=0.039) and average (Qave) urine flow rates with every 10 years increase of age (p=0.001). The majority of respondents (59.5%) have heard of BPH before. Over 78.2% of the respondents would seek medical attention if they have LUTS with 15.9% saying they would seek traditional treatment. In conclusion, the prevalence of LUTS was high and the level of awareness was satisfactory.