MyMedR

Fulltext An introduction to DARC technology

Ahmad SS

Saudi J Ophthalmol, 2017 Jan-Mar;31(1):38-41.

PMID: 28337061 DOI: 10.1016/j.sjopt.2016.08.001

Glaucoma is a multi-factorial neurodegenerative disorder. The common denominator in all types of glaucomas is retinal ganglion cell death through apoptosis. However, this cellular demise in glaucoma is detected late by structural or functional analyses. There can be a 10-year delay prior to the appearance of visual field defects and pre-perimetric glaucoma is an issue still being addressed. However, a new cutting-edge technology called detection of apoptosing retinal cells (DARC) is being developed. This technique is capable of non-invasive, real-time visualization of apoptotic changes at the cellular level. It can detect glaucomatous cell damage at a very early stage, at the moment apoptosis starts, and thus management can be initiated even prior to development of visual field changes. In future, this technique will also be able to provide conclusive evidence of the effectiveness of treatment protocol and the need for any modifications which may be required. This article aims to provide a concise review of DARC technology.

Controversies in the vascular theory of glaucomatous optic nerve degeneration

Ahmad SS

Taiwan J Ophthalmol, 2016 Oct-Dec;6(4):182-186.

PMID: 29018738 DOI: 10.1016/j.tjo.2016.05.009

An understanding of the pathogenesis of glaucoma is one of the foundations in glaucoma management. A number of theories have been presented to explain glaucomatous neural degeneration. The vascular theory attempts to explain the causation of glaucoma on the basis of vasogenic factors and altered he-modynamics in the body; however, this theory remains controversial. There are proponents for and against the role played by vascular factors in the development of glaucomatous optic nerve degeneration. This review aims to analyze the various studies performed to provide evidence for and against the vascular theory of glaucoma. It also affirms the need to undertake further studies regarding the path-ogenesis of glaucoma and integrate them into our management strategies. The literature search for this systemic analysis was performed using search engines, such as PubMed, The Virtual Library of the Ministry of Health Malaysia, Google Scholar, and ClinicalKey.

Fulltext Glaucoma suspects: A practical approach

Ahmad SS

Taiwan J Ophthalmol, 2018;8(2):74-81.

PMID: 30038885 DOI: 10.4103/tjo.tjo_106_17

Glaucoma suspects are controversial clinical dilemmas. These individuals harbor certain risk factors or demonstrate some clinical features suggestive of an increased probability to develop glaucomatous optic atrophy in the future. These characteristics range from high intraocular pressure; optic disc, visual field, or retinal nerve fiber layer abnormalities; or abnormal angles to a positive family history of glaucoma and other risk factors. Individuals having these characteristics should be assessed diligently before a diagnosis of glaucoma is made. Glaucoma is a chronic, lifelong condition, having a negative impact on the quality of life, with an increased risk of medication-related side-effects, adverse economic impacts, and the need for lifestyle changes in the patient. Overdiagnosis and unnecessary treatment of such individuals is bereft of any advantage. This review aims to provide a practical blueprint for the proper diagnosis and management of such glaucoma suspects.

Fulltext Water related ocular diseases

Ahmad SS

Saudi J Ophthalmol, 2018;32(3):227-233.

PMID: 30224888 DOI: 10.1016/j.sjopt.2017.10.009

A number of ocular diseases can be attributed to contaminated water and we have coined a term "Water-related ocular diseases (WRODs)" to denote this wide-spectrum of conditions. WRODs are directly related to human contact with water and can occur through toxic, allergic, inflammatory or infective mechanisms. The non-infective causes can include chemicals used to clean swimming pools, oil spills and water-sport related injuries. Similarly, a number of infective organisms causing ocular diseases are transmitted through water. Since, these conditions can occasionally prove devastating, a review was done with the following aims: (i) To study the epidemiology of WRODs (ii) To assess the clinical presentation and current management of WRODs (iii) To highlight the future challenges and possible solutions to these problems. The online search was conducted utilizing search engines such as PubMed, Google Scholar, ClinicalKey and the Virtual Library of the Ministry of Health, Malaysia for relevant terms such as water-borne, swimming pool and eye infections.

Florid diabetic retinopathy in a young patient

Ahmad SS, Ghani SA

J Ophthalmic Vis Res, 2012 Jan;7(1):84-7.

PMID: 22737392

Kearns-Sayre syndrome: An unusual ophthalmic presentation

Ahmad SS, Ghani SA

Oman J Ophthalmol, 2012 May;5(2):115-7.

PMID: 22993469

Kearns-Sayre syndrome (KSS) belongs to the group of neuromuscular disorders known as mitochondrial encephalomyopathies. It has characteristic syndromal features, which include: chronic progressive external ophthalmoplegia, bilateral atypical pigmentary retinopathy, and cardiac conduction abnormalities. So far, only a single case has been reported where a patient with KSS had a normal retina. Herein, we report this extremely rare variant of KSS, which not only presented later than the normal age of presentation, but also had minimal pigmentary retinopathy.

Fulltext Pigmentary Glaucoma with Retinochoroidal Pigmentation

Ahmad SS, Ghani SA

J Ophthalmic Vis Res, 2016 5 20;11(1):120-3.

PMID: 27195097 DOI: 10.4103/2008-322X.180710

Fulltext A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy

Lau LL, Lung CK, Ahmad SS

Indian J Ophthalmol, 2015 Nov;63(11):856-8.

PMID: 26669339 DOI: 10.4103/0301-4738.171969

A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.

Fulltext A case of choroidal melanocytoma mimicking a choroidal melanoma

Ahmad SS, Lad L, Ghani SA

Saudi J Ophthalmol, 2015 Jul-Sep;29(3):242-5.

PMID: 26155089 DOI: 10.1016/j.sjopt.2015.02.002

A 17-year-old young girl was seen by us with complaints of progressive, painless decreasing vision in one eye for the last 4 years. No other supporting history could be elucidated. On examination, a large choroidal mass was found. Since the features were suggestive of malignant melanoma of the choroid, an enucleation of the eye was performed. Subsequently, histopathological examination of the enucleated eye revealed findings consistent with melanocytoma of the choroid. This case is unique in that the patient was of relatively young age and the tumor was huge compared to previous such reports.

Fulltext A case of bilateral, spontaneous absorption of lenses

Ahmad SS, Rahim AA, Ghani SA

Digit J Ophthalmol, 2011;17(1):3-5.

PMID: 23362385 DOI: 10.5693/djo.02.2011.01.002

Spontaneous absorption of lenses or cataracts is rare. We report a case of bilateral spontaneous lens absorption in a 36-year-old woman for which no cause could be determined despite extensive laboratory testing.

Fulltext Cut-it-out technique for ocular fish-hook injury

Ahmad SS, Seng CW, Ghani SA, Lee JF

J Emerg Trauma Shock, 2013 Oct;6(4):293-5.

PMID: 24339666 DOI: 10.4103/0974-2700.120384

An 11-year-old boy was involved in an injury with a fish-hook to his eye. The hook had impaled itself to the cornea and deeper structures. There was associated corneal edema and hyphema, making visualization difficult. In this case, we performed the unusual "cut-it-out" technique to remove the hook from the eye.

Fulltext Herpes Zoster Ophthalmicus, Central Retinal Artery Occlusion, and Neovascular Glaucoma in an Immunocompetent Individual

Ahmad SS, Suan ALL, Alexander SM

J Ophthalmic Vis Res, 2019 3 2;14(1):97-100.

PMID: 30820294 DOI: 10.4103/jovr.jovr_65_17

Purpose: To report the unusual case of an immunocompetent individual with herpes zoster ophthalmicus who developed central retinal artery occlusion and subsequent neovascular glaucoma.

Case Report: A 40-year-old, immunocompetent patient was diagnosed with herpes zoster ophthalmicus and central retinal artery occlusion on initial presentation. Subsequently, he developed neovascular glaucoma.

Conclusion: There are a few case reports of central retinal artery occlusion developing after varicella zoster virus infection. However, a literature search found no reports of neovascular glaucoma following central retinal artery occlusion secondary to varicella zoster virus infection. The present case report indicates that neovascular glaucoma is a possible complication in such a scenario.

Fulltext 5-year-old girl with left upper eyelid swelling

Ahmad SS, Ghani SA, Peng KS, Sellamuthu P

Digit J Ophthalmol, 2012;18(4):15-7.

PMID: 23847451 DOI: 10.5693/djo.03.2012.05.001

Fulltext Bilateral persistent pupillary membranes associated with cataract

Ahmad SS, Binson C, Lung CK, Ghani SA

Digit J Ophthalmol, 2011;17(4):62-5.

PMID: 23362401 DOI: 10.5693/djo.02.2011.10.001

Exuberant persistent pupillary membranes (PPM) are rare in adult eyes. We report the case of a 53-year-old man diagnosed with bilateral, profuse, persistent pupillary membranes and unilateral cataract.

Ajmalicine and its Analogues Against AChE and BuChE for the Management of Alzheimer's Disease: An In-silico Study

Liu S, Dang M, Lei Y, Ahmad SS, Khalid M, Kamal MA, et al.

Curr Pharm Des, 2020;26(37):4808-4814.

PMID: 32264807 DOI: 10.2174/1381612826666200407161842

BACKGROUND: Alzheimer's disease (AD) is the most well-known reason for disability in persons aged greater than 65 years worldwide. AD influences the part of the brain that controls cognitive and non-cognitive functions.

OBJECTIVE: The study focuses on the screening of natural compounds for the inhibition of AChE and BuChE using a computational methodology.

METHODS: We performed a docking-based virtual screening utilizing the 3D structure of AChE and BuChE to search for potential inhibitors for AD. In this work, a screened inhibitor Ajmalicine similarity search was carried out against a natural products database (Super Natural II). Lipinski rule of five was carried out and docking studies were performed between ligands and enzyme using 'Autodock4.2'.

RESULTS: Two phytochemical compounds SN00288228 and SN00226692 were predicted for the inhibition of AChE and BuChE, respectively. The docking results revealed Ajmalicine, a prominent natural alkaloid, showing promising inhibitory potential against AChE and BuChE with the binding energy of -9.02 and -8.89 kcal/mole, respectively. However, SN00288228- AChE, and SN00226692-BuChE were found to have binding energy -9.88 and -9.54 kcal/mole, respectively. These selected phytochemical compounds showed better interactions in comparison to Ajmalicine with the target molecule.

CONCLUSION: The current study verifies that SN00288228 and SN00226692 are more capable inhibitors of human AChE and BuChE as compared to Ajmalicine with reference to ΔG values.

Fulltext Cytomegalovirus retinitis associated with high CD4 counts and DHEA abuse

Keat GY, Ahmad SS, Subramaniam S, Ghani SA, Samsudin A

Indian J Sex Transm Dis AIDS, 2020 06 18;41(1):119-122.

PMID: 33062999 DOI: 10.4103/ijstd.IJSTD_90_15

The most frequent ocular manifestation of acquired immunodeficiency syndrome (AIDS) is cytomegalovirus retinitis (CMVR). This infection is reportedly inversely proportional to the CD4 counts. Usually CMVR develops once the CD4 counts fall below 50/mm3. Our case report documents an AIDS patient who developed CMVR despite CD4 counts being persistently >200/mm3. The patient was self-administering dehydroepiandrosterone, high dose Vitamin C, testosterone and hydrocortisone. This case report describes a unique case of pharmacologically induced elevated CD4 counts, which however, did not prevent the development of CMVR in the patient.

Molecular evidence and hematological alterations associated with the occurrence of coronavirus in domestic dogs in Pakistan

Sulehria MU, Ahmad SS, Ijaz M, Mushtaq MH, Khan AY, Ghaffar A

Trop Biomed, 2020 Dec 01;37(4):963-972.

PMID: 33612749 DOI: 10.47665/tb.37.4.963

Canine Enteric Coronavirus (CCoV) is one of the major enteric pathogen affecting dogs. This study aims to investigate the molecular prevalence, phylogenetic analysis, associated risk factors, and haemato-biochemical alterations in Canine Coronavirus in dogs in district Lahore, Pakistan. 450 fecal samples were collected from symptomatic dogs originating from various pet-clinics and kennels during 2018-2019. Samples were initially analyzed by sandwich lateral flow immunochromatographic assay and then further processed by RT-PCR (reverse transcriptase polymerase chain reaction) targeting the M gene followed by sequencing. RT-PCR based positive (n=20) and negative (n=20) dogs were samples for their blood for the haemato-biochemical analysis. A questionnaire was used to collect data from pet owners, in order to analyze the data for risk factors analysis by chi square test on SPSS. The prevalence of CCoV was 35.1%, and 23.8 % through Sandwich lateral flow immunochromatographic and RT-PCR respectively. Various risk factors like breed, age, sex, vomiting, diarrhea, sample source, body size, cohabitation with other animals, living environment, food, deworming history, contact with other animals or birds feces, and season were significantly associated with CCoV. The CCoV identified in Pakistan were 98% similar with the isolates from China (KT 192675, 1), South Korea (HM 130573, 1), Brazil (GU 300134, 1), Colombia (MH 717721, 1), United Kingdom (JX 082356, 1) and Tunisia (KX156806). Haematobiochemical alterations in CCoV affected dogs revealed anaemia, leucopenia, lymphopenia, neutrophilia, and decreased packed cell volume, and a significant increase in alkaline phosphate and alanine transaminase. It is concluded that infection with canine coronavirus appears widespread among dog populations in district Lahore, Pakistan. This study is the first report regarding the molecular detection and sequence analysis of CCoV in Pakistan.

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