Objective IgA nephropathy (IgAN) and IgA vasculitis (IgAV) are part of a similar clinical spectrum. Both clinical conditions occur with the coronavirus disease 2019 (COVID-19). This review aims to recognize the novel association of IgAN and IgAV with COVID-19 and describe its underlying pathogenesis. Methods We conducted a systematic literature search and data extraction from PubMed, Cochrane, ScienceDirect, and Google Scholar following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Our search identified 13 cases reporting IgAV and IgAN associated with COVID-19 infection and 4 cases of IgAN following COVID-19 vaccination. The mean, mode, and median ages of patients were 23.8, 4, and 8 years, respectively. Most cases associated with COVID-19 infection were reported in males (76.9%). Rash and purpura (84.6%) were the most common clinical features, followed by gastrointestinal symptoms (61.5%). In symptomatic cases, skin or renal biopsy and immunofluorescence confirmed the diagnosis of IgAN or IgAV. Most patients were treated with steroids and reported recovery or improvement; however, death was reported in two patients. Conclusion There is a paucity of scientific evidence on the pathogenesis of the association of IgAN and IgAV vasculitis with COVID-19, which thus needs further study. Current research suggests the role of IgA-mediated immune response, evidenced by early seroconversion to IgA in COVID-19 patients and the role of IgA in immune hyperactivation as the predominant mediator of the disease process. Clinicians, especially nephrologists and paediatricians, need to recognize this association, as this disease is usually self-limited and can lead to complete recovery if prompt diagnosis and treatment are provided.

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Objective: To evaluate the demographic, social, and religious factors influencing perceptions towards receiving only palliative care near the end of life among cancer patients in Pakistan, and to determine their preferred location for receiving end-of-life care and the reasons behind their choice. Results: Out of a total of 112 patients, 61% of patients preferred palliative care. Those who were well aware of their prognosis (OR=5.383, p=0.006), had a positive perception of palliative care (OR=4.165, p=0.001) and believed that it aligned with their religious beliefs (OR=2.964, p=0.004) indicated that they would prefer palliative care over curative treatment near the end of life. Fewer patients preferred to opt for palliative care with the increasing cost of stay per day at the hospital (OR=0.121, p=0.002) and increasing age (OR=0.939, p=0.001). More than two-thirds of the patients preferred receiving palliative care at their homes. Some of the major reasons for this included being able to receive care from friends or family (n= 27) and being able to let their family have a normal life (n=20).

This paper describes a perineal access tool for MRI-guided prostate interventions and evaluates it using a phantom study. The development of this device has been driven by the clinical need and a close collaboration effort. The device seamlessly fits into the workflow of MRI-guided prostate procedures such as cryoablation and biopsies. It promises a significant cut in the procedure time, accurate needle placement, lower number of insertions, and a potential for better patient outcomes. The current embodiment includes a frame which is placed next to the perineum and incorporates both visual and MRI-visible markers. These markers are automatically detected both in MRI and by a pair of stereo cameras (optical head) allowing for automatic optical registration. The optical head illuminates the procedure area and can track instruments and ultrasound probes. The frame has a window to access the perineum. Multiple swappable grids may be placed in this window depending on the application. It is also possible to entirely remove the grid for freehand procedures. All the components are designed to be used inside the MRI suite. To test this system, we built a custom phantom with MRI visible targets and planned 21 needle insertions with three grid types using the SCENERGY software. With an average insertion depth of about 85 mm, the average error of needle tip placement was 2.74 mm. We estimated the error by manually segmenting the needle tip in post-insertion MRIs of the phantom and comparing that to the plan.