Background and objectives There is a shortage of kidneys for transplant, and many patients on the deceased donor kidney transplant waiting list would likely benefit from kidneys that are currently being discarded. In the United States, the most common reason given for discarding kidneys retrieved for transplant is procurement biopsy results. This study aimed to compare biopsy results from discarded kidneys with discard attributed to biopsy findings, with biopsy results from comparable kidneys that were successfully transplanted.Design, setting, participants, & measurements In this retrospective, observational, case-control study, biopsy reports were examined from 83 kidneys discarded in 2010 due to biopsy findings (cases), 83 contralateral transplanted kidneys from the same donor (contralateral controls), and 83 deceased donors randomly matched to cases by donor risk profile (randomly matched controls). A second procurement biopsy was obtained in 64 of 332 kidneys (19.3%).Results The quality of biopsy reports was low, with amounts of tubular atrophy, interstitial inflammation, arteriolar hyalinosis, and acute tubular necrosis often not indicated; 69% were wedge biopsies and 94% used frozen tissue. The correlation between first and second procurement biopsies was poor; only 25% of the variability (R 2 ) in glomerulosclerosis was explained by biopsies being from the same kidney. The percentages of glomerulosclerosis overlapped substantially between cases, contralateral controls, and randomly matched controls: 17.1%615.3%, 9.0%66.6%, and 5.0%65.9%, respectively. Of all biopsy findings, only glomerulosclerosis.20% was independently correlated with discard (cases versus contralateral controls; odds ratio, 15.09; 95% confidence interval, 2.47 to 92.41; P=0.003), suggesting that only this biopsy result was used in acceptance decisions. One-year graft survival was 79.5% and 90.7% in contralateral and randomly matched controls, respectively, versus 91.6% among all deceased donor transplants in the Scientific Registry of Transplant Recipients.Conclusions Routine use of biopsies could lead to unnecessary kidney discards.

There have been multiple reports of the development of de novo or relapse of glomerular diseases after SARS-CoV-2 vaccination. While most of them have occurred with the mRNA vaccines (Pfizer/BioNTech and Moderna/NIAID), there also have been reports associated with the vector vaccines (AstraZeneca/ChAdOx1-S) vaccine and the inactivated vaccines. Minimal change disease (MCD) is one of the more common glomerular diseases noted to have been associated with the COVID-19 vaccination. We report here 4 more cases of MCD occurring in association with the COVID-19 vaccine, 3 were de novo cases, and 1 case had a relapse of MCD. We also review all the 41 cases described thus far in the literature and review potential common pathways activated by the vaccination that play a role in the pathogenesis of MCD.

Background: This study aims to assess dry eye indices following cataract surgery. Materials and Methods:  A single center descriptive and comparative study was performed. A total of 100 eyes of 100 cases fulfilling the inclusion criteria from 1st June 2017 to 30th May 2018 were enrolled. Out of 100 eyes, 50 eyes each went through manual small incision cataract surgery (MSICS) and phacoemulsification respectively. For objective analysis : schirmer 1 test(ST-I), tear breakup Time(TBUT) along with lissamine Green Surface Staining(LGSS) was performed on pre-operative day, 1st, 4th and 12th week respectively. Ocular Surface Disease Index (OSDI) was done for subjective analysis on pre-operative day and at 12th week. Results: The mean age of the patient was 53.66 ± 7.839 years with 34 (68%) being female in a small incision cataract surgery group.  In the phacoemulsification group, mean age was 54.72 ± 7.985 years and 32 (64%) were female.  On analyzing the objective dry eye indices: ST-I,TBUT and  LGSS at 12thweek was 18.80 ± 7.393 mm, 11.30 ± 5.456 seconds and 1.62 ± 1.193 in Small incision cataract surgery group and 27.10 ± 6.326 mm, 16.60 ± 4.699 seconds and 0.38 ± 0.602 in Phacoemulsification group respectively which was statistically significant. (p< 0.001).  Conclusion: Regardless of the type of cataract surgery, dry eye disease is unavoidable affecting both tear quality and quantity postoperatively. In our study, phacoemulsification had lesser effect in dry eye indices than small incision cataract surgery.

Background: With the outspread of global pandemic Corona virus disease 19. (COVID-19), use of face masks was taken as a vital deed against severe acute respiratory syndrome coronavirus-2. (SARS-CoV-2) The aim of this study was to assess symptoms of mask associated dry eye (MADE) among health workers. Materials and Methods:   A total of 169 heath workers meeting the inclusion criteria were selected by simple random sampling from respective department. Data were obtained by providing with questionnaire established by the researcher and Ocular Surface Disease Index (OSDI) to the participants from November 1, 2020 to March 31, 2021 at National Medical College and Teaching Hospital. The data were evaluated using correlation test. Results: A total of 169 heath workers were enrolled in the study.  The mean age of the patient was 31.74±7.34 years (range 19-56).According to OSDI, 27(15.9%) of the participants had mild dry eye symptoms followed by 15 (8.87%) cases of moderate and 44(26.03%) of severe respectively. Duration of mask wearer and electronic devices usage were two variables that were statistically correlated with OSDI (p<0.01). The OSDI was not statistically correlated with age, glass wear and sleep duration. Conclusion: With the emergence of COVID -19, measures to cope against this pandemic are must. With the increasing use of controlling measures, it is prime responsibility of ophthalmic faculty to start awareness regarding proper use of these anti-COVID measures and make sustainable environment in future.

Subconjunctival dislocation of the intraocular lens secondary to trauma is an unusual and serious condition in the pseudophakic eye. Here, a case of 75 years old male who had traumatic superior subconjunctival dislocation of intraocular lens to his right eye with cow’s horn is reported. The patient was managed with surgical extraction of the lens and planned for secondary intraocular lens implantation. It is quite challenging to manage such a case. Despite, proper surgical management visual outcomes are always guarded in such patients with blunt trauma.

Retinal arterial macro-aneurysms are pathological dilatations of retinal arterial branches mostly found in posterior pole. Here we present a 51 years old female with a diagnosis of retinal artery macro-aneurysm in the superior temporal arcade associated with macular edema based on clinical and optical coherence tomography (OCT) finding. Patient was treated with intra-vitreal injection (1.25 mg in 0.05 ml) of anti-vascular endothelium growth factor (bevacizumab) which showed both improvement in visual acuity and resolution of macular edema. Intra-vitreal injection of bevacizumab (Avastin) is safe and effective in treatment of macular edema associated with retinal arterial macro-aneurysms.

Introduction: Abnormalities of any of the components of lacrimal function unit can lead to dysfunctional tear film and development of dry eye. Dry eye is a commonly encountered problem in general population. Materials and Methods: A hospital-based, case-control study was conducted at National Medical College and Teaching Hospital, Nepal from 1st August 2018 to 30th July 2019.  A total of 279 participants: 93 cases of pterygium (Group A: case) and186 (Group B: control) normal individuals with no ocular surface disorder were enrolled. Objective analysis was done by Schirmer’s (SCH) without and with anesthesia and Tear Break up Time (TBUT). Dependent t test was used to analyze the data. P value <0.05 was considered statistically significant. Results: The mean age of the patients was 47.82 ±11.09 years (range 26-71) with male being 48 (51.6%) in Group A and in Group B, 101 (54.3%) were male with mean age being 42.16 ±13.13 years (range 32-75). The mean SCH without and with anesthesia and TBUT values were 16.94±5.61mm, 13.81±5.06mm, 10.14± 4.06 sec in Group A whereas in Group B, 20.39 ±6.08mm, 16.74 ±5.25mm and 13.05 ±4.32 sec respectively which was statistically significant (p < 0.05).  Patients with pterygium had higher risk of having dry eye than normal individuals (Odd ratios: 2.69, 2.44 and 2.27 respectively). Conclusion: Pterygium is a common ocular surface disorder which could result in instability of tear film indices, dysfunctional tear film and thus dry eye.

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