Search

(COVID-19) has resulted in significant morbidity and mortality in solid organ transplant recipients. In December 2020, at the peak of the Los Angeles outbreak, our center rapidly implemented a protocol to improve outpatient management and provide bamlanivimab or casirivimab-imdevimab [COVID monoclonal antibody (mAb) therapies] to all eligible COVID-19 positive liver and kidney transplant recipients.A retrospective review of all abdominal organ transplant recipients who were COVID-19 polymerase chain reaction positive between February 2020 and February 2021 from our center was performed. Patient demographics, COVID-19 treatments, hospitalizations, and survival were reviewed. Patients were considered eligible for COVID mAb therapy if they met outpatient criteria at the time of diagnosis.In the study period, 121 patients in the kidney transplant recipients group (KG) and 105 patients in the liver or combined liver/kidney transplant recipients group (LG) were COVID-19 polymerase chain reaction positive. Hospitalization rates were similar for the KG (45%) versus LG (35%) (P = 0.20), but mortality was higher for the KG (22%) when compared to LG (10%) (P = 0.02). Our programmatic response, including outpatient COVID mAb therapies, reduced hospitalizations (P = 0.01) and deaths (P = 0.01). Ninety-four KG and 87 LG patients were identified as potentially eligible for COVID mAb therapy, and 17 KG and 17 LG patients were treated. COVID mAb therapies reduced hospitalization from 32% to 15% (P = 0.045) and eliminated mortality (13% versus 0%, P = 0.04).An aggressive approach including outpatient COVID mAb therapy in the COVID positive abdominal organ transplant recipients significantly decreased hospitalization and death. Early outpatient intervention for COVID-19 disease in transplant patients should be considered where possible.

Introduction: Diabetes has become a global epidemic. Diabetic retinopathy (DR) is a leading cause of loss of vision in diabetics. Since the global prevalence of diabetes is estimated to rise exponentially, the prevalence of DR is also bound to rise. Consequently, a large population will be at risk by DR in near future. Materials and Methods: A cross sectional observational study was conducted on eligible diabetic patients. Demographic data and history was noted. A complete ophthalmic examination in which fundus was examined by +90 D and +20D lenses. Statistical analysis was performed. Results: Out of 291 eligible patients, 159 (55%)were males. 76 (26.11%) had DR of which 43 (27.04%)were males. For duration of diabetes (years) 10, DR was found in 5 (6.57%), 30 (39.47%) and 41 (53.94%) respectively. DR in age groups (years) of 80,was 1(2%),32(25%), 44(30%) and 9(100%) respectively. Mild, moderate, severe NPDR and PDR were found in 39(51.31%), 17(22.36%), 13 (17.1%) and 7 (9.2%) patients respectively. Conclusion: The prevalence of DR is very high in Indian population. Diabetic patients are unaware of development of DR in early stages. The severity of DR rises with increase in duration of diabetes. Keywords: Diabetic retinopathy, Prevalence, NPDR, PDR, Risk factors.

Background: Effects of DM are gradual, progressive and due to chronic exposure to high blood sugar levels. DM also affect the eyes which can lead to ocular morbidity as DR can cause blindness. In that view, it becomes increasingly important to diagnose them at the earliest for proper management and prevention of complications.Methods: A total of 182 patients examined, out of which 91 were diabetic and 91 were non diabetic. Complete ocular examination was done that included visual acuity, anterior segment and fundus. Diabetic retinopathy was graded according to ETDRS classification. Diabetic patients were divided into 3 groups on the basis of HbA1c level (%): group-A (6-8), group-B (8-10) and group-C (>10). Patients were divided into 3 groups on the basis of duration (years): group1 (10).Results: Ocular manifestations were more prevalent in diabetics than non-diabetics along with that DR was found in diabetic patients and no retinopathy was found in non-diabetic patients. Out of 91 diabetic patients, DR was found in 30(33.3%) patients. Out of 30 DR, NPDR was found in 25(75%) and PDR was found in 5 (15%). DR in group A, B and C: 0, 17 (58%) and 13 (86%) respectively. DR in group1,2 and 3 was 3 (7.5%), 11 (35.4%) and 16 (80%) respectively.Conclusions: Longer duration of diabetes and higher HbA1c level are associated with increased prevalence and severity of DR.

Introduction: Myopia is a refractive error in which ability to see an object at a distance is reduced. Not only is this widely prevalent but also there has been an increase in the prevalence of myopia around the globe. Myopia leads to short-sightedness and sometimes irreversible blindness. Myopic patients have to use optical device like spectacles or contact lenses which have recurring expenses or undergo a laser refractive surgery which is very expensive. Pathological myopia if complicated by retinal detachement leads to immense morbidity and financial burden. Although many hypotheses have been proposed, but definite cause has not been established. Materials and Methods: A cross-sectional study was conducted on medical students. Detailed history and eye examination was done. Uncorrected visual acuity, best corrected visual acuity, visual acuity by pin-hole, colour vision cycloplegic refraction, tonometry and fundus examination were performed. Intraocular pressure, keratometry and axial length measurements were done. Myopia was classified into low (-0.5D to -2.00D), moderate (-2.25D to -6.00D) and high (>-6.00D). Myopia prevalence was calculated and then statistically analyzed. P Results: Out of 233 (107 males) students myopia was found in (123) 52.78%. Myopia was distributed in males and females as 54.47% vs. 45.52% (p Conclusion: Myopia was found to be highly prevalent in medical students. Greater time spent on near –work and indoor activities while lesser time on outdoor activities is a risk factor for myopia. Keywords: Cycloplegic refraction, Myopia, Medical students, Near vision, Prevalence.

There has been increased recognition of the importance of non-technical skills (e.g., communication and leadership) for cardiac arrest management. However, training is often insufficient to cultivate the requisite level of proficiency of these non-technical skills. We evaluated non-technical and technical skills performance of internal medicine residents in simulated cardiac arrest cases prior to and following a novel application of an interactive teaching strategy known as the Jigsaw Method. This method is one of the several established teaching strategies intended to actively engage learners. Internal medicine residents participated in pre- and post-intervention medical knowledge quizzes and cardiac arrest simulation cases. Technical skills (i.e., medical knowledge) were assessed by multiple-choice quizzes and non-technical skills (i.e., leadership, communication) with performance scoring. Fifty-six residents, including 50 of 53 (94%) matriculated senior residents from within the internal medicine program, participated. There was statistically significant improvement in quiz scores (median 63.3 vs. 80.0, p

Background: Retinopathy of prematurity (ROP) is a vasoproliferative disease of premature infants which leads to permanent blindness. Early screening is needed to diagnose ROP and prevent blindness.Methods: Retrospective study was conducted in 225 neonates from January 2018 to December 2020. All neonates with birth weight 0.05). Out of 148 neonates who were given oxygen 19 (12.83%) developed ROP (odds ratio: 5.52). Out of 42 neonates who had sepsis, 2 (4.76%) developed ROP (odds ratio: 0.43).Conclusions: The prevalence of ROP was 9.33%. The prevalence is showing a decreasing trend. ROP is not affected by gender. Oxygen given to neonates is associated with greater ROP. But sepsis in neonates is not associated with development of ROP.

Background: Among the refractive errors, myopia is the most common in school children. Due to myopia, school children are unable to see the blackboard which severely affects their performance. Moreover, they are unable to play outdoor sports thereby hampering their all-round development.Methods: This is a cross-sectional observational and analytical study. All children from 5-12 years attending eye OPD were included. Detailed history was taken and complete ophthalmic examination was done. Low myopia was defined as refractive error of -0.25D to -3D. Moderate myopia was defined refractive error of -3.25 D to -6 D. High myopia was defined as refractive error of ≥-6D. The children were divided into 3 groups according to their age (in years): group-1 (5-7), group-2 (8-9) and group-3 (10-12). The data obtained was subjected to statistical analysis using IBM SPSS version 24. P value was calculated by chi-square test. P0.05), Low, moderate and high myopia was found in 19 (73.07%), 6 (23.07%) and 1 (3.84%) child respectively.Conclusions: The prevalence of myopia in school children is 16.99%. There is a need for regular screening of school children to diagnose myopia in them. The limitation of this study is hospital based and small sample size. So, we recommend a community-based study with a larger sample size.

In a nonuniform memory access (NUMA) system, I/O to a local interconnect is more efficient than I/O to a remote interconnect. Managing resources of virtual machines (VMs) is complex in a virtualized NUMA system because multiple VMs are competing for CPU, memory, and devices spread across NUMA nodes. In this article, the authors study how to schedule VMs for better I/O on a NUMA system. They discuss the design of a NUMA-aware I/O hypervisor scheduler that aligns VMs and hypervisor threads on NUMA boundaries while extracting the most benefit from local device I/O.

Pulmonary Epithelioid Hemangioendothelioma is a rare and low grade tumor of endothelial origin found in the lungs. At onset patients are usually asymptomatic or present with non-specific symptoms. Chest imaging shows the presence of multiple, bilateral small nodules and diagnosis usually requires a lung biopsy. At this time there is no standardized treatment regimen and the prognosis is variable.

Background: Due to advancement in phacoemulsification techniques, there has been growing shift from peribulbar anesthesia (PA) to topical anesthesia (TA). But dilemma exists regarding the supremacy of one over the other as both types have certain advantages and disadvantages.Methods: A prospective study was conducted. Patients were divided into two groups. Group-1 underwent PA while group-2 underwent TA. Satisfaction score of patients and surgeons and incidence of complications were noted. The data was analyzed.Results: Lowest patients’ satisfaction score among group-1 vs. group-2 was 160 (87.9%) vs.82 (45.81%). Highest surgeons satisfaction score among group-1 and group-2 was 74(40.65%) vs. 2(1.1%). Intraoperative complications among the group-1 and group-2 were 35 (19.2%) vs. 86(48.0%).Conclusions: While TA provides initial painless phase of surgical procedure, PA results in lesser intraoperative complications resulting in better visual outcome.

(2015). Alternate Derivation for the Parity of the nth Triangular Number. The American Mathematical Monthly: Vol. 122, No. 6, pp. 551-551.