Irfan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Hospital-acquired nephrotoxic exposures in the precipitation of acute kidney injury-A case series analysis and a call for more preventative nephrology practices

sicca commonly called 'dry eye' has many causative factors; and diabetes is identified as one of the etiology of dry eye syndrome worldwide. Diabetes is one of the leading causes of ocular morbidity and blindness in 20-74 years of age. 1 As it affect not only the anterior, posterior segment of the eye and lens, but also the retina leading to retinopathy. According to WHO, the prevalence of diabetes in Pakistan 2016 is 9.8%. The reported prevalence of dry eye syndrome is 15-33% in those of over 65 years of age. 2

In the cognate nephrology literature, a few recent publications from major academic centers in the United States have suggested that the incidence of contrast nephropathy was exaggerated and overstated. These investigators have concluded that intravenous contrast material administration was not associated with an increased risk of acute kidney injury (AKI), emergent dialysis, and short-term mortality in a cohort of patients with diminished renal function. As a contrarian opinion, we first describe a clear cut case of contrast-nephropathy resulting in AKI requiring hemodialysis treatment managed in the Renal Unit of the Mayo Clinic Health System, Northwestern Wisconsin, in the Spring of 2017. We subsequently revisit the overwhelming evidence-base in the English literature that supports the enormous impact of contrast-nephropathy as a clinical syndrome. We finally posit that these recent repudiations of the existence and significance of contrast-nephropathy as a significant clinical entity represent an overreach in statistical expertise. There is no basis for a requiem song over contrast-nephropathy

A 20 years old female came to our hospital with sudden painless loss of vision in her right eye for two days. She was diagnosed with dengue fever two and a half weeks back and was managed conservatively. Ocular examination showed mid-dilated pupils with sub-conjunctival hemorrhage, lens opacity, vitreous hemorrhage and haze, sub-retinal hemorrhage and retinal detachment. Visual acuity in right eye was perception of light only. Ultrasound revealed moderate number of low to moderately reflective vitreous echoes and a highly reflective membrane attached to the disc suggesting retinal detachment. An urgent ophthalmologist opinion was sought followed by pars plana vitrectomy with silicon oil. She was lost to follow up after surgery.