Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices

Purpose: The purpose of this study is to review the history and evolution of the National Eye Bank (NEB) and analyze the impact over the years and report the outcome of the invested resources. Methods: Review of archival material, records, project reports, policy and procedures' manuals, and publications was done. Descriptive and analytical processing of data obtained was undertaken. Parameters evaluated included total collection, transplantation, utilization rates of donor cornea, changing trends over time in terms of numbers and duration of recipients waiting, impactful research translated into changes in standard operating protocols, new facilities, and subsequent effects on numbers or quality assurance measures and overview of major achievements. Periodic situational analysis with contextual relevance and interpretation of outcomes was done pertaining to national goals and international standards. Results: The NEB and cornea services have played a key leadership role in furthering the development of eye banking and corneal transplantation services. The contribution extends beyond routine patient care to education, training, generation of resources, advocacy, and policymaking. In quantifiable terms, the overall performance has steadily increased over the years. Major contributions include training of doctors, eye bank staff and corneal surgeons, introduction of innovative techniques for corneal transplantation, setting of national standards for eye banking and provision of preservation media, customized corneal, and ocular surface cell replacement therapy in collaboration with other departments and institutes. Conclusion: The eye banking and corneal transplantation facilities have evolved with time providing quality services, modernized as appropriate with updated knowledge and incorporating technological advances supported by the systematic evidence-based approach

A Novel Approach for Treatment of Two Adjacent Gingival Recession Defects using Modified Bilateral Pedicle Flap and Tunnel Technique combined with TitaniumPrepared Platelet Rich Fibrin

Gingival recession being the most common mucogingival problem among adult patients is often associated with root hypersensitivity, erosion, root caries, and compromised aesthetics. The primary goal of treating gingival recession include complete root coverage along with improving gingival biotype to facilitate proper plaque control, improve patient aesthetics, and to prevent further periodontal breakdown. Although numerous root coverage techniques and regenerative materials are available, a novel technique involving the bilateral pedicle flap with subperiosteal tunnel in interdental papilla along with use of Titanium Prepared Platelet-Rich Fibrin (T-PRF) has been described in this case report. A 20-year-old male patient reported with the chief complaint of teeth sensitivity in lower front teeth. Intraoral examination revealed Recession Type 1 (RT-1) defects in mandibular central incisors which were treated using modified bilateral pedicle flap and tunnel technique combined with T-PRF. This technique allowed excellent blood supply at recipient site along with complete coverage of T-PRF membrane and root surfaces. The subperiosteal tunnel created in between the two affected teeth, allowed better stabilisation of membrane and inhibited apical retraction of flap during healing phase. Using this novel technique, complete root coverage was achieved along with gain in gingival thickness hence, it can be considered as a predictable approach for the treatment of RT-1 defects involving two adjacent teeth

Donor-Derived Cell-Free DNA as a Non-Invasive Biomarker for Graft Rejection in Kidney Transplant Recipients: A Prospective Study among the Indian Population

Monitoring graft health and detecting graft rejection is crucial for the success of post-transplantation outcomes. In Western countries, the use of donor-derived cell-free DNA (dd-cfDNA) has gained widespread recognition as a diagnostic tool for kidney transplant recipients. However, the role of dd-cfDNA among the Indian population remains unexplored. The recipients were categorized into two groups: the post-transplant recipient (PTR) group (n = 16) and the random recipient (RR) group (n = 87). Blood samples were collected daily from the PTR group over a 7-day period, whereas the RR group’s samples were obtained at varying intervals. In this study, we used a targeted approach to identify dd-cfDNA, which eliminated the need for genotyping, and is based on the minor allele frequency of SNP assays. In the PTR group, elevated dd-cfDNA% levels were observed immediately after transplantation, but returned to normal levels within five days. Within the RR group, heightened serum creatinine levels were directly proportional to increased dd-cfDNA%. Sixteen recipients were advised to undergo biopsy due to elevated serum creatinine and other pathological markers. Among these sixteen recipients, six experienced antibody-mediated rejection (ABMR), two exhibited graft dysfunctions, two had active graft injury, and six (37.5%) recipients showed no rejection (NR). In cases of biopsy-proven ABMR and NR, recipients displayed a mean ± SD dd-cfDNA% of 2.80 ± 1.77 and 0.30 ± 0.35, respectively. This study found that the selected SNP assays exhibit a high proficiency in identifying donor DNA. This study also supports the use of dd-cfDNA as a routine diagnostic test for kidney transplant recipients, along with biopsies and serum creatinine, to attain better graft monitoring