Pre Renal Assessment For A Successful Kidney Transplant

Introduction:Living donor kidney transplantation is the treatment of choice for patients with end stage kidney disease, which prevents chronic dialysis and its long term side effects. In addition to the detailed clinical history and thorough laboratory testing, anatomical assessment of kidneys, pre donation kidney volume and its function before transplantation are important factors to assess post transplant outcome. Materials and methods: Patients undergoing first renal transplant and those between age group of 18 to 60 years were included in the study. Donor kidney volume was measured ultrasonographically, from which donated kidney volume was calculated to evaluate GFR of the donated kidney from the total GFR of the donor. Estimation of recipient graft function was done using four variable abbreviated MDRD equation at 3, 6, 9 and 12 months post transplant. Results :Correlation of the donor age and donor kidney volume with recipients eGFR was done and the results were tabulated. Statistical analysis was done and correlations were seen with Pearson’s correlation coefficient. Statistical significance was defined as p value 0.05. Conclusion: Living donor kidney transplantation remains one of the vitally important treatment option for the end stage renal disease patients. Estimation of donor kidney volume, eGFR and donor age all together play an important role in post transplant graft survival and also better renal outcomes and functioning

Pathya & Apathya (Wholesome & Unwholesome diet and regimen) in Yakrit Kshaya (Liver Cirrhosis) : A Narrative Review

Yakrit Kshaya (Liver Cirrhosis) is associated with vitiated Agni (digestive power), production of Ama (Undigested food) and Anuloma and Pratilomakshyaya (forward and backward depletion of Dhatu). Approximate 20% compensated cirrhosis patients and 65-95% decompensated cirrhosis patient have either Anuloma Dhatu Kshaya (forward depletion) or Pratilomana Dhatu Kshaya (backward depletion) or both types of malnutrition. Pathya (wholesome diet and regimen) is defined as the Ahara (Diet) and Vihara (regimen) that give proper nutrition to body and mind, clear the micro channels of Body (Pantha/Marga/Srotas), and provide happiness; that opposite is Apathya(unwholesome diet and regimen). A Pathya and Apathya chart for Yakrit Kshaya (Liver Cirrhosis) is prepared and presented. Chinta (anxiety), Shoka (depression), Krotha (anger), Duhkha (sorrow), Dukkha Shaiya (uncomforted bed) and Ratrijagarana (insomnia) can contribute for the indigestion even if a small quantity of Pathyaahara (wholesome diet). Normal diet with Goghruta (ghee) prepared from curd (Emulsified fat), Mamsa Rasa, milk can balance the protein. The Yakrit Kshaya patients should eat 6-8 times in small quantity (snax, mini meal ) as their Agni is low to very low. Mid night meal is also advisable for reduce protein breakdown. Restriction of water, sour and salty foods, fast foods are very crucial for the treatment outcome as it create Ama. More research on Pathya (Ayurveda diet) in Yakritkshaya (Liver cirrhosis) is encouraged

Ayurvedic treatment outcome for Chronic Liver diseases

Currently available medical therapies for liver disorders have more systemic toxicity, cost effective and liver transplantation was advised to many cases. So many patients want to take ayurveda medication as last choice or as a choice due to poverty. We have documented more than 200 cases and found 40% cases are Non Alcoholic Fatty liver diseases followed by Cirrhosis of liver. There are more than three hundred herbo-mineral preparations in Ayurveda system of medicine for the treatment of jaundice and chronic liver diseases. More than 50% people of our country relay on Ayurveda and herbal medicine for liver diseases. Ayurveda medicine could represent a promising tool to postpone the need of liver transplantations, increase the QoL of patients with cirrhosis, and reduce overall treatment costs of Chronic liver diseases. Ayurveda also delivered sodhana ( Purificatory treatment) by means of Panchakarma treatment. Rasayana therapy is very helpful in CLD. Diet has a integral role in Outcome of a CLD patient. Evidences are coming for remission of hepatao-cellular carcinoma and reversal of fibrosis of liver with high life expectancy. So public participation as well as awareness for Ayurveda treatment in Chronic liver diseases are required. Proper training and modern skill development should be mandatory for of Ayurveda Physicians treating liver diseases . More evidences in terms of Ayurveda outcome studies are the need of the hour to create a hope for CLD Patients

Machinability Investigation on Novel Incoloy 330 Super Alloy using Coconut Oil Based SiO2 Nano fluid

Over the years, the quality of the finished surface has become the foremost prevalent owing to better output performance, reliability and life span of a machined part.  Moreover, the effects of cooling and lubrication approach during the machining process play a vital role. Incoloy 330 generally used in petrochemical, chemical, power generations, thermal processing applications. This exploration focuses on the appropriate utilization of the Minimum Quantity Lubrication (MQL) based cooling approach using diverse concentrations of coconut oil based SiO2 nanofluids in the turning practice of Incoloy 330 alloy. The input variables are nanofluids concentration (Nc), feed (f) and cutting speed (Vc). The cutting insert TiAlN PVD coated cemented carbide tool is utilized to study the output responses like tool flank wear (VBc), surface roughness (Ra), material removal rate (MRR), and chip morphology. SiO2 nanofluids work effectively as tool flank wear is found to be less (VBc varies in between 0.057 mm to 0.077 mm). From ANOVA, cutting speed is found to be topmost influencing input (83.24%) for tool flank wear. Machining on the highest feed value (0.35 mm/rev) is not recommended for this work as Ra is found to be greater than 1.6 µm. With increasing cutting speed and feed rate, MRR increases. In each run, coiled continuous helical chips are obtained. Deformed chip thickness is found to be lower ( 0.3 to 0.74 mm) due to the application of SiO2 nanofluid through MQL which enhanced the heat dissipation thus eliminated the tendency of chip welding on the top surface of the tool. Chip reduction coefficient decreases with feed and cutting speed. Further, the TOPSIS optimization technique has been implemented to get an optimum set of cutting parameters for multiple responses and it is found to be Nc3 (0.3 % wt)-f1 (0.15 mm/rev)-Vc3 (160 m/min)

Effect of Multiple Substitutions (Pb, Ti, Zr) on Structural, Permittivity and Electrical Properties of BiFeO3 Ceramics

Three complex polycrystalline samples of Bi1-xPbxFe1-x Zrx-yTiyO3,with the combination of (i) x, y = 0.0 (BFO), (ii) x = 0.5 and y = 0.5 (BFPTO)and (iii) x = 0.5 and y = 0.25 (BFPZTO) were prepared by a standard mixed oxide (solid state reaction route) method at optimized calcinations (900oC) and sintering (930-950oC)temperatures. The effect of multiple (Pb, Ti and/or Zr) substitutions of different amount onthe permittivity, impedance and modulus characteristics of the materials has been investigated at different frequencies and temperature. Limitation associated with BiFeO3 (BFO) due to its semiconducting behavior acts as constraint in polling the material at room temperature leading to large dielectric loss. Attempts were made to minimizethe loss by substitution of Pb on the Bi site and Ti and/or Zr at the Fe site of BFO. The study indicates that the phase transition temperature of BFO is lowered,the degree of diffuse phase transition is enhanced and electrical parameters (dielectric constant, electrical resistivity, remnant polarization and maximum polarization) areincreased with a significant reduction in dielectric loss as a consequence of the substitution. Detailed studies of Nyquist plots with impedance and electric modulus data suggest that the existence of non-Debye type of relaxation phenomena in the materials. The ac conductivity study reveals that the conduction mechanism in the material obeys universal Jonschers power law

Phyto extracts of Carica papaya and Tinospora cordifolia can correct thrombocytopenia in alcoholic decompensate liver cirrhosis : Case Series

Thrombocytopenia (platelet count <150 × 109/L) is a frequent complication of decompensate cirrhosis and is considered as an indicator of advanced disease. Carica papaya leaf juice has beneficial effect in thrombocytopenia associated with dengue. Tinospora cordifolia has been shown to prevent the fibrous tissue deposition of liver by modulation of kupffer cell activation. An attempt was taken to observe the usefulness of extract Carica papaya and Tinospora cordifolia in alcoholic decompensate cirrhosis. A market available product Cariden is easily available to the patients which contains Phyto extracts of Carica papaya 1100mg and Tinospora cordifolia 500mg. Phyto extracts of Carica papaya and Tinospora cordifolia can enhance the platelet count within 15 days and it can normalise the platelet within 90 days of therapy in all three cases. Further randomised control trial is suggested