Etiology and determinants of allograft dysfunction.

INTRODUCTION : Treatment option for Chronic Kidney Disease-Stage5 (CKD-stage5) patients fall into three categories viz., Haemodialysis, Peritoneal dialysis and Renal Transplantation. Many studies proved that the kidney transplantation is distinctly superior and it is associated with reduced mortality and morbidity compared to haemodialysis or peritoneal dialysis. The renal donors are of three types viz. live related, live unrelated and cadaver. Due to shortage organs and long waiting period in cadaver transplant prevention of second or re transplant is more important. To improve the graft survival identifying etiology of graft dysfunction or loss is more important. Once we identified the etiology we have to evaluate for immunologic, nonimmunologic, modifiable, non modifiable risk factors to improve the graft and patient survival. METHODS : All renal transplant recipients on regular follow up are included - September 2009 to march 2011. Those who died and those who are in irregular follow up during the period of study are excluded from the study. All the patient having graft dysfunction underwent renal biopsy. CONCLUSION : According to Univariate analysis following conclusion were made Tacrolimus gives a better graft survival than cyclosporine for both live and cadaveric transplants. Donor age has significant impact on long term graft survival; younger the donor better the outcome. With female donors the graft dysfunction is more, may be due to difference in antigencity and smaller renal mass. The Male recipients do worse than female recipients; probably due to female recipients has higher degree of sensitization to HLA antigen. Blood group, cross match results, day one urine output, First post operative day creatinine, discharge creatinine are not having significant association with cause graft dysfunction. Delayed graft function has significant impact on long term graft survival according to Univariate analysis. Side of the kidney , number of blood vessels, post operative events are not statistically significant to cause graft dysfunction

BER Analysis of Reconfigurable Intelligent Surface Assisted Downlink Power Domain NOMA

The use of software controlled passive Reconfigurable Intelligent Surface (RIS) in wireless communications has attracted many researchers in recent years. RIS has a certain degree of control over the scattering and reflection characteristics of the electromagnetic waves, compared to the conventional communications in which the received signal is degraded due to the uncontrollable scattering of the transmitted signal and its interaction with the objects in propagating medium. Further, in RIS assisted communications, the phases of the multiple incoming signals can be controlled to enable constructive addition of multiple signals from different channel paths to improve Signal to Noise Ratio (SNR). On the other hand, Non-Orthogonal Multiple Access (NOMA) provides massive connectivity and low latency. The power domain variant NOMA uses superposition coded symbols with different powers for different user symbols. In this paper, a novel RIS assisted downlink NOMA system is proposed by combining the merits of both RIS and NOMA to improve the reliability of the system. Analytical expressions are derived for the Bit Error Rate (BER) performance of the proposed RIS assisted power domain NOMA system. The BER performance of the proposed system is analyzed using the numerical simulation results. It is observed that the proposed system has better performance than the conventional NOMA system.Comment: 4 pages, 5 figures, accepted manuscript for a conference, peer reviewe

Synthesis and characterization of <img src='/image/spc_char/micro.gif' border=0>-phenoxo-bridged binuclear copper(II) complexes derived from binucleating ligands

29-34The new pentadentate binucleating symmetrical ligand 2,6-bis [N-(3,5-dichloro-2-hydroxybenzyl)-N-cyclohexylamino-methyl]-4-methylphenol (H3L1) has been prepared and its binuclear copper(II) complexes of the general formula [Cu2L(X)], where X = OH (perchlorato counter ion complexes), OAc, NO3 have been prepared. Their spectral properties and catecholase activities were studied. New unsymmetrical ligands and their complexes have also been synthesized. The phenolate oxygen atom of the binucleating ligands behaves as a bridging group. Conductivity studies showed that all the complexes are neutral. ESR spectra of the complexes show a broad band centred at 3500 G with no hyperfine splittings. The observed room temperature magnetic studies were found to be less than spin only value for d9 system. The rate constants of the complexes for the oxidation of catechol to o-quinone were in the range of 0.7210-3 to 15.010-3 min-1

Investigation of Static, Modal and Harmonic vibration analyses of Single Row SKF6205 Deep Groove Ball Bearing for thermal applications

It is the necessary to predict the endurance capability of the mechanical element with its increased application and complexity. The present research work estimates the stress variation and displacement characteristics using finite element analyses of Single Row SKF6205 Deep Groove Ball Bearing under radial and axial loadings. The vibration analyses are evaluated in three aspects; static, modal, and harmonic analysis. The simulations show the variation of stress levels of the bearing in different loads. These results are used to predict the fatigue life, wear rate, and productivity of the ball bearing at various stochastic conditions

Dengue Viral Myositis Complicated with Rhabdomyolysis and Superinfection of Methicillin-Resistant Staphylococcus aureus

Dengue is endemic in Sri Lanka and the physician should be aware of different and unusual presentation of the illness. Rhabdomyolysis is a well-known complication following many viral and bacterial infections; however, only a few cases have been reported with dengue viral infections. Further occurrence of coinfection by dengue and bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) has been underestimated, and few reports have been published so far. This case describes a 17-year-old boy who presented with prolonged severe myalgia, dark red urine, and a febrile illness that was diagnosed as having dengue viral myositis, dark red urine, and a febrile illness that was diagnosed as having dengue viral myositis complicated with rhabdomyolysis and superinfection of MRSA. Despite intensive care management, he died due to multiorgan failure. Autopsy and serological studies confirmed the diagnosis. This case stresses that red-coloured urine in dengue patients is not always due to haematuria, and if a patient’s vital signs do not respond to appropriate fluid management in DHF, sepsis from a secondary pathogen including MRSA should be suspected

Distribution of Semen Parameters Among Adolescent Males Undergoing Fertility Preservation in a Multicenter International Cohort

To determine the distribution of semen parameters among adolescent and adult males presenting for fertility preservation. A retrospective, cross-sectional cohort study of adolescent males age 11-19 who underwent semen analysis for fertility preservation at 3 centers in 2 countries with a comparison cohort of adult men presenting for fertility preservation. Prevalence of azoospermia and distribution of semen parameters was compared across groups. A total of 197 adolescents and 95 adults underwent semen analysis for fertility preservation. Azoospermia was present in 17 (8.6%) adolescents and 3 (3.2%) adults. There was decline in the prevalence of azoospermia with increasing age. After exclusion of patients with azoospermia, the adolescent and adult cohorts were comprised of 180 and 92 patients, respectively. Median age at presentation among adolescents vs adults was 16.5years (interquartile range [IQR] 15.2-17.6) and 30.8years (IQR 22.7-43.8), respectively. Median semen volume was 1.0mL (IQR 0.5-2.0) vs 2.5mL (IQR 1.5-3.5), P <.001. Median sperm concentration was 30million/mL (IQR 10-57) vs 39million/mL (IQR 14-57), P = .2. Median sperm motility was 39% (IQR 20-55) vs 45% (IQR 35-55), P = .01. Median total motile sperm count was 11million (IQR 1.4-33) for adolescents vs 29million (IQR 13-69) for adults, P <.001. Young adolescent males had higher prevalence of azoospermia and lower semen parameters compared to adults. In conjunction with physical examination, Tanner stage, and specific clinical context, these data can help to inform patients and their families about potential for fertility preservation, even in very young adolescent patients