Kidney Transplantation

Renal transplantation remains the optimal treatment for end stage renal disease. Compared with dialysis, it is associated with increased patient survival and better quality of life, and is cost effective. Kidney transplantation requires a multi-disciplinary approach in the pre-operative assessment and work-up of donors and recipients, and subsequent post-operative care. The classical surgical procedure for renal transplantation has changed little from the original pelvic operation originally described in 1951, but the surgical complexity however has been magnified by the increasing age of recipients, frequently with other comorbidities, and impetus to utilise kidneys from extended criteria donors, either as single or dual transplants. There have also been tremendous advances in the technical aspects of live-donation. This chapter details the surgical aspects of kidney donation and transplantation, including preparation of the graft, vessel reconstruction, urinary drainage and identification and management of post-donation and transplantation complications. It is hoped the reader is provided with a comprehensive account of the technical aspects of renal transplantation, with a description of variation in procedure based on anatomical aberrations. An overview of current practise with a look to the future is provided

Detection of Sugar-Lectin Interactions by Multivalent Dendritic Sugar Functionalized Single-Walled Carbon Nanotubes

We show that single walled carbon nanotubes (SWNT) decorated with sugar functionalized poly (propyl ether imine) (PETIM) dendrimer is a very sensitive platform to quantitatively detect carbohydrate recognizing proteins, namely, lectins. The changes in electrical conductivity of SWNT in field effect transistor device due to carbohydrate - protein interactions form the basis of present study. The mannose sugar attached PETIM dendrimers undergo charge - transfer interactions with the SWNT. The changes in the conductance of the dendritic sugar functionalized SWNT after addition of lectins in varying concentrations were found to follow the Langmuir type isotherm, giving the concanavalin A (Con A) - mannose affinity constant to be 8.5 x 106 M-1. The increase in the device conductance observed after adding 10 nM of Con A is same as after adding 20 \muM of a non - specific lectin peanut agglutinin, showing the high specificity of the Con A - mannose interactions. The specificity of sugar-lectin interactions was characterized further by observing significant shifts in Raman modes of the SWNT.Comment: 12 pages, 3 figure

The performance of organ dysfunction scores for the early prediction and management of severity in acute pancreatitis: an exploratory phase diagnostic study

Objective: To evaluate contemporary organ dysfunction scoring systems for early prediction of severity in acute pancreatitis (AP). Methods: In a consecutive cohort of 181 patients with AP, organ dysfunction scores (logistic organ dysfunction system [LODS] score, Marshall organ dysfunction score, and sequential organ failure assessment score) were collected at 24 and 48 hours. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated on admission and 24 and 48 hours and C-reactive protein level measured at 48 hours. Patients who died or used critical care facilities (level 2/3) during admission were classed as severe. Results: Area under curve for APACHE II score at admission was 0.78 (95% confidence interval, 0.69-0.86). At 24 hours, area under curve for LODS, Marshall organ dysfunction system, sequential organ failure assessment, and APACHE II scores were 0.82, 0.80, 0.80, and 0.82, respectively. The LODS score at cutoff of 1 achieved 90% sensitivity and 69% specificity, corresponding to a positive predictive value of 38%. Acute Physiology and Chronic Health Evaluation II score as a rule-out for selection of mild cases at a test threshold of 9 (scores <= 8 being selected) gives homogeneity of 91% and efficiency of 79%. Conclusions: Contemporary organ dysfunction scoring systems provides an objective guide to stratification of management, but there is no perfect score. All scores evaluated here perform equivalently at 24 hours. Acute Physiology and Chronic Health Evaluation II may have practical clinical value as a rule-out test

Computational engineering analysis of external geometrical modifications on the MQ-1 unmanned combat aerial vehicle

This paper focuses on the effects of external geometrical modifications on the aerodynamic characteristics of the MQ-1 predator Unmanned Combat Aerial Vehicle (UCAV) using computational fluid dynamics. The investigations are performed for 16 flight conditions at an altitude of 7.6 km and at a constant speed of 56.32 m/s. Two models are analysed, namely the baseline model and the model with external geometrical modifications installed on it. Both the models are investigated for various angles of attack from −4° to 16°, angles of bank from 0° to 6° and angles of yaw from 0° to 4°. Due to the unavailability of any experimental (wind tunnel or flight test) data for this UCAV in the literature, a thorough verification of calculations process is presented to demonstrate confidence level in the numerical simulations. The analysis quantifies the loss of lift and increase in drag for the modified version of the MQ-1 predator UCAV along with the identification of stall conditions. Local improvement (in drag) of up to 96% has been obtained by relocating external modifications, whereas global drag force reduction of roughly 0.5% is observed. The effects of external geometrical modifications on the control surfaces indicate the blanking phenomenon and reduction in forces on the control surfaces that can reduce the aerodynamic performance of the UCAV

TASTE ABATEMENT AND CHARACTERIZATION OF DISPERSIBLE TABLETS OF ARTEMETHER PREPARED BY HOT MELT EXTRUSION

Objective: The aim of this study was to formulate and evaluate a taste-masked formulation using hot melt extrusion approach for artemether.Methods: Taste masking of artemether was done by preparing solid dispersion with coating polymer kollicoatsmartseal 30D using hot melt extrusion. The prepared solid dispersion was subjected to taste masking evaluation like sensory evaluation parameters against five levels set for taste evaluation using artemether as control standard along with in vitro release studies in simulated salivery fluid. After taste evaluation of solid dispersion was subjected to the formulation of dispersible tablets by direct compression method. The final taste masking evaluation of dispersible tablets of solid dispersion containing artemether were done by a sensory evaluation panel of nine members along with in vitro release study in simulated salivary and gastric fluid.Results: The percent drug content was found 35.09±0.06 % in solid dispersion. The drug excipients compatibility studies performed with the help of FTIR instrument and DSC that indicates there were no interactions between drug and polymers. Solid dispersions (1:1, 1:2, 1:3 drug polymer ratio) of artemether were evaluated by sensory evaluation panel from which 1:3 drug: polymer solid dispersion was found more palatable. Release rate study in simulated salivary fluid shown no release but shows release of drug in simulated gastric fluids which indicates that the drug was taste masked. The optimized batch of dispersible tablets (F1) were subjected for evaluation parameters like dispersion time (70±1.90), wetting time (63±1.86), etc. Dissolution studies of optimized formulation indicated that the polymer does not allow drug to release in simulated salivery pH 6.8 but shows immediate release in simulated gastric pH which also confirms taste masking efficiency of polymer. Final optimized F1 batch evaluated for taste masking evaluation by sensory evaluation panel using pure drug as control standard found to be palatable.Conclusion: It may be concluded that kollicoatsmartseal 30D could mask the taste of the drug in salivary pH and shows drug release at gastric pH which confirms its efficiency for taste masking

Formulation And Evaluation Of Oral Ibuprofen-Paracetamol Jelly On Laboratory Scale

Oral medicated buprofen paracetamol jellies are best semi solid dosage forms administered through the oral route. Oral medicatedibuprofen paracetamol jellies provide several advantages as pharmaceutical formulations however with some disadvantages like Dysphagia. Oral medicated jellies as a dosage form can be adopted laboratory equipmentfor drug delivery system. Oral solid dosage forms were the most preferred dosage forms for a wide range of populationin elderly and 12 years and above age patient due to they easy to administration. Solving difficulties and Dysphagia problems are the main disadvantages which can minimize as possible. The ultimate purpose for this formulation is to introduce opportunities of providing the oral jelly as a suitable alternative to the readily available solid dosage forms of the same medicamen

Editorial: Why should we read Dalit literature?

http://journals.sagepub.com/toc/jcla/0/0Numéro spécial papier publié en 2019International audienc