The privilege of induction avoidance and calcineurin inhibitors withdrawal in 2 haplotype HLA matched white kidney transplantation

BACKGROUND: White recipients of 2-haplotype HLA-matched living kidney transplants are perceived to be of low immunologic risk. Little is known about the safety of induction avoidance and calcineurin inhibitor withdrawal in these patients. METHODS: We reviewed our experience at a single center and compared it to Organ Procurement and Transplantation Network (OPTN) registry data and only included 2-haplotype HLA-matched white living kidney transplants recipients between 2000 and 2013. RESULTS: There were 56 recipients in a single center (where no induction was given) and 2976 recipients in the OPTN. Among the OPTN recipients, 1285 received no induction, 903 basiliximab, 608 thymoglobulin, and 180 alemtuzumab. First-year acute rejection rates were similar after induction-free transplantation among the center and induced groups nationally. Compared with induction-free transplantation in the national data, there was no decrease in graft failure risk over 13 years with use of basiliximab (adjusted hazard ratio [aHR], 0.86; confidence interval [CI], 0.68-1.08), Thymoglobulin (aHR, 0.92; CI, 0.7-1.21) or alemtuzumab (aHR, 1.18; CI, 0.72-1.93). Among induction-free recipients at the center, calcineurin inhibitor withdrawal at 1 year (n = 27) did not significantly impact graft failure risk (HR,1.62; CI, 0.38-6.89). CONCLUSIONS: This study may serve as a foundation for further studies to provide personalized, tailored, immunosuppression for this very low-risk population of kidney transplant patients

Replacement Policies of Items

This paper discusses two categories of replacement techniques to determine the best replacement strategies for the items that deteriorate with time and those do not deteriorate but fail suddenly. These models are discussed with respect to the parameters like maintenance cost, time and value of money

Management of Post-transplant Hyperparathyroidism and Bone Disease.

Significant advances in immunosuppressive therapies have been made in renal transplantation, leading to increased allograft and patient survival. Despite improvement in overall patient survival, patients continue to require management of persistent post-transplant hyperparathyroidism. Medications that treat persistent hyperparathyroidism include vitamin D, vitamin D analogues, and calcimimetics. Medication side effects such as hypocalcemia or hypercalcemia, and adynamic bone disease, may lead to a decrease in the drugs. When medical management fails to control persistent post-transplant hyperparathyroidism, treatment is a parathyroidectomy. Surgical techniques are not uniform between centers and surgeons. Undergoing the surgery may include a subtotal technique or a technique including total parathyroid gland resection with partial heterotopic gland reimplantation. In addition, there are possible post-surgical complications. The ideal treatment for persistent post-transplant hyperparathyroidism is the treatment and prevention of the condition while patients are being managed for their late-stage chronic kidney disease and end-stage renal disease

Energy Consumption Analysis of AODV and DSR routing protocols in Mobile Ad Hoc Network

MANET (Mobile Ad hoc Network) is selforganizing and self configuration and selfcontrolled network without the need of any basestation AP(Access Point). Mobility of nodes inMANET causes ever changing topologies. As one ofconstraints in MANET is limited battery resources,It is important to know energy efficiency of routingprotocols to limit the power consumption, prolongthe battery life and to improve the robustness of thesystem. This paper focuses on energy consumptionmetric Total Energy Consumed, Total RemainingEnergy and Energy Consumption per successfuldata delivery (ECSDD) in some of the routingprotocols in MANET such as DSR, AODV byvarying pause time, node velocity and packetsending rate and area of network. Simulation isdone by using NS-2

Standardization of Mandalay Personality Type Survey

This study is an attempt to standardize Mandalay Personality Type Survey (MPTS). This scale is an attempt to measure personality, to assess three broad personality dimensions. These dimensions are (1) anti-social type (2) neuroticism and (3) pro-social type. The MPTS contains 180 items, which can be answered in Yes or No form. This scale was constructed by Dr.Htun Than & et al(2005). The reliability of the MPTS is .68 for anti-social, .71 for the neuroticism and .80 for pro-social. The validity of the MPTS is .31 for anti-social, .54 for the neuroticism and .62 for pro-social. The reliability and validity of MPTS is found to be satisfactory. Objectivity is one of the characteristics of a good test. For a test to be objective, it is necessary to assist the reliability, validity of the test and standardize it. By standardizing the test, it can interpret the test results or scores. Thus, the present study is fulfilled this requirement. In this study, „ T score ‟ was used as norms for MPTS. „T scores‟ equivalents for raw scores were presented in table (2). The T scores were classified into five levels. Although there are few limitations in the population sampling for pro-social personality scale, these norms can interpret an evaluation of his or her status in reference to other person. Therefore, these norms can be used for practical purpose in personnel selection

Child health care

I. OVERVIEW Health is one of the rare rewards bestowed by Allah SWT that men are responsible to look after. It gets once in life, for it will not be restored when it is gone out of the hand. Every man is born at the fitnah (nature) of Islam, as they create Allah SWT; they have to submit to him alone and worship him alone. Allah SWT promised humankind that they are in the welfare stage, as long as they fulfil the Islamic religious duties; five pillars of Islam, six pillars of Iman and the pillar of Ihsan. Among them, the pillar of Ihsan indicates keeping oneself physically and spiritually fit, observing the middle role, the concept of (Wasatia). The manifestation of Wasatia in one’s life is a balanced approach in their social dealing, business, religion, dietary, dress code and way of living style. Enjoying good health is generally believed to be dependent on eating balanced food and regular physical exercise. Excessiveness and carelessness in this domain may lead to deterioration of health. Thus, men are susceptible to accommodate illness, infection, and diseases causing them to become unhealthy and sick. When the sickness reaches a stage where the cure is no more effective, it is too late to be healthy again. Thus, one must appreciate the reward of Allah SWT's good health and maintain it as much as possible. When one gets sick, no choice is left, but to make sure he has to find out what the disease is, and it is a common or severe type and any possibility of a cure. In this module book, we are here to deal with common types of diseases that generally take place in our environment. Particularly at the children's level, we surveyed several primary and secondary schools in the Gombak areas. All our findings suggest that common diseases that happened to children are mostly negligence of parents who lack the general health knowledge or understanding related to common disease and their symptoms awareness such as the importance of immunization, vaccination, types of vaccination, symptoms of healthy children, infectious disease, fever, pain, sleeplessness, constipation, ear infection and eye infection, etc. General health guidelines and common disease symptoms give the idea that parents and teachers who live close to children at home and the school can take necessary action against such a problem in children. In this way, children are saved from immense harm that can cause the life of children as well as a burden financially. The significant part of this chapter is the presentation of milestones for developing children's health, where signs of healthy children from birth to 6 years old are explained in simple language. The prophet Muhammad, PBUH, said, “ Allah has sent down both the disease and the cure, and He has appointed a cure for every disease, so treat yourselves medically, but use nothing unlawful. ( Sunan Abi Dawud, 3874, Book 29, Hadith 20) This hadith reminds us of the significance of health, not to be disheartened as the cure for every disease is already available as promised by Allah SWT. Still, we need to be careful about Halal ingredients in medicine

Clinical Study of Oestrogen Reception, Progesterone Receptor and HER2/ NEU Receptor Expression Status in Breast Cancer Patients

Hospital-based descriptive study was done from January 2017 to December 2017. The study was carried out in 100 breast cancer patients, attending the Medical Oncology Department of Yangon General Hospital by using convenience non-probability sampling method. The positive expression rate of ER, PR receptors observed were 53% and 57 % respectively. Her2/neu positive expression was 34% and equivocal (8%). The mean age of breast cancer patients was 51.1 years with the youngest being 26 and the oldest,78

Catalytically inactive, purified RNase H1: A specific and sensitive probe for RNA-DNA hybrid imaging.

R-loops are three-stranded nucleic acid structures with both physiological and pathological roles in cells. R-loop imaging generally relies on detection of the RNA-DNA hybrid component of these structures using the S9.6 antibody. We show that the use of this antibody for imaging can be problematic because it readily binds to double-stranded RNA (dsRNA) in vitro and in vivo, giving rise to nonspecific signal. In contrast, purified, catalytically inactive human RNase H1 tagged with GFP (GFP-dRNH1) is a more specific reagent for imaging RNA-DNA hybrids. GFP-dRNH1 binds strongly to RNA-DNA hybrids but not to dsRNA oligonucleotides in fixed human cells and is not susceptible to binding endogenous RNA. Furthermore, we demonstrate that purified GFP-dRNH1 can be applied to fixed cells to detect hybrids after their induction, thereby bypassing the need for cell line engineering. GFP-dRNH1 therefore promises to be a versatile tool for imaging and quantifying RNA-DNA hybrids under a wide range of conditions