23 research outputs found
Audit of acute rejection in renal allografts
No full textA research report submitted in partial fulfilment of
the requirements for the degree of Master of Medicine to the Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, 2019Acute graft rejection is acknowledged to have a negative impact on graft survival in renal
transplantation. South Africa provides for limited renal transplantation amidst the increasing
burden of chronic kidney disease in the local context. Despite this suboptimal provision and
limited resources, amongst many other concerns, the role of acute graft rejection on graft
survival has not been characterized in the context of South Africa, as well as the African
continent. This study is an audit, characterising acute graft rejection diagnosed at the
Charlotte Maxeke Johannesburg Academic Hospital over a ten-year period (2003-2012).
The study revealed the incidence of acute rejection in renal transplants to be 34.5%, similar
to that reported in international studies. The majority of acute rejections occurred within the
first year of transplantation (53.8%), which was lower than that reported in other studies, with
40% of patients having recurrence of acute rejection. The main form of rejection diagnosed
was acute cellular rejection (predominantly BANFF grades 1A and 1B), followed by Borderline
acute cellular rejection, the combination of which comprised the majority (86.9%) of all
rejections diagnosed.
This population was found to be a male dominant and Black African dominant study group, in
keeping with the racial distribution of the dialysis population of South Africa, commonly
influenced by treatment-seeking behaviour. Cadaveric donor grafts were engrafted in 77.7%
of this population and 77.8% of the population had less than 40% of HLA antigens in common
with their donor. Delayed graft function was observed in 22.4% of recipients with a significant
association with more severe acute graft rejection. Hypertension was the most dominant
primary aetiology leading to chronic kidney disease of native kidneys in this population.
Immunosuppressive regimen, including cyclosporin, mycophenolate mofetil and prednisone,
was used in 80% of recipients, with 97.6% of recipients on mycophenolate mofetil and
prednisone.
The five-year survival of grafts developing acute rejection was 61.7%. Graft function
deteriorated more dramatically amongst recipients who progressed to graft loss, with
recovery of graft function observed to be more prominent amongst recipients with surviving
grafts.
This study adds to the literature on this topic, and also describes the characteristics and
outcomes of this entity.TL (2021
Search For a Biomarker For The Diagnosis And Prognosis of Rheumatoid Arthritis
No full textRheumatoid Arthritis (RA) is one of the commonest systemic autoimmune disease. Diagnosis of Rheumatoid Arthritis is based on the detection of Rheumatoid factor (RF) and Anti cyclic citrullinated peptide Antibody (ACCP).But these markers have limited use in predicting the prognosis of the disease. Hematological and Inflammatory markers are indicators of disease activity.Correlation of the various biomarkers would be beneficial in effective treatment and management of the condition.An attempt is being made to correlate the conventional markers like RF and ACCP with the newer marker Anti Sa Antibody (Anti Sa) and hematological parameters such as Hemoglobin (Hb) , Red cell Distribution Width (RDW) and Erythrocyte Sedimentation Rate (ESR).It was observed that these parameters together serve as better biomarkers for the diagnosis and prognosis of RA. Index term
Intramolecular Charge Transfer and Photochemical Isomerization in Donor/Acceptor-Substituted Butadienes
No full textIntramolecular charge transfers, triplet state properties, and photoisomerization of five donor/acceptor (D/A)
substituted butadienes were investigated. Four of these derivatives (1−4) show dual fluorescence arising
from a locally excited (LE) state and a considerably more polar intramolecular charge transfer (ICT) state.
The presence of an amino substituent with the nitrogen atom directly attached to the butadiene chain is essential
for observing dual fluorescence in this class of compounds. The compounds undergo E−Z photoisomerization
from the excited singlet state with a quantum efficiency of about 0.1 in benzene at room temperature. The
intersystem crossing efficiency for these compounds is negligible. The triplet excited-state properties of the
five butadienes have been characterized via triplet−triplet sensitization with benzophenone as the donor
Is intraoperative parathyroid hormone monitoring necessary in symptomatic primary hyperparathyroidism with concordant imaging?
No full textIntroduction: Symptomatic primary hyperparathyroidism (PHPT) is still seen frequently in referral centers all over India. These patients require parathyroidectomy and this study aimed to assess the roll of intraoperative parathyroid hormone (PTH) assay when concordant results of two localization studies were available. Study Design: We analyzed the case records of patients who underwent parathyroidectomy for PHPT from January 2005 to June 2015. Results: Of 143 patients included in the study, technetium 99m methoxyisobutylisonitrate dual phase scintigraphy showed true positive images in 93.7% and high definition ultrasonography in 84.6% of patients. Concordance in localization studies was observed in 121 (84.6%) patients, successful parathyroidectomy was done in 117 (96.7%) patients with concordant localization studies. Intraoperative PTH monitoring showed 97.84% sensitivity and 75% specificity and predicted failure in 2 patients with concordant imaging. However, re-exploration was not successful in these patients. Conclusion: When concordant result is available between parathyroid scintigraphy and anatomical imaging surgical cure rate is high in trained hands. Re-exploration is unlikely to be successful since these patients require higher imaging
Intramolecular charge transfer and photochemical isomerization in donor/acceptor-substituted butadienes
No full textIntramolecular charge transfers, triplet state properties, and photoisomerization of five donor/acceptor (D/A) substituted butadienes were investigated. Four of these derivatives (1-4) show dual fluorescence arising from a locally excited (LE) state and a considerably more polar intramolecular charge transfer (ICT) state. The presence of an amino substituent with the nitrogen atom directly attached to the butadiene chain is essential for observing dual fluorescence in this class of compounds. The compounds undergo E-Z photoisomerization from the excited singlet state with a quantum efficiency of about 0.1 in benzene at room temperature. The intersystem crossing efficiency for these compounds is negligible. The triplet excited-state properties of the five butadienes have been characterized via triplet-triplet sensitization with benzophenone as the donor
Classification of Patients with COPD on LAMA Monotherapy Using the GOLD Criteria: Analysis of a Claims-Linked Patient Survey Study
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Predictors of Symptom Burden in Patients with COPD on LAMA Monotherapy: Multivariable Analysis of a Claims-Linked Survey Study
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Patient-Reported Burden of Illness in a Prevalent COPD Population Treated with Long-Acting Muscarinic Antagonist Monotherapy: A Claims-Linked Patient Survey Study
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ensure the content is of the highest scientific standard and all features are
marked as ‘peer reviewed’ to ensure readers are aware that the content has been
reviewed to the same level as the articles they are being presented alongside.
Moreover, all sponsorship and disclosure information is included to provide
complete transparency and adherence to good publication practices. This ensures
that however the content is reached the reader has a full understanding of its
origin. No fees are charged for hosting additional open access content.
Other enhanced features include, but are not limited to:
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Association between ABO blood group and blood component transfusion requirements in dengue infection: a retrospective study from a tertiary hospital in Kerala, India
No full textObjective Platelet and fresh frozen plasma (FFP) transfusions are routinely employed in the management of severe dengue. Previous research has indicated a potential link between ABO blood groups and susceptibility to dengue, with evidence suggesting that mosquito vector feeding preferences may be influenced by host blood type. These factors could potentially impact transfusion demands during outbreaks. This retrospective study aimed to investigate the relationship between ABO blood groups and transfusion requirements in patients with dengue.Design Retrospective study.Setting The study was conducted at a tertiary care hospital in Kerala.Methods Clinical and laboratory data were reviewed for 199 patients confirmed with dengue who received blood component transfusions and compared with two control groups: 200 randomly selected patients with dengue who did not require transfusions and 200 patients without dengue who required transfusions, over a period spanning January 2015 to March 2023.Results Among transfused dengue cases, blood groups O (41.71%), A (28.14%) and B (23.12%) were most prevalent; however, no statistically significant association was observed between ABO blood group and transfusion requirement. Furthermore, the total volumes of FFP and platelet transfusions did not differ significantly across ABO groups among patients with dengue. Notably, platelet transfusions were significantly more frequent in dengue cases (92.0%) compared with transfused patients without dengue (35.5%), whereas FFP transfusions were more common in non-dengue transfused cases (84.5%) than in patients with dengue (44.7%). Patients with dengue also received significantly higher mean volumes of both FFP and platelets.Conclusion Despite earlier reports linking ABO blood types to dengue susceptibility, this study found no significant association with transfusion requirements, warranting confirmation through larger multicentre studies
