Cyclophosphamide in renal transplantation.

Success in renal transplantation is now largely dependent on safe and effective immunosuppression. Nonspecific immunosuppression by chemical agents continues to be the mainstay of clinical immunosuppression. Azathioprine and prednisolone have remained the two main drugs used in combination in standard immunosuppressive therapy in renal transplantation for many years. Although cyclophosphamide (CP) was tried in the early years of transplantation, enthusiasm for its use was dampened by the advent of newer agents. We have analyzed our experience with 29 recipients of living-related donor (LRD) renal allotransplantation on cyclophosphamide therapy. Cyclophosphamide is a safe and effective alternative to azathioprine in clinical renal allotransplantation. Due to its easy availability and the fact that it is a cheaper alternative to azathioprine and cyclosporine, it is more significant for developing countries.

Psychological assessment of blood related renal donors.

The impact of kidney donation on the psychological health of 31 living related donors was assessed by administering certain psychological tests before and after the operation (for donating the kidney). The results indicated a significant rise in the somatization subscale of the Middlesex Hospital Questionnaire (MHQ) from a mean of 1.61 to 3.23. There was no significant change in the other variables of these instruments or in the locus of control score. Only about one-fourth of the donors had prior knowledge of renal transplant. In almost all cases, the decision to donate had been voluntary and immediate, motivated by a concern for the recipient; there was virtually no second thoughts or regrets subsequently, which was apparently partly related to the opinions of other relatives who positively valued the act of donation.

Renal allograft rupture and its management.

Renal allograft rupture, although a rare complication, was encountered in 11 of our 137 cases of live kidney donor transplants. The commonest finding was an associated acute rejection. Our cases were mainly given conservative treatment with repair of the rupture and antirejection therapy. Eight of our kidneys were saved in this way, thus eight of the 11 patients survived. None of the deaths were related to the graft rupture or its effects.

Gastro-intestinal injuries in abdominal trauma.

Management of 55 patients of gastro-intestinal injuries has been reviewed. Eighty percent of the patients presented with generalised peritonitis and jejunum was the commonest segment of the bowel injured. Pneumoperitoneum co-related poorly with intestinal disruption. It was present in 35.8 per cent of the cases. Repeated physical examination was found to be paramount importance. Sixty percent of the patients has associated intra-extra-abdominal injuries. Preoperative shock, multiple hollow visceral injury, septicemia, and location of injury (colon and duodenum) were significant prognostic factors associated with the high mortality. Mortality in the series was 25.4 per cent.

Change in structural morphology on addition of ZnO and its effect on fluorescence of Yb³âº/Er³âº doped Y2O3.

Yb(3+)/Er(3+) codoped Y(2)O(3) phosphor and its composite with ZnO have been synthesized by combustion method. Morphology of the materials has been investigated using X-ray diffraction pattern (XRD) and scanning electron microscopy (SEM) techniques. XRD confirms the constituents as Y(2)O(3) and ZnO, with average crystallite size of 112 nm. On addition of ZnO, a small shifting in XRD pattern of Y(2)O(3) is observed. SEM pattern suggests that the average particle size lies in micro-range (0.5 µm). A dumble like structure is observed for hybrid material on annealing at 1473 K. A strong green (525, 546 nm) with weak blue (411 nm) and red (657 nm) emissions through upconversion has been observed from the phosphor on excitation with 976 nm diode laser. The observed emissions involve (2)H(9/2)→(4)I(15/2), (2)H(11/2)→(4)I(15/2), (4)S(3/2)→(4)I(15/2) and (4)F(9/2)→(4)I(15/2) electronic transitions, respectively. The upconversion process has been confirmed by power dependence measurements and its slope value was found to be 1.85, 1.72 for green and red emissions, respectively. On addition of ZnO, the intensity of these emissions is enhanced several times. The reason behind the enhancement is discussed with the help of the emitting level lifetime. An interesting dual mode property (upconversion and downconversion) to the same material has been observed on excitation with 532 nm laser source.