Comparison of EKFC, Pakistani CKD-EPI and 2021 Race-Free CKD-EPI creatinine equations in South Asian CKD population: A study from Pakistani CKD community cohort.

INTRODUCTION: South Asian individuals possess a high risk of chronic kidney disease. There is a need to study, evaluate, and compare the newly suggested glomerular filtration rate (eGFR) equations for accurate CKD diagnosis, staging, and drug dosing. This study aimed to (1) evaluate the European Kidney Function Consortium (EKFC), Pakistani CKD-EPI, and 2021 Race-Free CKD-EPI creatinine equation in the South Asian population with CKD and (2) to examine the expected implications on both CKD classification as well as End Stage Renal Disease (ESRD) prevalence across these equations in South Asian population. METHODS: We carried out a cross-sectional investigation on 385 participants, a CKD cohort ≥ 18 years, at Allama Iqbal Medical College, Jinnah Hospital, Lahore. Serum creatinine was measured by Jaffe's method and rGFR was measured by inulin clearance. RESULTS: Pakistani CKD-EPI has a lower median difference at -1.33 ml/min/1.73m2 elevated precision (IQR) at 2.33 (-2.36, -0.03) and higher P30 value at 89.35% than 2021 CKD-EPI and EKFC equations. The mean difference (ml/min/1.73m2), 95% agreement limits (ml/min/1.73m2) of CKD-EPI PK: -1.18, -6.14, 2021 CKD-EPI: -5.98, -13.24 and EKFC: -5.62, -13.01 (P <0.001). These equations highly correlated to rGFR (P <0.001). An upward re-classification in GFR categories was shown by 2021 CKD-EPI and EKFC compared to the Pakistani CKD-EPI equation. However, there was an exception regarding the G5 category, where an elevated count of 217 (56.36%) was shown for CKD-EPI PK. The prevalence of ESRD was seen in entire age groups and prevailed among females more than in males overall equations. CONCLUSIONS: Pakistani CKD-EPI exhibited outstanding performance, while 2021 CKD-EPI and EKFC demonstrated poor performances and could not show an adequate advantage for both CKD classification and prevalence of ESRD compared to Pakistani CKD-EPI. Therefore, Pakistani CKD-EPI appears optimal for this region and warrants future validation in other South Asian countries. In contrast, suitable measures must be implemented in Pakistani laboratories.

Sources, Chemical Functionalization, and Commercial Applications of Nanocellulose and Nanocellulose-Based Composites: A Review.

Nanocellulose is the most abundant material extracted from plants, animals, and bacteria. Nanocellulose is a cellulosic material with nano-scale dimensions and exists in the form of cellulose nanocrystals (CNC), bacterial nanocellulose (BNC), and nano-fibrillated cellulose (NFC). Owing to its high surface area, non-toxic nature, good mechanical properties, low thermal expansion, and high biodegradability, it is obtaining high attraction in the fields of electronics, paper making, packaging, and filtration, as well as the biomedical industry. To obtain the full potential of nanocellulose, it is chemically modified to alter the surface, resulting in improved properties. This review covers the nanocellulose background, their extraction methods, and possible chemical treatments that can enhance the properties of nanocellulose and its composites, as well as their applications in various fields.

Appraisal of organic extracts and isolated compounds of Azadirachta indica for in-vitro antioxidant, acetylcholinesterase and butyrylcholinesterase inhibitory activity.

The current study emphasized on assessment of Antioxidant, Acetylcholinesterase (AChE) and Butyrylcholinesterase (BChE) inhibitory activity of the crude methanolic and chloroform leaves extracts along with their isolated compounds derived from Azadirachta indica. Phytochemical analysis revealed the manifestation of ancillary metabolites like alkaloid, anthraqinones, catechins, flavonoids, phenolic compounds, saponins, tannins and steroids. Methanolic crude extract of Azadirachta indica leaves revealed comparable antioxidant activity as that of quercetin and propyl gallate. As far as enzyme inhibitory activity was concerned, a significant AChE enzymes inhibition was observed. These findings confirm the traditional use of Azadirachticha indica as medicinal plant in the treatment of mental ailments and anti-inflammatory illnesses. Chloroform crude extract and isolated compounds showed weak antioxidant and enzyme inhibitory activities.