Divalent metal ion in the active site of purple acid phosphatase modulates substrate binding: Kinetic and thermodynamic properties.

The purple acid phosphatase was purified from 5.9-fold to apparent homogeneity from Anagelis arvensis seeds using SP-Sephadex C-50 and Sephadex G-100 chromatography. The results of residual activity tests conducted using different temperature ranges (50-70 °C) were calculated as the activation energy (Ed = 72 kJ/mol), enthalpy (69.31 ≤ (ΔH°â€¯≤ 69.10 kJ/mol), entropy (-122.48 ≤ ΔS°â€¯≤ -121.13 J/mol·K), and Gibbs free energy (108.87 ≤ ΔG°â€¯≤ 111.25 kJ/mol) of the enzyme irreversible denaturation. These thermodynamic parameters indicate that this novel PAP is highly thermostable and may be significant for use in industrial applications. However, it may be confirmed by stopped-flow measurements that this substitution produces a chromophoric Fe3+ site and a Pi-substrate interaction that is about ten times faster. Additionally, these data show that phenyl phosphate hydrolysis proceeds more rapidly in metal form of A. arvensis PAP than the creation of a µ-1,3 phosphate complex. The Fe3+ site in the native Fe3+-Mn2+ derivative interacts with it at a faster rate than in the Fe3+-Fe2+ form. This is most likely caused by a network of hydrogen bonds between the first and second coordination spheres. This suggests that the choice of metal ions plays a significant role in regulating the activity of this enzyme.

Driving frugal innovation in SMEs: how sustainable leadership, knowledge sources and information credibility make a difference.

This study investigates the driving factors behind frugal innovation in Small and Medium-sized Enterprises (SMEs). It specifically examines sustainable leadership as an independent variable, considering its impact on frugal innovation, with sources of knowledge mediating this relationship and information credibility moderating the effects. Employing a Partial Least Squares Structural Equation Modeling (PLS-SEM) approach, data were gathered from 325 employees of SMEs in Pakistan. This methodology was chosen for its ability to handle complex relationships between multiple variables simultaneously, offering robust insights into the interplay among sustainable leadership, sources of knowledge, information credibility, and frugal innovation. The results reveal significant associations between sustainable leadership, sources of knowledge, information credibility, and frugal innovation. Sustainable leadership demonstrates a substantial influence on both sources of knowledge and frugal innovation. Furthermore, sources of knowledge play a vital role in mediating the relationship between sustainable leadership and frugal innovation. Information credibility emerges as a significant moderator, affecting the pathways between sustainable leadership, sources of knowledge, and frugal innovation. The findings underscore the importance of sustainable leadership and credible information sources in driving frugal innovation within SMEs. They highlight the intricate interdependencies among these variables and emphasize the pivotal role of information credibility in shaping these dynamics. These results carry significant implications for SMEs in Pakistan, shedding light on the mechanisms through which sustainable leadership and reliable knowledge sources can stimulate frugal innovation in emerging economies.

Alkaline protease based hydrothermal synthesis of novel Pd/CuO/ZnO nanocomposite: A new entry into photocatalytic and biomedical applications.

Here, we reported the process for the production of Pd/CuO/ZnO nanocomposite utilizing alkaline protease from Phalaris minor seed extract, which is a unique, effective biogenic approach. Alkaline protease performed a crucial part in the reduction, capping and stabilization of Pd/CuO/ZnO nanocomposites. A series of physicochemical techniques were used to inquire the formation, size, shape and crystalline nature of Pd/CuO/ZnO nanocomposites. The notable performance of the synthesized nanocomposite as a photocatalyst and an antibacterial disinfectant was astonishing. The Pd/CuO/ZnO nanocrystals showed considerable photocatalytic activity by eliminating 99 % of the methylene blue (MB) in <30 min of exposure. After three test cycles, the nanocatalyst demonstrated exceptional reliability as a photocatalyst. The nanocomposite was also discovered to be an effective antibacterial agent, with zones of inhibitory activity for Staphylococcus aureus and Escherichia coli bacteria of 30(±0.2), 27(±0.3), 22(±0.2), and 21(±0.3) mm, respectively, in both light and dark conditions. Moreover, the Pd/CuO/ZnO nanocomposites showed strong antioxidant activity by efficiently scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals. The photocatalytic, antibacterial and antioxidative performance of Pd, CuO, ZnO, and CuO/ZnO were also assessed for the sake of comparison. This work shows that biogenic nanocomposites may be employed as a feasible alternative photocatalyst for the decomposition of dyes in waste water as well as a sustainable antibacterial agent.

Heartfelt living: Deciphering the link between lifestyle choices and cardiovascular vitality.

Cardiovascular diseases (CVDs) are still leading to a significant number of deaths worldwide despite the remarkable advancements in medical technology and pharmacology. Managing patients with established CVDs is a challenge for healthcare providers as it requires reducing the chances of recurring cardiovascular events. On the other hand, changing one's way of life can also significantly impact this area, reducing the likelihood of cardiovascular disease and death through their unique advantages. Consequently, it is advisable for healthcare providers to regularly advise their patients with coronary issues to participate in organized physical exercise and improve their overall physical activity. Additionally, patients should adhere to a diet that promotes heart health, cease smoking, avoid exposure to secondhand smoke, and address any psychosocial stressors that may heighten the risk of cardiovascular problems. These lifestyle therapies, whether used alongside drug therapy or on their own in patients who may have difficulty tolerating medications, face financial barriers, or experience ineffectiveness, can substantially reduce cardiovascular mortality and the likelihood of recurring cardiac events. Despite the considerable advancements in creating interventions, it is still necessary to determine the optimal intensity, duration, and delivery method for these interventions. Furthermore, it is crucial to carry out further investigations incorporating extended monitoring and assessment of clinical outcomes to get a more comprehensive comprehension of the efficacy of these therapies. Presenting the findings within the framework of "lifestyle medicine," this review seeks to offer a thorough synopsis of the most recent scientific investigations into the potential of behavioral modifications to lower cardiovascular disease risk.

Liquid Metal-Promoted Graphene Oxide Supramolecular Film for Self-Healing Actuator with Multiple-Stimuli Responses.

The structural vulnerability and immobility of the multi-responsive actuators restrict its application in soft robots. Hence, self-healing film actuators based on interfacial supramolecular crosslinking and hierarchical structural design have been developed. The graphene oxide supramolecular film with asymmetric structure reveals excellent reversible deformation under different trigger signals like moisture, thermal, and infrared light. Meanwhile, it shows a good healing property based on supramolecular interaction, achieving the structure restoration and reconstitution of stimuli-responsive actuators (SRA). The re-edited SRA realizes reverse reversible deformation under the same external stimuli. To enhance the functionality of graphene oxide-based SRA, the reconfigurable liquid metal could be modified on the surface of the graphene oxide supramolecular film at low temperature (defined as LM-GO) due to its compatibility for hydroxyl. The fabricated LM-GO film displays satisfactory healing property and good conductivity. Besides, the self-healing film maintains strong mechanical strength, which can bear more than 20 grams of weight. This study provides a novel strategy to fabricate self-healing actuator with multiple responses, accomplishing the functional integration of the SRAs.

Advances and Challenges for GWAS Analysis in Cardiac Diseases: A Focus on Coronary Artery Disease (CAD).

The achievement of genome-wide association studies (GWAS) has rapidly progressed our understanding of the etiology of coronary artery disease (CAD). It unlocks new strategies to strengthen the stalling of CAD drug development. In this review, we highlighted the recent drawbacks, mainly pointing out those involved in identifying causal genes and interpreting the connections between disease pathology and risk variants. We also benchmark the novel insights into the biological mechanism behind the disease primarily based on outcomes of GWAS. Furthermore, we also shed light on the successful discovery of novel treatment targets by introducing various layers of "omics" data and applying systems genetics strategies. Lastly, we discuss in-depth the significance of precision medicine that is helpful to improve through GWAS analysis in cardiovascular research.

Acid protease functionalized novel silver nanoparticles (APTs-AgNPs): A new approach towards photocatalytic and biological applications.

Herein, we described for the first time, an efficient biogenic synthesis of APTs-AgNPs using acid protease from Melilotus indicus leaf extract. The acid protease (APTs) has an essential role in the stabilization, reduction, and capping of APTs-AgNPs. The crystalline nature, size, and surface morphology of APTs-AgNPs were examined using different techniques such as XRD, UV, FTIR, SEM, EDS, HRTEM, and DLS analysis. The generated APTs-AgNPs demonstrated notable performance as dual functionality (photocatalyst and antibacterial disinfection). By destroying 91 % of methylene blue (MB) in <90 min of exposure, APTs-AgNPs demonstrated remarkable photocatalytic activity. APTs-AgNPs also showed remarkable stability as a photocatalyst after five test cycles. Furthermore, the APTs-AgNPs was found to be a potent antibacterial agent with inhibition zones of 30(±0.5 mm), 27(±0.4 mm), 16(±0.1 mm), and 19(±0.7 mm) against Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria, respectively, under both light and dark conditions. Furthermore, APTs-AgNPs effectively scavenged 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals, demonstrating their potent antioxidant activity. The outcomes of this study thus demonstrates the dual functionality of APTs-AgNPs produced using the biogenic approach method as a photocatalyst and an antibacterial agent for effective microbial and environmental control.

A Comprehensive Review: Epidemiological Strategies, Catheterization and Biomarkers used as a Bioweapon in Diagnosis and Management of Cardio Vascular Diseases.

Coronary artery disease (CAD) is a serious health problem that causes a considerable number of mortality in a number of affluent nations throughout the world. The estimated death encountered in many developed countries includes including Pakistan, reached 111,367 and accounted for 9.87% of all deaths, despite the mortality rate being around 7.2 million deaths per year, or 12% of all estimated deaths accounted annually around the globe, with improved health systems. Atherosclerosis progressing causes the coronary arteries to become partially or completely blocked, which results in CAD. Additionally, smoking, diabetes mellitus, homocystinuria, hypertension, obesity, hyperlipidemia, and psychological stress are risk factors for CAD. The symptoms of CAD include angina which is described as a burning, pain or discomfort in the chest, nausea, weakness, shortness of breath, lightheadedness, and pain or discomfort in the arms or shoulders. Atherosclerosis and thrombosis are the 2 pathophysiological pathways most frequently involved in acute coronary syndrome (ACS). Asymptomatic plaque disruption, plaque bleeding, symptomatic coronary blockage, and myocardial infarction are the prognoses for CAD. In this review, we will focus on medicated therapy which is being employed for the relief of angina linked with CAD including antiplatelet medicines, nitrates, calcium antagonists, blockers, catheterization, and the frequency of recanalized infarct-related arteries in patients with acute anterior wall myocardial infarction (AWMI). Furthermore, we have also enlightened the importance of biomarkers that are helpful in the diagnosis and management of CAD.

Non-traumatic chylothorax: diagnostic and therapeutic strategies.

Non-traumatic chylothorax refers to accumulation of chyle in the pleural space in the absence of any traumatic disruption to the thoracic duct. Chyle originates from the intestines and is transported via the thoracic duct into systemic circulation. The anatomical course of the thoracic duct is complex with considerable variation; therefore, development of chylothorax is dependent on the site and level of the thoracic duct defect. Non-traumatic chylothorax is associated with a wide range of medical disorders, but malignancy accounts for three-quarters of cases. In up to 9% of cases, the aetiology remains unknown (termed idiopathic chylothorax). Gross appearance of pleural fluid is neither sensitive nor specific enough to diagnose chylothorax; therefore, biochemical analysis of the pleural fluid is required. Pleural fluid triglyceride level >1.24 mmol·L-1 (110 mg·dL-1) with a cholesterol level <5.18 mmol·L-1 (200 mg·dL-1) is diagnostic of chylothorax. In borderline cases, lipoprotein electrophoresis can help confirm the diagnosis by detecting chylomicrons in the pleural fluid. Once the diagnosis of chylothorax is confirmed, the next step is to find the cause and identify the leakage point, for which various lymphatic specific radiological investigations may have an important role. There is paucity of data on the most suitable approach to manage non-traumatic chylothoraces and treatment often depends on the underlying cause. In general, conservative treatment is tried first, usually for a limited time, before considering more invasive measures. A multidisciplinary approach is recommended with close liaison among the respiratory physicians, thoracic surgeons, oncologists, interventional radiologists, dietitians and pharmacists. Educational aims: To review the pathophysiology, aetiology, and epidemiology of non-traumatic chylothorax.To discuss diagnostic and therapeutic strategies in the management of non-traumatic chylothorax.

The impact of the COVID-19 pandemic on pleural infection incidence: a UK multicentre retrospective analysis.

There was a significant reduction in pleural infection incidence, by almost a third, in the year following the start of the #COVID19 pandemic. Public health measures enforced during this period are likely to have played a significant role. https://bit.ly/3QAPPR9.

Metagenomics analysis of the fecal microbiota in Ring-necked pheasants (Phasianus colchicus) and Green pheasants (Phasianus versicolor) using next generation sequencing.

Pheasant reintroduction and conservation efforts have been in place in Pakistan since the 1980 s, yet there is still a scarcity of data on pheasant microbiome and zoonosis. Instead of growing vast numbers of bacteria in the laboratory, to investigate the fecal microbiome, pheasants (green and ring neck pheasant) were analyzed using 16S rRNA metagenomics and using IonS5TMXL sequencing from two flocks more than 10 birds. Operational taxonomic unit (OTU) cluster analysis and phylogenetic tree analysis was performed using Mothur software against the SSUrRNA database of SILVA and the MUSCLE (Version 3.8.31) software. Results of the analysis showed that firmicutes were the most abundant phylum among the top ten phyla, in both pheasant species, followed by other phyla such as actinobacteria and proteobacteria in ring necked pheasant and bacteroidetes in green necked pheasant. Bacillus was the most relatively abundant genus in both pheasants followed by Oceanobacillus and Teribacillus for ring necked pheasant and Lactobacillus for green necked pheasant. Because of their well-known beneficial characteristics, these genus warrants special attention. Bird droppings comprise germs from the urinary system, gut, and reproductive sites, making it difficult to research each anatomical site at the same time. We conclude that metagenomic analysis and classification provides baseline information of the pheasant fecal microbiome that plays a role in disease and health.

Photoinhibition and photocatalytic response of surfactant mediated Pt/ZnO nanocomposite.

Water pollution and bacterial resistance are universal problems. Drugs and protocols have been employed to deal with involved microbes and pollutants but these customary chemicals have many limitations. It is essential to produce new methods and materials to deal with these deleterious microbes. In the present contribution, highly efficient and stable nanocomposite of platinum activated zinc oxide was synthesized by a new plant extract and surfactant assisted protocol. The cetylpyridinium chloride was applied as surfactant to obtain high dispersion of spherical ZnO. The platinum ions were reduced on the ZnO surface by the use of Rhazya stricta plant extract. The prepared nanomaterial was used for photoinactivation of multidrug resistant bacterium Escherichia coli (E. coli). The synthesized nanomaterial showed strong E. coli inhibition efficiency in the presence of light and the observed diameter of zone of inhibition was 21 ±0.4. The effect of light on the inhibition of E.coli was studied by measuring the activated oxygen radicals inside the bacterium cell. The surface morphology of E.coli before and after treatment with Pt/ZnO was studied by SEM. Such effect was not observed in dark. The toxicity of the synthesized nanomaterials was also studied through haemolytic activity and the result shows that the nanomaterial prepared by the said method has very low toxicity. The photocatalytic degradation of methylene blue (MB) was also investigated in the presence of the synthesized nanomaterials. Effect of different parameters such as concentration of Pt/ZnO, Irradiation time and dye concentrations were also studied. An incredible photocatalytic deprivation of MB (98 %) was observed for Pt/ZnO nanocomposite as compared to individual Pt (48%) and ZnO (71%) nanoparticles after 5 minutes of irradiations. Further research is required to investigate the applications of Pt/ZnO nanocomposite.

Assessment of risk management and control measures against coronavirus disease.

This article presents the COVID-19 situation and control measures taken by the Government of Pakistan. Two waves of pandemic are faced globally and similar in the study area. We have investigated the risk management decision in two phases. Primarily, strict lockdown was observed from March 2020 to July 2020 and smart lockdown was enforced from August 2020 to December 2020. It has been studied that during strict lockdown, COVID cases reduced gradually but reopening of institutes and smart lockdown strategy resulted gradual increase in confirmed cases and death rates. During first wave of COVID-19 in Pakistan, a total confirmed number of patients of COVID-19 were 263,496 till 18th of July 2020 with total deaths of 5,568 people and 204,276 recoveries, while total number of COVID-19 patients reached 555,511 till 9th of February 2021 with total deaths of 12,026 people. Province of Sindh was affected badly with total number of 251,434 COVID-19 cases followed by Punjab Province with total number of 161,347 COVID-19 till 9th of February 2020.

Investigating the thermodynamic and kinetics properties of acid phosphatase extracted and purified from seedlings of Chenopodium murale.

Herein acid phosphatase isoenzyme was extracted from the C. murale seedlings. The purification was accomplished by chromatographic techniques and passing through DEAE-cellulose and Sephadex G-100 column. The specific activity of acid phosphatase 5.75 U/mg of protein was obtained with 66 purification fold 15.8% yield and molecular mass was 29 kDa with very faint bands corresponding to 18 kDa and 14 kDa. The maximal activity at pH 5.0 and 50 °C best illustrated by first order kinetics. When temperature was raised (55 °C to 75 °C), the deactivation rate constant was increased from 0.001 to 0.014 min-1, while half-life was decreased from 693 to 49 min-1. The results of activity collected at different temperature were then used to estimate, activation energy of hydrolysis reaction (Ea = 47.59 kJmol-1). A high Z-value (18.86 °C min-1) was obtained indicating a less sensitivity towards temperatures. The residual activity examinations were carried out from 55 °C to 75 °C and assessing the Deactivation Energy (Ed 116.39 kJmol-1), Enthalpy change (ΔH° 113.55kJmol-1), Entropy change (ΔS° 110.33kJmol-1) and change in Gibbs free energy (ΔG° 10.02 kJmol-1). Taken together, thermodynamic parameters confirm the high stability of enzyme and show potential commercial applicability.

Soft-sensor modeling for L-lysine fermentation process based on hybrid ICS-MLSSVM.

The L-lysine fermentation process is a complex, nonlinear, dynamic biochemical reaction process with multiple inputs and multiple outputs. There is a complex nonlinear dynamic relationship between each state variable. Some key variables in the fermentation process that directly reflect the quality of the fermentation cannot be measured online in real-time which greatly limits the application of advanced control technology in biochemical processes. This work introduces a hybrid ICS-MLSSVM soft-sensor modeling method to realize the online detection of key biochemical variables (cell concentration, substrate concentration, product concentration) of the L-lysine fermentation process. First of all, a multi-output least squares support vector machine regressor (MLSSVM) model is constructed based on the multi-input and multi-output characteristics of L-lysine fermentation process. Then, important parameters ([Formula: see text], [Formula: see text], [Formula: see text]) of MLSSVM model are optimized by using the Improved Cuckoo Search (ICS) optimization algorithm. In the end, the hybrid ICS-MLSSVM soft-sensor model is developed by using optimized model parameter values, and the key biochemical variables of the L-lysine fermentation process are realized online. The simulation results confirm that the proposed regression model can accurately predict the key biochemical variables. Furthermore, the hybrid ICS-MLSSVM soft-sensor model is better than the MLSSVM soft-sensor model based on standard CS (CS-MLSSVM), particle swarm optimization (PSO) algorithm (PSO-MLSSVM) and genetic algorithm (GA-MLSSVM) in prediction accuracy and adaptability.

Nanoparticles individualities in both Newtonian and Casson fluid models by way of stratified media: A numerical analysis.

The current paper contains the simultaneous analysis of both Newtonian and non-Newtonian nanofluid models. The fluid flow is achieved by considering the no-slip condition subject to a stretched cylindrical surface. The flow regime manifests with pertinent physical effects, namely temperature stratification, concentration stratification, thermal radiation, heat generation, magnetic field, dual convection and chemical reaction. The strength of fluid temperature and nanoparticles concentration adjacent to an inclined cylindrical surface is assumed to be higher than the ambient flow field. A mathematical model is developed in terms of differential equations. A self-constructed numerical algorithm is executed to report the numerical solution. The resultant annotations are illustrated through both tables and graphs. It is noticed that the Casson fluid shows significant variations with respect to the involved physical parameters as compared to the Newtonian fluid model. Moreover, the analysis is certified through comparison with the existing values in a limiting sense.

Physiological and molecular responses of pearl millet seedling to atrazine stress.

Pearl millet has been recommended beneficial for several therapeutic purposes. However, little is known of the physiological responses to abiotic stressors, especially of atrazine. In order to elucidate the physiological and molecular responses of pearl millet to atrazine stress, we studied the response of various biomarkers under increasing herbicide concentrations (0, 5, 10, and 50 mg/kg). We also quantified the levels of malondialdehyde (MDA) and reactive oxygen species (ROS) (H2O2 and O2•-) produced in the leaves to evaluate the extent of oxidative damage. Increasing atrazine concentrations significantly increased ROS and MDA production in the plant leaves. Ascorbate peroxidase (APX) and peroxidase (POD) activities increased, while catalase (CAT) and superoxide dismutase activities reduced with increasing atrazine concentrations. Generally, atrazine applied at 50 mg/kg suppressed chlorophyll contents, whereas, chlorophyll (a/b) ratio was increased. Atrazine applied at 50 mg/kg significantly suppressed antioxidant gene expressions to the lowest. The APX gene showed overall low response to the atrazine treatments. The chloroplastic psbA gene showed highest expression with 10 mg/kg atrazine, whereas atrazine at 50 mg/kg significantly suppressed the gene expression to its lowest. Pearl millet was able to suppress oxidative stress under low atrazine levels, but high atrazine concentration could induce more oxidative damage.

Exogenous calcium induces tolerance to atrazine stress in Pennisetum seedlings and promotes photosynthetic activity, antioxidant enzymes and psbA gene transcripts.

Calcium (Ca) has been reported to lessen oxidative damages in plants by upregulating the activities of antioxidant enzymes. However, atrazine mediated reactive oxygen species (ROS) reduction by Ca is limited. This study therefore investigated the effect of exogenously applied Ca on ROS, antioxidants activity and gene transcripts, the D1 protein (psbA gene), and chlorophyll contents in Pennisetum seedlings pre-treated with atrazine. Atrazine toxicity increased ROS production and enzyme activities (ascorbate peroxidase APX, peroxidase POD, Superoxide dismutase SOD, glutathione-S-transferase GST); but decreased antioxidants (APX, POD, and Cu/Zn SOD) and psbA gene transcripts. Atrazine also decreased the chlorophyll contents, but increased chlorophyll (a/b) ratio. Contrarily, Ca application to atrazine pre-treated seedlings lowered the harmful effects of atrazine by reducing ROS levels, but enhancing the accumulation of total chlorophyll contents. Ca-protected seedlings in the presence of atrazine manifested reduced APX and POD activity, whereas SOD and GST activity was further increased with Ca application. Antioxidant gene transcripts that were down-regulated by atrazine toxicity were up-regulated with the application of Ca. Calcium application also resulted in up-regulation of the D1 protein. In conclusion, ability of calcium to reverse atrazine-induced oxidative damage and calcium regulatory role on GST in Pennisetum was presented.

Peritoneal dialysis for chronic kidney disease patients: a single-center experience in Saudi Arabia.

To evaluate the peritoneal dialysis (PD) program in our hospital, we retrospectively studied all patients dialyzed with this modality over the last 5 years. A total of 56 patients having end-stage renal disease (ESRD), with mean age ± SD of 49 ± 20 years (range 16-92 years), were dialyzed with PD: 38 (68%) patients with continuous ambulatory PD and 18 (32%) patients with automated PD. Twenty-six (46%) patients were females. The mean follow-up time of these patients was 17 ± 14 months. The underlying etiologies for ESRD in these patients were diabetes mellitus (48%), glomerulonephritis (9%), and hypertension (7%). Twenty-seven patients (48%) were put on PD from the start, while 29 (52%) patients were switched from hemodialysis (HD) to PD. Nineteen (34%) patients developed a total of 29 episodes of peritonitis. The incidence of peritonitis was 0.4 episode per patient-year. Exit-site infections occurred in 17 (30%) patients. No tunnel infection was observed during the study period. Non-infectious catheter-related complications occurred in 12.5% of the patients; six (11%) patients had hernia (umbilical or inguinal). At the end of the study, 23 (41%) patients continued on PD, 17 (30%) received a renal transplant, 7 (13%) suffered technique failure and subsequently switched to HD, and 9 (16%) patients died. To conclude, our study demonstrates that the rate of PD related complications is found to be quite low in our program, with an acceptable technique failure rate and mortality. Therefore, PD is a safe and an effective treatment modality in the integrated care approach to patients with ESRD.