Charlson Comorbidity Index for Prediction of Outcome of Acute Kidney Injury in Critically Ill Patients.

INTRODUCTION: This study aimed to determine predictors of outcomes in critically ill patients with acute kidney injury (AKI), and to study the impact of the Charlson Comorbidity Index (CCI) as a prognostic indicator. MATERIALS AND METHODS: This retrospective study included critically ill patients who were admitted with AKI or developed AKI during their hospital stay. The impact of comorbidity was evaluated by the CCI, while severity of AKI was assessed by the RIFLE criteria. RESULTS: The mean age of 786 patients with AKI was 59.0 ± 17.0 years (59% men). The most common cause was sepsis in 51% of the patients. In-hospital mortality rate was 42%. The need for mechanical ventilation (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.23 to 3.04), vasoactive drugs (OR, 9.67; 95% CI, 6.35 to 14.73), dialysis (OR, 1.78; 95% CI, 1.14 to 2.78), failure class of RIFLE criteria (OR, 2.02; 95% CI, 1.00 to 4.08), and a CCI greater than 6 (OR, 2.20; 95% CI, 1.38 to 3.52) were independently associated with mortality. At 90 days of follow-up, 6% of the patients were dialysis dependent, while 32% and 62% had partial and complete recovery, respectively. In multivariable analysis, a CCI greater than 6 (OR, 0.47; 95% CI, 0.26 to 0.83), need for dialysis in hospital (OR, 0.31; 95% CI, 0.17 to 0.54), and failure class (OR, 0.19; 95% CI, 0.07 to 0.55) were independent predictors of poor renal outcomes. CONCLUSIONS: The CCI independently predicts in-patient mortality and poor renal outcomes in patients with AKI.

Studies on α-glucosidase inhibition and anti-glycation potential of Iris loczyi and Iris unguicularis.

AIMS: One of the aims of this research work is the isolation and identification of various constituents of two medicinally important plants (Iris loczyi and Iris unguicularis). Secondly, the prime aim is the biological evaluation of these natural products to discover new potential inhibitors of α-glucosidase enzyme and protein glycation. MAIN METHODS: Plants of the genus Iris contain a variety of secondary metabolites. Chromatographic techniques were applied for the isolation of different compounds from Iris loczyi and Iris unguicularis. All the isolated compounds were screened for their α-glucosidase enzyme inhibition and antiglycation potential. KEY FINDINGS: It is shown in the results that two compounds (Kaempferol and 8-Methoxyeriodictyol) isolated from plant Iris unguicularis and compounds (Arborinone and 5,7-dihydroxy-2',6-dimethoxyisoflavone) isolated from plant Iris loczyi possess promising activity against α-glucosidase enzyme as compare to acarbose which is used as a standard α-glucosidase inhibitor in this study. A flavanone (2',5-dihydroxy-6,7-methylenedioxy) isolated from Iris loczyi was explored as most active anti-glycating agent. SIGNIFICANCE: α-Glucosidase enzyme is a therapeutic target to treat carbohydrate mediated diseases. In this study various inhibitors of α-glucosidase are identified which might be important for the management of diabetes. Similarly, antiglycation agents may have application for the management of late diabetic complications.

Purunusides A-C, alpha-glucosidase inhibitory homoisoflavone glucosides from Prunus domestica.

Purunusides A-C (1-3), new homoisoflavone glucosides together with the known compounds beta-sitosterol (4) and 6,7-methylenedioxy-8-methoxycoumarin (5) have been isolated from n-butanol and ethyl acetate soluble fractions of Prunus domestica. Their structures were assigned on the basis of spectral studies. The compounds 1-3 showed potent inhibitory activity against the enzyme alpha-glucosidase.