Herbs and Kidney diseases

Context: Fagonia cretica is a medicinal herb reported to have flavanoids of potential therapeutic value and Citrus paradisi is a fruit, whose juice is of great therapeutic value due to its anti-hyperglycemic effects.

Aims: To determine anti-hyperglycemic and renal protective effect of methanolic extract of Fagonia cretica and Citrus paradisi juice (grapefruit juice) in alloxan induced diabetic rabbits.

Methods: Diabetes was induced in rabbits by alloxan monohydrate (150 mg/kg, i.p.). The therapies including Fagonia cretica methanolic extract (500 mg/kg), Citrus paradisi juice (7 mL/kg) and sitagliptin (10 mg/kg) were administered (p.o.) to diabetic groups for 14 days. The biochemical parameters, glucose, creatinine, urea, bilirubin, albumin, total protein, globulins and albumin/globulin ratio were estimated.

Results: Fagonia cretica extract and grapefruit juice therapy significantly (p<0.05) reduced glucose levels in diabetic rats. Fagonia cretica extract was more effective anti-hyperglycemic agent than Citrus paradisi juice and sitagliptin. Significant (p<0.05) improvement in kidney function was observed in treated groups, the plant extract showing significant improvement as compared to the other two treatments. The histopathological results verified improvement in structural damage of kidney, liver and pancreas with these treatments.

Conclusions: Fagonica cretica and Citrus paradisi juice therapy markedly improved hyperglycemia and kidney functions in alloxan-induced diabetic rabbits.

Urolithiasis is a common worldwide problem with high recurrence. This review covers forty four (44) families starting from alphabet A to L and includes Bignoniaceae (05) Juglandaceae (01) plant used globally in different countries. The plants of three families Asteraceae, Fabaceae and Lamiaceae are revisited to provide updated information. This review will not only be useful for the general public but also attract the scientific world for antiurolithiatic drug discovery.

Urolithiasis is a global health problem with high recurrence rate. Different in vivo and in vitro models have been successfully used to evaluate the antiurolithiatic potential of medicinal plants. In vitro models provide the study of renal stone formation and in vivo models declare pathological effects of urolithiasis. Thus, in vitro models are significantly and effectively used to evaluate prophylactic management and in vivo gives the direction towards urolithiasis treatment. This paper describes the advantages, limitations and applications of both model specially, the role of in vitro studies in the evaluation of prophylactic management. Introduction Urolithiasis is commonly referred as stone formation in any part of the urinary tract such as kidneys, ureters, urinary bladder and urethra. It is one of oldest, most frequent and highly recurrent disease and was initially found in the tombs of Egyptian mummies dating back to 4000 BC [1]. Epidemiological studies revealed that urolithiasis is more common in men than in women and is more prevalent between the ages of 20 to 40 in both sexes [2]. Uroliths are generally composed of calcium as calcium oxalate monohydrate and calcium hydrogen phosphate dihydrate (75-90%), magnesium as ammonium magnesium phosphate hexahydrate (10-15%), uric acid and urates (3-10%); and 0.5-1% is composed of cystine, hippuric acid, L-tyrosine and xanthine. Calcium containing uroliths are known as brushite, whewellite, weddellite, whitlockite and carbonate apatite. Struvite and newberyite are magnesium containing where as ammonium acid urate, mono sodium urate monohydrate, uric acid anhydrous, uric acid mono and dihydrate are commonly existing urate stones [1, 3]. Medicinal plants are considered as a rich source of therapeutic agents due to the belief and observations regarding their traditional use for the prevention of various ailments. Various research findings and data from different part of the globe are contributing and helping the scientific community in evaluating and establishing the pharmacological activities of these plants. Different in vitro and in vivo (animal models) studies are used for determining various mechanism profiles of testing extract or compounds against different pathophsiological conditions and also for urolithiasis. These models best describe both prophylactic and curative action of the test sample. In vitro studies provide preliminary examination before conducting in vivo studies. These studies also provide smaller setups using a little test substance, allowing low costs and high number of replicates. Thus, providing motivation to minimize drug costs through economical testing procedures and gives more direct assess toward extract or compound performance than do conventional in vivo studies and therefore provide important insights into fundamental mechanisms for biological effects. It also avoids or decreases the need for laboratory personnel experienced in animal handling and there is no need to submit permission by the institutional animal ethics committee [4]. Urolithiasis is a multistep biochemical process with high recurrence rate. After urolithiasis treatment, there is 50% chance of stone formation within 7 years if left untreated. Therefore, prophylactic management is of great importance and advisable, especially in such individual subjects [5]. Crystallogenesis is the first and essential step in stone formation which is based on three steps nucleation, growth and aggregation.

Background: Upto date, the scientific documentation regarding in-vivo antiurolithiatic activity of Kalanchoe pinnata has been reported, although it has not reported for in-vitro antiurolithiatic activity up till now.
Objective: To explore anti-urolithiatic activities of Kalanchoe pinnata leaves extract by utilizing different in-vitro models. To investigate the inhibitory effect of extract on in vitro crystallization through analyzing nucleation and aggregation assays. Material and Methods: Aqueous extract of Kalanchoe pinnata fresh leaves was prepared and arranged in the different concentrations. Homogenous precipitation method was used to prepare artificial stones such as calcium oxalate and calcium phosphate and semi-permeable membrane of eggs was used as dissolution bags. Dissolution models were incubated in 72hrs and after that, the entire content in dissolution bags was estimated spectrophotometrically. The inhibitory activity of Kalanchoe pinnata leaves extract on the nucleation of calcium oxalate crystals and the rate of aggregation in calcium oxalate crystals was determined by spectrophotometric assay. Results: In dissolution models, the extract of Kalanchoe pinnata has greater capability to dissolve calcium oxalate while Cystone standard has shown better demineralization for calcium phosphate rather than extract of Kalanchoe pinnata. Cystone exhibited strongly inhibitory action in the nucleation assay rather than aggregation assay. The extract of Kalanchoe pinnata exhibited inhibitory action in both of nucleation and aggregation assays to significant level. Discussion: The present investigation will be supportive to the scientific documentation related in-vitro studies. Correlation between in-vitro and in-vivo studies may be helpful to understand the molecular mechanism of litholysis process and to reveal phytochemicals of the extract responsible for dissolving or disintegrating renal calculi. Conclusion: Kalanchoe pinnata extract exhibited significant in-vitro anti-urolithiatic activity.

Nowadays, alternative medicines have become a multibillion-dollar industry and continue growing. Herbal medicine is one of the primeval forms of medicine which is prepared exclusively from herbal plants. The Ayurvedic medicinal cure method is also been used as a prescription for chronic diseases such as cancer, asthma, diabetes, and end-stage renal diseases and increasing interest in European countries respectively. According to the report of world health organization (WHO), 4 billion people (80% of the world's population) use herbal medicines for some perspective of primary healthcare; approximately 25% of modern drugs used in the United States have been procured from plants. It is estimated that 11% of the total 252 medicinal drugs found in crucial medicine list of WHO are particularly of plant origin. The purpose of this study is to find out the toxic and beneficial effects of medicinal herbs on renal health by which evidence for benefit or toxicity has been found. The review aims to provide knowledge and guide to encourage future toxicity studies on the kidney by medicinal herbs.

Urolithiasis is a common problem afflicted for many centuries with high recurrence. The aim of this review is to provide comprehensive information about traditionally used antiurolithiatic plants and their scientifically proved pharmacological activities like analgesic, anti-inflammatory, antioxidant, astringent, demulcent, diuretic, litholytic, lithotriptic, antiurolithiatic, antispasmodic, ACE inhibition and Phospholipase A2 inhibition as a plausible mechanism of action. A total of 503 species, 365 genera and 119 families were cited for treating kidney stones. The most cited families are Asteraceae (41), Fabaceae (34), Lamiaceae (26), Apiaceae (21), Rosaceae (19) and Poaceae (16). The most common used plant parts are root and rhizome (25%), mode of preparation decoction (62%) and route of administration is oral in all cases. This review will provide the opportunities for the future research and development of new natural antiurolithiatic compounds. Introduction The belief and observations regarding traditionally used medicinal plants, increasing the interest of people to use natural medicine for their primary health care needs. A wide range of medicinal plants have been used in different countries and cultures as a prophylactic and curative agent for urolithiasis. Most of the remedies are very useful, but their mechanism of action remains unclear. Scientific studies reveal the mechanism of actions of these antiurolithiatic plants and the results show very interesting and multidimensional action, responsible for their effectiveness at different stages of urolithiasis, such as, the diuretic action increases the quantity of fluid going pass through the kidneys as a result flush out the deposits. Therefore, the increase in urine volume decreases the saturation of the salts and prevents the precipitation of the crystals at physiological pH. Breaking, disintegration and dissolution of preformed stones (litholytic activity) and binding inhibition among particles to form stones (lithotriptic activity) play an important role in this pathological condition. Crystal inhibitors decrease crystal nucleation, aggregation and growth. Furthermore, they inhibit crystallization by their adsorption to the crystal surface which makes them unable for renal tubular attachment (crystallization inhibition activity). In urine different crystalloids like oxalate, uric acid, calcium and cystine are present with mucin and sulphuric acid colloids in dissolved form. The disturbance in crystalloid-colloid balance (increase in crystalloid and decrease in colloid) causes renal stone formation. Renal exposure to oxalate and calcium oxalate causes lipid peroxidation, produces Reactive Oxygen Species followed by renal cell injury and inflammation. This loss of membrane integrity, promotes fibrosis and collagen formation, facilitates calcium oxalate retention and subsequent stone formation [1, 2]. Renin-Angiotensin System activates the NADPH oxidase in renal cells, which produces Reactive Oxygen Species. Angiotensin converting enzyme inhibition significantly reduces calcium oxalate crystal deposition and renal inflammation. The Reactive Oxygen Species end up phospholipase A 2 activation through nuclear transcription factor NF-κB. Activation of cytosolic phospholipase A 2 generates arachidonic acid and lysophosphatidylcholine, which increase reactive oxygen species production that in turn increase in cell death and crystal formation [1, 3]. The obstructing stone causes renal colic and in this condition an antispasmodic activity of the smooth muscles along with analgesic and anti-inflammatory activities play an important role in symptomatic relief from renal colic and dysuria. Antispasmodics help in stone passage. The obstruction of urine outflow by stones decreases the glomerular filtration rate (GFR) resulting nitrogenous waste (urea, creatinine and uric acid) accumulation in blood

Urolithiasis is a common worldwide problem with high recurrence. This review covers the forty one (41) antiurolithiatic plants of family Rosaceae used in 14 different countries. Hopefully, this review will not only be useful for the general public but also attract the scientific world for antiurolithiatic drug discovery.

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Whewellite crystals are most commonly found in kidneys, ureter and urinary bladder causing urolithiasis. The purpose of the present in vitro study was to observe the possible growth patterns and morphology of whewellite crystals. The study was carried out in U-shaped test tubes. Bow shape, donuts and their aggregates, dumbbell, platy, prismatic, rosette, styloid, X-shape and tetragonal bipyramidal crystals were observed. Energy Dispersive X-ray, Fourier Transform Infra-Red spectroscopies and Scanning Electron Microscopy were used to characterize the crystals. This study will be helpful to determine the promotion, modulation and inhibition of the crystals evaluate risk factors and prophylactic management of urinary stones.

Natural  products  once  served  humankind  as  the  source  of  all
drugs, and higher plants provided most of these therapeutic agents.
Natural  products  continue  to  provide  useful  drugs  in  their  own
right  but  also  provide  templates  for  the  development  of  other
compounds.  A  major  advantage  of  natural  products  approach  to
drug delivery is that it is capable of providing complex molecules
that  is  not  accessible  by  other  routes.  Among  CNS  disorders,
neurodegenerative  disorders  affects  majority  of  population
worldwide.  Neurodegenerative  disorders  such  as  Parkinson's
disease  (PD),  Alzheimer's  disease  (AD),  Huntington's  disease
(HD)  and  amyotrophic  lateral  sclerosis  (ALS)  are  currently
incurable  pathologies  with  huge  social  and  economic  impacts
closely  related  to  the  increasing  of  life  expectancy  in  modern
times. Although the clinical and neuropathological aspects of these
debilitating  disorders  are  distinct,  they  share  a  pattern  of
neurodegeneration in anatomically or functionally related regions.
The  majority  of  the  compounds  examined  to  date  with  a  direct
relevance  to  AD  are  primarily  from  plants,  from  animal,  marine
and microbial sources. Successful drugs achieved so far are found
to act by inhibiting acetyl cholinesterase enzyme. In future, more
emphasis should be given in finding new targets for AD therapies.
The review focuses on the natural products that might underlie the
purported  beneficial  improvements  in  memory  and  cognition,
neurovascular  function,  and  in  neuroprotection.  It  may  be
concluded  that  natural  product  chemistry  brings  tremendous
diversity and historical precedent to a huge area of unmet medical
need. Cooperative effort from all  the technical disciplines related
to  drug  discovery  should  be  continued  to  make  plant-derived
natural product research an essential contributor in future.

This study examined the disaggregated impact of government expenditure on human capital development in Nigeria from 1989 – 2018. In spite of the enormous government spending, little have been felt in the area of human capital development, fundamental to consistent economic growth of any nation. It no news that educational sector has been poorly managed and funded to regenerate the desired human capital development which in turn spurs economic growth. Intuitively, the study adopted the ordinary least squares method, novel for its BLUE properties of it estimators. Several pre and post tests were done on the series used. The result found that capital expenditure has significant impact on human capital development cum economic growth in Nigeria and this finding is consistent with the endogenous hypothesis. Amazingly, variance decomposition result suggests that recurrent and capital expenditure collectively contribute to change in human capital development in Nigeria, approximates Wagner...

Brushites are most commonly found phosphate stones in the kidneys, ureters and urinary bladder. The study was conducted to observe the possible growth patterns of brushite crystals in gel for 14 days. The crystals formation was observed as a bullet, needle, platy, columnar shaped and their aggregates. These shapes were further explained by Magono and Lee meteorological classification. Beside the morphology, average size, number and weight of crystals were also observed at 7th and 14th day. Energy Dispersive X-ray, Fourier Transform Infra Red spectroscopy and Scanning Electron Microscopy were used to characterize the crystals. These results can help to determine the promotion, modulation and inhibition of the crystals which will be helpful to evaluate the risk factors and prophylactic management of brushite type urinary stones.

About 12% of world population is affected by different forms of urolithiasis in which the recurrence rate in female is 47-60% and in male is 70-80%. According to WHO 75% people rely on traditional medicines for the prevention and cure of different ailments. Similarly, the majority of the world population use a number of plants to treat problems related to the urinary tract system in which urolithiasis is the major cause. The aim of the review is to collect the data of the plants used in different parts and cultures of the world against urolithiasis with their parts, mode of preparation, dosage and administration. A literature review was conducted for traditionally used antiurolithiatic plants. The articles mentioning plant, parts, mode of preparation, dose and route of administration were selected. This information was extracted to compose Mono and Poly herbal antiurolithiatic formulations used in Appalachia (region in Eastern United States), Yemen. The review provides an important data about plants used as antiurolithiatic in different parts of the world. The information not only useful for common people, but also for the scientific community to carry out further phytochemical, pharmacological and toxicological studies for the discovery of new, effective and safer molecules against urolithiasis.

BACKGROUND Mycophenolate mofetil has replaced azathioprine in immunosuppression regimens worldwide to prevent graft rejection. However, evidence that its antirejection activity is better than that of azathioprine has been provided only by registration trials with an old formulation of ciclosporin and steroid. We aimed to compare the antirejection activity of these two drugs with a new formulation of ciclosporin. METHODS The mycophenolate steroids sparing multicentre, prospective, randomised, parallel-group trial compared acute rejections and adverse events in recipients of cadaver-kidney transplants over 6-month treatment with mycophenolate mofetil or azathioprine along with ciclosporin microemulsion (Neoral) and steroids (phase A), and over 15 more months without steroids (phase B). The primary endpoint was occurrence of acute rejection episodes. Analysis was by intention to treat. FINDINGS 168 patients per group entered phase A. 56 (34%) assigned mycophenolate mofetil and 58 (35%)...

The purpose of the present study was to explore the possible morphological features and growth patterns of calcium oxalate monohydrate crystals. The study was carried out on a glass slide under microscope. The results showed that the calcium oxalate monohydrate crystals may be present in the form of arborescent, donut, dumbbell, needles, platy, prismatic, rosette, round edges, loose agglomerates and compact aggregates. The study provides detailed information about the morphology and aggregation patterns of calcium oxalate monohydrate crystals.

This study was aimed to identify of chemical composition of kidney stones of patient in Sana’a, Yemen because the lack of research done in this field. The study was integrated within the clinical practice. Patients, mothers or child&#39;s guardian received a simple explanation for the aim of the study as an ethical issue. 581 samples of chemical compositions were collected andanalyzed in the National Center for Public Health Laboratories Sana&#39;a, Yemen according to qualitative method. The results showedthat 54.6 % of the calcium oxalate, 6.3 % of the uric acid, 0.7 % of the calcium phosphate, 29.6 % of the calcium oxalate and uric acid, 6.7 of the calcium oxalate and calcium phosphate, 1 % calcium oxalate and calcium carbonate, 0.5 % of the calcium oxalate, calcium phosphate and uric acid, 0.5 % of the calcium oxalate, calcium carbonate and uric acid, and 0.2 % calcium phosphate and uric acid. In conclusion, calcium oxalate was the most predominant chemical compositions in stones...

Department of Medical Genetics, Medical University Sofia, Bulgaria Department of Clinical Nephrology, Medical University Sofia, Bulgaria Department of Clinical Laboratory and Clinical Immunology, Medical University Sofia, Bulgaria University Hospital “Maichin Dom” Sofia National cardiological hospital, Sofia, Bulgaria Medical University – Sofia, Department of Health Economics, Faculty of Public Health Specialized Hospital for Active Treatment in Pediatrics Sofia

This  study  was  aimed  to  identify  of  chemical  composition  of
kidney  stones  of  patient  in  Sana’a,  Yemen  because  the  lack  of
research  done  in  this  field.  The  study  was  integrated  within  the
clinical  practice.  Patients,  mothers  or  child's  guardian  received  a
simple explanation for the aim of the study as an ethical issue. 581
samples of chemical compositions were collected andanalyzed in
the National Center for Public Health Laboratories  Sana'a, Yemen
according to qualitative method. The results showedthat 54.6 % of
the calcium oxalate, 6.3 % of the uric acid, 0.7 %  of the calcium
phosphate, 29.6 % of the calcium oxalate and uric acid, 6.7 of the
calcium oxalate and calcium phosphate, 1 % calcium  oxalate and
calcium  carbonate,  0.5  %  of  the  calcium  oxalate,  calcium
phosphate  and  uric  acid,  0.5  %  of  the  calcium  oxalate,  calcium
carbonate  and  uric  acid,  and  0.2  %  calcium  phosphate  and  uric
acid.  In  conclusion,  calcium  oxalate  was  the  most  predominant
chemical  compositions  in  stones  and  it  represents  common
urological problem in Sana’a, Yemen.

This study examined the disaggregated impact of government expenditure on human capital development in Nigeria from 1989 – 2018. In spite of the enormous government spending, little have been felt in the area of human capital development, fundamental to consistent economic growth of any nation. It no news that educational sector has been poorly managed and funded to regenerate the desired human capital development which in turn spurs economic growth. Intuitively, the study adopted the ordinary least squares method, novel for its BLUE properties of it estimators. Several pre and post tests were done on the series used. The result found that capital expenditure has significant impact on human capital development cum economic growth in Nigeria and this finding is consistent with the endogenous hypothesis. Amazingly, variance decomposition result suggests that recurrent and capital expenditure collectively contribute to change in human capital development in Nigeria, approximates Wagner...

Context: Medicinal plants are a highly sought-after alternative to current pharmaceutical drugs because they can be locally cultivated, inexpensive and possess minimal adverse effects. Given that Terminalia phanerophlebia (TP) possesses many useful properties and plays a role in modulating lethal diseases, the cytotoxic effect should be evaluated before its application for therapeutic use. Aims: To investigate the oxidative effect and molecular mechanisms of TP on human embryonic kidney (HEK293) cells. Methods: 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and adenosine triphosphate (ATP) assays were used to determine the cell viability whilst the thiobarbituric acid reactive species (TBARS) assay was used to detect lipid peroxidation. Endogenous antioxidants, catalase, superoxide dismutase, glutathione peroxidase, heat shock protein 70 and nuclear factor erythroid 2-related factor 2 (Nrf2), were used as oxidative stress markers and were detected via western blotting. Results: A decrease in cell viability with an IC50 of 1.36 mg/mL and ATP were noted. The concentration of malondialdehyde (MDA) increased significantly (p<0.005). Superoxide dismutase, Nrf2 and heat shock protein concentrations were increased. However, glutathione, glutathione peroxidase and catalase were depleted. Conclusions: The results obtained suggest that Terminalia phanerophlebia extract is toxicogenic and induced oxidative stress in HEK293 cells.

Context: Doxorubicin (DXR) is a common anticancer drug known to produce several complications. Terminalia chebula popularly known as 'King of medicine' is found to possess wound healing, anti-inflammatory and antioxidant properties. Aims: To evaluate the effects of Terminalia chebula extract on doxorubicin-induced renal damages in rats. Methods: Coadministration of Terminalia chebula extract (0.25, 0.5 and 1.0 g/kg) was tested against DXR (2.5 mg/kg) induced renal damages in rats. Additional two groups were evaluated by administering 0.5 g/kg of the extract to animals either before or after DXR treatment. Kidney function tests were performed by measuring the serum levels of urea, creatinine, uric acid, and total protein. The antioxidant activity of the extract was evaluated by in vivo and in vitro methods. Histopathology of kidney tissues was performed to assess the morphological changes. The significance of results obtained were statistically analyzed. Results: The data obtained indicated that co-administration of the extract at higher doses (0.5 and 1.0 g/kg) significantly (p<0.01) reduces the serum levels of creatinine, urea, uric acid, and total proteins compared to DXR group. The extract also decreases the structural damages induced by DXR and exhibited antioxidant property. However, the pre-and post-treatments of Terminalia extract neither alter significantly the biomarker levels nor ameliorated the histopathological changes induced by DXR in rats. Conclusions: The observations indicated that co-administration of Terminalia chebula decreased the renal damage induced by DXR in rats. The protective action of the extract may be related to its wound-healing and antioxidant properties, the latter of which diminished the free-radical damage induced by DXR.

Medical anthropology is still not well developed branch in the Eastern European scholarly studies. However, the focus of such a wonderful researcher like Alexandra Comşa on trephination and related to it another phenomenon, herbal
ancient medicine, is a good luck for the whole global medical anthropology. Comsa's book is available at http://www.elefant.ro
Trephination
is
a
theme
with
different
independent
directions
of
research
in
historiography