Histopathological study of the combination of metformin and garlic juice for the attenuation of gentamicin renal toxicity in rats.

INTRODUCTION Tubular toxicity is one of the most important side effects of aminoglycoside antibiotics, especially gentamicin. OBJECTIVES We histopathologically studied the effect of garlic extract and metformin co-administration, in attenuation of genetamicin induced tubular toxicity in rats. MATERIALS AND METHODS In this study seventy rats were divided into seven equal groups and except group 1 (control) were injected 100 mg/kg/day gentamicin (GM) intraperitoneally (i.p.) for 10 days. Other than GM, group III received 20 mg/kg garlic (i.p.), group IV metformin (MF) (100 mg/kg, orally), group V a combination of MF with garlic juice (100 and 20 mg/kg/day, respectively) and group VI a combination of MF and garlic juice (50 and 10 mg/kg/day, respectively) for following 10 days. Group VII received a combination of MF and garlic juice (100 and 20 mg/kg, respectively) along with GM. Animals were sacrificed on the 20(th) day of the experiment and the kidneys were removed for histological examinations. RESULTS GM induced nephrotoxicity and garlic or MF alone and a combination of both with high doses (not low doses) significantly abolished the kidney tubular injury induced by GM. In addition, co-administration of GM, MF and garlic (group 7) prevented the GM- induced tissue damage more than the groups in which MF and garlic were injected 10 days post GM administration. CONCLUSION Garlic extract and Metformin, alone or in a combination, might be safely used to ameliorate GM induced tubular toxicity

Medicinal plants, diabetes mellitus and urgent needs

Implication for health policy/practice/research/medical education: The limitation of available antidiabetic agents in terms of efficacy or safety coupled with the emergence of the disease into global epidemic have encouraged alternative therapy for the management of diabetes more safely and efficiently. Although alternative therapies with antidiabetic activity have been researched and used extensively, however, medical students either do not study these courses or their length of the study is too short. Therefore, complementary and alternative medicine is needed to be widely taught in medical schools and widely practiced in hospital

Anethum graveolens and hyperlipidemia: A randomized clinical trial

Background: It has been established that hyperlipidemia increases the incidence and mortality associated with coronary heart disease. In this study, the effects of Dill (Anethum graveolens) were evaluated on lipid profile of hypercholesterolemic patients. Materials and Methods: In this clinical study, 91 hyperlipidemic patients were randomly designated into two groups. One group received gemfibrozil (900 mg daily) and the other group received Dill tablet (six tablets daily) for 2 months. The blood lipids including total cholesterol, triglyceride and high density lipoprotein (HDL)-cholesterol from each group were assessed at the beginning and end of the trial. Results: Use of gemfibrozil brought about increased HDL-cholesterol by 3.91% (P < 0.05) and reduced triglyceride and total cholesterol by 32.7% (P < 0.05) and 9.41% (P < 0.05), respectively. Applying Dill tablet for 2 months resulted in reduction of total cholesterol up to 18% (P < 0.05) and triglyceride by 7.38% (P < 0.05). However, circulating HDL-cholesterol was not affected by this treatment. In this study, gemfibrozil decreased triglyceride and increased HDL-cholesterol more than anethum (P < 0.05). Anethum decreased total cholesterol more than gemfibrozil (P < 0.05). Patients treated with anethum did not report any side effects. Conclusion: The results of this trial indicate that Dill might be beneficial for hypercholesterolemic and hypertriglycemic patients

Oxidative stress and hypertension: Possibility of hypertension therapy with antioxidants

Hypertension is a major risk factor for myocardial infarction, heart failure, stroke, peripheral arterial disease, and aortic aneurysm, and is a cause of chronic kidney disease. Hypertension is often associated with metabolic abnormalities such as diabetes and dyslipidemia, and the rate of these diseases is increasing nowadays. Recently it has been hypothesized that oxidative stress is a key player in the pathogenesis of hypertension. A reduction in superoxide dismutase and glutathione peroxidase activity has been observed in newly diagnosed and untreated hypertensive subjects, which are inversely correlated with blood pressure. Hydrogen peroxide production is also higher in hypertensive subjects. Furthermore, hypertensive patients have higher lipid hydroperoxide production. Oxidative stress is also markedly increased in hypertensive patients with renovascular disease. If oxidative stress is indeed a cause of hypertension, then, antioxidants should have beneficial effects on hypertension control and reduction of oxidative damage should result in a reduction in blood pressure. Although dietary antioxidants may have beneficial effects on hypertension and cardiovascular risk factors, however, antioxidant supplementation has not been shown consistently to be effective and improvement is not usually seen in blood pressure after treatment with single or combination antioxidant therapy in subjects thought to be at high risk of cardiovascular disease. This matter is the main focus of this paper. A list of medicinal plants that have been reported to be effective in hypertension is also presented

Comment on: Anti-Oxidative Stress Activity of Stachys lavandulifolia Aqueous Extract in Humans

A recent article by Rahzani et al. (1) published in the esteemed Cell Journal reported the antioxidative stress activity of Stachys lavandulifolia aqueous extract in humans and suggested its consumption as a supplement in the management of diseases related to oxidative stress. We would like to emphasize some of the limitations regarding antioxidant supplementation, in general, and Stachys lavandulifolia, in particular. It has been established that oxidative stress is involved in the development of a wide variety of chronic and degenerative diseases such as cancer, Parkinson and Alzheimer’s (2-5). Antioxidants are also effective in the prevention or reduction of adverse effects related to medication usage (5-10). However, they may potentially have deleterious effects. A major concern of antioxidant supplementation is their harmful effect on reactive oxygen species (ROS) production (prooxidant action), particularly when precise modulation of ROS levels are necessary for normal cell function (4-10). In fact, it has been reported that antioxidants may exhibit pro-oxidant activity under specific conditions. Of particular importance are redox conditions the dosage and the presence of free transition metals at cellular sites. For example, the antioxidant vitamin C in the presence of ferric iron may act as a potent mediator of lipid peroxidation. It has been suggested that β-carotene sometimes acts as a pro-oxidant in the lungs of smokers and similarly vitamin C may increase DNA damage in humans (11, 12). Therefore, it is necessary to take into account the bioavailability and differential activities of antioxidant compounds before their administration. Other than general considerations for antioxidant consumption, the aspects of each particular antioxidant should also be considered (3, 13, 14). Recently, in a preclinical study we reported the renal toxicity of hydroalcoholic extract of Stachys lavandulifolia Vahl in Wistar rats (15). In this experimental study we randomly assigned 100 male Wistar rats to five equal groups, one control and four experimental. Animals received intraperitoneal injections of saline or Stachys lavandulifolia extract (50, 100, 150, 200 mg/kg) for one month after which blood samples were collected from half of the animals from each group. Other animals received no injections for one additional month, then blood samples were obtained. In the groups that Stachys lavandulifolia Vahl extracts were used for one month we observed mild degeneration of renal tubular epithelial cells (6, 9). In the second month of the study these histologic lesions significantly increased (p< 0.05). We concluded that hydroalcoholic extract of Stachys lavandulifolia has renal tubular toxicity which might continue following drug discontinuation (6, 9, 15). Therefore, although antioxidant supplements generally have beneficial effects, as a caution it is advised to only consume such supplements under medical supervision in order to avoid any potential negative effects

Protection of Renal Tubular Cells by Antioxidants: Current Knowledge and New Trends

Acute renal damage mainly develops following toxic or ischemic insults and is defined as acute. These damages have largely been attributed to oxidative stress. Recently much attention has been directed toward decreased renal tubular cell regeneration during tubular cell injury. Antioxidants have recently been the focus of researchers and scientists for prevention and treatment of various oxidative stress-related conditions, including renal toxicities. Although free radicals are known to contribute in kidney injury and abundant researches, particularly laboratory trials, have shown the beneficial effects of antioxidants against these complications, long term clinical trials do not uniformly confirm this matter, especially for single antioxidant consumption such as vitamin C. The aim of this paper is to discuss the possible explanation of this matter

Significance of extracapillary proliferation in IgA-nephropathy patients with regard to clinical and histopathological variables

Background and Aim: Extracapillary proliferation (crescent) was not included in the Oxford classification, although previous attempts to correlate the crescent with clinical outcomes have produced conflicting results. In this study, we investigated the clinical and morphological significance of extracapillary proliferation in a group of IgA nephropathy (IgAN) patients with regard to the Oxford classification. Patients and Methods: In an observational study conducted on IgAN patients, we collected a total of 114 biopsies. We diagnosed IgAN by light and immunofluorescence for all patients. Results: Of the 114 patients, 70.2% were male. The mean age of the patients was 37.7 +/- 13.6 years. The mean proteinuria was 1742 +/- 1324 mg/ day. The mean serum creatinine was 1.6 +/- 1.5 mg/dL. Twenty-five (21.9%) patient kidney biopsies had extracapillary proliferation. We found a significant positive correlation between the number of crescents and serum creatinine (p< 0.001). Furthermore, we found a positive association between the nephrotic syndrome and the total number of crescents (p< 0.05). Additionally, we observed a significant positive correlation between the amount of sclerosed glomeruli and extracapillary proliferation (p= 0.028). Conclusion: Our findings confirm that extracapillary proliferation has a significant association with proteinuria and sclerotic glomeruli. We anticipate that extracapillary proliferation will be included in a revision of the Oxford classification of IgAN to widen the scope of the classification