Protective Effect of Sankol Herbal Product on Kidney Stone in Balb/C Mice

Background and purpose: Kidney stone is a common form of kidney disease and many efforts have been made to find medications for its prevention and treatment. Current study evaluated the protective effects of Sankol herbal product in the formation of renal stone in male Balb/c mice. Materials and methods: Nephrolithiasis was induced in male Balb/C mice within 21 days by adding 75% ethylene glycol (EG) v/v and 2% Ammonium Chloride (AC) w/v in drinking water. Animals were divided into three groups (n=12 per group); a control group that received purified water, another group that was given EG/AC and the other group that received Sankol (Goldaro Company, Isfahan, Iran) 888mg/kg.  Results: In EG/AC group, increased levels of serum creatinine, urea, and uric acid indicated renal damage.  In the group that received Sankol, these levels decreased which could help in preventing kidney stones. Histopathologic evidence showed inflammation and renal deposition in EG/AC group. In Sankol group, a decrease in the levels of renal sediments was observed, while inflammation of kidney and tissue damage increased. Present findings did not prove the safety of Sankol. Conclusion: This study showed the beneficial effect of Sankol in preventing kidney stones but various side effects question treatment with this product

The Diagnostic Value of Serum Fibrinogen Level in the Diagnosis of Acute Appendicitis

Background and purpose: Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention. Diagnostic tests with high accuracy could lead to immediate diagnosis and timely surgery could prevent further complications. This study was performed to assess the diagnostic value of serum fibrinogen level in diagnosis of acute appendicitis. Materials and methods: This cross-sectional diagnostic study was performed in patients (n=165) attending the emergency department in Sari Imam Khomeini Hospital with an initial diagnosis of appendicitis and available histopathologic examination results in 2016-2017. Fibrinogen levels were measured before surgery. Student's t test, Mann-Whitney test, and Chi-square were used to examine the relationship between fibrinogen level, demographic and clinical variables, acute appendicitis, and complicated/uncomplicated appendicitis. ROC Curve test was also performed and indicators associated with diagnostic accuracy were calculated. Results: The mean fibrinogen level in patients with normal appendices was 278.0±50.5, while it was 349.4 ± 68.7 in those with appendicitis (P<0.0001). The area under the curve was 0.794 (CI = 0.724-0.853). Moreover, at the optimal cut-point of fibrinogen level of 344 mg/dl, the sensitivity, specificity, negative predictive value, and positive predictive value were 51.7%, 90.4%, 94.4%, and 37.6%, respectively. Positive and negative likelihood ratios were 5.43 and 0.53, respectively. Conclusion: This study showed that measuring serum fibrinogen levels, as an acute phase reactant, is useful for diagnostic screening of acute appendicitis and for predicting complicated appendicitis

Renal aspergillosis after COVID‐19‐associated pulmonary aspergillosis: A case report

Key Clinical Message Renal aspergillosis is a rare condition and this case the first case of Renal aspergillosis reported after COVID‐19‐associated pulmonary aspergillosis. Renal symptoms should arise clinical suspicion to renal involvement that happened as a result of hematogenous spreading of pulmonary aspergillosis. Abstract Secondary fungal infections are among the most significant complications that can arise after COVID‐19 and have the potential to lead to a high rate of morbidity and mortality. As COVID‐19 primarily involves the airway, the majority of fungal infections reported have been related to the respiratory system. However, renal aspergillosis that we have reported is a rare condition that also can occur. A 67‐year‐old man was referred to our hospital and admitted as a COVID‐19 patient. After the initial recovery, he experienced a recurrence of fever accompanied by a productive cough. The histopathological studies were conducted on the sputum and bronchoalveolar lavage samples, which revealed the presence of Aspergillus flavus. We treated the patient with voriconazole and the patient was discharged after a period of time. However, after approximately 6 months, he returned to the hospital with a fever and abdominal pain. We started a fever workup. Two new hypoechoic abscess‐like masses were spotted in the right kidney in the ultrasonography (U/S) and the direct molecular studies of the biopsy sample obtained under U/S guidance identified Aspergillus flavus. Although renal aspergillosis is a rare condition, it should not be overlooked, especially in patients with severe COVID‐19 and pulmonary aspergillosis, as these conditions can lead to renal aspergillosis, which may present with symptoms such as abdominal pain with fever. Therefore, it is necessary to perform radiological and histopathological studies when renal aspergillosis is suspected

Evaluation of the Therapeutic Effect of the Traditional Herbal Medicine Atrifil and Oshagh Gum on Testosterone-Induced Benign Prostatic Hyperplasia in Wistar Rats

Benign prostatic hyperplasia (BPH) is a common disease that affects elderly men with various complications. This study evaluates the effects of an Iranian traditional herbal medicine “Atrifil and Oshagh gum” on BPH in male Wistar rats. Atrifil is a combination of three medicinal plants: Emblica officinalis Gaertn, Terminalia chebula Retz, and Terminalia bellerica Retz” extracts, and Oshagh gum is Dorema ammoniacum D. Dono gum. In this study, 30 male Wistar rats were divided into five groups: normal control, disease, finasteride, and extract with 300 and 600 mg/kg groups. The extract is a combination of hydroalcoholic Atrifil extract and Oshagh gum. All groups received intramuscular testosterone enanthate to induce BPH except the normal control group. On the twenty-eighth day, prostate glands were separated. Histopathological changes were observed. Furthermore, the prostate-specific antigen (PSA) and prostate weights were measured. The binding propensities of finasteride, equol, and flavonoids present in this extract such as quercetin, rutin, and kaempferol for 5α-reductase, estrogen receptor alpha and beta, and estrogen-related receptor gamma were assessed using in silico docking approach. Histopathological evaluation, biochemical parameter, and PSA level results indicated significant inhibition of accruing and progression of BPH in groups treated with 600 mg/kg extract (p<0.01). Furthermore, molecular docking showed that rutin had a high affinity to bind the receptors 5α-reductase, estrogen receptor beta, and estrogen-related receptor gamma even more than finasteride, and on average, quercetin had a higher affinity to all these receptors. In the end, it can be concluded that Atrifil and Oshagh gum is effective in preventing BPH