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| PHARMACOLOGICAL RESEARCH |
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| Year : 2010 | Volume
: 31
| Issue : 3 | Page : 361-366 |
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Urolithic property of Varuna (Crataeva nurvala): An experimental study
Sanjay Agarwal1, Shiv Ji Gupta2, AK Saxena3, Neelam Gupta4, Shweta Agarwal5
1 Department of Shalya Tantra, V.Y. S. Ayurvedic College, Khurja, U.P., India
2 Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
3 Center of Experimental Medicine and Surgery, IMS, BHU, Varanasi, India
4 Department of Anatomy, IMS, BHU, Varanasi, India
5 Department of Kayachikitsa, Government Autonomous Ayurveda College, Rewa, Madhya Pradesh, India
| Date of Web Publication | 26-Feb-2011 |
Correspondence Address:
Sanjay Agarwal
HIG Junior 37, Vindhya vihar colony, Padara, Near agriculture college, Rewa - 486 001, Madhya Pradesh
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-8520.77161
 Abstract | | |
Despite modern techniques, the recurrence rate of Urolithiasis is approximately 50% within 5 years. Thus, there must be some drug that corrects the metabolic errors and prevents the formation of stone. In Ayurveda, a detailed description of urolithiasis is mentioned under the heading of Ashmari. A group of Ayurvedic drugs are described for the management of Urolithiasis, like Pashanbheda (Bergenia ligulata), Varuna (Crataeva nurvala), Kullattha (Dolichos biflorus), Gokshur (Tribulus terrestris), etc. in our ancient texts. The present work was designed to study the effect of Varuna (Crataeva nurvala) on the experimental model of urolithiasis (albino rats). The study was categorized into two groups: Group I, treated and Group II, control. In all albino rats, stone was surgically implanted into the urinary bladder. Estimation of the urinary and serum electrolyte done periodically and x-rays were exposed at a regular interval. This study suggests the decoction of Varuna (Crataeva nurvala) is effective in the management of urolithiasis. Keywords: Gokshur, kullattha, Pashanbheda , urolithiasis, Varuna
How to cite this article:
Agarwal S, Gupta SJ, Saxena A K, Gupta N, Agarwal S. Urolithic property of Varuna (Crataeva nurvala): An experimental study. AYU 2010;31:361-6 |
| Introduction | |  |
Urolithiasis is a problematic condition, especially with regards to its treatment, in all the systems of medical sciences. In the system of modern medicine, which is supposed to be the most advanced and highly scientific system, the problem of urolithiasis has no satisfactory answer. Despite modern techniques, the recurrence rate of Urolithiasis is approximately 50% within 5 years. [1] The only rational treatment in this therapy is surgical removal or lithotripsy of the stone. But, this does not stop the formation of a subsequent stone. Thus for, there is no drug or therapy known that would dissolve or fragment the stone in the system by changing the lithogenic potential of a particular person.
In Ayurveda, urinary stone diseases have been described in detail under the heading of Ashmari. Sushrut, "The Father of Surgery," being a surgeon himself has described in detail its etiopathogenesis, symptomatology, medical and surgical treatment and prognosis separately.
In Ayurveda, a number of drugs have been described that are very effective against urolithiasis, namely Shatavari, Gokshur, Varuna, Shilajeet, etc. In the present work, an attempt has been made to determine the effect of Varuna (Crataeva nurvala) on the metabolic correction or on serum as well as urinary electrolytes in the experimental model, i.e. in albino rats.
| Materials and Methods | | |
Study design
This study was an open, experimental trial and was designed in the following two phases:
- Pre-experimental study for 1 month
- Experimental study of 3 months
Experiment no. 1
Objectives: To determine the pre-experimental normal serum electrolyte and urinary electrolyte values and variations.
To obtain the pre-experimental normal values of urinary output, 24 h water intake and pH of 24 h urine sample.
Experiment no. 2
Objectives: Experimental production of vesicle calculus by implanting glass beads in the urinary bladder of albino rats and to observe the effect of the drug on the formation and growth of the vesicle calculus.
To determine the effect of the drug on the serum and urinary electrolytes.
The experimental study in the present work was carried out in 18 albino rats of either sex, with a weighting range between 225 and 250 g. They were divided into two groups, with nine rats in each group, termed as control and treated. A balanced diet of 10-15 g/day and water for drinking were provided to all albino rats. The whole study was carried out for 90 days.
Drug: The drug Varuna Kashaya (decoction) was used in this study.
The dose for the study was selected by converting the human dose to animal dose on the basis of body surface area ratio by referring to the table of Paget and Barnes (1969). [2]
Human dose × conversion factor (0.018) for rat = "x"/200 g i.e., 0.9 ml/100 g body weight of albino rat.
Method of collection of urine
Urine was collected in the experimental cage.
Method of collection of blood sample
Blood was collected by puncturing the optic artery through the capillary tube.
Method of producing urinary stone
Measured glass beads, approximately uniform in size (1.5-2.0 mm in diameter) and shape, with a weight in the range of 9-10 mg, were implanted into the urinary bladder of each rat. From the third post-operative day, the rats of the control group were started on treatment with a calculated 2.25 ml dose of distilled water in a single dose per day, whereas the rats of the treated group were provided with a calculated 2.25 ml dose of Varuna Kashaya in a single dose per day by adopting the method described earlier.
For the estimation of serum electrolyte (calcium, phosphorus), serum creatinine and serum phosphorus in the pre-experimental animals, the amount of blood was collected by puncturing the optic artery through the capillary tube. [3] This was repeated at least three times at an interval of 10 days.
The total experiment was carried out up to 90 days after implantation of the glass beads and the estimation of serum and urinary electrolytes was performed periodically at an interval of 15 days.
| Observation | | |
[Table 1] shows that the mean urinary output was 9.19 ml/24 h. The variation in urinary pH was 8.0-9.0 and the mean observed value of urinary pH was 8.33. | Table 1: Water intake, urine output and urinary pH in the pre-experimental albino rats
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[Table 2] and [Figure 1] show the mean values of water intake, urine output and urinary pH in the pre-experimental animals and in the control and the treated groups. | Table 2: Comparison of the mean water intake, mean urinary output and mean urinary pH in different groups
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 | Figure 1: Graphical presentations of comparison of the mean water intake, mean urinary out--put and mean urinary pH in different groups
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Serum and urinary electrolytes
[Table 3] shows that the mean value of serum creatinine, calcium, phosphorus and uric acid in the pre-experimental albino rats were 0.55 mg%, 10.79 mg%, 4.50 mg% and 2.55 mg%, respectively. | Table 3: Estimation of serum creatinine, calcium, phosphorus and uric acid in the pre-experimental albino rats
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[Table 4] and [Figure 2] show that the mean standard value of serum creatinine, calcium, phosphorus and uric acid were 0.30 mg%, 10.70 mg%, 5.20 mg% and 1.44 mg%, respectively. | Table 4: Effect of drug on serum electrolytes in the pre-experimental, control and treated groups
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 | Figure 2: Graphical presentation showing the effect of drug on serum electrolytes in the pre--experimental, control and treated groups
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Urinary electrolytes
[Table 5] shows that the mean value of urinary excretions of urinary creatinine, calcium, phosphorus and uric acid in the pre-experimental albino rats were 0.31 mg/24 h, 11.09 mg/24 h, 5.12 mg/24 h and 38.23 mg/24 h, respectively. | Table 5: Estimation of urinary creatinine, calcium, phosphorus and uric acid in the pre-experimental albino rats
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[Table 6] and [Figure 3] show that the mean standard value of urinary creatinine, calcium, phosphorus and uric acid were 0.40 mg/24 h, 11.20 mg/24 h, 5.26 mg/24 h and 37.40 mg/24 h, respectively.  | Table 6: Effect of drug on urinary electrolytes in the pre-experimental, control and treated groups
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 | Figure 3: Graphical presentation showing the effect of drug on urinary electrolytes in the pre--experimental, control and treated groups
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[Table 7] shows the mean values of excretion of urinary creatinine, calcium, phosphorus and uric acid with reference to urinary output in the pre-experimental, control and treated groups.  | Table 7: Effect of drug on urinary electrolytes in the pre-experimental, control and treated groups with reference to urinary output (mg/ml)
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Effect of drug on the implanted glass beads in the control and the treated groups
The progress of stone formation in the urinary bladder was assessed during the period of the experiment by studying the albino rats exposed to X-rays on the 30 th , 60 th and 90 th days in the control and the treated groups.
The above table shows that in the control group, of the nine rats, one rat was found dead probably due to post-operative complications or due to environmental factors. Therefore, assessment was made only on the observation of eight rats. At the end of the experiment, stones were formed in five albino rats by deposition of crystals over the glass beads. Apart from this, all the albino rats were sacrificed at the end of 90 days of the experiment and stones were collected by suprapubic cystolithotomy.
All the stones got dried and the weight of individual stones was taken. In the control group, the mean weight of the glass beads was 9.66 mg and the mean weight of the stone formed was 89.75 mg. The mean net weight gain of the formed stone was 80.12 mg. The minimum net weight of the stone was found to be 8.0 mg whereas the maximum was 539 mg. The size of the urinary bladder was also found to be enlarged according to the size of the stone.
In the Varuna decoction-treated group, of nine rats, one rat was found dead and the assessments were made only on the observation of eight rats. Of eight rats, only in two rats stones were formed while in the remaining six albino rats, stone was not formed. In this group, the mean weight of the implanted glass beads was 9.55 mg and the mean weight of the formed stones was 12.00 mg. Thus, the net gain of weight of the formed stones was 2.5 mg.
Hence, on the basis of the above observations, it can be said that the incidence of formation of stone was low in the treated group in comparison with the control group [Table 8], [Figure 4]. | Table 8: Effect of drug on implanted glass beads in the control and treated groups
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 | Figure 4: Graphical presentation showing the effect of drug on implanted glass beads in the control and treated groups
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[Table 9] and [Figure 5] show that in 56% of the albino rats, stone was formed in the control group. In the treated group, only 22% of the rats showed stone formation [Figure 6].  | Table 9: Percentage of stone formation in the control and treated groups
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 | Figure 5: Graphical presentation showing percentage of stone formation in the control group
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 | Figure 6: Graphical presentation showing percentage of stone formation in the treated group
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| Discussion | | |
In the control group, there is a slight increase in the serum and urinary creatinine, which might be due to obstructive uropathy or other pathology developed in the urinary system of the rat. But, in the treated group, the serum and urinary creatinine were decreased. Therefore, it can be assumed that the drug is helpful in reducing or normalizing the serum and urinary creatinine and restoring the normal metabolism of the urinary system.
In the present study, the drug (Crataeva nurvala) causes hypercalciuria and hyperphosphoruria, which are the most important factors for urolithiasis. [4] The present study also shows an increase in the urinary output. The total volume of urine increased in 24 h in the treated group in comparison with the control group. This factor dilutes the concentration of the urinary electrolytes. As a result of this, calcium and phosphorus flush out from the urine and there is a lesser chance of precipitation and decrease formation as well as growth of urinary stone. Apart from this, there are certain anti-aggregation factors present in the urine that are responsible for the prevention of crystallization of urinary lithiasis.
The observation reveals very little change in the serum and urinary uric acid, which was almost stationary, indicating that the drug was not very effective on the serum and urinary uric acid.
In the treated group, the size of the implanted glass beads did not increase even after 90 days, except in two albino rats where there was a mild increase in the size of the beads due to deposition on implanted glass beads, showing that the drug Varuna (Crataeva nurvala) prevents the deposition on implanted glass beads due to its anti-crystallization property and may be due to dieresis.
The formation of stones was found to be higher in the control group, i.e. 55.55%, whereas in the treated group it was found to be only 22.22%, which may be due to the effect of the drug that does not allow the deposition on the bead. The weight of the formed stone in the control group varies from 8 mg to 539 mg. It indicates the individual tendency of stone formation in albino rats.
One rat died in the control and the treated group each either due to post-operative complications or due to environmental factors.
| Conclusion | | |
Stone formation is a complex process, which depends on multiple factors, and the presence of nidus in the urinary bladder is not the only main single factor for the formation of stone. Experimentally, the drug Varuna prevents stone formation due to the anti-lithogenic activity and the anti-crystallization property. The drug decreases the urinary pH toward acidic. The diuretic action of this drug attributes the metabolic correction of the serum and urinary electrolyte levels in experimentally induced urolithiasis in albino rats.
Therefore, it can be concluded that the Varuna (Crataeva nurvala) is helpful in reducing the recurrence of urolithiasis.
| References | | |
| 1. | Silay MS, Miroglu C. The risk of urolithiasis recurrence may be reduced with anti-nanobacterial therapy. Med Hypotheses 2007;68:1348-50. 
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| 2. | Ghosh MN. Fundamentals of experimental pharmacology. 3 rd ed. Calcutta: Hilton and Company; 2005.
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| 3. | Kumar B. Effect of Gokshur in the management of urolithiasis, Thesis submitted for the degree of MS (Ayu). 1998.
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| 4. | Available from: http://www.Medicine Net.com [last accessed on 2010 Jul 20].
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]
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