Int J Health Nutr 2012 3(2): 1-5
ISSN 1309 8071
Orjinal Article
Effect of Corn Silk Extract on Kidney Stone Decomposition in Comparison with Alkalinizeragent (uralyte) Abdulwahid SHAMKHY, Rawa'a Al-CHALABI I, Hayder AL-AMERY University of Al-Nahrian, College of Science, Dept. Of biotechnology, Bagdad, Iraq
R eceive eceived: d: 28.03.2012
A ccept ccepted ed:: 08.08.2012
Publishe Publi shed: d: 15.08.2012
Abstract
Kidney stone is one of the most important problems in different countries over the world. They are affected by different factors like nutrition, age, drug history and other environmental and family factors. Locally, corn silk used as decompose of stones. This study proved that corn silk extract does not act as decompose for kidney stones in comparison with alkalinizer agent which consider effective decompose factors. This work has been carried out at Al-Yarmook Teaching Hospital for the period between (the 1st of October 2010 to the thirty of April 2011). Sixty male patient with ages range between (20-60 years) were taken, all of them were suffering from renal stone. They were divided in two groups (each group consists of 30 patients). The The first group of patients with with lower urinary stone size ( 6-8 mm), we're advised advised to take an alkalinizer agent (Uralyt-U (Uralyt-U one cup of tea three times daily) while the other group of patients was advised advised to take corn silk, (two cup of tea daily ). Corn silk increased the urinary output and increased the percentage the passage of urinary stones through the urinary tracts without decomposed stones. The alkalinizer agent increases the decomposition of stone mainly radiolucent stone and calcium oxalate stones. Corn silk was playing an important physical role in treatment by increasing the contraction of smooth muscles an led to increase the urinary output without decomposition of stones while Uralyt-UUralyt-U- decompose stones by providing alkaline pH. K ey words: Alkalinizer Agent, Corn Silk, Kidney Stone
*
Corresponding author: A. Shamkhy e-mail:
[email protected] [email protected],, Phone: +9647803677942 +9647803677942
INTRODUCTION
The kidney is an important organ of the human .It has many functions such as remove waste products from the body, blood pressure regulation, regulation , keep body’s chemicals in balance, and maintain the body’s water balance balance (Chandhoke 2007). There are many different renal problems that may occur. Kidney stones represent the most commonly important problems over the world. The crystals can form in urine from various salts that build up on the inner surfaces of the kidney. These crystals can become large enough to form stones in the kidneys. This type of stones called nephrolithiasis and they may also form in the ureter or in the bladder (Parmar 2004; Moe 2006)
Renal stones contain various combinations of chemicals. The most common types of chemical present in many stones are calcium in combination with either oxalate, phosphate or a mixture of them. These chemicals are part of the normal diet. They made up important parts of the bodies, such as bones and muscles. The less common types of stone are caused by infection in the urinary tract. These types of stones are called a struviteor infection stone. The uric acid stones and the rarely cystine stones are the less types (Taylor 2005; Cameron 2007; Miller 2007). There are many risk factors that can cause stones like diet include low include low fluid intake, high intake, high intake of animal protein, animal protein,
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sodium, refined sugars, oxalate, grapefruit juice, apple juice and cola drinks, exercise, family history , drug history, environmental parameter and kidney disease (Finkielstein 2006; Johri 2010; Wasserstein 2005; Taylor 2005). The formation of various types of kidney stones is strongly influenced by the pH of the urine. An alkaline pH favors for the crystallization of calcium- and phosphatecontaining stones, whereas an acidic pH of the urine promotes uric acid or cystine stones (Wagner 2010) . Plants have played an important role in maintaining human health. The medicinal value of plants lies in some chemical substances that produce a definite physiological action on the human body. The most important of these bioactive compounds of plants are alkaloids, tannins and phenol compound .The main advantage of the treatment with plant drugs are reducing the side effects that often occur with the synthesized medicine. This may be due to the lower concentration of the active compounds found in the plants so that human’s body could be needed. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts) (Bruneton 2001). Corn silk is a rich source of potassium, soothing, relaxing diuretic and a wonderful remedy for acute inflammation of the urinary system, such as cystitis, urethritis and prostatitis. Also helping the passage of urinary stones (Duvick 1999). Corn silk encourages urination, while the potassium in the herb offset potassium loss caused by increased urination. It contains flavonoids (maysin), Alienation , Alkaloids , Saponins , Volatile oil, Mucilage , Vitamins B, C and K , Silicon. It also has moderate amounts of Iron, Zinc, Potassium, Calcium, Magnesium and Phosphorus Corn silk works mainly in the urinary tract. The saponins largely act as an anti-inflammatory in the body and the Allentown as a healing agent, with the mucilage giving a demulcent or soothing effect to irritated tissues. The potassium balances out the diuretic effect of the herb, which is used in conditions of water retention. Their combined action is useful for a number of urinary tract conditions, such as cystitis and prostatitis. Vitamin K is a fat soluble vitamin that is essential for blood clotting within the body (Evan Peacock 2005). Uralyt-U is a medication that belongs to the urinary alkalinize class of drugs, and is mainly used as a nonirritating diuretic. It's considered to be a urinary pH modifier, which works to reduce the amount of acid in the urine. Potassium citrate in this drug is effective in the treatment and management of a variety of medical disorders, including urinary calculi (kidney stones), cystine kidney stones, renal tubular acidosis, gout and hypokalemia. In addition to being prescribed for patients that need to limit their intake of potassium and sodium, it's increasing the effectiveness of some of antibiotics (Coe 2005; Bazari 2007).
PATIENTS AND METHODS
This study was designed to show the difference between the effect of corn silk and uralyt. Sixty male patients were taken. Their ages range was between (20- 60 year). This study was carried out at AL-Yarmook Teaching Hospital during the period (the 1st of October 2010 to the thirty of April 2011). Patients suffered from renal stones divided in two groups. First group advice to take alkaline agent and the second group have taken corn silk. Both groups exposed to contrast uropathy intravenously to ass the function of the renal system and peristalsis movement after treatment with corn silk and alkaline agent. Preparation of Corn Silk Extract Corn silk was obtained from local market and used as infusion fresh or dried in urinary tract infections. An aqueous extraction was performed by adding 200 ml boiling water to 10 GM corn silk, filtering after 20 min and then taking 1 cup two times daily has been taken (Gu1 2009). Measurement of Uric Acid Concentration (Uricase Method) Uric acid concentration was measured by using a kit which obtained commercially from (BIOLABO/France). Kit depends on uricase acts on uric acid to produce alienation, carbon dioxide and hydrogen peroxide. Hydrogen peroxide in the presence of peroxide reacts with a chromogen to yield quinoneimine a red colored complex. The absorbance measured at 520 NM is proportional to the amount of uric acid in the specimen. The procedure wae as follow: one ml of reagent was put in tube and then 25 µl of sample was added and mixing. The mixture was kept for 10 minutes at 37 ⁰C. After that the observance was measured at 540nm. The results were calculated according to this formula: Uric acid concentration= Test / Stander x factor. The value of the factors given by the supplier in this case the factor was (10) Measurement of Calcium Concentration (CPC Method) Calcium concentration was measured by using a kit which obtained commercially from (BIOLABO/France). Kit depends on a CPC (O-Cresol Phtalein Complexone) in alkaline solution it reacts with calcium to form a dark red colored. The complex which absorbed at 570nm. It is proportional to the amount of calcium in the specimen. In this procedure we have two reagents, 0.5ml of reagent one and 0.5ml of reagent two were mixed and then 20ul of standard were added and tht asbsorbance measure at 570 nM. The same think was repeatedly put we add 20ul of the sample instead of the stander and kept at let at 37 ⁰C for 10 minutes
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and then the observance were measured at 520 NM. The results then calculated according to the formula calcium concentration = Test/standard x factor. The factor in this case was (8)
calcium in the serum of patients infected with calcium oxalate stones after the interval time of drinking corn silk. The increase in the value of calcium was nearly same after all the time and it is nearly equal to the containing of corn silk of calcium (1.9 mg/ dl) as mentioned before. That indicates the effect corn silk is not chemically but physically.
Identification of Ureter Contractions Ureter contractions by prestatilsis can be identified by two methods: through out flow of urine by ultrasound or by I.V.U under fluoroscopic guide inside the ESWL unit in Alyarmok teaching hospital.
Table 2 Patients infected with calisum oxalte stones.
No of Patients
Ages
The value of calcium in the serum of the patients after drink uralyt mg/dl 0 day 5 days 10 days 15 days
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
50 57 60 45 49 58 43 60 53 9 29 25 22 20 20
6.2 6.5 7.0 8.8 9.0 9.1 8.0 7.9 5.9 7.0 7.0 8.0 5.7 8.2 6.0
RESULTS
The experiment as we had mentioned before designed to measure the value of the dissociation of calcium and uric acid which give an indication about the effect of using corn silk and Uralyt-U as a decomposed agent of kidney stone. The normal value of calcium is (8.5- 10.5 mg/dl) and the normal ++ value of uric acid is (3-7 mg/dl), rate of Ca of natural corn silk=1. 9. Table one indicates the values of calcium in the serum of patients infected with uric acid stones after the interval time of drinking uralyt. The data show that there is some gradual increase in the value of calcium by time, and also the increase differs from patient to another. Table 1 Patient infected with uric acid stones.
No of Patients 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Ages
46 38 57 60 46 43 36 25 27 32 32 60 59 47 38
The value of calcium in the serum of the patients after drink uralyt mg/dl 0 day 5 days 10 days 15 days 3.9 2.9 6.00 7.50 5.0 7.0 10.0 11.30 6.0 5.8 6.30 7.20 4.7 3.8 6.00 8.20 3.8 2.9 4.30 7.50 5.6 4.9 7.10 8.80 7.0 5.6 6.90 9.00 8.0 6.5 8.10 10.00 9,0 7.3 9.00 10.90 7.9 7.9 9.30 11.5 6.0 5.3 7.10 9.30 10 8 10.10 12 8.0 7.5 10.40 19.80 5,3 4.5 5.20 8.00 6.1 3.0 6.60 7.9
6.2 5.9 10.3 8.5 9.7 11.7 6.8 10.0 8.8 9.0 8.3 8.0 5.2 9.2 7.4
8.8 9.0 11.7 10.0 11.2 14.3 8.9 11.0 10.4 10.5 9.5 10.3 8.0 11.0 8.9
9.7 10.8 13.5 11.3 13.6 21.5 13.6 12.2 11.0 12.0 10.9 13.0 11.0 12.7 10.0
Table 3 Patients infected with calisum oxalte stones treated with corn silk.
Table two contain the value of calcium of patients infected with calcium oxalate stones after the interval time of drinking urlat. The dates show that there is some gradual increase in the value of calcium by time. The amount of calcium increase differs from patient to another and that was also found in table one. Table three shows the value of
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No of Patients
Ages
The value of calcium in the serum of the patients after drink corn silk mg/dl (2 cap/day) 0 day 5 days 10 days 15 days
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
50 57 60 45 49 58 43 60 53 9 29 25 22 20 20
6.8 5,0 8.0 7.1 7.5 5.2 4.9 7.0 6.5 7.0 6.5 6.7 5.0 5.4 6.0
8.8 7.2 10.1 9.2 9.4 7.0 6.9 9.0 8.6 9.4 8.7 8.8 7.0 7.4 6.0
10.0 7.2 10.2 9.2 9.4 7.1 6.9 9.2 8.6 9.5 8.8 8.7 7.2 7.4 7.9
10.1 7.2 10.2 9.3 9.4 7.1 6.9 9.2 8.6 9.5 8.8 8.8 7.2 7.4 7.9
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The data in table four show the direct effect of both corn silk and urlyt on both types of stones. These data give us strong inducation that corn silk has no direct effect on the both types of stones but the urlyt has. Table five and six show the statical analysis of the data given in the bereves tables.
Table 6 The value of calcium after treatment patients of uric acid stone with both corn silk and alkalinizer agent. Corn silk extract for UA stones
Table 4 The value of calcium after soaking stones in silk and urlyte solutions.
Types of stones
Time of soaking 5 days
Calcium oxalate stones
Uric acid stones
10 days
Types of solutions
Calcium mg/dl
Corn silk
2
urlyte
13.6
Corn silk
3.12
urlyte
16.2
Corn silk
4,3
15 days
urlyte
22.4
5 days
Corn silic urlyte
0.1 5.2
Corn silk
o.19
10 days
urlyte Corn silk
9.6 0.21
15 days
urlyte
16.8
Alkalinizer for CaOx stones
6.27±1.00 (4.9-8.0)
7.26±1.21 (5.0-9.1)
0.021*
Ca level (mg/dl) after 5 days Ca level (mg/dl) after 10 days Ca level (mg/dl) after 15 days
2.05±0.16 (1.8-2.4)
8.34±1.79 (5.2-11.7)
0.0001*
2.17±0.33 (1.9-3.2)
10.25±1.55 (8.0-14.3)
0.0001*
2.27±0.59 (1.9-4.3)
12.47±2.80 (9.7-21.5)
0.0001*
0.831
Serum UA (mg/dl)
6.25±1.86 (3.6-9.7)
6.40±1.86 (3.8-10.0)
UA level (mg/dl) after 5 days
0
5.53±1.83 (2.9-8.0)
-
UA level (mg/dl) after 10 days
0
7.51±1.92 (4.3-10.6)
-
UA level (mg/dl) after 15 days
0
9.93±3.16 (7.2-19.8)
-
DISCUSSION
Table one patients treated with Uralyt give different values of calcium verses time reflecting a significant effect of uralyt on the decomposition of the calcium oxalate stones while table two show that the gradually increasing in the values of uric acid stones after treated with Uralyt is proportional to time and give significant diff erence with each period but the treated patients infected with uric acid stones do not give any detectable change in value of uric acid after all the periods of time. Table three shows that patients treated with corn silk extract (two cups daily) do not change the values of calcium significantly and the changes appear to be so closed to the normal percent of calcium which found originally in the corn silk extract. Increasing detectable change in the value of calcium and value of uric acid after treated with alkalinizer agent indicate that Uralyt was act as a powerful decompose agent, while the none changeable value of calcium and uric acid after treatment with corn silk reflect no significant role of corn silk as a decomposed agent of stones. Although corn silk is not decomposed agent for stones but plays an important role in the treatment of kidney stones as a physical agent which increase the rate of stone passage in 85% of patients and increase the urinary output through the urinary tracts by increasing contraction of ureter smooth muscle and ass the function of the renal system and bristles movement after corn silk uptake. Which determined by abdominal ultrasound and intravenous pyelography .The effect of corn silk belongs to its composition that contain different materials specially potassium which considered to be a urinary pH modifier, which works to reduce the amount of acid in the urine. It is effective in the treatment and management of a variety of medical disorders, including
P value
Serum Ca (mg/dl)
P value
*Significant using Students-t-test for two independent means or paired two means t-test at 0.05 level of significance
Table 5 The value of calcium after treatment patients of calcium oxalate stone with both corn silk and alkalinizer agent.
Corn silk extract for CaOx stones
Alkalinizer for UA stones
*Significant using Students-t-test for two independent means or paired two means t-test at 0.05 level of significance
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A.Shamkhy et al Coe FL, Evan A, and E, Worcester. Kidney stone disease. The Journal of Clinical Investigation 2005;115 (10): 2598 – 608. Bazari H, 2007. Approach to the patient with renal disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;chap 115. Gu1 J, Liu T, Han L, and Y, Liu .Nutrition and metabolism .2009; Vol (6): 47
urinary calculi (kidney stones), cystine kidney stones . Potassium gets absorbed quickly by the body, and is then excreted as a carbonate salt. It also works as a diuretic by helping the body urinate regularly. As a result, symptoms that result from having an excessive amount acid in the urine. It's able to modify the urinary pH level (a measure of the acidity), lowering and neutralizing the total amount of acid in the urine. CONCLUSIONS
An Alkalinizer agent like Uralyt-U able to decomposed stones because change the pH of the urine from acid to alkaline. This has the effect of reducing stinging and irritation at the time of urination .While corn silk extract not decomposed stone but increase urinary output. We note after consumptions of corn silk the peristalsis movement of the ureter increase from 2-5 /min. to 4-8/min. But after alkalizing agent mildly increase in movement to 4-5 /min. its normally movement from 2-5 /min. Generally speaking an adult requires an intake of 2-3 liters of liquid per day in order to maintain adequate hydration and good urinary output. Some substances such as alcohol and the caffeine containing drinks (tea, coffee and cola drinks) can cause significant bladder irritation REFERENCES Chandhoke, P.S.Evaluation of t he recurrent stone former.Urol Clin North Am 2007; 34(3): 315-322. Parmar MS, Kidney stones. British Medical Journal 2004; 328 (7453): 1420 – 4. Moe OW, Kidney stones: pathophysiology and medical management. The Lancet 2006; 367 (9507): 333 – 44. Taylor EN, Stampfer MJ, and GC, Curhan. Obesity, weight gain, and the risk of kidney stones. JAMA 2005;293 (4): 455-462. Cameron MA, .and K.Sakhaee. Uric acid nephrolithiasis. Urol Clin North Am. 2007 ;34(3): 335-346. Miller NL, Evan AP, and JE, Lingeman. Pathogenesis of renal calculi. Urol Clin North Am 2007; 34 (3): 295-313. Finkielstein, V.A. Strategies for preventing calcium oxalate stones. CMAJ 2006.;174(10): 1407-1409. Johri N, Cooper B, Robertson W, Choong S, Rickardsm D, and R, Unwin . Nephron Clinical Practice 2010;116 (3): c159 – 71.. Wasserstein AG, Nephrolithiasis. American Journal of Kidney Diseases 2005; 45 (2): 422-428. Taylor EN, Stampfer MJ, and GC. Curhan. Fatty acid intake and incident nephrolithiasis. Am J Kidney Dis 2005;45 (2): 267-274. Wagner CA, And N, Mohebbi. Urinary pH and stone formation. J, Nephrol 2010.;23(16): 165-169. Bruneton J, 2001. Pharmacognosy, Phytochemistry, Medicinal plants. 2nd edition . Lavoisier Publishers. Paris. Duvick DN, and KG, Chessman. "Post-green-revolution trends in yield potential of t emperate maize in the north-central United States". Crop Science 1999; 39 (6): 1622 – 1630. Evan Peacock, Wendell R, and JR, Warren. Prehistoric decline in freshwater mussels coincident with the advent of maize agriculture". Conservation Biology 2005;19 (2): 547 – 551.
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