RESUMEN
It is often difficult to differentiate acute renal failure (ARF) from chronic renal failure (CRF) when the patient presents with advanced uremia for the first time. Assessments of kidney size, history of nocturia, and pallor are used as indirect indicators of CRF. Some investigators have proposed an estimation of finger nail creatinine concentrations to differentiate between ARF and CRF, as patients with CRF have higher nail creatinine concentrations. Measurement of creatinine in the nail can be performed easily in a biochemistry laboratory. The nail clippings are cleaned, dried, pulverized and creatinine extracted from the powdered nail to be assessed biochemically. By standardizing the methods, the biochemistry laboratory can provide the results within 48 hours. In this study, we analyzed the nail clippings of 49 normal subjects, 50 cases of known acute kidney injury (AKI), and 50 cases of known CRF on follow-up at the Nephrology Clinic, Medical College, Trivandrum between December 1999 to November 2000. Forty-nine normal individuals were selected from healthy bystanders of respective patients. On study, it was revealed that patients with ARF had a mean fingernail creatinine level of 30.9 mg/100 g of nail as against 30.1 mg/100 g of nail in normal controls. There was no difference between the controls and ARF patients.Patients with known CRF had a mean fingernail creatinine level of 69.2 mg/100 g. There was a significant increase in the level of nail creatinine in patients with known CRF versus ARF patients and normal controls. The measurement of nail creatinine is useful, easy and can be standardized and performed in a biochemistry laboratory. This simple investigation can help in solving the question of ARF versus CRF in a given case. From this study, it is concluded that the result of creatinine concentrations of nail clippings can indicate chronicity of renal failure.
RESUMEN
Indukantha Ghritha (IG) is a polyherbal preparation consisting of 17 plant components widely prescribed by ayurvedic physicians for various ailments. Though it is a known ayurvedic drug, no attempt has been made to scientifically validate its mechanism of action. Preliminary studies in our laboratory showed IG to possess considerable immunomodulatory effects with a Th1 type of immune response. In this regard, we attempted to elucidate its role as an adjuvant to cancer chemotherapy. BALB/c mice were administered IG, for a period of 14 days and parameters such as Hb, total and differential WBC count, bone marrow cellularity, lymphocyte proliferation and function, macrophage phagocytosis and tumor remission were studied. Administration of IG could inhibit tumor development in mice challenged with Dalton's lymphoma ascites. IG-induced leukopoiesis and enhanced median survival time as well as life span in tumor bearing animals. Macrophage phagocytic capacity was also elevated. Flow cytometric analysis of lymphocyte subsets and MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium salt] assay for lymphocyte proliferation, yielded promising results which reinforces its use as an adjuvant to cancer chemotherapy. The polyherbal drug could reverse cyclophosphamide-induced myelosuppression in control tumor bearing animals significantly to values near or above normal levels. These results demonstrate the potential of IG, especially in several immunosuppressed conditions and patients suffering from leukopenia as a consequence of cancer chemotherapy.
