Oleander Stem and Root Standardized Extracts Mitigate Acute Hyperglycaemia by Limiting Systemic Oxidative Stress Response in Diabetic Mice.

The extracts of different parts of Nerium oleander L. are used as antidiabetic remedy in the traditional medicinal systems of different parts of the world. Despite these uses in ethnomedicinal system, the antihyperglycemic potentials of oleander stem (NOSE) and root (NORE) extracts have not been pharmacologically evaluated. Therefore, we aimed at evaluating the antidiabetic ethnomedicinal claims of NOSE and NORE, primarily focusing on glucose homeostasis and associated metabolic implications. Alloxan-treated mice with hyperglycaemia (blood glucose >200 mg/dL) were treated with oleander 70% hydromethanolic extracts (200 mg/kg) for 20 consecutive days, and the results were compared with positive control glibenclamide. Blood glucose level was 52-65% lowered (P < 0.001) in oleander treated groups, which was otherwise 4.62 times higher in diabetic mice, compared to control. Insulin resistance was lowered 51-36% irrespective of any significant (P > 0.05) changes in insulin sensitivity throughout the treatments. Improved serum insulin remained associated with lowered glucose level (r P = -0.847 and -0.772; P < 0.01). Markers of hyperglycaemia-related hepatic glycogen, glycated haemoglobin (HbA1c), hyperlipidaemia, hepatic injury, and diabetic nephropathy were normalized as well. Improvement of systemic intrinsic antioxidant enzymes (catalase and peroxidase) were correlated (r P = -0.952 to -0.773; P < 0.01) with lower lipid peroxidation by-product malondialdehyde (MDA) in the circulation. Principal component analysis coupled with hierarchical cluster analysis represented shift in metabolic homeostasis in diabetic mice, which was further normalized by oleander and glibenclamide treatment. Additionally, molecular docking studies of the phenolic acids measured by HPLC with intracellular cytoprotective transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) revealed strong molecular interactions. The results collectively support the ethnomedicine antidiabetic claims of oleander stem and root and suggest that the oleander mediated elevation of systemic antioxidant status is likely responsible for the improved glycaemic control.

Genito-urinary tuberculosis in 67 cases: experience from a tertiary core centre in India.

Tuberculosis is very much prevalent in developing countries like India. Genito-urinary tuberculosis usually occurs after 5 to 15 years of the primary lung infection. After lymph node involvement,it is the second common form of extrapulmonary tuberculosis. In this retrospective study, case records of 67 patients diagnosed with genito-urinary tuberculosis in our institute were thoroughly reviewed regarding age, sex, the urogenital organ involved by tuberculosis,mode of diagnosis,and treatment given to the patients. Median age of the patients was 38.5 years, males were more commonly involved than females, kidney was the most common organ involved by tuberculosis followed by ureter and urinary bladder.HIV infection was present in a single patient who had developed tuberculous perinephric abscess. Most common mode of diagnosis was by histopathological examination of the organ involved. Hydronephrosis of the involved kidney with echogenic debris in the dilated pelvicalyceal system on ultrasonography and non-visualised kidney on intravenous urogram was the most common findings on imaging studies who underwent nephrectomy. One patient was seen with tuberculosis of the glans penis which is not much common. Surgical intervention was ablative in nature in most of the cases in the form of nephrectomy. Early diagnosis is important and can prevent the anatomical defor- mity and loss of function of the involved organ.

Analysis of 88 nephrectomies in a rural tertiary care center of India.

Nephrectomy is not an uncommon surgery in day-to-day practice of urology. Trauma is the most common cause of emergency nephrectomy. On the other hand, elective nephrectomy is done for both benign and malignant diseases of the kidney. This study has been performed to know the different causes of nephrectomy in a rural, tertiary care center of India. In our series, we have studied all the elective nephrectomies done in our hospital during a period of eight years. We have analyzed 88 cases of nephrectomies regarding their age, sex, laterality of disease, and histopathologic report of the nephrectomy specimens. Out of 88 cases, 61 were males and 27 were females. In our series, 62.5% cases of nephrectomies were done for benign causes and 37.5% cases for malignant causes. Among the benign causes, neglected pelviureteric junction obstruction was the leading cause, followed by calculus disease resulting in obstruction. On the other hand, renal cell carcinoma was the most common malignant pathology requiring nephrectomy.