Author: Karan Kumar

Diarrheal diseases kill one out of every nine children worldwide, making diarrhea the second leading cause of death in children under the age of five. Dehydration is the most serious threat posed by diarrhea. Water and electrolytes such as sodium, chloride, potassium, and bicarbonate are lost during a diarrhea episode through liquid stools, vomit, sweat, urine, and breathing. When these losses are not replaced, a person suffering from diarrhea becomes dehydrated. Furthermore, diarrhea is a major cause of malnutrition, making the individual more vulnerable to future recurrence of diarrheal and other diseases.

Diarrhea is defined as the passage of three or more loose or liquid stools per day, or more frequently than the individual's normal frequency. It is typically a sign of a gastrointestinal infection caused by a variety of bacterial, viral, and parasitic organisms. The infection spreads from person to person as a result of poor hygiene or through contaminated food or drinking water.

Diarrhea is classified into three clinical types, each with its own set of treatments:

• Acute watery diarrhea that can last for hours or days and can include cholera.
• Dysentery is a term used to describe acute bloody diarrhea.
• Persistent diarrhea that lasts 14 days or longer.

Historically, severe dehydration and fluid loss were the leading causes of death in children suffering from diarrhea. Other causes, such as septic bacterial infections, are now expected to account for a growing proportion of all diarrhea-related deaths. Exclusive breastfeeding is protective and helps to prevent diarrhea in young children. Breastfeeding also helps to alleviate the severity of diarrhea.

The following are important diarrhea prevention measures:

• access to clean drinking water
• utilisation better sanitation
• Soap for handwashing
• Breastfeeding should be the only source of nutrition for the first six months of life.
• Personal and food hygiene should be maintained at all times.
• Health education on the spread of infections
• rotavirus immunization

The following are important diarrhea treatment measures:

• Oral rehydration salts (ORS) solution: ORS, especially the low osmolarity formula, be a life-saving commodity in the treatment of diarrhea in children.
• Zinc supplements reduce the duration of a diarrhea episode by 25% and are linked to a 30% reduction in stool volume.
• Nutrient-rich foods: The vicious circle of malnutrition and diarrhea can be broken by continuing to give nutrient-rich foods.
• A general rule is not to use over-the-counter medications for diarrhea with fever or stool in the blood.
• Further, if diarrhea is caused by an infection or parasite, there is a need to see a healthcare provider for treatment.
• In the case of severe dehydration or shock, rehydration may necessitate hospitalization.

Research also suggests therapeutic usage of potent herbs can play a vital role in the effective management of diarrhea. As per Ayurveda and modern science, several herbs possess the potential to cure diarrhoeal problems. these herbs are:

Kutaj (Holarrhena antidysenterica): One of the important herbs for diarrhea and dysentery, helpful in killing enteropathogenic bacteria.

Ark pudina (Mentha spicata) & Shunthi (Zingiber officinale): Both medicinal herbs play vital roles in reducing increased gastric motility.

Dadim (Punica granatum) & Amra majja (Mangifera indica): supplements essential phytonutrients that are important in improving water and electrolyte absorption.

Bael (Aegle marmelos): Bael is very effective for the treatment of diarrhea which is not accompanied by fever. The unripe or half-ripe fruit is eaten for best results.

Dill (Anethum sowa): The oil obtained from the dill is used for the treatment of diarrhea. Dill oil is so mild that it is also an ingredient used in medicines for treating baby colic.

Fenugreek (Trigonella foenum graecum): Fenugreek seeds are useful in the treatment of digestive problems including diarrhea.

Babul (Acacia arabica): The babul tree is very useful in preventing diarrhea. Each part of the babul tree is useful. Its leaves can be taken as a mixed dose with black cumin seeds, its bark can be taken as an infusion with water and even its gum can be taken as a syrup.

Available research suggests that herbal medicines can help in managing diarrhoeal diseases. To extend the benefits, Aimil Pharmaceuticals (India) Limited has come up with Amydio forte which combines all the above-mentioned herbs along with other gastro-protective herbs of their best quality.

Fasting during Ramadan, Islam's holy month, is a requirement for all healthy adult Muslims. During Ramadan, approximately 40–50 million diabetics worldwide fast. Ramadan is a lunar-based month that lasts between 29 and 30 days. Its timing varies according to the season. Depending on the geographical location and season, the daily fast can last anywhere from a few hours to more than 20 hours. Muslims who fast during Ramadan must refrain from eating, drinking, using oral medications, and smoking from predawn to after sunset; however, there are no food or fluid limitations between sunset and dawn. During this month, most people eat two meals per day, one after sunset, referred to in Arabic as Iftar (breaking of the fast meal), and one before dawn, referred to as Suhur (predawn). Fasting is not intended to cause undue hardship to Muslims.

Fasting during Ramadan may put diabetic patients at risk of a variety of concerns. There are some major risks associated with fasting in patients with diabetes such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, and dehydration. Patients with type 1 diabetes should be strongly advised not to fast in general. Patients with type 1 diabetes who have a history of recurrent hypoglycemia or hypoglycemia unawareness, or who have poorly controlled diabetes, are at a very high risk of developing severe hypoglycemia. On the other hand, in these patients, an excessive reduction in insulin dosage (to prevent hypoglycemia) may put them at risk for hyperglycemia and diabetic ketoacidosis.

Hypo-and hyperglycemia may also occur in patients with type 2 diabetes but generally less frequently and with less severe consequences compared with patients with type 1 diabetes. A patient's decision to fast should be made after extensive discussion with his or her doctor about the risks involved. Patients who insist on fasting should be assessed before Ramadan and receive appropriate education and instructions regarding physical activity, meal planning, glucose monitoring, and medication dosage and timing. The management strategy must be highly personalized. Close monitoring is required to reduce the risk of developing problems.

How to manage diabetic issues during fasting

It is worth emphasizing that fasting for diabetic patients is a significant personal decision that should be made in light of religious exemption guidelines and after careful consideration of the associated risks, as well as extensive discussion with the treating physician.

Several important issues deserve special attention.

Nutrition

The common practice of consuming good amounts of carbohydrates, proteins, and fat-rich foods, especially at the sunset meal, should be avoided. Because of the delay in digestion and absorption, foods containing "complex" carbohydrates may be more appropriate at the predawn meal, while foods containing more simple carbohydrates may be more appropriate at the sunset meal. It is also advised to increase fluid intake during non-fasting hours and to eat the predawn meal as late as possible before the start of the daily fast.

Exercise

Normal levels of physical activity are possible to maintain. Excessive physical activity, on the other hand, may increase the risk of hypoglycemia and should be avoided, especially in the few hours before the sunset meal.

Breaking the fast

All patients should understand that if hypoglycemia (blood glucose of 60 mg/dl [3.3 mmol/l]) occurs, they must always and immediately end their fast because there is no guarantee that their blood glucose will not drop further if they wait or delay treatment. It is also recommended that the fast be broken if blood glucose levels exceed 300 mg/dl (16.7 mmol/l) to prevent hyperglycemia.

Anti-diabetic medications during Fasting

It is extremely important to use anti-diabetic medication to manage diabetes mellitus to avoid its adverse effects. It is recommended to regularly check blood glucose levels. During fasting, patients with diabetes mellitus, if allowed, preferably take the medications after sunset so that they can avoid the religious aspects and can take food till sunrise. Further, some natural antidiabetic herbs can be added to the regular diet to have strict glycemic control. As per Ayurveda and modern science, the below-mentioned herbs have been reported to have positive effects on glycemic levels

Methi (Trigonella faenum gracum) Diabetes patients can benefit from methi by lowering their blood sugar levels. It contains fibre, which aids digestion by slowing digestion and regulating carbohydrate and sugar absorption.

Kalonji (Nigella sativa) can improve hyperglycemia and diabetes control after treatment, with a significant decrease in fasting blood glucose, blood glucose level 2 hours postprandial, glycated hemoglobin, and insulin resistance.

Daruharidra (Berberis aristata) acts as a natural DPP-4 inhibitor to effectively manage diabetes, improves glucose tolerance, and reduces raised blood glucose level effectively along with cardiac protection.

Gudmar (Gymnema Sylvestre) & Vijaysaar (Pterocarpus marsupium) help modulates insulin release, help in the repair & revival of β cells of the pancreas, and increase glucose-mediated insulin release.

Manjistha (Rubia cordifolia) tends to support cardiac protection, generally requires in diabetics, being reported activities which show that it acts as a potent antioxidant, diuretic, calcium channel blocker, antiplatelet, antidiabetic, anti-stress, immune-modulator, etc. which can play an important role to detoxify ischemia-induced free radical generation.

In conclusion, the most important pieces of advice for diabetics to stay protected during the Ramadan and second is to monitor blood glucose more frequently and manage euglycemia by regularly taking the prescribed OHGs and/or polyherbal formulation comprising antidiabetic herbs (BGR-34 and Amree Plus) to effectively manage diabetes.

WILL LIVER DISORDERS BE THE NEXT BIG THING AFTER DIABETES?

SAVE IT WITH

KUTAKI #1 BITTER HERB FOR LIVER HEALTH

According to the latest WHO data published in 2017, liver disease deaths in India reached 259,749 of total deaths. Liver is a major organ of intermediary metabolism & due to poor eating habits, alcohol abuse, and an overdose of certain drugs it is exposed to a variety of metabolic insults. These indigenous factors when stayed for a long time can damage and weaken the Liver functions, and eventually lead to many diseases including metabolic syndrome, indigestion, obesity, Non-alcoholic fatty liver disease (NAFLD), type- 2 diabetes mellitus & many more.  

Looking at the alarming prevalence rates of liver disorders. Ranging from simple and reversible fat accumulation in hepatocytes (liver cells) to irreversible fibrosis has compelled the need to discover an appropriate & effective intervention. These concerns & in-depth researchers then highlighted the most beneficial #1 herb: KUTAKI (Picrorhiza kurroa)

“A HERB THAT IS HEPATOPROTECTIVE & HEPATOCORRECTIVE”

The name Picrorhiza comes from the bitter root, in which “Picros” stands for bitter while “Rhiza” stands for root. This herb has been scientifically evaluated on all the grounds for its effective & protective action on the Liver, emphasizing its regular administration for a healthy functioning liver.

BOOSTS THE NATURAL DETOXIFICATION PROCESS

Liver plays a central role in detoxifying and excusing many endogenous and exogenous compounds from the body helping the system to work efficiently. A recent study found that picroside-I and kutkoside in picrorhiza prevent liver cell damage by controlling the uncontrolled propagation of free radicals. It was also believed that Picrorhiza extract helps hepatocytes (liver cells) to repair their intracellular glutathione (antioxidant) stores after any injury or infection. It detoxifies various chemical toxins & thus directly takes part in the detoxification & hepatoprotective process of the Liver.

PROTECTS LIVER FROM OVER-THE-COUNTER PILLS

Pills are the best companion in pain but consuming them for a long time without medical advice may surge the level of hepatotoxicants in the body. Hepatotoxicants are exogenous agents that lead to Hepatotoxicity. It is scientifically found that Kutkins in Picrorhiza kurroa changes the structure of the external membrane of liver cells & helps control the entry of the toxins into the interior part of liver cells. Kutkins also stimulates ribosomal protein synthesis; thus, encouraging the regenerative capacity & formation of new hepatocytes.

Looking at the promising therapeutic effects & leads available on Picrorhiza kurroa or kutaki, Aimil pharmaceuticals years back has formulated a poly-herbal formulation- AMLYCURE D.S, a desired strengthen liver protective & corrective. The formulation is fortified with the desired strength of active phytoconstituents from Picrorhiza kurroa (kutaki), kalmegh (Andrographis paniculata), bhuiamla (Phyllanthus amarus), chitarak (Plumbago zeylanica) & many more present in a therapeutic concentration. The formulation is helping masses to protect & correct deranged liver parameters, ensuring optimum liver health.

Ayurveda is the most ancient medical science that is treating both acute and chronic diseases without a hitch. Looking at the miraculous work of this 5000-year-old science, many modern scientists are reading Ayurvedic scriptures and trying to understand the Ayurvedic principles. Worldwide people are opting for Ayurveda to benefit their health in a better way.

Recently Mr. Raila Odinga, the former PM of Kenya, even sought the support from Indian Prime Minister in expanding Ayurveda treatment to the African countries, after his daughter regained vision from pure Ayurvedic treatment. Not just this, the oldest man to be conferred with the Padma Shri award, Swami Sivananda (125 years old) is a monk from Varanasi, who lived his life on the principles of Ayurveda and is still leading a healthy life for his age. These live examples are proof that introducing Ayurveda in life can make a big difference by helping in reversing chronic ailment’s effects and can elongate a peaceful healthy life.

Ayurvedic knowledge is as big and deep as an ocean and to know about it in detail can be a catch-22. But learning some basic principles to lead a life according to Ayurveda and following them religiously can help anyone to lead a disease-free life for a longer period of time. Follow this article till the end to know more about such principles.

1.     Correct the daily routine (Dincharya)

In today’s era, people are mostly spending their time on screens immediately after waking up. This time can be utilized for building a habit. According to research it only takes 21 days to form a habit. Know what can be changed or added to the daily routine below:

• Start by waking up early from your usual waking time.
• Drinking a glass of lukewarm water before going straight to the washroom.
• After coming out of the washroom one should do yoga and stretches. Ayurveda says one should practice Suryanamaskaram every day.
• Before taking a bath, one should massage their body with oil or use herbal scrubs made of Agaru, Chandana, etc.
• After eating gargles should be done.
• Massaging of feet is recommended for a sound sleep.
• Try not to use screens before sleeping.
• Try to sleep early to wake up early the next day.

Like this slowly adding a new routine per day or week can help form a habit and will give benefits to the body rapidly.

2.     Follow the right seasonal regimen (Ritucharya)

Ayurveda texts have mentioned the great importance of following a seasonal regimen. Adapting and leaving the daily routine according to seasons can help prevent many seasonal disturbances. Knowing what should be eaten, worn, and drank according to the season can give a miraculous boost to the immunity of the person.

·        In Hemant Ritu (Early Winter season)

• One should take Methi, Bathua, spinach, ginger, carrot, radish, orange, grapes, dry fruits, stuffed paratha, soup, warm milk, sesame seeds, etc.
• Sunbathing, residing in warm places, wearing heavy warm clothes, and oil massage is recommended.

·        In Shishir Ritu (Winter season)

• Bajra, ragi, rice, wheat, beans, green vegetables, sweet lime, grapes, etc can be added to the diet.
• Exercise, sunbathing, oiling is recommended.

·        In Vasant Ritu (Spring season)

• Pointed gourd, pumpkin, capsicum, beans, garlic, amla, apple, grapes, moong dal, masoor dal, arhar dal, wheat, barley, honey, cinnamon can be added to the diet.
• Regular exercise, dry massage, gargling, etc are recommended activities.

·        In Greeshma Ritu (Summer season)

• Bottle gourd, pointed gourd, watermelon, litchi, papaya, mango, rice, daliya, sattu, milk, and products can be consumed.
• Bathing with cold water, chandana pack application, not doing any excessive physical exertion is recommended.

·        In Varsha Ritu (Rainy Season)

• Brinjal, ginger, garlic, cumin seeds, jamun, fenugreek seeds, litchi, pomegranate, banana, papaya, old barley, wheat, rice, honey can be added in diet.
• Boiled water for bath, dry massage and not spending the time in sun is recommended.

·        In Sharad ritu (Autumn season)

• Radish, tomato, coconut, spinach, singara, chickoo, dried raisin, honey, coconut water, rose sharbat, and cow’s milk can be consumed.
• Use of seasonal flowers, morning walk, moonlight bath, exercise should be added.

These 6 seasons affect health in their own way, so following Ritucharya is a wise move to preserve the overall health of an individual. Other Ayurvedic principles include the time to eat the meal, which natural urges to suppress, the correct way and time to drink water, etc.

Including everything in one article is not possible for a text that is extensively written. Subscribe to our newsletter to get exclusive Ayurvedic wisdom regularly to refine health. Till then keep practicing Ayurveda and have a happy life.

Upper respiratory tract infections (URTI) are one of the most common reasons for doctor visits resulting in missed work or school with symptoms ranging from a runny nose, sore throat, cough, to difficulty in breathing. URTIs can occur at any time of year, but they are most common during the winter.

The infections in the respiratory tract are mostly of viral origin and often lead to secondary bacterial infections. The treatment options available for such infections are effective and provide instant relief, however, linked to some side effects. On the other hand, herbal medicines are gaining importance because of their multidisciplinary actions in alleviating the symptoms from their root cause.

One of such herbs is Jufa or Hyssopus officinalis or Hyssop which is referred as magical herb for respiratory problems. Hyssop is considered to have soothing, expectorant, and cough suppressant properties in herbal medicine. Hyssop is being used in classical medicine for centuries  to increase circulation and treat a variety of conditions such as coughing and sore throat. Hyssop has the ability to stimulate the gastrointestinal system.

Jufa contains glycoside hyssopin, flavonoids (including diosmin and hesperidin), tannins, caffeic acids, resin, gum, and the bitter substance known as marrubiin. Terpenoids include marrubiin, ursolic acid, and oleanolic acid. Hence possesses antioxidant, anti-inflammatory, antifungal, antimicrobial, antispasmodic, and several other pharmacological activities.

Anti-viral properties

Common viral respiratory diseases can be treatable without altering the gastric or intestinal flora. Jufa can act as anti-viral by inhibiting the replication of the virus in the lungs by enhancing interferon production. Therefore, protecting the lungs from damage and giving relief in no time.

Anti-microbial activity/ Anti-inflammatory activity

The disease-causing bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins (poisons), which damage the cilia and cause
 
airways to swell. Here, Hyssopus officinalis has in vitro antimicrobial activity against Gram +ve and Gram −ve bacteria hence inhibiting microbial growth. The levels of immunoglobulins decrease due to anti-inflammatory properties and in turn give relief in symptoms.

Broncho-tonic effect

The aerial flowering tops of Jufa have been suggested for broncho-tonic effects due to its essential oil constituents namely, I-pinocamphone, pinene, terpinene, etc. Therefore, providing demulcent and soothing actions in bronchial diseases.

Mucolytic effect

Jufa works effectively in excessive mucous production. Jufa liquefies thick and tenacious mucous and at the same time gently stimulates expectoration.

Airway remodeling inhibition effect

The relieved pathological changes including smooth muscle proliferation, mucus secretion, and collagen deposition support its airway remodeling inhibition by correcting the imbalance of the MMP-9/TIMP-1 ratio in respiratory

Potent Antioxidant

H. officinalis’s stems, leaves, and flower’s ethanolic extracts showed good antioxidant activity in the hemoglobin-induced linoleic acid which repairs any damage caused by the foreign particle and boosts cell repairing activity.

Looking at the benefits of Jufa herb AIMIL pharmaceuticals an Ayurveda based pharma company has made an Ayurvedic syrup with the benefits of Jufa and other respiratory system friendly herbs like Clove, Peepli, Gojiya, cinnamon, Kateli, Baheda, dried fig, and Unab which can be consumed with lukewarm water with the name JUFEX to help relieve symptoms of various respiratory ailments.
 

Nearly one in every seven couples are infertile, which indicates they haven't been able to conceive naturally despite having frequent, unprotected sexual intercourse for a year or more. Even though the research focus of infertility and its treatment has historically been on women, infertility affects both men and women equally, with male-factor causes contributing to infertility approximately one-half of the time. As per cultural assumption, men are virile and can quickly become fathers; however, the incidence of male sexual problems is continuously growing at an alarming rate.

Furthermore, it is difficult to obtain accurate values for the true prevalence of male sexual dysfunctions. Many patients do not seek medical attention, and many physicians hesitate to ask patients about their sexual health. It is estimated that over 150 million men worldwide suffer from sexual dysfunction. Due to reporting bias, cultural factors, a general failure by many physicians to inquire about their male patients' sexual health, and embarrassment issues, these values are likely a gross underestimation of the actual number of men with sexual problems.

The pathophysiology of the male reproductive disorder is complex as multiple systems  contribute to delivering reproductive functions. Besides structural deformities, male reproductive disorders are mainly erectile dysfunction, low libido, poor sperm and semen quality. A plethora of evidence suggests that in reproductive dysfunctions, there is a close interplay between the psychological and physiological status of the body. With the rising prevalence of psychological disorders viz stresses, anxiety, and depression, males' number of reproductive disorders is also increasing. In stressed out males, the outcomes are worse, as an imbalance in brain function may impose a harmful impact on the physiology of the reproductive systems and vice versa. One of the hypotheses of this fact can be that psychological disorders negatively influence the physiology of the hypothalamic-pituitary-adrenal axis, or HPA axis, which ultimately affects reproductive functions. Similarly, male suffering from sexual dysfunctions has higher chances to develop stress, anxiety, and depression.

Despite the continuous advancement in the management or treatment of reproductive disorders, the number is not decreasing. Considering the tolerability and safety concern along with the
 
targeted effects of modern medicines, natural medicines can also be given due consideration. As per Ayurveda, classical or natural medicine is safe, tolerable, and effective as it acts on multiple underlying pathophysiological pathways. These multifactorial actions from natural treatment can be rationalized for an effective, safe, and tolerable approach to treating complex ailments like males' reproductive disorders. Several phytoconstituents found in the botanicals listed below are beneficial in maintaining and managing male reproductive health. Some of them are:

Kaunch seeds (Mucuna pruiens): The seeds are a rich source of L-DOPA that increases the dopamine level in the brain. It increases the plasma testosterone level and induces the activation of sexual behavior. It also improves semen quality by restoring antioxidant levels and reducing lipid peroxide content.
Gokhru (Tribulus terrestris): The fruit increases nitric oxide production, which enhances the smooth muscles relaxation that results in increased blood flow in the columns of spongy tissue within the shaft of the penis (the corpora cavernosa and corpus spongiosum) and thus manages erectile dysfunction.
Ashwagandha (Withania somnifera): Indian ginseng produces GABA-like activity that decreases neuron activity and inhibits nerve cells from over-firing. The standardized extract of Ashwagandha was proved effective on the adverse effects of stress. It increases energy, reduces fatigue, better sleep, enhances the sense of well-being, and  reduction of cortisol levels up to 26%. Thus, it improves Psycho Sexual endurance.
Jaiphal (Myristica fragrans): By facilitating the activity of norepinephrine, a neurotransmitter, in the central nervous system improves sexual function by its chemical constituents such as sterols, phenols, alkaloids, and amino acids.
Pumpkin seeds: Pumpkin seeds are the rich source of Zinc that exerts the antioxidant effect and improves fertility and male sexual health, strengthening prostate gland and male hormonal function. Thus, improving sperm morphology and motility.
Vidarikhand (Pueraria tuberosa): Pueraria tuberosa possesses numerous activities like nootropic, antioxidant, and antifertility. It increases sperm count by improving the androgenic and sexual behavior parameters.
 
By acting multidimensionally, these herbal phytoconstituents act on the crosstalk between psychological and physiological pathways and alleviate the male reproductive disorders' root cause. Recognizing the increasing burden of male reproductive issues, Aimil Pharmaceuticals (I) Ltd has developed a unique polyherbal formulation (Semento capsules) to improve male reproductive health. This polyherbal formulation contains biologically active herbal phytoconstituents from the best quality of herbs reported to treat erectile dysfunction, low libido, poor sperm, and semen quality for better male fertility.

The current scenario suggested a sudden spike in the number of CKD suffers. With no suitable treatment, the condition intimidates high-end physical, mental & financial burdens on family & co-supporters. The rising cases no longer look to slow down, associated diabetes or Diabetes kidney diseases (DKD) can be a massive load over the entire system. Turing, the tire with recently advanced treatment, is in need of an hour.

DKD can be defined by elevated urine albumin excretion or reduced glomerular filtration rate (GFR) in patients with diabetes. With the increase in the prevalence of diabetes, the burden of chronic kidney disease (CKD) is parallelly increasing. The CKD registry claims more than 31% of people with kidney disease and diabetes in India. According to a 2015 report titled "Start India Project," more than 40% of type 2 diabetes mellitus patients have CKD, whereas only one CKD patient out of every five hypertensive subjects has CKD. Epidemiological studies predict this prevalence is expected to rise in the future even faster. A recent study concludes that despite the advancements, current therapy can not completely halt the progression of DKD, and DKD remains the leading cause of end-stage kidney disease (ESKD) or kidney failure worldwide.

DKD: A silent progressor

In diabetes, high blood sugar affects the kidneys’ ability to remove waste products and extra fluid from the body. In the initial phase of DKD, a slow and gradual decline in renal function remains unnoticed, and consequently, 90% of patients do not experience any signs and symptoms. The gradual decline in the functions of the kidney progress silently towards renal failure or ESKD, making it challenging to preserve residual renal functions. In the late stage of CKD, it is tough to manage kidney health, and most intervention aims to improve the health-related quality of life of patients with kidney disease. Therefore, guidelines recommend intervention therapeutically as early as possible to delay disease development. Duration of diabetes mellitus and other associated comorbidities or risk factors can help predict the kidneys' health and accordingly choose the appropriate therapeutic approach to manage DKD.

DKD: The missing link/unmet need

Recent advances in medicine and technology have helped patients with DKD better control their blood sugar and blood pressure levels, leading to a significant reduction in amputations and heart-disease complications. Unfortunately, all currently available therapies aim to slow the disease progression and there are no therapies to stop or reverse the damage to the kidneys' filtering system. Therefore, the therapeutic interventions/approach to preserve renal functions can be considered helpful in improving the kidney's functional capacity.
 
DKD: Finding the root cause to meet the unmet need

Several underlying pathophysiological mechanisms like oxidative stress, inflammation, apoptosis, etc., individually or collectively contribute to the progression of DKD. It is important to target all the possible causes to alleviate the progression. The occurrence of serious adverse events has hampered the increasing use of western medicine during the management or treatment of kidney disease. On the other side, traditional medicines deal with various phytoconstituents that play an essential role in disease treatment due to their synergistic potential. Herbal medicine is becoming more popular as an alternative treatment in developed and developing countries due to its natural origin, low or no side effects, affordability, and accessibility. Notably, herbal medicines are reported to preserve renal functions by preventing tubular damage in the nephrons. In cases where dialysis or kidney transplant are the only options for patients, herbal medicine may be an effective treatment option by improving biochemical markers, glomerulosclerosis, and GFR.

Turn the tide of DKD: Management by natural approach

Herein, some essential herbs are listed that are beneficial in maintaining and managing kidney disease:

Boerhavia diffusa: Restores antioxidant defense, the functional capacity of kidney and hasten recovery from glomerulonephritis, tubular cell toxicity, and altered intraglomerular hemodynamics with a reduction in inflammatory and oxidative responses.

Cichorium intybus: Reconditions the function of glomerular, peritubular, blood vessel congestion with the presence of inflammatory cells causing severe necrosis.

Nelumbo nucifera: Enhances speedy restoration of nephron functions via antioxidative action.

Butea monosperma; Preserve podocyte and tubulointerstitial inflammation via antioxidative action, normalize biochemical and histopathology altered due to oxidative stress.

Tribulus terrestris: Improve renal epithelial damage, inflammation, and glomerular morphology and reduce biochemical biomarkers urea and creatinine levels to normal and reduce onslaughts of oxidative stress.

Coriandrum sativum L.: Preserve the absorption function distorted due to damaged glomerular and tubular parts of the kidney.

Hemidesmus indicus L.: Restore the function of renal tubule against glomerulonephritis, antioxidant defense system, and altered intraglomerular hemodynamics.

Moringa oleifera L.: Ameliorates urinary excretion of electrolytes or plasmatic levels of Na+ and K+ ions.
 
On-time supplementation of the right combination of herbs can surely be a boon for patients suffering from DKD. Available research suggests that herbal medicines can help improve the functional capacity of kidneys and preserve renal functions. To extend the benefit Aimil Pharmaceuticals (India) Limited has come up with NEERI KFT, which combines all the herbs mentioned above and other reno-protective herbs in their best quality, helping sufferers to delay the episodes of dialysis & kidney transplant.
 

“The AMP-Activated Protein Kinase”:

In the body, cells constantly manage their energy consumption in response to nutrient availability and ATP production capacity. The metabolic processes ensure the adequate production and utilization of energy. Catabolic processes such as the breakdown of glucose or lipids produce ATP, and the majority of ATP production in cells occurs in mitochondria, which are sites of oxidative phosphorylation. When cells use the stored energy for various cellular processes, ATP is broken down into ADP, which can then be converted to AMP. When cellular ATP levels fall, cells must reduce their energy consumption to avoid depleting their remaining resources. Simultaneously, emergency measures must be implemented to restore cellular energy supply, such as increasing nutrient intake and activating alternative energy-producing pathways. In our body, such processes are regulated by some important protein kinases and the key player in this system is AMP-activated protein kinase (AMPK). An article published in “Nature Reviews Molecular Cell Biology” referred, to AMPK as the “Guardian of Metabolism and Mitochondrial Homeostasis”. AMPK is also considered a “Metabolic Master Switch of the Body” and some researchers also denote it as a metabolic 'magic bullet' protein.

Functions of AMPK

 

 

AMPK is a Metabolic Master Switch of the Body for some reason as it is essential in controlling mitochondrial health and plays an integral role in energy homeostasis. With increased energy
 
demands while exercising and energy-deprived conditions such as starvation, and hypoxia (deficiency in the amount of oxygen delivered to the body tissues), AMPK regulates energy flow. AMPK increases energy production by stimulating catabolism and reducing energy consumption by inhibiting anabolism. The metabolic targets of AMPK are as follow:

To produce energy AMPK stimulates catabolic pathways and

·    Stimulates glucose utilization by increasing glucose uptake into cells
·    Pushes cells towards using their lipid stores
·    Regulates lipid homeostasis
·    Promotes mitochondrial biogenesis

To preserve energy AMPK inhibits anabolic pathways such as:

·    Suppresses ribosomal protein synthesis
·    Reduces lipid synthesis
·    Prevents glycogenesis and gluconeogenesis.

Over the last decade, extensive research has revealed a variety of molecular mechanisms and physiological conditions that regulate AMPK activity. AMPK controls a variety of metabolic and physiological cascades; however, it is dysregulated in major chronic diseases such as obesity, inflammation, diabetes mellitus, and cancer. These chronic pathological conditions can suppress the activity of AMPK, consequently, cells suffer from its physiological functions because of underlying overexpression of reactive oxygen species, increased oxidative stress, inflammation, apoptosis, and impaired autophagy. AMPK activation has been very helpful in various disease domains like diabetes mellitus, liver diseases, chronic kidney diseases, etc. The AMPK  activation has been demonstrated to ameliorate multiple components of metabolic syndrome by regulating a balance between anabolic and catabolic cellular reactions. Therefore, AMPK activation remains a key target link in the management of diseases in a natural way. Based on the available scientific literature, we have summarized below several herbs that have shown AMPK activation as a therapeutic approach:

Nigella sativa (Ranzmculaceae) possesses antihyperglycaemic, antihyperlipidemic, anti-inflammatory, antioxidant, etc through activation of the AMPK pathway. It has also been reported to control liver marker enzymes alleviates disease progression.
 
Trigonella faenum graecum (Leguminosae) reverses insulin resistance by the activation of the AMPK pathway and improves insulin sensitivity by promoting mitochondrial biogenesis.

Chichorium intybus (Compositae) via AMPK activation significantly attenuates the non-alcoholic fatty liver disease (NAFLD) and promotes liver functions.

Berberis aristata (Berberidaceae) improves glucose-lipid metabolism in the liver and  also exerts AMPK mediated antihyperglycaemic, cardioprotective and hypolipidemic actions

Glycyrrhiza glabra (Fabaceae): Through AMPK activation, licorice the active phytoconstituent of G. glabra inhibits the activity and/or expression of lipogenic genes, including those of acetyl coenzyme A (CoA) carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase 1 (SCD), and sterol regulatory element-binding protein 1 (SREBP1). Thus, influences the activity of various endocrine hormones, such as insulin, glucagon, and leptin in the body.

A plethora of scientific evidence suggest that herbs such as Ocimum sanctum, Tinospora cordiofolia, etc, have the ability to improre cellular bioenergetics in natural way by activating AMPK upregulation. Therefore, herbal formulations can be used in the therapeutic avenue by  keeping their ability to activate AMPK upregulation in mind.