Ali Reza Nasiri, Amir Reza Karamibonari,
Volume 17, Issue 1 (1-2023)
Abstract
Background and objectives: Gentamicin is an aminoglycoside antibiotic used in the treatment of Gram-negative bacterial infections. One of the side effects of this antibiotic is nephrotoxicity. In this study, the protective effect of Melissa officinalis L. extract on diabetes- and gentamicin-induced nephrotoxicity was studied.
Methods: Forty male Wistar rats were randomly divided into four groups. The first group received distilled water, and the second group received M. officinalis L. extract (100 mg/kg) for 28 days. The third group received streptozocin (60 mg/kg) for 18 days, and then received gentamicin (80 mg/kg) on day 20 for 8 consecutive days. The fourth group received streptozocin, gentamicin, and M. officinalis L. extract for 28 days. Serum levels of blood urea nitrogen (BUN), creatinine, glucose, and amylases were measured. The right kidney was maintained in 10% formalin for hematoxylin and eosin staining, and oxidative stress markers in the left kidney were assessed.
Results: In the third group, serum BUN, creatinine, glucose, amylase, and malondialdehyde (MDA) increased, while glutathione peroxidase, superoxide dismutase, and catalase activities decreased significantly compared to the other groups (P<0.05). The extract of M. officinalis L. significantly inhibited the enhancement of serum creatinine, BUN, glucose, amylase, and MDA (P<0.05). Histological examinations showed that diabetes and gentamicin could lead to kidney damage by inducing necrosis and inflammation. Finally, the extract of M. officinalis L. could significantly reduce the adverse effects of both gentamicin and diabetes (P<0.05).
Conclusion: The extract of M. officinalis L. improves biochemical parameters and histological lesions in diabetic rats treated with gentamicin.
Ali Jabbari, Reza Afghani, Ayesheh Enayati,
Volume 17, Issue 2 (3-2023)
Abstract
Background: Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem disorder characterized by progressive renal cysts formation and extra-renal manifestations. Infection within the cysts and abscess formation are rare but life threatening if left untreated. We present a rare case of peritonitis presentation due to intraperitoneal rupture of an infected cyst in a woman with polycystic kidney disease.
Case description: A 42-year-old woman presented with constant progressing abdominal pain and vomiting. She complained of abdominal distention, bloating, and a change in bowel habits from two days ago. On physical examination, bilateral enlarged masses of flanks, generalized tenderness, and distention of the abdomen were found. The patient received conventional therapy. After appropriate fluid and electrolyte management and rescue care, appropriate antibiotics were prescribed, and laparotomy was performed. The rupture of an infected cyst of the right polycystic kidney into the peritoneal cavity was the cause of peritonitis in this patient. She successfully underwent a right radical nephrectomy (32×21cm, and 3,300 gr). The postoperative period was uneventful and the patient was discharged from the hospital after a week.
Conclusion: Antibiotic therapy is the first step in the treatment of renal cyst infection. When primary antibiotic therapy fails, drainage of the infected cyst is recommended. In medically fit patients for surgery and patients who present with complications of the infected cyst, radical surgery and nephrectomy is the procedure of choice. The best outcome is achieved after nephrectomy.
