Attitude and awareness of medicinal plants in treatment of kidney lithiasis in eastern Morocco: a retrospective study

Summary Introduction: Kidney stone is a major public health problem. Over 5% of the population is affected by kidney stones, with causes a lifetime risk of transmitting renal lithiasis of about 8 to 10%. Objective: The goal of our study is the attitude and awareness of lithiasis patients regarding the use of medicinal plants in eastern Morocco. Methods: We carried out a study on lithiasis patients to retrospectively identify medicinal plants used in this disease, using a pre-established questionnaire. The study was carried out from 10 December 2017 to 28 February 2018. Results: Our survey describes several medicinal plants used to treat renal lithiasis in eastern Morocco. Most patients used Herniaria hirsuta L., Zea mays L., Urtica dioica L., and Petroselinum crispum (Mill.) Fuss. This preliminary study showed that the first reason to use medicinal plants in half of lithiasis patients is to calm the pain and expel the stones. The primary source of plant use information is oral tradition. However 67% of lithiasis patients are unaware of the harmful and toxic effects that can appear. Conclusion: Medicinal plants must, like medicines, comply with strict requirements and standard rules of use to which only the specialist in herbal medicine can respond and sensitize people to the dangers of irrational consumption of medicinal plants.

SÍNDROME DE MUNCHAUSEN RELACIONADA À CALCULOSE URINÁRIA NÃO METABÓLICA: UM RELATO DE CASO

The term Munchausen Syndrome (MS) was first described in 1951 by Asher to characterize individuals who intentionally produce signs and symptoms of a disease. People with this syndrome pretend to be sick and tend to look for treatment, without secondary gain, in different health services. A report of an 18-year-old woman in renal lithiasis research is reported and, at the end of the investigation, it was concluded that the "stones" were not of renal origin. The MS is rare and promotes massive health care spending, with unnecessary and costly examinations, exposing patients to iatrogenics. An underdiagnosed disease with little knowledge of health professionals. Key-words: Munchausen Syndrome; Urinary calculosis; Iatrogeny.

Comparison of Two Dietary Supplements for Treatment of Uric Acid Renal Lithiasis: Citrate vs. Citrate + Theobromine

Background. Uric acid (UA) renal lithiasis has a high rate of recurrence and a prevalence ranging from 10% and 15%, depending on the population. The most important etiological factor is persistence of urinary pH below 5.5 and one of the most common treatments is alkalization with citrate. Recent studies demonstrated that theobromine, which is abundant in chocolate and cocoa, is a potent inhibitor of UA crystallization. Aim. The aim was to compare the efficacy of citrate versus citrate + theobromine as treatment for UA lithiasis. Methods. This randomized cross-over trial investigated the efficacy of two treatments in 47 patients with UA renal lithiasis. Urine volume, pH, UA excretion, theobromine excretion, and risk of UA crystallization (RUAC) at baseline and at the end of each intervention period were measured. Results. Each treatment significantly reduced the risk of UA crystallization compared to basal values. The RUAC after citrate + theobromine was lower than the RUAC after citrate, although this difference was not statistically significant. Conclusion. The combined consumption of citrate and theobromine may be a promising strategy for the prevention of UA kidney stones.