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International Journal of

Innovative Drug Discovery

POTENT HERBAL WEALTH WITH LITHOLYTIC ACTIVITY: A REVIEW

ABSTRACT The most painful urologic disorder is calculi or stone formation in the kidneys and urinary bladder due to imbalance between promoters and inhibitors of crystallization in urine. Stone formation is documented from traditional periods and is considered as a medical challenge due to its multifactorial etiology. Stone formation commonly occur due to inadequate urinary drainage, foreign bodies in urinary tract, microbial infections, diet with excess oxalates and calcium, vitamin abnormalities like vitamin A deficiencies, excess vitamin D, and metabolic diseases like hyperthyroidism, cystinuria, gout, intestinal dysfunction etc., Herbal remedies are gaining their importance due to inefficiency of standard pharmaceutical drugs, and reoccurance is possible by treating with ultrasonic energy and surgery. As investigations proved that phytotherapy is potent in preventing and curing renal calculi with less side effects and produced satisfactory results in preventing reoccurance of renal stones, the present study is mainly focused on providing information on potent herbal wealth with litholytic property. KEY WORDS: Litholysis, Crystallization, Phytotherapy, Renal calculi, Herbal wealth. INTRODUCTION Stone formation is one of the painful urologic disorders that occur in approximately 12% of the global population and its re-occurence rate in males is 70-81% and 47-60% in female [1]. It is assessed that atleast 10% of the population in industrialized part of the world are suffering with the problem of urinary stone formation. The occurrence of the renal calculi is less in the southern part when compared with other parts [2]. The rate of occurence is three times higher in men than women, because of enhancing capacity of testosterone and inhibiting capacity of oestrogen in stone formation [3]. It has been found that the formation of urinary calculi dates back not only to 4000 B.C in the tombs of Egyptian mummies also in graves of North American Indians from 1500 to1000 B.C [4]. Stone formation is also documented in the early Sanskrit documents during 3000 and 2000 B.C [5]. The problem of stone formation is considered as a medical challenge due to its multifactorial etiology and high rate of reoccurrence [2]. Stone formation is also caused due to imbalance between promoters and inhibitors. From ancient periods, a number of herbal medicines have been found with potential effect in treating the problem of renal calculi [6]. RENAL CALCULI The problem of calculi formation is observed and reported in all parts of the urinary tract, the kidney, the ureter and the urinary bladder which may considerably vary in size [7]. Nephrolithiasis and urolithiasis are the oldest and wide spread diseases in which reoccurance of stone formation is considered as the most serious problem [8]. Nephrolithiasis is characterized by formation of stones in the kidney, where as urolithiasis is characterized by formation of stones in urinary bladder. In more than 60% of the kidney stones the primary constituent responsible for the formation of crystals is calcium oxalate (CaOx) which exist in the form of

Corresponding Author:- Jyothi M Joy Email:-:jyothijoy59@gmail.com

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CaOx monohydrate (COM) and CaOx dihydrate (COD). Many steps like nucleation, crystal growth, crystal aggregation and crystal retention are involved in the calcium oxalate stone formation. Various substances in body show effect in promoting or preventing these stone forming processes [5]. Life style and dietary factors are the important biological events that are responsible for formation of stones [9]. Stones that commonly occur are the calcium containing stones, especially calcium oxalate monohydrate (whewellite), calcium oxalate dehydrate (weddellite) and basic calcium phosphate (apatite) to an extent of 75 -90%, Magnesium ammonium phosphate stones (struvite) occur to an extent of 10-15%, uric acid 310%, and cystine stones 0.5-1% [10]. The inhibition of CaOx stone formation is limited to some minerals like selenium, magnesium and orthophosphates, some medicinal herbs also contain chemical compounds that inhibit CaOx formation [5]. REASONS FOR STONE FORMATION Stone formation commonly occur due to inadequate urinary drainage, foreign bodies in urinary tract, microbial infections, diet with excess oxalates and calcium, vitamin abnormalities like vitamin A deficiencies, excess vitamin D, and metabolic diseases like hyperthyroidism, cystinuria, gout, intestinal dysfunction etc.,[11]. Calcium oxalate is considered as main constituent in the renal calculi formed and its formation is attributed to intake of cereals rich in calcium and phosphorus besides lack of animal proteins and high intake of oxalate rich vegetables [2]. Oxalate is excreted in urine under normal conditions but causes stone formation under pathological conditions [12]. The use of Diuretics, Allopurinol, Tamsulosin and NSAIDS [13] can also alleviate risk factor like stone formation [14]. Along with these mechanisms stone formation may also occur due to oxidative stress, epithelial damage in kidney or bladder which offers suitable environment for crystal attachment [3]. The formed renal calculi have been divided into two categories namely tissue attached and tissue unattached. In development of renal calculi a prominent role is played by renal epithelial cell damage [15]. Abnormalities in renal morphology, disturbances in urine flow, genetic factors, bacterial infections in urinary tract : Urinary stone forming infection is caused by bacteria such as Proteus vulgaris, Pseudomonas aeruginosa, Enterobacter spp., Serratia spp., Staphylococcus aureus, Staphylococcus epidermitis etc., Metabolic abnormalities like increased excretion of the stone forming constituents and decreased excretion of the inhibitors of crystallization [13]. Supersaturated urine is required for the stone formation and its supersaturation depends on urinary P H, ionic strength, solute concentration and complexations [5]. PROBLEMS ENCOUNTERED The presence of renal calculi is diagonised by the symptoms explained by the patients and the stones are

recognized in the body with the help of X-rays. The analytical markers in urine and serum that are responsible for the clinical diagnosis of the urologic disorders are calcium, albumin, creatinine, urate and oxalate [11]. The problem of stone formation produces pain and obstruct the flow of urine as the stones formed are unable to travel through ureter, It also causes, severe back ache (the worst pain known as colicky pain is produced in the lower back), bloody, cloudy, and smelly urine, sickness, urge for urination, burning sensation during urination, fever, chills etc., less urine volume, change in urinary p H, and infections [3]. Available standard pharmaceutical drugs used in preventing and curing renal calculi are not effective in all patients and may produce adverse effects on long term use [15]. WAYS TO RESTRICT CALCULI FORMATION In order to avoid calculi formation there must be enough fluid intakes to produce atleast 2 lit of urine per day as drinking more water keeps the urine diluted which allow easy passage of materials that may aggregate to form stone. Studies suggested that lemonade and citrus drinks are helpful in reducing the problem of stone formation as the juices contain citrates which control growth of crystals to form stones. But the intake of juices like grape fruit juice, cranberry juice and dark colas may increase the risk of stone formation as these contain oxalates. Salt content in food must be reduced as the sodium in salt increases calcium excretion which results in increased risk of stone formation. To minimize the content of oxalates in urine the foods that are to be avoided are spinach, rhubarb, nuts and wheatbran. Alcohol and the supplements like vitamin C & D must also be avoided as they may contribute to increased risk of stone formation. Animal protein rich foods like meat, eggs and fish contain purines that can increase the risk of uric acid stones and calcium stone formation. POSSIBLE TREATMENTS FOR THE CALCULI FORMED The foremost treatment is considered with pain medication as the worst pain known as colicky pain is produced in the lower back. The formed calculi are most commonly removed by surgical methods, but the rate of reoccurance is high in this case. The ultrasonic energy is used to break and reduce the size of the stone to make them easily pass in urine, but this is not beneficial in all the cases as some larger stones do not respond to this energy. Extracorporeal shock wave lithotripsy (ESWL) uses sound waves which are also known as shock waves to break the stones in to small pieces for their easy passage out. Many allopathic agents like Thiazide diuretics (e.g. Hydrochlorothiazide), Alkali (e.g. Potassium citrate), Allopurinol, Sodium cellulose phosphate (SCP), Penicillamine (Cuprimine), Analgesic (Diclophenac sodium), Bisphosphonates, Potassium phosphate, Oxalobacter Formigenes and other probiotics are used in

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treating the stones formed which act by decreasing the excretion of stone forming agents such as oxalates, calcium, phosphates etc., [13]. The ayurvedic medicine used in the treatment are Cystone, Calcuri, Chandraprabha bati, Trinapanchamool, Rencare Capsul, Patherina tablet, Ber Patthar Bhasma, Chander Prabha vati SIGNIFICANCE OF HERBAL THERAPY The treatment of urolithiasis is mainly considered with the dissolution of existing stones and preventing the reoccurrence of stones. (DODOALA et al., 2010) Standard pharmaceutical drugs used to prevent and cure urolithiasis are not effective in all cases, costly, quite common reoccurrences, risks of long term fertility, potential side effects and no guarantee [17]. Surgical treatment causes some problems like long term renal damage, hypertension and reoccurrence of stones. Extracorporeal shock wave lithotripsy is considered as a revolution in treating renal stones, but this treatment also causes some problems like long term renal damage, hypertension and reoccurrence of stones and so an approach is being extensively investigated to prevent or inhibit the stone reoccurance, which resulted in treatment with hydrochlorothiazide, orthophosphate, alkali-citrates and magnesium to reduce the rate of stone reoccurrence. It is a well known fact that glycosamino glycons and urinary proteins which are present in the matrices of the urinary stones are the strong inhibitors against CaOx crystal formation [18]. References prove that litholytic herbs for treatment of renal stones are used since ancient periods before inventing modern treatments [5]. Standard pharmaceutical drugs used to prevent and treat urolithiasis are not effective in all cases and also produce many adverse effects [8]. Scientific studies are mostly

focused on phytotherapy as it is proved to be vital in preventing reoccurance of stones [9]. Herbal drugs are reported to be effective with no side effects. The drug for prevention of the disease or its reoccurance is of great interest as no drug in clinical therapy is of satisfactory result [1]. MECHANISM OF ACTION IN PHYTOTHERAPY Herbal agents act by allowing spontaneous passage of small calculi in urine by increasing the urinary volume, PH. The herbs also act by regulating oxalate metabolism, by maintaining balance between inhibitors and promoters of crystallization, by producing anti-oxidant, anti-microbial, analgesic, anti-inflammatory activities [12]. Modern medicine are proved to target only one aspect of urolithiatic pathophysiology where as herbal remedies have been shown to exert effectiveness at different stages of stone pathophysiology. Herbal remedies produce multiple mechanism of action such as diuretic activity (Beneficial in increasing the urinary volume that allows the easy passage of small calculi out of the body in urine), crystallization inhibition activity (Helps to inhibit the different stages of stone formation by maintaining the balance between inhibitors and promoters of stone formation), lithotriptic activity (Avoid binding mucin of calculi to prevent crystal aggregation to form a large stone), analgesic and anti inflammatory activities (Helps to escape the symptoms of stone formation), Anti oxidant activity (Prevent renal tissue injury), Anti microbial activity (Prevent the occurrence of infections) Herbs also improve the renal function and regulate oxalate metabolism which help in reducing the re occurrence of renal calculi [5].

Table 1. List of food and beverages that enhance and controls calculi formation FOODS AND BEVEREGES THAT ENHANCE THE FOOD AND BEVERAGES THAT CONTROL THE RISK RISK OF CALCULI FORMATION OF CALCULI FORMATION Grape fruit juice, cranberry juice, apple juice and dark colas Lemon and citrus juices, coffee, tea and soft drinks rich in citrates Foods rich in organic acids (oxalates) like spinach, rhubarb, Foods such as radish, beet root and horsegram nuts and wheatbran. Animal protein rich foods like meat, eggs and fish Low protein diets and fiber rich foods Supplements like vitamin C & D Supplements like Vitamin E, B6, and magnesium Alcohol Beer and wine to a little extent as they contain purines High intake of salt Low salt diets Table 2. Available treatments for calculai MEDICINE THERAPY AVAILABLE TREATMENTS Thiazide diuretics (e.g. Hydrochlorothiazide), Alkali (e.g. Potassium citrate), Allopurinol, Sodium cellulose phosphate (SCP), Penicillamine (Cuprimine), Analgesic (Diclophenac sodium), Bisphosphonates, Potassium phosphate, Oxalobacter Formigenes and other probiotics Extracorporeal Shock Wave Lithotripsy, Percutaneous Nephrolithotomy, Ureteroscopic stone removal etc., Cystone, Calcuri, Chandraprabha bati, Trinapanchamool, Rencare Capsule, Patherina tablet, Ber Patthar Bhasma, Chander Prabha vati

SURGICAL THERAPY HERBAL THERAPY

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Table 3. List of herbs with potent litholytic property S.No BOTANICAL NAME COMMON NAMES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Acalypha indica Linn. Abutilon indicum L. Achyranthes aspera L. Achyranthes indica Linn. Aegle marmelose L.Corr. Aerva lanata L. Ageratum conzoides L. Alhagi mannifera Desv (L.) Alismatis rhizome (Sam.) Juzepcz. Amaranthus caudatus L. Amaranthus spinosus L. Amaranthus viridis L. Ammannia baccifera Linn Amni visnaga (L.) Lam Argemone maxicana L. Armoracia lopathifolia Gilib. Asperagus racemosus Willd. Asphodelus tenuifolius Cav. Barbarea vulgaris R.Br. Benincasa Hispida (Thumb) Berberis vulgaris L. Indian nettle Kanghi Putkhanda, Prickly chaff flower Chirchira Bael Sirupoolai, Chaya Billygoat weed, Chick weed, White weed. Camels thorn Takusha Love lies bleeding Jangali Chauli Mariro Blistering ammania, Jangli mehandi Bisnaga, Toothpickweed. Datturigida Horse radish, Mountain radish, Red cole. Shatavari, Shatamuli. Piazi Rocket, Bittercress, Wound rocket. Ash gourd, Winter melon. European barberry, Jaundice berry, Ambarbaris, Barberry Paashaanbhed Paashaanbhed Ullam gadda

FAMILY Euphorbiaceae Malvaceae Amaranthaceae Amaranthaceae Rutaceae Amaranthaceae Asteraceae Fabaceae Alismataceae Amaranthaceae Amaranthaceae Amaranthaceae Lythraceace Apiaceae Papaveraceae Cruciferae

PLANT PART Whole plant Leaf juice Roots Roots Fruit pulp, Leaves. Whole plant Whole plant Roots Whole plant Leaves Roots All parts Leaves Whole plant Roots Seeds

REFERENCE Sathyaa et al 2011[8] Prachi et al, 2009 [20] Anshu aggarwal et al, 2010 [21] Surendra K.Pareta et al 2011 [5] Ghatapanadi et al, 2010 [22] Soundararajan et al 2006 [1] Mohd. azaz Khan et al 2011 [23] Choubey ankur et al, 2010 [13] Koji sujuki et al 1999 [18] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24] Neha sharma et al, 2011[24] Prasad et al, 1994 [25] Yadav et al, 2011 [19] Ghatapanadi et al, 2010 [22] Choubey ankur et al, 2010 [13] Satish Kumar et al, 2009 [26] Neha sharma et al, 2011 [24] Choubey ankur et al, 2010 [13] Patel et al 2011 [27] Samra bashir et al, 2010 [28] Sarmistha saha et al 2011 [29] Harsoliya et al 2011 [10] Neha sharma et al, 2011 [24]

17 18 19 20 21

Asperagaceae Liliaceae Brassicaceae Cucurbitaceae Berberidaceae

Roots Leaves Roots, Leaves Seeds Root bark

22 23 24

Bergenia ciliata Wall. Bergenia ligulata Wall. Beta vulgaris L.

Saxifragaceae Saxifragaceae Amaranthaceae

Rhizomes Rhizomes Roots

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25 26 27

Bombex ceiba Linn. Borrhaavia diffusa L. Bridelia crenulata Roxb.

Silk cotton tree Bishkapra, Punarnava Adamaruthu, Maarivengai, Mulvengai and Oothiravengai Patharkuchi Patharchata, Ajubu, Ghavpatta, Parnbeej. Indian red wood Mothers heart Kakke gida Devadaru, Deodar cedar. Khadula Chilua Dhalaa, Lahg. Mahalakri cana-do-brejo or cana-de-macaco Barna, Varuna. Cucu, Cucumber Pathi Dhoob ghas, Doobra, Hari doob. Gajar Korat nasi

Bombacaceace Nyctaginaceace Euphorbiaceae

Stem and bark Root Stem bark

Neha sharma et al, 2011 [24] Prachi et al, 2009 [20] Amrit Pal Singh et al, 2007 [30]

28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44

Bryophyllum calycinum Salisb. Bryophyllum pinnatum (lamk.) oken. Caesalpinia huga L. Capsella bursapastor L. Medik Cassia fistula L. Cedrus deodara Roxb. Ceropegia bulbosa Roxb. Chenopodium album Linn. Corbichonia decumbens Forrsk.(Jack). Costus speciosus Koen. Costus spiralis (jacq) Roscoe Crateava nurvula BuchHam Cucumis sativus L. Cyclea peltata Lam Cynodon dactylon Linn. Daucus carota Linn. Desmodium styracifolium(osbeck) Merr. Dichrostachys cinerea L.

Crassulaceae Crassulaceae Caesalpiniaceae Brassicaceae Caesalpinioideae Pinaceae Asclepidaceace Chenopodiaceace Molluginaceace Costaceace Zingiberaceae Capparaceae Cucurbitaceae Menispermaceae Poaceae Apiaceae Leguminosae

Leaves Fresh leaf juice Root Entire herb Fruits Heart wood Tubers Leaves Leaves Tubers Whole plant Bark Leaves Root Root Gajar juice Whole plant

Amrit Pal Singh et al, 2007 [30] Prachi et al, 2009 [20] Chitme et al, 2010 [7] Choubey ankur et al, 2010 [13] Ghatapanadi et al, 2010 [22] Ramesh et al, 2010 [31] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24] Tania araujo viel et al, 1999 [32] Prachi et al, 2009 [20] Choubey ankur et al, 2010 [13] Christina et al,2002 [33] Prachi et al, 2009 [20] Prachi et al, 2009 [20] Hirayama et al, 2008 [34] Jayakumari et al, 2011 [35] Amrit Pal Singh et al, 2007 [30] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24]

45

46

Didymocarpus pedicellata Roxb. Digera muricata L. Diospyros melaoxylon Roxb.

47 48

Sicklebush, Bell mimosa, Kalahari Christmas tree. Stone flower, Shantapushpi, Charela, Patharphori. Lesua, Latmahuria. Timru, Tendu

Mimosaceae

Root

Gesneriaceae

Leaves

Amaranthaceace Ebenaceace

Leaves Fruit, Flower and bark

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49 50 51 52 53 54 55 56 57 58

Dolichous biflorus L. Eleusine coracana Gaertn. Equisetum debile Roxb. Ficus carica L. Gomphrena celosioides Mart. Grewia flavescens A. Juss Helianthus annus Linn Helichrysum plicatum DC. Herniaria hirsute Linn Homonoia riparia Lour.

Kulattha, Horsegram, Ulavalu. Mandva, African millet, Ragi Jod tod ki ghas Fig Gomphrena weed Kali-siali Sunflower Everlasting flower Hairy rupture wort Attuvanchi, Kadallari, Neervanchi, Puzhavanchi. Black creeper Spanish flag, West Indian lantana Henna Horse gram, Horse grain, Kulthi bean, Poor mans pulse, Madras bean. Peppermint Spanish cherry, Bullet wood. Bitter melon, Bitter gourd. Drum stick tree, Horse radish tree, Clarifier tree. Kela Banana plantain Black cumin seed Olive

Fabaceae Poaceae Equisetaceace Moraceae Amaranthaceace Tiliaceace Asteraceae Asteraceae Illecebraceae Euphorbiaceae

Seeds Grains All parts Fruit, Latex Whole plant Roots Leaves Flowers Whole plant Root

Rana gopal singh et al 2010 [2] Bahuguna et al 2009 [4] Neha sharma et al, 2011 [24] Choubey ankur et al, 2010 [13] Neha sharma et al, 2011 [24] Neha sharma et al, 2011 [24] Khan et al 2010 [6] Yasin bayir et al, 2011 [36] Yadav et al, 2011 [19] Chitme et al, 2010 [7] Anbu et al, 2011 [38] Mayee et al, 2011 [15] Kore et al, 2011 [12] Anantha krishana chaitanya et al, 2010 [14] Choubey ankur et al, 2010 [13] Purnima ashok et al, 2011 [39] Shah et al, 2011 [40] Vijayalakshmi et al, 2010 [41] Prachi et al, 2009 [20] Kalpana devi et al 1993 [3] Harsoliya et al 2011 [10] Choubey ankur et al, 2010 [13]

59 60 61 62

Ichnoccarpus frutescens L. Lantana camara Linn Lawsonia inermis Linn Macrotyloma uniflorum Lam.

Apocynaceae Verbenaceae Lythraceae Fabaceae

Roots Leaves Leaves Seeds

63 64 65 66

Mentha piperita L. Mimusops elengi L. Momordica charantia Linn Moringa oleifera Lam

Lamiaceae Sapotaceae Cucurbitaceae Moringaceae

Entire herb Bark Fruits Pods, Bark, Root wood. Roots Ripe kernel juice Seeds Oil

67 68 69 70

Musa bulbisiana Colla. Musa paradisica Linn Nigella sativa L. Olea europeae L.

Musaceae Musaceae Ranunculaceae Oleaceae

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71 72 73 74

Parmelia perlata L. Paronychia argentea Lam. Pedalium murex Linn. Pergularia daemia Forssk. Phyllanthus fraternus Webster. Phyllanthus niruri L. Pimpinella anisum L. Pinus eldarica Medw. Plantago major L. Pyracantha crenulata Roem. Pyracantha crenulated (Hance) Rehder Raphanus sativus Linn Ricinus communis Linn. Rosmarinus officinalis L. Rotula aquatica Lour. Rubia cordifolia L. Santalum album L. Sesamum indicum L. Sesbania grandiflora L. Solanum Indicum Linn. Solanum surattense Burn. Solanum xanthocarpum Schrad & Wendi. Tamarindus indica Linn. Terminalia arjuna Roxb. Tinospora cordifolia Willd (L.)

Stone Flower, Lichen Algerian tea Dakhi gokhru Pergularia, Dustapuchettu, jittupaku. Nela nelli Stone breaker Anise, Aniseed Goldwater pine, Afgan pine, Tehran pine. Greater plantain, Common plantain Nepalese firethorn

Parmeliaceae Caryophyllaceae Pedaliaceae Asclepiadaceae

Dried lichen Aerial parts Fruits Whole plant

Chitme et al, 2010 [7] Bouanani et al, 2010 [42] Anantha et al, 2011 [43] Vyas et al, 2011 [44] Ghatapanadi et al, 2010 [22] Mirian et al, 2010 [45] Choubey ankur et al, 2010 [13] Hosseinzadeh et al 2010 [46] Sharifa abdul aziz et al, 2005 [47] Yogendr Bahuguna et al, 2009 [48] Yadav et al, 2011 [19] Vargas et al, 1999 [49] Neha sharma et al, 2011 [24] Choubey ankur et al, 2010 [13] Gilhotra Umesh Kr et al 2011 [9] Kalyani Divakar et al, 2010 [50] Choubey ankur et al, 2010 [13] Ghatapanadi et al, 2010 [22] Sujatha doddola et al, 2008 [52] Prachi et al, 2009 [20] Neha sharma et al, 2011 [24] Vina B Patel et al 2010 [52] Satish Kumar et al, 2009 [26] Chaudhary et al, 2010 [53] Ghatapanadi et al, 2010 [22]

75 76 78 79 80 81

Euphorbiaceae Euphorbiaceae Apiaceae Pinaceae Plantaginaceae Rosaceae

Whole plant Whole plant Fruit Fruits Whole plant Fruit

82 83 84 85 86 87 88 89 90 91 92 93 94 95 96

Broad leaf firethorn, chinese firethorn Radish, Rabano negro Arandi, Arand andi, Chian. Rosemary Pashannabedha Common maddar, Indian madder White sandal Ellu Agati Bari kateli Ber kaleli, Neeli kateti Yellow berried nightshade Indian date Arjuna, Arjun tree Amruthaballi

Rosaceae Cruciferae Euphorbiaceae Lamiaceae Boraginaceae Rubiaceae Santalaceae Pedaliaceae Fabaceae Solanaceae Solanaceae solanaceae Fabaceae Combrataceae Menispermeaceae

Leaves Bark Root Leaves Roots Roots Oil Tender leaves Leaf juice Roots Roots Berries Fruit pulp Bark Stems

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97 98

Trachyspermum ammi L. Trianth0ema portulacastrum Linn. Tribulus terrestris L. Tridex procumbens L.

Ajwan seeds, Ajowan, Carom, Bishops weed Saunthi, Lalsubuni, Patharchata, Bishkapra. Gokhuru, Chhota gokhuru Coat buttons, tridax daisey, Gaddi chemanthi. Patta chatta Makki, Makka

Umbelliferae Ficoidae

Seeds Fresh leaf juice

Kaur et al, 2009 [54] Prachi et al, 2009 [20] Satish et al, 2010 [55] Sailaja et al 2011 [56] Neha sharma et al, 2011 [24] Prachi et al, 2009 [20]

99 100

Zygophyllaceae Asteraceae

Fruits, Roots Whole plant

101 102

Tubiflora acaulis L.F Kuntze. Zea mays Linn.

Acanthaceae Poaceae

Leaves Decoction of styles obtained from female inflorecence or immature cells. rhizomes

103

Zingiber officinale Rosc.

Ginger, Sunthi

Zingiberaceae

Prachi et al, 2009 [20]

CONCLUSION The present review conveys information about the treasure trove of medicinal plants with litholytic nature. The use of herbal remedies for prevention and cure of ailments is of increasing interest due to the superiority and efficiency of activity provided by phytoconstituents in herbs and undesirable effects of modern medicine. Evidences prove that herbal therapy is more effective than other available treatments, with lesser side effects, economic nature, no risk of long term fertility and reoccurrence. As there are no satisfactory drugs in modern medicine, herbal remedies are proved to exert their effectiveness at different stages of stone pathophysiology, the plant based therapy is used as adjunct therapy for better relief. Further research is needed to identify active principles from medicinal plants to assess their dosage and quality control, and investigate their

interactions and adverse effects. Many herbs themselves possess inhibitory activity against crystallization. The anti oxidant activity of the herbs also help in preventing the urolithiatic renal cell damage. Although use of herbal medicine is popular from traditional periods because of their potent activity and safety, it is of great importance to carry out further research to understand the pathophisiology of disease, mechanism of action of herbal medicines inorder to develop an efficient and safe litholytic agent. ACKNOWLEDGEMENT Authors are thankful to Chairman Padmasree Dr. Mohan babu for providing all the facilities and to Mr.G. Avinash Kumar Reddy, Assistant Professor, Department of Pharmaccognosy for his gracious support during the work.

REFERENCES 1. Soundararajan P, Mahesh R, Ramesh T, Hazeena Begum V. Effect of Aerva Lanata on calcium oxalate urolithiasis in rats. Indian journal of experimental biology, 44, 2006, 981-986. 2. Rana Gopal Singh, Sanjeev Kumar Behura, Rakesh Kumar. Litholytic Property of Kulattha (Dolichous Biflorus) vs Potassium Citrate in Renal Calculus Disease: A Comparative Study. JAPI, 58, 2010, 287. 3. Kalpana Devi V, Baskar R,Varalakshmi P. Biochemical effects in normal and stone forming rats treated with the ripe kernel juice of Plantain (Musa Paradisiaca). Ancient Science of Life, 3 & 4, 1993, 451 461. 4. Bahuguna YM, Rawat MSM, Juya V, Gnanarajan G. Antilithiatic effect of grains of Eleusine Coracana. Saudi Pharmaceutical Journal, 17, 2009, 182. 5. Surendra K pareta, Kartik Chandra Patra, Ranjit Harwansh. In-vitro calcium oxalate crystallization inhibition by Achyranthes indica Linn. Hydroalcoholic extract: An approach to antilithiasis. International Journal of Pharma and Bio Sciences, 432. 6. Khan NI, Shinge JS, Naikwade NS. Antilithiatic effect of Helianthus Annuus Linn. leaf extract in ethylene glycol and ammonium chloride induced nephrolithiasis. Int J Pharm Pharm Sci, 2, 2010, 181. 7. Havagiray R, Chitme, Shashi Alok, JAIN SK, Monika Sabharwal. Herbal treatment for urinary stones. IJPSR, 1, 2010. 8. Sathyaa M, Kokilavani R , Ananta Teepa KS, Balakrishnan A. Supplementation of ethanolic extract of Acalypha Indica Linn prevents hyperoxaluria in experimental urolithic rats. Journal for Bloomers of Research, 4, 2011. 9. Gilhotra Umesh KR., Christina AJM. Effect of Rotula aquatica Lour. on ethylene-glycol induced urolithiasis in rats . Int. J. Drug Dev. & Res, 3, 2011, 273-280.

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