A Pharmacognostical Study Of Amlavetas (Garcinia pedunculata Roxb.) Fruit And To Evaluate Its Efficacy In Mutrashmari w.s.r. To Urolithiasis.

Ayurveda has great antiquity dates back to about 5,000 years B.C. The Materia Medica of Ayurveda comprises of resources of plant, animal, metal and mineral origin, which have been prescribed in therapeutics. WHO has considered traditional system of medicine, as a part of integrated system of medicine. It is reported that traditional systems of medicines are being used since centuries for healthcare by people in countries of the Asia Region as well as in other parts of the world. In recent times, public interest has increased towards traditional medicines for various concerns. Herbal medicines are valuable source of remedies to the people around the world to secure their health.

Ashmari (Urolithiasis), a disorder of Mootravaha Srotasa1, included in Ashtomahagada2 is affecting mankind since antiquity which is manifested due to lack of Sodhana procedures (purification of toxic materials lodged in body parts) and indulging of Apathykari (unsuitable)foods leading to aggravation of Shlesma Dosha which after mixing with urine3, leads to crystal formation known as Sharkara or Sikta (gravels /concretion) which further grows like a stone. This concept of Ashmari formation is understood on one hand as stagnation theory and on the other hand theory of supersaturation/ crystallization (physio-chemical theory) of urine according to modern medicine4.

The incidence of urolithiasis is increasing globally, with geographic, racial, and gendervariation in its occurrence. Positive family history of stone disease, young age at onset, recurrent urinary tract infections (UTIs), and underlying diseases like renal tubular acidosis (RTA) and hyperparathyroidism are the major risk factors for recurrence. High incidence and recurrence rate add enormous cost and loss of workdays.

It has been reported that 12% of the total population are prone to urinary stones. Of this 12%, 50% of the population are severely affected by renal damage, which even leads to a loss of kidneys5. Males are most commonly affected than females with a male to female ratio of 3:1.6 the peak age of developing calculi is between 30-50 years and recurrence is common.

In modern medicine, diuretics, smooth muscle relaxants and non-invasive, invasive surgical procedures are adopted to manage urolithiasis.7 But all kinds of non-invasive, invasive surgical procedures are expensive, therefore not possible to advise for poor people and it will not checkthe recurrence of stone. The medicines including diuretics, alkalizers etc are used to prevent the frequency of hypercalciuria and hyperoxaluria (few etiological factors of calculi formation) but they are not promising enough due to their limited effectiveness and low tolerability.