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No paywalls. No subscription cost. Free delivery at 800 locations. Help support independent journalism by donating today. Charleston City Paper MORNING HEADLINES | Gun violence on the nation’s school grounds has seen a notable uptick over the last four years, according to a review of data collected by the K-12 School Shooting Database. According to the report, there were 116 school gun incidents involving brandishing or shooting weapons in 2020, but the numbers jumped dramatically in the years following – from 257 incidents nationally in 2021 to 349 in 2023. So far this year, there have been 326 incidents, the report said. In a different metric across the nation since the beginning of this year, there have been 488 total mass shootings, which included those at schools, according to gunviolencearchive.org. In South Carolina since Nov. 27, 20 people have been shot and killed across the state, including one in Charleston County. Another 15 were hurt in shootings, according to data collected through the City Paper’s weekly Gun Violence Tracker. In The New York Times today, David Riedman, the founder of the K-12 database, said researchers define shootings at schools in many different ways, “but in any one of those measures, the trend line is up.” The uptick in school gun violence re-entered the national conversation this week after the authorities said a 15-year-old student opened fire at a Christian school in Madison, Wis., on Monday, killing another student and a teacher, while injuring six others. And Dec. 14 was the twelfth anniversary of the Newtown, Conn., shooting that killed 20 students and six staffers at Sandy Hook Elementary School. In other headlines: CP NEWS:Combination bar, dog park now open in North Charleston. The Broken Leash opened over the weekend at 8811 Old University Blvd. in North Charleston. The space features two fenced-in areas for dogs to play off-leash, one for dogs under 25 pounds and one for larger dogs. Both areas are supervised by “rufferees” who will make sure everyone’s pooch gets along. The bar, dedicated to customers 21 and older, will serve a range of local craft beers and wines. Fraternities, sororities at S.C. universities cited for hazing students. Five fraternities and sororities at the University of South Carolina and the College of Charleston were punished for hazing this fall, according to the universities’ state-mandated reports. Charleston takes next step to build Johns Island fire station. Construction of a multi-million-dollar fire station on Johns Island is finally moving forward after years of talk as the City of Charleston approved a construction manager at risk contract during Tuesday night’s council meeting. Charleston Waterkeeper uses seeds to repair Lowcountry oyster reef coastlines. Charleston Waterkeeper is participating in the S.C. Department of Natural Resources’ “South Carolina Oyster Recycling and Enhancement” by harvesting marsh grass seeds to ensure healthy oyster reefs continue to exist along the Lowcountry shoreline. Lowes Foods eyes 2025 opening for Maybank Highway location. The KJ’s Market at 3575 Maybank Highway is getting a facelift and upgrade as plans to turn the market into a Lowes Food is expected next year. KJ’s is one of the main food-shopping options on the island with the next-closest supermarket being a Food Lion 3 miles away. Tanger Outlets expands hours for holiday shopping. Tanger Outlets Charleston has extended its hours and is offering daily deals to assist with holiday shopping in the Lowcountry. Help keep the City Paper free. No paywalls. No subscription cost. Free delivery at 800 locations. Help support independent journalism by donating today.
LiveGood, a direct selling company launched just 13 months ago, has already reached the milestone of one million members. Focused on helping people through advanced nutritional supplementation made with results-driven ingredients, LiveGood operates as a membership-based program and differentiates itself through a lower-cost pricing strategy that prioritizes direct membership sales and affiliate marketing. Memberships provide access to wholesale product pricing and are available for $9.95 per month or $99.95 annually with the ability to cancel at any time. The company also offers an affiliate marketing opportunity that customers can leverage to earn money on products they share with others. The company’s growing product portfolio includes a variety of multivitamins and supplementations that target specific needs, like sleep aids, inflammation management, muscle recovery and weight management. All of them are manufactured in the US, have been produced in a cGMP/NSF certified manufacturing facility and were developed under the guide of LiveGood’s Director of Product Development Ryan Goodkin, who holds a doctorate in pharmacy and has a background as a natural health practitioner and pharmacist. “I don’t create products to sell,” Goodkin said. “I create products to use, and for my family to use. There is no way I am going to let my family put something in their body that I don’t trust 100%. That’s why I started LiveGood. I formulated every product. I know exactly what is in them. And I would not go a day without them!” LiveGood’s unique pricing strategy eliminates the “middle man” and instead delivers products directly to the consumer at a lower price point. This approach, which has already attracted one million members and counting, led the company to grow its revenue 3000% in its first full year, from $300,000 in 2022 to $92 million in 2023. Members who are interested in developing a side hustle can utilize the company’s affiliate program to earn additional income by sharing the LiveGood memberships and products without the pressures of having to build or lead a team. “People need nutritional supplements to be healthy,” said Ben Glinsky, LiveGood Founder, who has more than two decades of experience leading successful nutritional supplement companies. “Unfortunately, most people just can’t afford them. On top of that, it’s very difficult for many people to sell expensive products to friends just so a few people at the top of a compensation program can make money. Now, people can get the products they need at prices they can afford, and can be proud to share them with friends.” Breaking global news, emerging trends and powerful stories conveniently curated to help direct selling executives stay informed, engaged and a step ahead.
Payal Kapadia’s remarkable feature debut charts the daily lives of three women in Mumbai in a beautifully shot ode to the city and to the power of human connections More on the best culture of 2024 “Evening is my favourite time of the day,” says a character in All We Imagine As Light, as twilight descends on Mumbai – it’s when the city comes alive. In the film-maker Payal Kapadia’s feature debut, which won the Grand Prix at Cannes, night-time in the city is shown in loving detail, as we see markets, fluorescently lit shops and trains full of women returning from work. Vermeer is famously said to have “painted with light”. The same principle seems to animate every frame of Kapadia’s film, as light delicately bounces around the screen, indicating the film’s interest in illuminating moments of hope as untold secrets lie in the shadows. On two occasions, a phone torch cuts through the dark to reveal words – in a notebook, on a cave wall – professing great love that feels otherwise impossible to say. The film follows Prabha, Anu and Parvaty, who work as nurses and cooks at a hospital. The sensible Prabha (Kani Kusruti) is being courted by a doctor. She likes him, but she’s married. Though she is estranged from her husband, Prabha feels pressured to remain a loyal wife. Her roommate, the free-spirited Anu (Divya Prabha), is secretly seeing a Muslim man, and their love affair is as tender as it is aware of the politics undermining their match. Would her father approve, he asks, “if I used a Hindi name”? The two women are also helping Parvaty (Chhaya Kadam), who is being evicted from her home by developers. A banner across her building shows a city on the march to gentrification: “Class,” it announces, “is a privilege reserved for the privileged!” All three stories are concerned with the ways in which politics shapes individual lives, which is a longstanding interest of Kapadia’s – her first film, A Night of Knowing Nothing, is a documentary exploring the 2015 student protests against Narendra Modi’s appointment of political sympathiser as a university chair (Kapadia was also a leading figure in the protests). In All We Imagine As Light, each woman’s personal circumstances are depicted with humanity and subtlety, and the film also gives a sense that they’re not alone. One night, Prabha talks to Anu about her failed marriage. As she talks wistfully of the past, the camera surveys the tower blocks of Mumbai, with some apartments still dotted with light. Listening to Prabha’s monologue against this wide open vista, one begins to wonder: how many other women are out there with the same thwarted desires, the same pain? At a time when political forces all across the world are performing acts of closure – narrowing our understanding of who we can call neighbours, fellow citizens, lovers – All We Imagine As Light looks out into the world with roving empathy and curiosity, finding in it moments of intimacy and connection, and plenty to love.
Advertisement International Journal of Emergency Medicinevolume 17, Article number: 189 (2024) Cite this article Metrics details Chenopodium album, commonly known as “lambsquarters,” is a plant consumed as food and used in traditional medicine. Its popularity is increasing due to the belief that it has fewer side effects compared to synthetic drugs. However, its use can lead to acute or chronic poisoning. The growing interest in herbal remedies, along with uncontrolled usage and disregard for expert recommendations, contributes to adverse effects. : A 68-year-old female patient presented to the emergency department with nausea, vomiting, and flank pain following the use of lambsquarters. Impaired kidney function was detected in the patient. A biopsy performed after Chenopodium album usage led to the diagnosis of tubulointerstitial nephritis (TIN). The patient responded positively to corticosteroid and hemodialysis treatment. Caution is necessary in the use of herbal medicines and traditional treatments. A thorough evaluation of factors such as patients’ nutritional status, herbal product usage, medication history, and genetic background is crucial. Chenopodium album can cause tubulointerstitial nephritis, resulting in kidney damage. Similarly, heavy metal poisoning through herbal products can lead to kidney damage. Adopting a multidisciplinary approach in the diagnosis and treatment process can contribute to better patient management. This case presents a rare instance of tubulointerstitial nephritis developed due to the use of herbal products. Physicians should inquire about patients’ history of exogenous substance use and conduct a comprehensive assessment, keeping such situations in mind. Conscious use of herbal medicines and traditional treatments can help prevent serious complications like kidney damage. Chenopodium album, also known colloquially as “lambsquarters” (Fig. 1), is a plant widely consumed as food in many cultures and utilized in certain traditional medical practices. This herbal food has been gaining popularity, attributed to the belief that herbal medicines have fewer side effects compared to synthetic drugs [1]. However, its use can significantly contribute to incidents of acute or chronic poisoning. Poison control centers admit over 100,000 patients exposed to toxic plants, with the majority involving minor toxicities related to the ingestion of medicinal plants in small quantities. In most severe poisoning cases, individuals consume a toxic plant either accidentally or with the intention of utilizing its therapeutic properties [2]. In recent years, the increasing interest in herbal remedies, uncontrolled usage of herbal products, and the disregard for recommendations from healthcare professionals prior to use have exacerbated the negative effects associated with these products [3]. An estimated one-third of adults in developed countries and over 80% of the population in many low- and middle-income countries use herbal and traditional medicines to enhance health or treat common illnesses. Herbal medicines can lead to kidney damage due to toxicity, contamination, misidentification, mislabeling, and adverse plant-drug interactions. The kidneys are particularly sensitive to toxic damage due to their high blood flow, extensive endothelial surface area, high metabolic activity, active uptake by tubular cells, medullary interstitial concentration, and low urine pH. Kidney damage can manifest as nephrolithiasis, chronic interstitial fibrosis, uroepithelial cancer, crystalluria, or hypertension, with some plants increasing potassium levels in those with kidney damage. The regulation of herbal and traditional medicines by global health organizations is critical to reduce the risk of acute kidney injury or chronic kidney disease associated with plant consumption. Nephrologists should be aware of potential nephrotoxicity arising from herbal medicines and supplements [4]. Additionally, some studies indicate that patients using alternative medicines may experience complications such as acute kidney injury (AKI) due to heavy metal poisoning. Defining the use of traditional herbal medicines as a source of toxicity can be challenging [5]. Tubulointerstitial nephritis (TIN) is a condition that can lead to chronic kidney disease (CKD), a common cause of kidney damage. TIN progresses to fibrosis in the renal interstitium through immune-mediated inflammation by inflammatory cells. Patients may present with nonspecific symptoms, and delays in the diagnosis and treatment of the disease can occur if not suspected. Etiologically, drugs, infectious agents, toxins, idiopathic causes, genetic factors, inflammatory bowel disease, or systemic inflammatory conditions associated with immunoglobulin G4 (IgG4) may lead to TIN. Clinical suspicion for TIN is necessary for diagnosis and treatment. Treatment depends on the underlying etiology, with corticosteroids forming the cornerstone of therapy [6]. In this case, a patient who used Chenopodium album for weight loss and experienced impaired kidney function was diagnosed with ATIN following a kidney biopsy. The patient benefited from corticosteroid and hemodialysis treatment. A literature review revealed that this is the first reported case of ATIN following the use of Chenopodium album. Coltsfoot (Chenopodium album) is widely used in alternative medicine A 68-year-old female patient presented to the emergency department with complaints of nausea, vomiting, and flank pain. She reported a history of using lambsquarters for weight loss for seven consecutive days two weeks prior. The patient had no chronic diseases except for diabetes mellitus and was taking metformin 500 mg/day. Upon admission, her vital signs were stable (temperature: 36.2 °C, blood pressure: 129/71 mm Hg, respiratory rate: 18/min, pulse rate: 88/min), and physical examination revealed findings such as arthralgia, edema, and rash. Laboratory investigations showed elevated serum blood urea nitrogen (BUN) at 40.4 mg/dL, creatinine at 2.84 mg/dL, and potassium at 6.1 meq/L. The complete urine analysis indicated leukocytes, leukocyte casts, and erythrocytes (Table 1), (Fig. 2). Two months ago, the serum creatinine was 0.82 mg/dL, and a renal ultrasound showed no abnormalities except for a grade 2 increase in bilateral parenchymal echoes. The patient was admitted to the nephrology clinic for further investigation of the etiology of acute kidney failure and initiation of treatment. On the first day of follow-up, despite medical treatment, hemodialysis was initiated due to persistently high potassium levels (Fig. 3). Following hemodialysis, a kidney biopsy was planned, performed, and pathology consultation was sought. The light microscopy of the kidney biopsy, evaluated with four glomeruli, revealed sclerosis in two glomeruli, thickening of the Bowman capsule in one glomerulus, tubular atrophy, interstitial fibrosis, and mononuclear inflammatory cell infiltration with dense eosinophils in the interstitium. Immunofluorescence showed no deposits (Fig. 3). Given the clinical indications of tubulointerstitial nephritis (TIN), corticosteroid therapy at a dose of 80 mg/day was initiated (Fig. 4). The patient’s metformin, used for diabetes, was discontinued, and insulin therapy was initiated. The patient underwent hemodialysis on the 2nd and 4th days of follow-up, continuing the same dose of steroid therapy. On the fifth day, evaluation revealed a decrease in creatinine levels to 2.33 mg/dL and a reduction in nausea and vomiting symptoms (Fig. 4), (Table 1). The temporary hemodialysis catheter was removed after hemodialysis, and steroid therapy continued at a dose of 64 mg/day. On the 11th day of follow-up, with no remaining complaints, the steroid dose was reduced by 16 mg to 48 mg/day. Linagliptin was initiated for diabetes regulation, and the patient was discharged for outpatient follow-up. Upon returning for a checkup five days later, her creatinine levels had returned to baseline at 0.89 mg/dL (Table 1). Steroid dosage was gradually reduced during follow-ups and discontinued over four weeks. Leukocytes, leukocyte casts, and clusters of erythrocytes in urine sediment under the light microscope Renal function and treatment course. HD: Hemodialysis Black arrows indicate crystals in renal tubules, while blue arrows demonstrate hemosiderin accumulation in renal tubule epithelium under light microscopy. (H&E, × 200) We presented in detail a case of AIN that emerged in a patient who consumed Chenopodium album for one week. To the best of our knowledge, this report represents the first such case in the literature. There are many cases of kidney failure in the clinical setting with unexplained etiology. This case emphasizes the importance of careful use of medications, including herbal medicines and traditional treatments. It highlights the necessity for healthcare professionals to obtain a comprehensive history, including factors such as nutritional status, herbal product usage, medication history, and genetic background, to understand the patient’s condition better. Moreover, it underscores the need for further research on the side effects of herbal products. Chenopodium album is known to be consumed in various regions of the world, believed to have protective effects against hepatotoxicity induced by carbon tetrachloride according to animal experiments [7,8,9]. However, there is insufficient research on its side effects, interactions with drugs, and the potential for contamination with heavy metals. AIN is usually confirmed when histological findings such as interstitial inflammation, edema, and tubulitis accompany acute kidney injury (AKI). The etiology of AIN is diverse, with known causes including drugs, various infections, autoimmune or systemic diseases, and idiopathic conditions. Several studies have shown that drugs are the most common etiology of AIN. Furthermore, AIN reported after the intake of herbal medicines has been documented [10]. In our case, the presence of findings such as tubular atrophy, interstitial fibrosis, and mononuclear inflammatory cell infiltration with dense eosinophils in the interstitium led to the diagnosis of AIN (Fig. 3). The pathogenesis of AIN typically involves allergic reactions triggered by exposure to a specific drug. T-cell-mediated hypersensitivity reactions and cytotoxic T-cell injuries play a role in the pathogenesis of AIN [11]. The exact disease mechanism leading to AIN caused by Chenopodium album is not clear based on the current data. Additionally, the kidneys are a sensitive organ to heavy metal poisoning, which can occur due to both acute and chronic exposure. Heavy metals taken into the body can lead to kidney lesions such as acute tubular necrosis, cortical necrosis, and interstitial nephritis. Exposure to heavy metals, both acutely and chronically, can cause tubulointerstitial injuries without any marked morphological changes, and these can manifest within days after exposure to the toxic substance. Heavy metal exposure constitutes a significant yet inadequately understood cause of kidney damage. The pathology findings, including crystals seen in the tubules, suggest this possibility. However, the absence of symptoms commonly observed in heavy metal poisoning cases, such as encephalopathy, seizures, mental status changes, papilledema, ataxia, and abdominal pain, makes this diagnosis challenging [12, 13]. The cornerstone of AIN treatment is discontinuation of the suspected nephrotoxic agent. There is a general consensus that when there is no evidence of improvement in kidney function after 5–7 days following the discontinuation of the suspected toxin, treatment, especially with steroids initiated promptly, may be beneficial. The rationale for this approach is that early corticosteroids may reduce the inflammatory infiltration of the renal interstitium and thereby prevent later fibrosis risk [11, 14]. In our case, a thorough evaluation of history, physical examination, laboratory, and pathological findings led to the initiation of steroid therapy, combined with hemodialysis due to electrolyte disturbances, acidosis, and uremic symptoms, resulting in a positive outcome. In conclusion, we aimed to provide a multidisciplinary perspective on the diagnosis and management of AIN following the use of herbal products through this case. Physicians should inquire about the history of exogenous substance use and conduct a comprehensive assessment, keeping such situations in mind. Conscious use of herbal medicines and traditional treatments can help prevent serious complications like kidney damage. No datasets were generated or analysed during the current study. Çalka Ö, Akdeniz N, Metin A, Behçet L. Phototoxic dermatitis due to Chenopodium album in a mother and son. Contact Dermat. Jul. 2005;53(1):58–60. https://doi.org/10.1111/J.0105-1873.2005.0456E.X. Froberg B, Ibrahim D, Furbee RB. Plant poisoning., Emerg Med Clin North Am, 25, 2, pp. 375–433; abstract ix, May 2007, https://doi.org/10.1016/j.emc.2007.02.013 Jurčić D, et al. Herbalife® associated severe hepatotoxicity in a previously healthy woman. Acta Clin Croat. Dec. 2019;58(4):771–6. https://doi.org/10.20471/ACC.2019.58.04.26. Del Granado RC, Espinosa-Cuevas M. Herbal Nephropathy, Contrib Nephrol, vol. 199, pp. 143–154, Nov. 2021, https://doi.org/10.1159/000517693 Moorthy S, Samuel AE, Moideen F, Peringat J. Interstitial nephritis presenting as acute kidney Injury following ingestion of Alternative Medicine containing lead: a Case Report. Adv J Emerg Med. 2018;3(1):e8. https://doi.org/10.22114/AJEM.V0I0.100. ArticlePubMedPubMed Central Google Scholar Joyce E, Glasner P, Ranganathan S, Swiatecka-Urban A. Tubulointerstitial nephritis: diagnosis, treatment, and monitoring, Pediatr Nephrol, vol. 32, no. 4, pp. 577–587, Apr. 2017, https://doi.org/10.1007/S00467-016-3394-5 Khoobchandani M, Ojeswi BK, Sharma B, Srivastava MM. Chenopodium album prevents progression of cell growth and enhances cell toxicity in human breast cancer cell lines. Oxid Med Cell Longev. 2009;2(3):160–5. https://doi.org/10.4161/OXIM.2.3.8837. ArticlePubMedPubMed Central Google Scholar Chamkhi I, et al. Genetic diversity, antimicrobial, nutritional, and phytochemical properties of Chenopodium album: a comprehensive review. Food Res Int. Apr. 2022;154. https://doi.org/10.1016/J.FOODRES.2022.110979. Hussain S, Asrar M, Rasul A, Sultana S, Saleem U. Chenopodium album extract ameliorates carbon tetrachloride induced hepatotoxicity in rat model. Saudi J Biol Sci. May 2022;29(5):3408–13. https://doi.org/10.1016/J.SJBS.2022.02.014. Krishnan N, Moledina DG, Perazella MA. 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Tubulointerstitial nephritis: diagnosis, treatment, and monitoring, Pediatric Nephrology, vol. 32, no. 4, pp. 577–587, Apr. 2017, https://doi.org/10.1007/s00467-016-3394-5 Download references Not applicable. This study received no financial support. Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey Alparslan Demiray Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey Sevil Demiray & Hülya Akgün Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey Tuğba Yılmaz & İsmail Koçyiğit You can also search for this author in PubMedGoogle Scholar You can also search for this author in PubMedGoogle Scholar You can also search for this author in PubMedGoogle Scholar You can also search for this author in PubMedGoogle Scholar You can also search for this author in PubMedGoogle Scholar Author Contributions: Alparslan Demiray (A.D.): Designed the manuscript, followed the patient, and wrote the article. Tugba Yılmaz (T.Y.): Conducted the literature review and contributed to the writing of the article. Ismail Koçyiğit (İ.K.): Contributed to the conceptualization of the article, patient follow-up, and provided assistance in ensuring the academic strength of the manuscript. Pathological evaluation was performed by Sevil Demiray (S.D.) and Hülya Akgün (H.A.). H.A. conducted the examination of the kidney biopsy, and S.D. made significant contributions to this examination process, contributing significantly to the academic richness of the article. Correspondence to Alparslan Demiray. Ethical approval and participant consent not applicable for this case report. Written informed consent was obtained from the patient for the publication of this case report. The authors declare no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Reprints and permissions Demiray, A., Yılmaz, T., Demiray, S. et al. A case of acute tubulointerstitial nephritis following the use of chenopodium album L. Int J Emerg Med17, 189 (2024). https://doi.org/10.1186/s12245-024-00790-3 Download citation Received: Accepted: Published: DOI: https://doi.org/10.1186/s12245-024-00790-3 Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article.
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