Princy Louis Palatty

Ginger in the Prevention of Nausea and Vomiting: A Review

Nausea and vomiting are physiological processes experienced by every human being at some stage of their life. They are complex protective mechanisms and the symptoms are influenced by the emetogenic response and stimuli. However, when these symptoms recur frequently, they can significantly reduce the quality of life and can also be detrimental to health. The existing antiemetic agents are ineffective against certain stimuli, are expensive, and possess side effects. Herbal medicines have been shown to be effective antiemetics, and among the various plants studied, the rhizome of Zingiber officinale, commonly known as ginger, has been used as a broad-spectrum antiemetic in the various traditional systems of medicine for over 2000 years. Various preclinical and clinical studies have shown ginger to possess antiemetic effects against different emetogenic stimuli. However, conflicting reports especially in the prevention of chemotherapy-induced nausea and vomiting and motion sickness prevent us from drawing any firm conclusion. The current review for the first time summarizes the results. An attempt is also made to address the lacunae in these published studies and emphasize aspects that need further investigations for it to be of use in clinics in the future.

Zingiber officinale (Ginger) as an Anti-Emetic in Cancer Chemotherapy: A Review

Despite significant advances and development of novel anti-emetics, nausea and vomiting (emesis) is a major side-effect of cancer chemotherapy. At times, severe nausea and vomiting may also lead to reduction in adherence to the treatment regimen, and this will concomitantly affect the patients survival. The rhizome of Zingiber officinale, commonly known as ginger, is globally an important spice. It has been used for centuries in the Indian, Chinese, Arabic, Tibetan, Unani, and Siddha systems of traditional medicine to treat nausea and vomiting induced by different stimuli. Preclinical studies with experimental animals (dogs and rats) have shown that the various extracts of ginger and the ginger juice possess anti-emetic effects against chemotherapy-induced nausea and vomiting. Gingerol, the active principle, is also shown to possess anti-emetic effects in minks. However, with regard to humans, while most studies have been supportive of the preclinical observations, a few have been contradictory. The exact mechanism responsible for the anti-emetic effects of ginger is unknown; however, the ginger phytochemicals, especially 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol, may function as a 5-hydroxytryptamine (5-HT3) antagonist, NK1 antagonist, antihistaminic, and possess prokinetic effects. The present review for the first time attempts to address the anti-emetic observations and the variability in response of the anti-emetic effects of ginger in cancer chemotherapy. An attempt is also made to address the lacunae in the published studies and emphasize aspects that need further investigations for ginger to be of use in clinics as an anti-emetic agent in the future.

Ocimum Sanctum L (Holy Basil or Tulsi) and Its Phytochemicals in the Prevention and Treatment of Cancer

Ocimum sanctum L. or Ocimum tenuiflorum L, commonly known as the Holy Basil in English or Tulsi in the various Indian languages, is a important medicinal plant in the various traditional and folk systems of medicine in Southeast Asia. Scientific studies have shown it to possess antiinflammatory, analgesic, antipyretic, antidiabetic, hepatoprotective, hypolipidemic, antistress, and immunomodulatory activities. Preclinical studies have also shown that Tulsi and some of its phytochemicals eugenol, rosmarinic acid, apigenin, myretenal, luteolin, β–sitosterol, and carnosic acid prevented chemical-induced skin, liver, oral, and lung cancers and to mediate these effects by increasing the antioxidant activity, altering the gene expressions, inducing apoptosis, and inhibiting angiogenesis and metastasis. The aqueous extract of Tulsi and its flavanoids, orintin, and vicenin are shown to protect mice against γ-radiation-induced sickness and mortality and to selectively protect the normal tissues against the tumoricidal effects of radiation. The other important phytochemicals like eugenol, rosmarinic acid, apigenin, and carnosic acid are also shown to prevent radiation-induced DNA damage. This review summarizes the results related to the chemopreventive and radioprotective properties of Tulsi and also emphasizes aspects that warrant future research to establish its activity and utility in cancer prevention and treatment.

Scientific validation of the ethnomedicinal properties of the Ayurvedic drug Triphala: A review

Triphala, a herbal formula composed of the three fruits of Terminalia chebula Retz. (Haritaki, Family: Combretaceae), Terminalia bellirica Roxb. (Bibhitaki, Family: Combretaceae) and Phyllanthus emblica Linn. or Emblica officinalis Gaertn. (Amalaki or the Indian gooseberry, Family: Euphorbiaceae) is considered to be a universal panacea in the traditional Indian system of medicine the Ayurveda. It has been described in the Ayurveda text as a “Rasayana’ and to rejuvenat the debilitated organs. Ayurvedic physicians use Triphala for many ailments but most importantly to treat various gastrointestinal disorders. Scientific studies carried out in the past two decades have validated many of the ethnomedicinal claims and researches have shown Triphala to possess free radical scavenging, antioxidant, antiinflammatory, antipyretic, analgesic, antibacterial, antimutagenic, wound healing, anticariogenic, antistress, adaptogenic, hypoglycaemic, anticancer, chemoprotective, radioprotective and chemopreventive effects. Clinical studies have also shown that Triphala was found to have good laxative property, to improve appetite and reduce gastric hyperacidity. Studies have also shown that Triphala was effective in preventing dental caries and that this effect was equal to that of chlorhexidine. The current review addresses the validated pharmacological properties of Triphala and also emphasizes on aspects that need further investigation for its future clinic application.

Medicinal Plants as Antiemetics in the Treatment of Cancer: A Review

Chemotherapy- and radiotherapy-induced nausea and vomiting are the most common, intractable and unpleasant side effects in patients undergoing treatment for cancer. 5-Hydroxytryptamine-3 (5-HT3) receptor antagonists plus dexamethasone have significantly improved the control of acute nausea and vomiting, but delayed nausea and vomiting remains a significant clinical problem. Combined neurokinin-1 receptor antagonists with 5-HT3 antagonists and steroids are observed to be better in the control of both acute and delayed emesis. However, the use of these antiemetics is observed to possess inherent side effects. The medicinal plants such as Scutellaria baicalensis, Korean red ginseng, American ginseng berry, Ganoderma lucidum, Zingiber officinale, grape seed extract, and the oil of Mentha spicata are reported to be effective in the treatment of nausea and vomiting mostly in preclinical studies. Of these, ginger has also been evaluated for its efficacy in humans and the results have been contradictory. The current review for the first time summarizes the results related to these properties. An attempt is also made to address the lacunae in these published studies and to emphasize aspects that need further investigations for these plants to be of use in clinics in the future.

Ginger Protects the Liver against the Toxic Effects of Xenobiotic Compounds: Preclinical Observations

According to the World Health Organization, chronic liver disease is a major ailment and causes significant morbidity and mortality in both western and developing countries. However, till date no ideal hepatoprotective agents are available in the modern system of medicine to effective prevent and cure liver ailments. This has necessitated the need to depend on complementary and alternative systems of medicine for liver ailments and diseases. Zingiber officinale Roscoe commonly known as ginger is arguably one of the most commonly used spice, and is an integral part of our diet. In addition to its dietary use, ginger is also reported to possess myriad health benefits, and has been used in the various traditional and folk systems of medicine to treat various ailments and illnesses. Preclinical studies carried out in the past decade have shown that ginger possesses hepatoprotective effects, and to protect against diverse xenobiotic compounds like alcohol, acetaminophen, fungicides, tetracycline, heavy metals and organophosphorus compounds. Mechanistic studies have shown that the protective actions are mediated through free radical scavenging, antioxidant, cytoprotective, and to modulate the levels of the detoxifying enzymes. This review for the first time summarizes the results related to the beneficial properties of ginger in ameliorating the toxic effects of hepatotoxins, and also emphasizes the aspects that warrant future research to establish its activity and utility as a broad spectrum hepatoprotective agent.

Clinical evaluation of Viscum album mother tincture as an antihypertensive: a pilot study.

Viscum album, an infrequently used antihypertensive in homeopathy, is evaluated by 1-group pretest–posttest model in primary hypertension. The drug was administered for 12 weeks at a dosage of 10 drops 3 times a day. Using paired t test, a significant drop in blood pressure (P < .0001) and serum triglyceride (P < .0001) was observed in the treatment group. This dual effect of Viscum album shows promise in optimizing therapy for primary hypertension.

Rasayana Drugs From the Ayurvedic System of Medicine as Possible Radioprotective Agents in Cancer Treatment

The use of ionizing radiation, which is the cornerstone of cancer treatment, is compromised by the radiosensitivity of normal tissues. A chemical that can give selective benefit to the normal cells against the deleterious effects of ionizing radiation has been a long-sought goal. However, most of the compounds studied have shown inadequate clinical application owing to their inherent toxicity, undesirable side effects, and high cost. Studies carried out in the past 2 decades have shown that some of the classical Indian Ayurvedic drugs (Amritaprasham, Ashwagandha Rasayana, Brahma Rasayana, Chyavanprasha, Narasimha Rasayana, and Triphala Churna) possess radioprotective effects. In the current review, an attempt is made to summarize the radioprotective observations of these Ayurvedic drugs and the mechanisms responsible for the radioprotective effects.

Sandalwood Oil and Turmeric-Based Cream Prevents Ionizing Radiation-Induced Dermatitis in Breast Cancer Patients: Clinical Study

Background: The primary objective of this study was to ascertain the benefit of Vicco turmeric Ayurvedic cream (VTC; Vicco Laboratories, Mumbai, India) sandalwood oil and turmeric-based cream in preventing radiodermatitis in women undergoing curative radiotherapy for their breast cancer. Methods and Materials: The study was an investigator-blinded randomized study with Johnsons Baby Oil (JBO; Johnson & Johnson Ltd., Baddi, India) as a comparator, administered daily from the start of radiation therapy for 5 weeks in women receiving breast radiation therapy, 50 Gy in 2 Gy fractions daily for 5 weeks. The endpoints were to ascertain the delay in the appearance and the degree of severity of dermatitis throughout the study period in accordance to the Therapy Oncology Group (RTOG) score. Results: The results indicated that the topical application of VTC delayed and mitigated the radiodermatitis. When compared to the Johnson’s Baby Oil, a significant decrease (p = 0.025) in the incidence of grade 1 was seen at week two, and also in grade 2 and 3 at week 3 (p = 0.003) and week 4 (p = 0.02), respectively, in the VTC cohort. A concomitant decrease in the average severity was also observed at week 2 (p = 0.02), week 3 (p = 0.05) and week 4 (p = 0.03). Conclusions: The results indicate that VTC cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. The result of this study indicates the beneficial effects. Double blind randomized control studies are required to further confirm the beneficial effects of VTC in mitigating radiodermatitis is people undergoing radiation treatment for their cancer.

Review on the Use of Aloe vera (Aloe) in Dermatology

Aloe vera (L.) Burm. f. Aloe barbadensis Miller (Fig. 13.1), family Asphodelaceae, is a important medicinal plant and history suggest that it was used by the natives of ancient Greece, Rome, Babylonia, Arabian countries, Egypt, India, and China. The plant is supposed to be native of North Africa and Spain; however, today the plants are found growing also in Mexico, the Pacific Rim countries, India, South America, Central America, the Caribbean, Australia, and Africa [1–3]. A. vera plants are shrubby or arborescent, perennial, and pea-green in color. They are extremely sensitive to freezing temperatures but grow profusely in the warm tropical areas as the leaves have water storage tissue and this helps them survive in dry areas where rainfall is minimal or erratic [1]. Historical observations indicate that the name Aloe vera, or true Aloe, is probably derived from the Arabic word “alloeh,” Syrian “alwai,” or Hebrew “halal” meaning a “shining bitter substance.” It is commonly called aloe, burn plant, lily of the desert, elephant’s gall [1>–3]. The terminologies in various other languages are enlisted in Table 13.1.