No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Prospective, non-randomised, open-label study of homeopathic Zingiber officinale (ginger) in the treatment of acne vulgaris
Abstract
Background
Zingiber officinale (ginger) has a long history of use in traditional medicine, including homeopathy. Studies carried out so far have validated some of the ethno-medicinal observations.Objective
To determine the effectiveness of homeopathic Z. officinale for the treatment of acne vulgaris and to identify its prescribing indications.MethodsA prospective, non-randomised open-label study was conducted on human participants with acne vulgaris. Homeopathic Z. officinale was prescribed in different potencies (6C up to 1M) over a period of 6 months. Outcomes included changes in lesion counts, Global Acne Grading System (GAGS) score, and Acne-Specific Quality of Life (Acne-QoL) score. Data were analysed using paired t-tests, Wilcoxon signed-rank tests and Pearson's correlation tests.ResultsThirty-two participants enrolled in the study; data for 31 participants were analysed. Statistically significant (P<0.001) changes in lesion counts, GAGS scores and Acne-QoL scores were observed.Conclusion
Homeopathic Z. officinale demonstrates encouraging results in the treatment of facial acne. Further investigation, using a randomised placebo-controlled trial design and a larger sample size is now required to draw firmer conclusions about the effectiveness of this intervention.
... 14 Some clinical studies have been conducted in which different homeopathic medicines were used to determine their effects in the treatment of AV and to verify their clinical indications. [15][16][17] One double-blind, placebo-controlled trial has also been done on a small sample of 30 patients. 18 Recently a clinical case series of homeopathic treatment of acne in 83 patients has been published. ...
... Neither the sample sizes nor the study designs were adequate to yield any clear conclusions. [15][16][17] These studies used specific medicines (clinical homeopathy) in non-randomized, open-label designs. Arctium lappa, 15 Zingiber officinale 16 or Azadirachta indica 17 were used in potencies from 6cH to 1000cH as and when required, over a period of 6 months, producing positive effects in the treatment of acne. ...
... [15][16][17] These studies used specific medicines (clinical homeopathy) in non-randomized, open-label designs. Arctium lappa, 15 Zingiber officinale 16 or Azadirachta indica 17 were used in potencies from 6cH to 1000cH as and when required, over a period of 6 months, producing positive effects in the treatment of acne. All these studies used acne lesion count, GAGS score and acne QoL questionnaire as the outcome measures. ...
Introduction Acne is estimated to affect 9.4% of the global population, making it the 8th most prevalent disease worldwide. Acne vulgaris (AV) is among the diseases that directly affect quality of life. This trial evaluated the efficacy of individualized homeopathic medicines (IHM) against placebo in AV.
Methods In this double-blind, randomized, placebo-controlled trial conducted at the National Institute of Homoeopathy, India, 126 patients suffering from AV were randomized in a 1:1 ratio to receive either IHM (verum) in centesimal potencies or identical-looking placebo (control). The primary outcome measure was the Global Acne Grading System score; secondary outcomes were the Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires — all measured at baseline and 3 months after the intervention. Group differences and effect sizes (Cohen's d) were calculated on the intention-to-treat sample.
Results Overall, improvements were greater in the IHM group than placebo, with small to medium effect sizes after 3 months of intervention; however, the inter-group differences were statistically non-significant. Sulphur (17.5%), Natrum muriaticum (15.1%), Calcarea phosphorica (14.3%), Pulsatilla nigricans (10.3%), and Antimonium crudum (7.1%) were the most frequently prescribed medicines; Pulsatilla nigricans, Tuberculinum bovinum and Natrum muriaticum were the most effective of those used. No harms, unintended effects, homeopathic aggravations or any serious adverse events were reported from either group.
Conclusion There was non-significant direction of effect favoring homeopathy against placebo in the treatment of AV.
Trial Registration: CTRI/2018/11/016248; UTN: U1111–1221–8164.
... 2 The effectiveness of these drugs has not been fully evaluated using measurable parameters. There are few studies wherein some lesser-known drugs like Azadirachta indica, Arctium lappa and Zingiber officinale [7][8][9] have been evaluated. ...
... 13 The five questions relate to feelings of aggression, frustration, interference with social life, avoidance of public changing facilities, and appearance of the skin all over the last month and an indication of how bad the acne is now. The final score ranges from 0 to 15. CADI scores were graded as low (0-4), medium (5)(6)(7)(8)(9), and high (10)(11)(12)(13)(14)(15). High scores indicate a higher level of disability. ...
... Study on A. indica 7 found that it has a role in early and recovery phases of acne when inflammatory changes are least (GAGS from 23 to 20 after 6 mo). Furthermore, another study on A. lappa 8 found positive effects on the inflammatory lesions (GAGS score from 20.3 to 10 after 6 mo) and study on Z. officinale (2014) 9 demonstrates encouraging results in the treatment of facial acne (GAGS score from 20.3 to 10 after 6 mo). In the abovementioned studies, Acne-QoL questionnaire was used to assess QoL. ...
To evaluate the effects of homeopathy on the treatment of acne using
specific outcome measures related to severity and disability.
... However, their recommendation for treatment is limited by lack of large scale studies and evidence about their efficacy and safety profile [7]. Previously few clinical trials have been done in homoeopathy where different medicinal plants were used to determine their usefulness in the treatment of acne vulgaris and to find their indications [8][9][10]. ...
... Comparison with other studies: The outcome measures we used were utilized in earlier homoeopathy trials on acne [8][9][10]. ...
... Published studies have shown the role of homeopathy in the management of acne vulgaris. Three studies using Arctium lappa (n = 34), [9] Azadirachta indica (n = 31), [10] and Zingiber officinale (n = 31) [11] showed statistically significant results in lesion counts, GAG score and Acne-QoL score (P < 0.001). All patients in presented case series came after prolonged conventional treatment without any significant benefit. ...
A BSTRACT
Background
Acne Vulgaris is a multi-factorial chronic inflammatory condition, in relation to sebum production of hair follicles under the action of sex hormones.
Methods
This is a case series of five patients suffering from acne vulgaris were treated with homoeopathy successfully at the Dermatology OPD of DDPRCRI (H), Noida (UP), India. Global Acne Grading Score (GAGS) was used to assess clinical severity of acne. Majority of study population were in the age group of 18 to 40 years.
Results
Face was the commonest site and pustules& cystic were the commonest form of acne at baseline. Three cases were observed to be of moderate and two were severe acne as per GAG Score at baseline. The selection of medicine was done on the basis of homoeopathic individualization, considering location, sensation, modalities (aggravation and amelioration factors) and concomitants of the symptoms in each case.
Conclusion
After treatment all cases were observed to be of mild acne as per GAG Score. Homoeopathic medicines Calcarea Carb, Mercurius Sol, and Natrum Mur were found useful.
... This study concludes that homeopathic Z. officinale demonstrates encouraging results in the treatment of facial acne. 60 The above-mentioned studies showed the pragmatic effect of homoeopathic intervention in the treatment of acne vulgaris; however, no studies have been focused or conducted on the adult acne. ...
Adult acne is defined as a presence of acne beyond the age of 25 years. Two main subtypes can be identified: persistent acne and late-onset acne (beginning after the age of 25 years), which are responsible for 80 and 20% of cases, respectively. Women have a high prevalence and incidence when compared with men. Hyperandrogenism is the main aetiology associated with acne in this age group. Stress-related worsening of acne is a common complaint. Due to the visibility of acne, it is known to have psychosocial impact that can influence person's perceptions regarding their self-appearance, resulting in poor quality of life. Adult acne is often refractory to treatment as older skin presents increased irritancy to topical applications and has potential for bacterial resistance. Treatment failures with antibiotics occur in up to 80% of adult women. Antiandrogens are associated with the risk of feminisation of male foetus, hepatotoxicity, hyperkalaemia etc. Isotretinoin which is given in severe cases is proved to be potent teratogen. In this backdrop, there has been a need for gentle and effective way of treatment, and homoeopathy has the answer. Homoeopathy has a holistic approach having the general acceptance and compliance amongst masses; it has been considered safe in pregnancy and during lactation period. Further, no bacterial resistance develops after prolonged use of homoeopathic medicines. Earlier studies conducted signify the action of homoeopathic medicines in the treatment of adolescent acne with effective results. Not many studies have focused or conducted on the adult acne. This review suggests conducting the future research studies on adult acne through homoeopathic medicine.
... Expert opinion without explicit critical appraisal or based on physiology bench research or "first principles" inflammatory and non-inflammatory lesions while the control group had no significant changes [24]. A report from Miglani et al. showed significant improvement (p < 0.001) in mild-tomoderate acne lesion counts and Global Acne Grading Scale score with the use of Zingiber officinale (ginger) over a period of 6 months [35]. Lim et al. studied Granulysin-derived peptide 20 and found it to be beneficial in treating cystic and pustular acne compared to baseline over 12 weeks (p < 0.05) while concomitantly increasing the severity of comedonal and papular acne [25]. ...
Purpose of Review
To review the current literature regarding complementary and alternative treatment options for acne vulgaris.
Recent Findings
Acne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications.
Summary
Studies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne without significant side effects. Nicotinamide oral and topical preparations demonstrated efficacy in the treatment of moderate inflammatory acne without significant side effects. Oral zinc gluconate was not as effective as oral minocycline in the treatment of inflammatory acne. CAM therapy has relatively few reported side effects for acne vulgaris, and is mildly effective in treatment of inflammatory and comedonal acne. More studies are needed for further comparison of CAM modalities with each other as well as with conventional treatment.
Acne vulgaris is a chronic inflammatory skin condition affecting teenagers, with significant impact on self-esteem. Even in mild form, acne has a detrimental psychological effect on patients. Acne vulgaris affects 85% of adolescents, often starts in preadolescence, and persists into adulthood. In conventional method, topical retinoids and other treatment modalities are available; however, these are fraught with potential side effects and expensive, and therefore an alternative method of treatment is required. A case series of three teenagers with acne vulgaris treated with individualized homoeopathy is presented here. The cases are reported according to the Homeopathic Clinical Case Reports (HOM-CASE) guidelines and followed up with photographic documentation. Severity of disease and its impact on quality of life (QoL) was assessed using the global acne grading system (GAGS) and the Teenager's Quality of Life (T-QoL). The Modified Naranjo Criteria for Homeopathy (MONARCH) inventory was used as a tool for assessing the causal relationship between homeopathic intervention and clinical outcome. All cases of acne vulgaris were successfully treated with individualized homeopathy within 2 months' duration without any complication. Eruptions resolved with decrease in both the GAGS and T-QoL scores. Individual curative response of the homeopathic medicine in each case assessed through MONARCH, demonstrated a positive causal attribution of homeopathy. This case series highlights successful outcomes using individualized homeopathic treatment, showing remarkable improvement of acne vulgaris in teenagers. Hence, this case series could serve as a basis for further research into the role of individualized homeopathic medicine in the treatment of acne vulgaris in teenagers.
Acne is a chronic inflammatory skin disorder that involves the pilosebaceous unit. It is a common universal disease affecting about 85% of teenagers. The disfiguring dermatosis of acne can destroy self-confidence, causing significant emotional distress. Topical and systemic therapies are available as a conventional acne treatment, including comedolytic agents, antibiotics, and various antiinflammatory drugs. Interest in medicinal herbs has been progressively increasing due to antibiotic resistance in acne-causing bacteria, side effects, and sometimes high cost of conventional treatment. This review provides up-to-date evidence on medicinal plants and the phytoconstituents used in acne treatment. The data presented in this review were gathered from several databases, including Pubmed, Wiley Online Library, Elsevier, and Web of Science, using keywords such as; Acne vulgaris, Cutibacterium acnes (formerly Propionibacterium acnes), skin diseases, medicinal plants, active constituents, complementary and alternative medicines. The present manuscript provides an updated review of the most reported active constituents with anti-acne properties. Among these classes were the phenolic compounds, exemplified by anthraquinones, flavonoids, tannins, alkaloids, certain terpenes and oxygenated terpenes present in the essential oils of many medicinal plants.
Homeopathy is a holistic system of integrative medicine that uses highly diluted doses of substances to achieve clinical effects. Despite some evidence for its efficacy, homeopathy remains controversial for many. Homeopathy is one of the commonest forms of complementary and alternative medicine (CAM) for outpatient skin conditions (37.9% of cases), being used by 2.1% of Americans and 27% of Germans. Acne and rosacea are among the commonest disorders treated with CAM. Homeopathic Zingiber officinale, Arctium lappa, Azadirachta indica, Tuberculinum, and Sulphur could be useful treatments for acne and acne scars. Individualized homeopathy using Lycopodium clavatum, Platinum metallicum, and Palladium metallicum may be efficacious acne therapy. Long-standing erythematotelangiectatic and papulopustular rosacea responded to individualized homeopathic therapy in one case study using homeopathic Causticum, Lachesis muta and Lycopodium clavatum.
Background Acne is often treated at homeopathic clinics in India based on existing literature without using any measurable parameters and the outcomes are seldom reported, hence this study.
Objective To evaluate the effects of homeopathy on the treatment of acne using specific outcome measures related to severity and disability.
Methods It is an open, single-arm, non-comparative study undertaken at a clinic located in rural India using individualised homeopathy. Global Acne Grading System (GAGS) scores and Cardiff Acne Disability Index (CADI) scores were analysed at baseline and post medication at 3 and 6 months using one-way repeated measure analysis of variance (ANOVA) in Statistical Package for the Social Sciences (SPSS) version 19 to assess the outcomes of intervention.
Results Eighty-four patients enrolled in the study were analysed under modified intention to treat approach. Nat-m (n = 14), Calc-s (n = 14), Sulph (n = 13), Kali-br (n = 10) and Hep-s (n = 9) were the most frequently used remedies. Significant differences were found in the severity of the disease and quality of life (QoL) from baseline to 6 months in terms of GAGS (mean difference, 15.47; standard error [SE], 0.69; 95% confidence interval [CI], 13.79–17.16; p < 0.001) and CADI (mean difference, 6.94; SE, 0.33; 95% CI, 6.12–7.75; p < 0.001) scores. A one–way repeated measures ANOVA was calculated and significant effects were found for GAGS scores (Wilks's lambda = 0.142; F [2, 82] = 248.50; p < 0.001; effect size = 0.748) and CADI scores (Wilks's lambda = 0.159; F [2, 82] = 217; p < 0.001; η2 = 0.786) at baseline and 3 and 6 months post medication. There was a positive correlation between the GAGS and CADI: r = 0.585, n = 84, p < 0.001.
Conclusions Acne can be effectively treated at homeopathic clinics along with improvement in QoL of patients. Increase in severity of acne was associated with worsening of QoL. Further pragmatic studies with comparative cohort is desirable.
Acne usually appears in adolescent age group, where apart from scarring, it also has psychological effects. The main purpose of undertaking this study was to provide better skin and overall (quality of life) improvement with homoeopathic treatment.This was an open-label, uncontrolled, mono-centric, prospective pragmatic study. Primarily, Quality of Life (QoL), was measured using the Acne-QoL questionnaire. The severity of Acne was measured using global acne grading system (GAGS). A total of 102 patients between 11 to 30 years age, suffering from Acne vulgaris for more than 3 months with mean GAGS score at baseline being 26.47±6.103 and mean Acne-QoL score at baseline being 57.84±2.208 were treated with individualized homoeopathic treatment on the basis of repertorisation and cross-repertorisation. QoL and acne status improved significantly (p<0.0001) after treatment as assessed by Acne-QoL and GAGS respectively.
Background
Homeopathy is gaining popularity globally, despite a lack of convincing evidence of its efficacy. For example, a 2015 review by the Australian National Health and Medical Research Council (NHMRC) found no discernible convincing effects beyond placebo. However, a concern was that publication bias and outcome reporting bias could have influenced the results of the included systematic reviews.
Objectives
To study (i) the rates of non‐publication and (ii) rates and types of alteration of planned outcomes of homeopathy studies registered in ClinicalTrials.gov.
Methods
We searched ClinicalTrials.gov for all homeopathy trials completed more than 2 years ago. We then checked the trial's publication status by examining the publication field in ClinicalTrials.gov, searching PubMed and finally Google Scholar. We also checked whether the registered primary outcome matched the published primary outcome.
Results
We found 35 registered homeopathy trials, from 11 countries, completed at least 2 years ago. Of these 35, we found 16 (46%) publications in MEDLINE and Google Scholar. In four (of 16), the primary outcome measures had been switched or modified.
Conclusions
Of all homeopathy trials registered in ClinicalTrials.gov, only 46% appear to have published within 2 years of completion, of which a quarter altered their primary endpoint. Further research is warranted on the nature and reasons for non‐publication.
Objective
To compare in vitro antioxidant and antimicrobial activities of the essential oil and oleoresin of Zingiber officinale Roscoe.
Methods
The antioxidant activity was evaluated based on the ability of the ginger extracts to scavenge ABTS°+ free radical. The antimicrobial activity was studied by the disc diffusion method and minimal inhibitory concentration was determined by using the agar incorporation method.
Results
Ginger extracts exerted significant antioxidant activity and dose-depend effect. In general, oleoresin showed higher antioxidant activity [IC50=(1.820±0.034) mg/mL] when compared to the essential oil [IC50=(110.14±8.44) mg/mL]. In terms of antimicrobial activity, ginger compounds were more effective against Escherichia coli, Bacillus subtilis and Staphylococcus aureus, and less effective against Bacillus cereus. Aspergillus niger was least, whereas, Penicillium spp. was higher sensitive to the ginger extracts; minimal inhibitory concentrations of the oleoresin and essential oil were 2 mg/mL and 869.2 mg/mL, respectively. Moreover, the studied extracts showed an important antifungal activity against Candida albicans.
Conclusions
The study confirms the wide application of ginger oleoresin and essential oil in the treatment of many bacterial and fungal diseases.
Introduction: Antioxidant activity of the methanol extract of Zingiber officinale was determined by Reducing power assay, Superoxide anion scavenging activity assay, Hydroxyl radical scavenging activity assay, Nitric oxide scavenging activity assay, DPPH free radical scavenging assay, and hydrogen peroxide method. Methods: Preliminary phytochemical screening revealed that the extract of Z. officinale possesses flavonoids, volatile oil and phenolic materials. In the present investigation, quantitative estimation of flavonoids and phenols was carried out by colorimetric methods, using aluminum chloride method and Folin Ciocalteu reagent respectively. Result: The extract showed significant activities in all antioxidant assays compared to the standard antioxidant in a dose dependent manner and remarkable activities to scavenge reactive oxygen species (ROS) may be attributed to the high amount of hydrophilic phenolics. The IC50 values of all parameters were determined while ascorbic acid was used as standard. Conclusion: The results obtained in the present study indicate that Z. officinale extract is a potential source of natural antioxidant.
The Acne-Specific Quality of Life Questionnaire (Acne-QoL) was developed to measure the impact of facial acne across four dimensions of patient quality of life. The main objective of the current study was to evaluate the responsiveness of this instrument. Secondarily, this study provided an opportunity to extend the developer's psychometric validation. The Acne-QoL was utilized in two randomized, double-blind, placebo-controlled studies of the efficacy of Estrostep (norethindrone acetate/ethinyl estradiol) in the treatment of facial acne; a total of 296 Estrostep and 295 placebo patients were evaluated. The Acne-QoL was completed at the beginning, middle (cycle 3), and end (cycle 6) of the 6-month treatment period. The responsiveness of the Acne-QoL was demonstrated through its ability to detect both small (baseline to mid-study) and moderate (baseline to study end) treatment advantages for Estrostep patients. Confirmatory factor analysis supported the subscale structure, and internal consistency estimates were excellent. Convergent and discriminant validity were supported by correlations between Acne-QoL scores and clinical measures that were both in the direction and relative magnitude hypothesized. Finally, item response theory analyses confirmed that each item is highly related to its subscale's latent construct and that each subscale is sensitive across a broad range of the underlying continuum. The results of this evaluation confirm that the Acne-QoL is responsive, internally consistent, and valid.
In traditional medicine the rhizome of ginger was held to possess medicinal properties. The scientific investigations relating to consumption of fresh or powdered rhizome by humans and in vitro effects of aqueous and organic extracts and of volatile oils are reviewed. Pungent components of ginger inhibit cyclooxygenase and lipoxygenase activity in the arachidonic acid metabolic pathway and thereby probably reduce inflammation and relieve pain in rheumatic disorders and migraine headache. Consumption of ginger reduces plasma thromboxane B2 (TXB2) levels in humans. Ginger is reported to reduce nausea vertigo and vomiting for which the mechanism of action is however not yet understood. Effects on the gastrointestinal system include increase in bile secretion and anti-emetic action. An acetone extract of ginger and (6)-shogaol given orally, accelerate gastroinstestinal movement in mice while given i.v. (6)-shogaol inhibits such movement. Galanolactone antagonises 5-HT3 receptors which may explain the anti-emetic and gastrointestinal movement enhancing effects. Zingiberone and(6)-gingerol are reported to protect against gastric mucosal lesions. (6)-Shogaol is known to reduce blood pressure by both a central and a peripheral action. (8)-Gingerol has a cardiotonic action via enhancement of the Ca-ATPase in the sarcoplasmic reticulum. Ginger contains mutagenic (gingerol and shogaol) and anti-mutagenic (zingiberone) compounds. Ginger extract exhibits cytotoxic effects in cultured plant cells but it is not known whether ginger can suppress tumour growth in experimental animals or humans. Some of the chemical compounds from ginger may prove to have anti-inflammatory, anti-emetic, cardiotonic and gastroprotective properties in humans without side effects.
Essential oils are used in skincare products for perfuming and aromatherapy purposes. In this study, the bioactivities of seven essential oils commonly used and claimed for skincare namely citronella grass (Cymbopogon nardus L.), lemongrass (Cymbopogon citratus DC), Kaffir lime (Citrus hystrix DC), holy basil (Ocimum sanctum L.), sweet basil (Ocimum basilicum L.), plai (Zingiber cassumunar Roxb) and ginger (Zingiber officinale Roscoe) were investigated. Investigation of the in vitro susceptibility of the oils against Propionibacterium acnes (P. acnes) using the broth microdilution technique revealed that citronella grass oil exhibited the lowest minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) at 0.005–0.3 and 0.6–1.2 μl/ml, respectively. The MIC and MBC values of lemongrass oil were 0.6 μl/ml and those of kaffir lime oil and holy basil oil were 5 μl/ml. Antioxidant activity using the DPPH free radical scavenging assay showed that the IC50 values of holy basil oil (0.03 μl/ml), plai oil (6.9 μl/ml) and citronella grass oil (2 μl/ml) were lower than that of ascorbic acid (7.9 μl/ml). Anti-inflammatory activity of the oils determined using the 5-lipoxygenase inhibition assay found that IC50 values of holy basil oil (0.04 μl/ml), kaffir lime oil (0.05 μl/ml) and citronella grass oil (0.15 μl/ml) were less than that of nordihydroquaretic acid (1.7 μg/ml). Since P. acnes has a role in the inflammation of acne leading to scar formation, citronella grass oil may help to relieve acne blemishes. However, further investigation in the form of clinical studies would be necessary.
Ginger is known to possess potent antioxidant and anti-inflammatory properties. Therefore, in vivo studies in rats were initiated to investigate if ginger fed through diet can improve their antioxidant status. Inbred male Wistar/NIN rats were divided into four groups containing six animals per group. The 1st group received a stock diet whereas the 2nd, 3rd and 4th groups were fed with a diet incorporating ginger powder at 0.5%, 1% and 5% levels for a period of one month. After one month of feeding, rats were sacrificed and their livers and kidneys collected for the analysis of antioxidant enzymes like superoxide dismutase (SOD), catalase and glutathione peroxidase (GSHPx), and to estimate lipid peroxidation and protein oxidation. The levels of all the three enzymes, which are the important components of antioxidative defenses, were significantly stimulated in the livers of groups fed with ginger. The significant reduction in lipid peroxidation in livers and kidneys and inhibition of protein oxidative products in livers indicated the antioxidant potential of ginger when consumed naturally through diet. The findings reported suggest that regular intake of ginger through diet can protect against oxidative tissue damage.
Most herbs and functional foods have not been scientifically tested; this is especially true for the horse. This paper reviews some of the literature pertinent to herbal supplementation in horses and other species. Common supplements like Echinacea, garlic, ginger, ginseng, and yucca are not regulated, and few studies have investigated safe, efficacious doses. Ginseng has been found to exert an inhibitory effect on pro-inflammatory cytokines and cyclooxygenase-2 expression. Equine studies have tested the anti-inflammatory effects of a single dose of ginger, post-exercise. Echinacea has been reported to have anti-inflammatory and antioxidant properties. Yucca contains steroid-like saponins, which produce anti-inflammatory, antioxidant, and anti-spasmodic effects. However, some herbs have drug-like actions that interact with dietary components and may contain prohibited substances like salicylates, digitalis, heroin, cocaine and marijuana. Horses fed garlic at >0.2 g/kg per day developed Heinz body anaemia. Drug–herb interactions are common and caution needs to be taken when implementing ‘natural product’ usage.
The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update reviews new information about acne pathophysiology and treatment-such as lasers and light therapy-and relevant topics where published data were sparse in 2003 but are now available including combination therapy, revision of acne scarring, and maintenance therapy. The update also includes a new way of looking at acne as a chronic disease, a discussion of the changing role of antibiotics in acne management as a result of concerns about microbial resistance, and factors that affect adherence to acne treatments. Summary statements and recommendations are provided throughout the update along with an indication of the level of evidence that currently supports each finding. As in the original supplement, the authors have based recommendations on published evidence as much as possible.
The essential oil and oleoresins (ethanol, methanol, CCl(4) and isooctane) of Zingiber officinale were extracted respectively by hydrodistillation and Soxhlet methods and subjected to GC-MS analysis. Geranial (25.9%) was the major component in essential oil; eugenol (49.8%) in ethanol oleoresin, while in the other three oleoresins, zingerone was the major component (33.6%, 33.3% and 30.5% for, methanol, CCl(4) and isooctane oleoresins, respectively). The antioxidant activity of essential oil and oleoresins were evaluated against mustard oil by peroxide, anisidine, thiobarbituric acid (TBA), ferric thiocyanate (FTC) and 2,2'-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging methods. They were found to be better antioxidants than butylated hydroxyanisole (BHA). The antimicrobial properties were also studied using various food-borne pathogenic fungal and bacterial species. The essential oil and CCl(4) oleoresin showed 100% zone inhibition against Fusarium moniliforme. For other tested fungi and bacteriae, the essential oil and all oleoresins showed good to moderate inhibitory effects. Though, both essential oil and oleoresins were found to be effective, essential oil was found to be better than the oleoresins.
One of the features of inflammation is increased oxygenation of arachidonic acid which is metabolized by two enzymic pathways--the cyclooxygenase (CO) and the 5-lipoxygenase (5-LO)--leading to the production of prostaglandins and leukotrienes respectively. Amongst the CO products, PGE2 and amongst the 5-LO products, LTB4 are considered important mediators of inflammation. More than 200 potential drugs ranging from non-steroidal anti-inflammatory drugs, corticosteroids, gold salts, disease modifying anti-rheumatic drugs, methotrexate, cyclosporine are being tested. None of the drugs has been found safe; all are known to produce from mild to serious side-effects. Ginger is described in Ayurvedic and Tibb systems of medicine to be useful in inflammation and rheumatism. In all 56 patients (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort) used powdered ginger against their afflictions. Amongst the arthritis patients more than three-quarters experienced, to varying degrees, relief in pain and swelling. All the patients with muscular discomfort experienced relief in pain. None of the patients reported adverse effects during the period of ginger consumption which ranged from 3 months to 2.5 years. It is suggested that at least one of the mechanisms by which ginger shows its ameliorative effects could be related to inhibition of prostaglandin and leukotriene biosynthesis, i.e. it works as a dual inhibitor of eicosanoid biosynthesis.
Aqueous extracts of onion, garlic and ginger inhibited platelet aggregation induced by several aggregation agents, including arachidonate (AA), in a dose-dependent manner. While onion and garlic extracts were found to be weak inhibitors of platelet thromboxane synthesis, ginger extract inhibited the platelet cyclooxygenase products and this effect correlated well with its inhibitory effects on the platelet aggregation induced by the above aggregation agents. These two effects were dose-dependent. Although the three aqueous extracts inhibited the biosynthesis of 6-keto-F1 alpha in rat aortic rings from labelled AA, they did not reduce prostacyclin production from endogenous AA pool in aortic rings. Aqueous ginger extract was extracted into three organic solvents in order of increasing polarity (n-hexane, chloroform, ethyl acetate). An analysis of the n-hexane extract revealed at least three clearly separated TLC bands containing materials that inhibited platelet thromboxane generation simultaneously increasing lipoxygenase products (HETE). The results indicate that if the same were happening in vivo, onion, garlic and ginger could be useful as natural antithrombotic materials.
Eighty-two patients with acne vulgaris were randomised into five groups. Four different Ayurvedic treatment schedules were given orally for 6 weeks, while one group received a placebo. Physical and clinical investigations were carried out at 2 week intervals. A significant reduction in lesion count was observed in patients receiving Sunder Vati when compared with the placebo and the other Ayurvedic formulations, which failed to produce any significant difference from the pretreatment condition. The drug therapies were well tolerated.
Despite widespread use of acne lesion counting, little has been published on its reliability, particularly for multiple raters.
Our purpose was to assess reliability of acne lesion counting with the use of a five-segment facial template.
After training, 12 raters each evaluated 12 patients in randomized order, in the morning and again in the afternoon, and recorded counts for different types of lesions on a five-segment facial template.
Individual raters could reproduce their total lesion counts (reliability estimates, 0.81 to 0.97). Variability between raters was high, and overall reliability estimated across raters was 0.61. For a subgroup of commonly trained raters, overall reliability was higher (0.80).
The reliability of acne lesion counting is excellent when performed by the same trained rater over time. The high variability between raters appears to be reduced by standardized training. Because fewer lesions are counted with less variation, use of a template may have contributed to the high within-rater reliability.
Although psychosocial aspects of skin diseases are well known, disease-specific questionnaires validated for use in clinical trials are not available to assess the impact of facial acne on health-related quality of life or to evaluate therapeutic change. Development of such an instrument was undertaken and included item generation, reduction and pilot-testing phases. By interviewing acne subjects and dermatologists and literature review, 168 possible items were identified. Next, 165 acne subjects identified which items affected them and rated importance on a 5-point scale. Reduction to a brief questionnaire was performed by evaluating patient-perceived importance and factor analysis; four domains were identified (self-perception, role-emotional, role-social, acne symptoms). After pilot-testing for comprehension in acne subjects, further revisions were made to improve clarity and applicability. The resulting instrument takes 10 minutes to complete, and consists of 24 questions assessing how acne affected certain aspects of patients' lives during the past week on a 7-point scale. Thus, an instrument with excellent content validity was developed to assess health-related quality of life in patients with facial acne, and is comprised of statistically meaningful items of importance to patients. Other measurement characteristics are being assessed in a recently initiated study to evaluate test-retest reliability and responsiveness to therapy.
The psychosocial effects of facial acne are well accepted but until recently few validated instruments existed which were suitable for use in clinical trials. The aim of this study was to assess measurement characteristics (reproducibility, correlation with acne severity, and sensitivity to detect change after acne therapy) of a new acne-specific quality of life instrument, the Acne-QoL. We found that the Acne-QoL is reliable, valid and able to distinguish differences across severity groups and improvement over 16 weeks of standard therapy. The use of the Acne-QoL should aid physicians in understanding the impact of facial acne on young adults, and may be useful in assessing therapeutic effects in acne clinical trials.
Plant extracts have been used for centuries as a popular mode of treatment for several health disorders. Over the last ten years, the study of those extracts has attracted attention in different fields of the biological sciences. Ginger, the rhizome of Zingiber officinale Roscoe (Zingiberaceae), is a commom constituent of diet worldwide and it has been reported that its extracts present some pharmacological activities. Here we investigate the effects of the crude hydralcoholic extract of ginger rhizomes on the classical models of rat paw and skin edema. The carrageenan-, compound 48/80- or serotonin-induced rat paw edema were inhibited significantly by the intraperitoneal administration of alcoholic ginger extract. Ginger extract was also effective in inhibiting 48/80-induced rat skin edema at doses of 0.6 and 1.8 mg/site. Rat skin edema induced by substance P or bradikinin was not affected by treatment with Z. officinalle extract. The intraperitoneal administration of ginger extract (186 mg/kg(-1) body wt.) 1 h prior to serotonin injections, reduced significantly the serotonin-induced rat skin edema. Our results demonstrated that crude extract of Zingiber officinale was able to reduce rat paw and skin edema induced by carrageenan, 48/80 compound and serotonin. The antiedematogenic activity seems to be related, at least partially, to an antagonism of the serotonin receptor.
Acne is a ubiquitous affliction that can leave physical and emotional scars that can persist throughout the life of the affected individual. Recent studies have substantiated the psychological impact and support a causal, and at times reciprocal, link between acne and the emotional and functional status of the patient. The present article will examine the recent data substantiating the emotional and functional impact of acne on the affected individual. Criteria to identify high-risk patients are provided. High-risk patients are those at increased risk for psychological and functional impairment or self-injurious behavior.
Disclaimer:
Adherence to these guidelines will not ensure successful treatment in every situation. Furthermore, these guidelines should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific therapy must be made by the physician and the patient in light of all the circumstances presented by the individual patient.
Chemistry, antioxidant and antimicrobial investigations on essential oil and oleoresins of Zingiber officinale
- Singh