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Alhanshali L, Khachemoune A. Clinical dermatologic applications of ginger: a focused review. Int J Dermatol 2024; 63:438-442. [PMID: 38102859 DOI: 10.1111/ijd.16963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/15/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023]
Abstract
Ginger is a traditional herb with medicinal properties. Although most commonly utilized as a spice, it has been used for various medicinal ailments for thousands of years. Over the past century, the anti-inflammatory, antioxidative, and antimicrobial properties of ginger have been increasingly studied. Ginger has been demonstrated to be beneficial for many conditions including dermatologic, gastrointestinal, neoplastic, and respiratory diseases. Herein, we examine the existing literature regarding the clinical uses of ginger with a focus on its dermatologic applications.
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Affiliation(s)
- Lina Alhanshali
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Amor Khachemoune
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
- Department of Dermatology, State University of New York Downstate, Veterans Affairs Medical Center, Brooklyn, NY, USA
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2
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Behboudi-Gandevani S, Bidhendi-Yarandi R, Hossein Panahi M, Mardani A, Prinds C, Vaismoradi M, Glarcher M. Prevalence of preterm birth in Scandinavian countries: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231203843. [PMID: 37843530 PMCID: PMC10683576 DOI: 10.1177/03000605231203843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES As welfare societies, Scandinavian countries share characteristics of equality related to healthcare access, gender, and social services. However, cultural and lifestyle variations create country-specific health differences. This meta-analysis assessed the prevalence of preterm birth (PTB) and its categories in Scandinavian countries. METHODS A systematic search in key databases of literature published between 1990 and 2021 identified studies of the prevalence of PTB and its categories. Following the use of the Freeman-Tukey double arcsine transformation, a meta-analysis of weighted data was performed using the random-effects model and meta-prop method. RESULTS We identified 109 observational studies that involved 86,420,188 live births. The overall pooled prevalence (PP) of PTB was 5.3% (PP = 5.3%, 95% confidence interval [CI] 5.1%, 5.5%). The highest prevalence was in Norway (PP = 6.2%, 95% CI 5.3%, 7.0%), followed by Sweden (PP = 5.3%, 95% CI 5.1%, 5.4%), Denmark (PP = 5.2%, 95% CI 4.9%, 5.3%), and Iceland (PP = 5.0%, 95% CI 4.4%, 5.7%). Finland had the lowest PTB rate (PP = 4.9%, 95% CI 4.7%, 5.1%). CONCLUSIONS The overall PP of PTB was 5.3%, with small variations among countries (4.9%-6.2%). The highest and lowest PPs of PTB were in Norway and Finland, respectively.
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Affiliation(s)
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, School of Social Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Christina Prinds
- Department of Clinical Research, University South Denmark, Odense, Denmark; Department of Women’s Health, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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3
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Im HB, Ghelman R, Portella CFS, Hwang JH, Choi D, Kunwor SK, Moraes SDTDA, Han D. Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil. Front Pharmacol 2023; 14:1268185. [PMID: 37795036 PMCID: PMC10546009 DOI: 10.3389/fphar.2023.1268185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/08/2023] [Indexed: 10/06/2023] Open
Abstract
Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately. Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in São Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0. Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers. Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women's HM use, ultimately promoting safer and more effective healthcare practices.
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Affiliation(s)
- Hyea Bin Im
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
| | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Caio Fábio Schlechta Portella
- Brazilian Academic Consortium for Integrative Health, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jung Hye Hwang
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Dain Choi
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
| | - Sangita Karki Kunwor
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
| | | | - Dongwoon Han
- Department of Global Health and Development, Graduate School, Hanyang University, Seoul, Republic of Korea
- Institute of Health Services Management, Hanyang University, Seoul, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
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Mexican traditional medicines for women's reproductive health. Sci Rep 2023; 13:2807. [PMID: 36797354 PMCID: PMC9935858 DOI: 10.1038/s41598-023-29921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Like China, Mexico has a traditional system of medicine dating back almost 5000 years that incorporates the healing practices of pre-Columbian civilizations, including the Maya and Aztec. Mexican Traditional Medicine (MTM) women depend on MTM practices and herbal medicines for their primary healthcare needs as limited access and high costs of Western medicine is a significant problem. The aims of this work were to determine the medicinal plants more commonly used in MTM for women's reproductive health issues and assess the clinical data supporting their use. Data from multiple sources was compiled and information on plants commonly used by women in Mexico MTM for the treatment of fertility and menstruation issues, pregnancy, and menopause was analyzed. Analysis of the data show that 185 species of plants representing > 60 families were used for a wide range of reproductive health issues. Some of these plants have been used in MTM for fertility regulation in women of which 35 species were used as emmenagogues and abortifacients. Approximate 40 species were used for the symptoms of premenstrual syndrome, heavy menstrual bleeding, and dysmenorrhea. In terms of pregnancy, 35 species were used for postpartum care and to facilitate breastfeeding, 16 species were used as oxytocic agents to induce labor and speed birth, and six plant species were used to prevent miscarriage. Fourteen plant species were reported to treat infertility or promote fertility, and seven species were used to treat uterine prolapse. Three plants species were reported to treat menopause and two plants were used for osteoporosis. Analysis of the clinical data for commonly used medicinal plants showed some clinical support for the use of these plants in MTM. In Mexico, women use medicinal plants for almost every aspect of reproductive health. While some plants have clinical data, most medicinal plants used in MTM have no safety or efficacy data available and could serve as the basis of future investigations.
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Barnes LAJ, Rolfe MI, Barclay L, McCaffery K, Aslani P. Women's reasons for taking complementary medicine products in pregnancy and lactation: Results from a national Australian survey. Complement Ther Clin Pract 2022; 49:101673. [PMID: 36332327 DOI: 10.1016/j.ctcp.2022.101673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 10/05/2022] [Accepted: 10/17/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND and purpose: Pregnant and breastfeeding women commonly use complementary medicine products (CMPs), including dietary supplements and herbal medicines. This study investigated women's reasons for use. MATERIALS AND METHODS A national, cross-sectional, online survey conducted between July-September 2019 investigated reasons for CMP use during pregnancy and lactation. Australian women who were currently pregnant and/or breastfeeding participated. Data analysis included descriptive statistics, Chi-square and principal component analyses. RESULTS Of the 810 women surveyed (n = 354 pregnant; n = 456 breastfeeding), most reported prior CMP use and felt that CMPs had been beneficial to maintaining and optimising their own and their children's health. However, when ill, they preferred medicines prescribed by doctors or pharmacists. Perceived benefits to their unborn or breastfeeding babies' health and their own health (both cohorts), the health of their pregnancy (pregnant participants), and benefits to the breastfeeding process and breastmilk supply (breastfeeding participants) were important reasons for women's CMP use. CONCLUSION Women's reasons for CMP use centred on perceived benefits to their own health and the health of their babies. Women's prior positive experiences with CMP use, combined with preferences for pharmaceutical use when ill, indicates their use of CMPs can be considered complementary, rather than alternative, to biomedical health care.
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Affiliation(s)
- Larisa Ariadne Justine Barnes
- The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Road, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia; University Centre for Rural Health, The University of Sydney, Faculty of Medicine and Health, 61 Uralba Street, Lismore, NSW, 2480, Australia.
| | - Margaret I Rolfe
- University Centre for Rural Health, The University of Sydney, Faculty of Medicine and Health, 61 Uralba Street, Lismore, NSW, 2480, Australia; The University of Sydney, School of Public Health, Edward Ford Building (A27), Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia
| | - Lesley Barclay
- University Centre for Rural Health, The University of Sydney, Faculty of Medicine and Health, 61 Uralba Street, Lismore, NSW, 2480, Australia; The University of Sydney, School of Public Health, Edward Ford Building (A27), Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia
| | - Kirsten McCaffery
- The University of Sydney, School of Public Health, Edward Ford Building (A27), Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Pharmacy & Bank Building (A15), Science Road, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia
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Balarastaghi S, Delirrad M, Jafari A, Majidi M, Sadeghi M, Zare-Zardini H, Karimi G, Ghorani-Azam A. Potential benefits versus hazards of herbal therapy during pregnancy; a systematic review of available literature. Phytother Res 2022; 36:824-841. [PMID: 35023227 DOI: 10.1002/ptr.7363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/03/2021] [Accepted: 12/10/2021] [Indexed: 11/07/2022]
Abstract
The use of herbal medicine has considerably grown worldwide in the past two decades. Studies have shown that the prevalence of herbal diet therapy in pregnancy ranged from 1% to 60% in different societies. Many clinical reports have shown that some herbal medicines may have toxic effects on pregnant women and their fetuses because active ingredients of some medicinal plants can readily pass through the biological barriers (e.g., placental barrier). In the present study, we aimed to systematically review the literature to discover potential benefits versus the hazards of herbal therapy during pregnancy. For this purpose, a comprehensive literature review was performed, and after the literature search and selection of the appropriate documents, the desired data were extracted and reported. From 35 articles with a total of 39,950 study population, the results showed that some medicinal plants could cause severe toxicity on mothers and fetuses, in addition to abortion during pregnancy. It was also shown that some plants may lead to developmental abnormalities or fetal death. Findings of this survey showed that some herbal medicines have toxic, teratogenic, and abortive potential, particularly in the first trimester of pregnancy because active ingredients of some medicinal plants are able to pass through the placental barrier and reach the fetus.
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Affiliation(s)
- Soudabeh Balarastaghi
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Delirrad
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abbas Jafari
- Department of Clinical Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Cellular and Molecular Research Center, Research Institute on Cellular and Molecular Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Majidi
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahmood Sadeghi
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Zare-Zardini
- Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Sciences, Farhangian University, Isfahan, Iran
| | - Gholamreza Karimi
- Pharmaceutical Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adel Ghorani-Azam
- Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Jahan S, Mozumder ZM, Shill DK. Use of herbal medicines during pregnancy in a group of Bangladeshi women. Heliyon 2022; 8:e08854. [PMID: 35128116 PMCID: PMC8810368 DOI: 10.1016/j.heliyon.2022.e08854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/29/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pregnancy-related illnesses are commonly treated by herbal medicines in our country as well as around the world. OBJECTIVES The purpose of this study was to find out how common herbal use is among Bangladeshi pregnant women, what factors influence it, and how it affects pregnancy outcomes. METHODS Random sampling was done among women who gave birth between July and September 2021 in the maternity ward of an NGO-based clinic and were requested to participate in the face-to-face questionnaire-based survey. RESULTS 275 women (71.80%) out of 383 used herbs during their pregnancy. Only 27.42% of women who used herbs informed their doctors, and 91.03% of users reported no side effects. Most users thought that herbs were safer than allopathic medications (71.8%). The ground behind the choosing herb was suggestion from family members or self-medication (34.73% and 31.83%, respectively). Ginger (Zingiber officinale Roscoe) (73.10%), lemon (Citrus limon L. Burm. F) (71.27%), black seed (Nigella sativa) (66.55%), mustard oil (Brassica Juncea Mane Kancor) (65.45%), and prune (Prunus domestica) (41.45%) were the most widely utilized herbs. The majority of women used herbs on a daily basis. There were statistically significant differences in several socio-demographic characteristics and pregnancy outcomes between herb users and non-users. CONCLUSIONS The usage of herbs throughout pregnancy is quite prevalent amid Bangladeshi womenfolk, according to this study. Herbs appear to be safe when used often during pregnancy. Furthermore, physicians or medical practitioners have to play a vital role in ensuring the safe usage of herbs among pregnant women.
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Affiliation(s)
- Sadia Jahan
- Department of Pharmacy, Faculty of Science, Comilla University, Bangladesh
| | | | - Diponkor Kumar Shill
- Department of Pharmacy, Faculty of Science and Engineering, East West University, Bangladesh
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Barnes LAJ, Rolfe MI, Barclay L, McCaffery K, Aslani P. Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey. Health Expect 2021; 25:667-683. [PMID: 34951097 PMCID: PMC8957740 DOI: 10.1111/hex.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample. Aim The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used. Methods A cross‐sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted. Results A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents). Conclusions Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self‐efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, School of Pharmacy and University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Margaret I Rolfe
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Lesley Barclay
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Kirsten McCaffery
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Parisa Aslani
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Laekeman GM, Van Calsteren K, Devlieger R, Sarafanova E, Van Limbeek J, Dierckxsens Y. Ginger (Zingiber officinale) Root Extract During Pregnancy: A Clinical Feasibility Study. PLANTA MEDICA 2021; 87:907-912. [PMID: 33706399 DOI: 10.1055/a-1386-8848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There is almost no experience with concentrated ginger extracts during pregnancy. The purpose of this trial was to include 50 pregnant women in a clinical feasibility study with EXT.GR10, a 10 × concentrated ethanolic extract of ginger root. The primary objective was to detect complications in the mother during pregnancy and malformations or complications in the newborn at delivery. The secondary purpose was to evaluate the satisfaction of the patients. In total, 51 pregnant women were included in this observational study. They could freely use ginger tablets with a maximum of 2 tablets of 50 mg EXT.GR10 a day in case of gastrointestinal discomfort. Tablets were taken by 44 patients. Stillbirth, prematurity, hypertension, and gestational diabetes occurred. There were no serious complications at birth. In the newborn, 4 cases of dysplasia of the hip were seen and 2 minor malformations. There was no relation between events affecting mother and child and the number of EXT.GR10 tablets taken. About ⅔ of patients appreciated the effects of ginger. This is the first clinical study with the EXT.GR10 extract. Based on this feasibility study, a follow-up clinical trial is planned with a fixed minimum of exposure to EXT.GR10 during the first trimester of pregnancy.
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Affiliation(s)
| | | | - Roland Devlieger
- Department of Gynecology and Obstetrics, UZ Gasthuisberg, Belgium
| | | | - Jonice Van Limbeek
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
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Zhang M, Zhao R, Wang D, Wang L, Zhang Q, Wei S, Lu F, Peng W, Wu C. Ginger (Zingiber officinale Rosc.) and its bioactive components are potential resources for health beneficial agents. Phytother Res 2021; 35:711-742. [PMID: 32954562 DOI: 10.1002/ptr.6858] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/17/2020] [Accepted: 08/02/2020] [Indexed: 12/25/2022]
Abstract
Zingiber officinale Rosc. (Zingiberacae), commonly known as ginger, is a perennial and herbaceous plant with long cultivation history. Ginger rhizome is one of the most popular food spices with unique pungent flavor and is prescribed as a well-known traditional Chinese herbal medicine. To date, over 160 constituents, including volatile oil, gingerol analogues, diarylheptanoids, phenylalkanoids, sulfonates, steroids, and monoterpenoid glycosides compounds, have been isolated and identified from ginger. Increasing evidence has revealed that ginger possesses a broad range of biological activities, especially gastrointestinal-protective, anti-cancer, and obesity-preventive effects. In addition, gingerol analogues such as 6-gingerol and 6-shogaol can be rapidly eliminated in the serum and detected as glucuronide and sulfate conjugates. Structural variation would be useful to improve the metabolic characteristics and bioactivities of lead compounds derived from ginger. Furthermore, some clinical trials have indicated that ginger can be consumed for attenuating nausea and vomiting during early pregnancy; however, there is not sufficient data available to rule out its potential toxicity, which should be monitored especially over longer periods. This review provides an up-to-date understanding of the scientific evidence on the development of ginger and its active compounds as health beneficial agents in future clinical trials.
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Affiliation(s)
- Mengmeng Zhang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rong Zhao
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Wang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qing Zhang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shujun Wei
- Basic Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Feng Lu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Peng
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chunjie Wu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Silveira D, Prieto-Garcia JM, Boylan F, Estrada O, Fonseca-Bazzo YM, Jamal CM, Magalhães PO, Pereira EO, Tomczyk M, Heinrich M. COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy? Front Pharmacol 2020; 11:581840. [PMID: 33071794 PMCID: PMC7542597 DOI: 10.3389/fphar.2020.581840] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/28/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. AIMS To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for "respiratory diseases" within the current frame of the COVID-19 pandemic as an adjuvant treatment. METHOD The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. RESULTS A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. CONCLUSIONS Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches.
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Affiliation(s)
- Dâmaris Silveira
- Department of Pharmacy, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Jose Maria Prieto-Garcia
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Fabio Boylan
- School of Pharmacy and Pharmaceutical Sciences and Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Omar Estrada
- Biophysics and Biochemistry Center, Venezuelan Institute of Scientific Research, Caracas, Venezuela
| | | | | | | | - Edson Oliveira Pereira
- Department of Pharmacy, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Michal Tomczyk
- Faculty of Pharmacy, Medical University of Bialystok, Bialystok, Poland
| | - Michael Heinrich
- Pharmacognosy and Phytotherapy, School of Pharmacy, University College of London, London, United Kingdom
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Ceulemans M, Liekens S, Van Calsteren K, Allegaert K, Foulon V. Community pharmacists’ attitudes, barriers, knowledge and counseling practice with regard to preconception, pregnancy and lactation. Res Social Adm Pharm 2020; 16:1192-1200. [DOI: 10.1016/j.sapharm.2019.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/24/2019] [Accepted: 12/09/2019] [Indexed: 11/28/2022]
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13
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Terzioglu Bebitoglu B. Frequently Used Herbal Teas During Pregnancy - Short Update. Medeni Med J 2020; 35:55-61. [PMID: 32733750 PMCID: PMC7384490 DOI: 10.5222/mmj.2020.69851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
The prevalence of herbal medicine use during pregnancy varies depending upon the geographical location and socio-cultural factors. With the belief of "being natural is safe", use of herbs and herbal products has become popular worldwide and used more frequently including period of pregnancy. The potential unwanted effects of any substance is more important during pregnancy period, because cellular development and division of the rapidly growing fetus is vulnerable to these adverse effects. As with medicines, herbal products must at least interact with a component of the organism at the molecular level in order to exert a response. Herbal preparations most commonly used during pregnancy were teas or infusions (hot-water extracts of dried herbs) which usually have the lowest concentrations and contain the least amount of compounds. The purpose of this review is to summarize the herbs that are most commonly used as "herbal teas" during pregnancy and their potential toxic effects to highlight the importance of being cautious about their use.
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Affiliation(s)
- Berna Terzioglu Bebitoglu
- İstanbul Medeniyet University, School of Medicine, Department of Medical Pharmacology, Istanbul, Turkey
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14
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Abstract
Synthesis of pooled data on herbal medicinal products used during and after pregnancy highlights the need for robust safety studies. OBJECTIVE: To report the incidence and nature of herbal medicinal products' adverse events and herb–drug interactions used by some pregnant and postnatal women. DATA SOURCES: The Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, the Cochrane Library, MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov were searched from inception until August 2018. METHODS OF STUDY SELECTION: Any studies reporting adverse events, herb–drug interactions or absence thereof associated with herbal medicinal products used during pregnancy or the postnatal period were included. Conference abstracts, pilot studies, and nonhuman studies were excluded. All included studies were critically appraised by two independent reviewers. TABULATION, INTEGRATION AND RESULTS: Database searches retrieved 3,487 citations. After duplicate removal and review of titles, abstracts, and full-text, 115 articles were critically appraised. After excluding irrelevant and low-quality articles, 74 articles were included for data extraction and synthesis. Adverse drug reactions, congenital malformations, fetal growth retardation or herb–drug interactions were the primary study objective reported by 19 of the 74 included studies, 16 cohort studies, one cross-sectional survey, and two randomized controlled trials. A total of 47 herbal medicinal products and 1,067,071 women were included in this review. Use of almond oil was associated with preterm birth (odds ratio 2.09, 95% CI 1.07–4.08), oral raspberry leaf was associated with cesarean delivery (adjusted odds ratio [AOR] 3.47, 95% CI 1.45–8.28); heavy licorice use was associated with early preterm birth by 3.07-fold (95% CI 1.17–8.05). African herbal medicine mwanaphepo was associated with maternal morbidity (AOR 1.28; 95% CI 1.09–1.50), and neonatal death or morbidity. Fourteen studies reported absence of adverse events. Four studies reported herb–drug interactions, but none studied adverse events arising from them. CONCLUSION: The use of herbal medicinal products during pregnancy and the postnatal period should be discouraged until robust evidence of safety is available. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42017081058.
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15
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Anh NH, Kim SJ, Long NP, Min JE, Yoon YC, Lee EG, Kim M, Kim TJ, Yang YY, Son EY, Yoon SJ, Diem NC, Kim HM, Kwon SW. Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials. Nutrients 2020; 12:E157. [PMID: 31935866 PMCID: PMC7019938 DOI: 10.3390/nu12010157] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 02/07/2023] Open
Abstract
Clinical applications of ginger with an expectation of clinical benefits are receiving significant attention. This systematic review aims to provide a comprehensive discussion in terms of the clinical effects of ginger in all reported areas. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline, randomized controlled trials on the effects of ginger were investigated. Accordingly, 109 eligible papers were fully extracted in terms of study design, population characteristics, evaluation systems, adverse effects, and main outcomes. The reporting quality of the included studies was assessed based on the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials and integrated together with studies that investigated the same subjects. The included studies that examined the improvement of nausea and vomiting in pregnancy, inflammation, metabolic syndromes, digestive function, and colorectal cancer's markers were consistently supported, whereas other expected functions were relatively controversial. Nevertheless, only 43 clinical trials (39.4%) met the criterion of having a 'high quality of evidence.' In addition to the quality assessment result, small populations and unstandardized evaluation systems were the observed shortcomings in ginger clinical trials. Further studies with adequate designs are warranted to validate the reported clinical functions of ginger.
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Affiliation(s)
- Nguyen Hoang Anh
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Sun Jo Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Nguyen Phuoc Long
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Jung Eun Min
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Young Cheol Yoon
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Eun Goo Lee
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Mina Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Tae Joon Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Yoon Young Yang
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Eui Young Son
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Sang Jun Yoon
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Nguyen Co Diem
- School of Medicine, Vietnam National University, Ho Chi Minh City 70000, Vietnam;
| | - Hyung Min Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
| | - Sung Won Kwon
- College of Pharmacy, Seoul National University, Seoul 08826, Korea; (N.H.A.); (S.J.K.); (N.P.L.); (J.E.M.); (Y.C.Y.); (E.G.L.); (M.K.); (T.J.K.); (Y.Y.Y.); (E.Y.S.); (S.J.Y.); (H.M.K.)
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16
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Niazi A, Rahimi VB, Hatami H, Shirazinia R, Esmailzadeh-Dizaji R, Askari N, Askari VR. Effective Medicinal Plants in the Treatment of the Cyclic Mastalgia (Breast Pain): A Review. J Pharmacopuncture 2019; 22:131-139. [PMID: 31673442 PMCID: PMC6820470 DOI: 10.3831/kpi.2019.22.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/15/2019] [Accepted: 05/31/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Mastalgia is the most common benign breast disorder during the fertility period of women. So far a wide range of natural or complementary medicines is used to cure mastalgia. Sanitary organizations need complete and suitable details to help women, for making the proper decision for alternative treatment based on the evidence. The aim of the present study is to introduce medicinal plant-based treatments about mastalgia and summarizes clinical trials about this disorder. Method The articles were provided using mixture of keywords including cyclic pain, breast, treatment, therapeutics, therapy, clinical trial, herbal, drug, mastalgia and all the probable terms, in national and international databases SID, Iran Medex, Magiran, PubMed, Scopus, Medline, Science direct and Cochrane library, in both Persian and English languages. All cross-sectional and review articles about herbal treatment of mastalgia until 2018 November were studied. Results Nineteen articles from all of the available articles (45 cases) and a sample size about of (1987 cases) were included in our study. The articles were clinical trials. The results revealed that mastalgia could be healed by Nigella sativa, Vitex agnus-castus, curcumin, Hypericum perforatum, Citrus sinensis, wheat germ, and Ginkgo biloba. Conclusion Most of the evaluated medicinal plants possessing antioxidant compounds with anti-inflammatory and analgesic properties, exhibited healing effects in the treatment of mastalgia. Thus, medicinal plants can be considered in the treatment of mastalgia; however, further investigations are needed to obtain more details about their probable side effects.
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Affiliation(s)
- Azin Niazi
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vafa Baradaran Rahimi
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Hatami
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Shirazinia
- Basic Science Department, Veterinary Medicine Faculty, University of Zabol, Zabol, Iran
| | | | - Nafiseh Askari
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Vahid Reza Askari
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Kam PC, Barnett DW, Douglas ID. Herbal medicines and pregnancy: A narrative review and anaesthetic considerations. Anaesth Intensive Care 2019; 47:226-234. [PMID: 31124378 DOI: 10.1177/0310057x19845786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The use of herbal medicines by pregnant women varies among different countries, ranging from 4.3% in Sweden to 69% in Russia. The aim of this narrative review is to evaluate the benefits and safety of common herbal medicines used during pregnancy. A systematic literature search (from 1995 to February 2018) was performed using a variety of electronic databases. The levels of evidence of the clinical studies were graded using the Oxford Centre for Evidence-Based Medicine levels of evidence guidelines. From the 736 articles retrieved, 69 articles were used for this review. Ginger has been investigated extensively and has been consistently found to decrease nausea and vomiting associated with pregnancy (Level 2). There is insufficient evidence concerning the efficacy of other herbal medicines such as garlic, cranberry and raspberry in pregnancy (Level 3–4). Much of the literature is based on case reports with limited pharmacodynamic/kinetic studies. There are no clear data on the adverse herb–drug interactions during anaesthesia. As the risks of these interactions are unknown, it would be prudent for anaesthetists to explicitly ask their patients about their use of herbal medicines before surgery and prior to labour and birth. The European Society of Anaesthesiology and American Society of Anesthesiologists recommend that patients cease taking herbal medicines two weeks before surgery.
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Affiliation(s)
- Peter Ca Kam
- 1 Discipline of Anaesthetics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Denise Wy Barnett
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Ian D Douglas
- 2 Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
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18
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Abstract
Ginger in its many forms, from juices of the fresh rhizome, to ginger powder and ginger essential oil, is growing in popularity for claimed universal health benefits. Nevertheless, and contrarily to the common notion of the public, ginger is not devoid of side effects, especially interactions with other drugs, and many of the claimed benefits remain to be substantiated. This work presents a comprehensive revision of the current state of the art on ginger pharmacokinetics and bioavailability, interaction with active pharmaceutical ingredients, raising awareness of the risks of uncontrolled ginger consumption. A second section of the work described the verified actions of various extracts of ginger, or of their main active ingredients, gingerols, based mainly on data obtained from controlled clinical trials. Finally, the last section is devoted to innovative technological solutions to improve the bioavailability of gingerols and ginger extracts that are expected to ultimately lead to the development of more consumer-compliant products.
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19
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Alshathly MR. Efficacy of Ginger ( Zingiber officinale) in Ameliorating Streptozotocin-Induced Diabetic Liver Injury in Rats: Histological and Biochemical Studies. J Microsc Ultrastruct 2019; 7:91-101. [PMID: 31293891 PMCID: PMC6585475 DOI: 10.4103/jmau.jmau_16_19] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Ginger (Zingiber officinale) was reported to have an antioxidant, antidiabetic effect. This study was done to investigate its therapeutic effect against functional and structural alteration in liver of diabetic rat (intraperitoneal streptozotocin (STZ) in a dose of 60 mg/kg/bw). Thirty adult male rats (three-months-old and 250 g weight) were sorted into five groups (N=6). G1 used as control, G2 was diabetic rats without any treatment, G3 was diabetic rats given oral ginger in a dose of 500 mg/kg/bw, G4 was diabetic rats treated with metformin (500 mg/kg/bw) while G5 received ginger orally. The experiment lasts for six weeks, animals were anesthetized by ether, body weight was recorded for all animals. Blood was collected for further analysis of lipid profile, liver enzymes and total antioxidant. Liver was dissected, weighted and samples were processed for histopathological study. The results showed significant decrease of glaucous level and liver enzymes in ginger treated rats. Total antioxidant was preserved. Ginger lowered blood glucose, level, regained body weight and liver index to near normal values. Diabetes induced degenerative changes and micro-vesicular lipid deposition in hepatocytes with moderate portal area fibrosis. Ultrastructure study confirmed such changes beside demonstrating increased lipid deposition in fat storing cells. Ginger was found to ameliorate those changes in treated animals. Results were matching metformin effects. In conclusion, Ginger as a natural safe Herbal medication can be used to support liver functions in diabetic status.
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Affiliation(s)
- Mona R. Alshathly
- Department of Biological Sciences, Faculty of Science, Northern Border University, Arar, Saudi Arabia
- Department of Biology, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
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20
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Volqvartz T, Vestergaard AL, Aagaard SK, Andreasen MF, Lesnikova I, Uldbjerg N, Larsen A, Bor P. Use of alternative medicine, ginger and licorice among Danish pregnant women - a prospective cohort study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:5. [PMID: 30611269 PMCID: PMC6320632 DOI: 10.1186/s12906-018-2419-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/19/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of alternative medicines and dietary supplements is constantly changing, as are dietary habits. One example of this phenomenon is the current popularity of ginger products as an everyday health boost. Ginger and licorice has also been shown to ameliorate nausea a common complaint in early pregnancy. Alternative medicines are often regarded as safe. However, they might affect fetal development, such as through alterations of hormone metabolism and cytochrome P450 function. Health care professionals may be unaware of the supplementation habits of pregnant women, which may allow adverse exposures to go unnoticed, especially if the rates of use in pregnancy are not known. We therefore investigated the use of alternative medicines and licorice among pregnant Danish women. METHODS A total of 225 pregnant women were included in a prospective cohort when attending the national prenatal screening program at gestational weeks 10-16. Participants were asked to complete a questionnaire regarding their socio-economic status and lifestyle habits, including their intake of alternative medicine and licorice. RESULTS We found that 22.7% of women reported taking alternative medicines, with 14.7% reporting daily consumption. Ginger supplements were consumed by 11.1%, mainly as health boost and 87.1% reported consumption of licorice. Regular or daily licorice consumption was reported by 38.2 and 7.1%, respectively. Notably, the use of licorice was reflected by an increase in blood pressure of the pregnant women. CONCLUSIONS The use of licorice and alternative medicines appears to be common in pregnant Danish women, supporting the need for further investigations into the safety of alternative medicine use during pregnancy and the importance of up-to-date personalized counseling regarding popular health trends and lifestyle habits.
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Affiliation(s)
- Tabia Volqvartz
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
| | - Anna Louise Vestergaard
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
| | - Sissel Kramer Aagaard
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
| | - Mette Findal Andreasen
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Iana Lesnikova
- Department of Pathology, Vidant Medical Center, Greenville, North Carolina USA
| | - Niels Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Agnete Larsen
- Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark
| | - Pinar Bor
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
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21
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Nikkhah Bodagh M, Maleki I, Hekmatdoost A. Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food Sci Nutr 2019; 7:96-108. [PMID: 30680163 PMCID: PMC6341159 DOI: 10.1002/fsn3.807] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 01/10/2023] Open
Abstract
Ginger, the rhizome of Zingiber officinale, which is used as a spice globally has a long history of medicinal use that stimulates investigators to assess its potential roles as an adjuvant therapy or alternative medicine in a range of diseases. Anti-inflammatory, antioxidant, antitumor, and antiulcer effects of ginger have been proven in many scientific studies, and some of the ancient applications of ginger as a home remedy has been confirmed in human. In this review, we summarized the current evidence on the effects of ginger consumption on gastrointestinal disorders based on clinical trials. Our data indicate that divided lower daily dosage of 1500 mg ginger is beneficial for nausea relief. Because of limited number of studies on some other gastrointestinal disorders, the results may not be as much powered as to find significant results. Therefore, more extensive and well-controlled human studies of ginger or its standard extracts are required to demonstrate its efficacy as a gastroprotective agent. Dose-finding studies should be undertaken to accurately determine the effective dose and preparation of ginger in further clinical trials protocol.
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Affiliation(s)
- Mehrnaz Nikkhah Bodagh
- Student Research CommitteeFaculty of Nutrition and Food TechnologyShahid Beheshti University of Medical SciencesTehranIran
| | - Iradj Maleki
- Gut and Liver Research CenterMazandaran University of Medical SciencesSariIran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and DieteticsFaculty of Nutrition Sciences and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical SciencesTehranIran
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22
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Mohammed OJ, Pratten MK. Micromass Methods for the Evaluation of Developmental Toxicants. Methods Mol Biol 2019; 1965:49-72. [PMID: 31069668 DOI: 10.1007/978-1-4939-9182-2_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Chick embryonic heart has recently been utilized as a model to create a micromass (MM) culturing system. The aim was to overcome the ethical barriers arising from testing the embryotoxicity of chemicals using human embryonic cells. The system represents a valuable tool to study the ability of chemicals to interfere with various embryonic developmental processes such as cellular communication, differentiation, cellular activity, and proliferation, where the disturbance any of them could result in maldevelopment. The system can also be utilized to investigate ROS production and expression of several transmembrane proteins to study their roles in chemical-induced teratogenicity or embryotoxicity.
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Affiliation(s)
- Omar J Mohammed
- School of Life Sciences, Faculty of Medicine and Health Sciences, Medical School, QMC, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Margaret K Pratten
- School of Life Sciences, Faculty of Medicine and Health Sciences, Medical School, QMC, University of Nottingham, Nottingham, NG7 2UH, UK.
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23
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Combining and Using the Utrecht Method and the Analytic Hierarchy Process to Facilitate Professional and Ethical Deliberation and Decision Making in Complementary and Alternative Medicine: A Case Study among a Panel of Stakeholders. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:2315938. [PMID: 30671126 PMCID: PMC6323446 DOI: 10.1155/2018/2315938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/14/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022]
Abstract
Background In daily practice, healthcare practitioners face many challenges in ethical and professional decision making. Currently, little is known on the ethical and professional deliberations and weighing benefits against risks in daily complementary and alternative medicine (CAM) practice. The aim of this study was to combine the Utrecht method and the Analytic Hierarchy Process (AHP) in deliberations, weighing benefits against risks of using ginger for a pregnant woman suffering nausea and vomiting of pregnancy (NVP) along with other comorbidities. Methods A hypothetical case was constructed using the twelve tips for constructing dilemma case-based assessment. Three CAM practitioners, two physicians, three pharmacists, and two patients were recruited, and the Utrecht and the AHP methods were combined and used to deliberate and weigh benefits against risks of using ginger for the presented case. Results Responses from the ten panelists were obtained. Priority ratings showed significantly higher scores (p-value < 0.001) for alleviating symptoms of NVP (30.7% ± 16.6%) compared to other potential benefits. Increasing the risk of bleeding was given significantly higher (p-value < 0.0001) weight scores (24.7% ± 13.5%) than other potential side effects. Potential risk of spontaneous abortion and risk of impairment of fetal development were given higher (p-value < 0.001) weight scores than risk of fetal hypoglycemia. When benefits were compared against side effects and risks to the fetus and pregnancy, potential benefits were given higher (p-value < 0.001) weight scores (72.3% ± 5.2%). Conclusions Considering the anticipated benefits and risks, a shared decision was made to use ginger in the case presented. The woman should also be informed of the potential side effects and risks of using ginger. The use of this combined method might promote openness and transparency in making shared decisions for healthcare providers and patients.
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Ahmed SM, Nordeng H, Sundby J, Aragaw YA, de Boer HJ. The use of medicinal plants by pregnant women in Africa: A systematic review. JOURNAL OF ETHNOPHARMACOLOGY 2018; 224:297-313. [PMID: 29842963 DOI: 10.1016/j.jep.2018.05.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Medicinal plant (MP) use during pregnancy is common in Africa and may have profound effects on both the mother and the developing foetus. A lack of overview complicates monitoring and regulating the use of MPs during pregnancy. AIM OF THE STUDY This systematic review analyses prevalence of use of MPs during pregnancy, regional distribution, types and prevalence, MP properties, potential health risks, and consensus of MPs use, and suggests relevant measures to mitigate negative effects on pregnancy. MATERIALS AND METHODS A search was undertaken using a range of scientific databases (Medline, Embase, African Journals OnLine, Google Scholar and Biological Abstracts), non-governmental organisations, various African universities and regulatory websites for original published and unpublished studies that assess and indicate the prevalence of use of MPs during pregnancy in Africa. Additional articles were located by exploring pertinent bibliographies, and contacting experts. RESULTS A total of 3659 MP-use studies were found, but only 303 articles received full-text assessment for eligibility and finally only 50 scientific papers were eligible for the systematic review. The prevalence of MP use by pregnant women varied widely from 2% to 100%. Twenty-eight studies (56%) specified one or more plant species used as MP during pregnancy. The major reasons for MP use were relief of nausea and vomiting during pregnancy (NVP), stimulation of labour, and facilitation of childbirth. The most commonly cited MP species were Zingiber officinale Roscoe, Allium sativum L. and Cucurbita pepo L. and these were used for relief of NVP, motion sickness and as a nutritional supplement. Route of administration was most commonly oral, and few adverse effects were reported. CONCLUSIONS The use of MPs among pregnant women in Africa is prevalent, and the most commonly used plant species are not known to have harmful foetal effects during pregnancy. However, many of the MP species are poorly studied and teratogenic effects cannot be ruled out. Collaboration between healthcare providers and traditional practitioners to inform about the safe use of MPs may promote safer pregnancies and better health for mothers and infants.
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Affiliation(s)
- Seid Mussa Ahmed
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Norway.
| | - Johanne Sundby
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Yesuf Ahmed Aragaw
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, Jimma Institute of Health, Jimma University, Ethiopia.
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Jambo A, Mengistu G, Sisay M, Amare F, Edessa D. Self-Medication and Contributing Factors Among Pregnant Women Attending Antenatal Care at Public Hospitals of Harar Town, Ethiopia. Front Pharmacol 2018; 9:1063. [PMID: 30337871 PMCID: PMC6178140 DOI: 10.3389/fphar.2018.01063] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/03/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Self-medication has been increasing in many developing and developed countries. Its use during pregnancy presents a major challenge due to potential undesirable effects on mother and the fetus. So the aim of this study was to assess the prevalence of self-medication and contributing factors, among pregnant women. Methodology: Institution based cross sectional study was conducted among 244 pregnant women attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal Hospital from February to March, 2017. A structured questionnaire based interview was used to collect data from each study subject. Then, data were categorized and analyzed using SPSS version 20 software. Logistic regression analysis was used to determine the significance of the association between the outcome and independent variables. P-value <0.05 was considered as a statistically significant in multivariate analysis. Results: The prevalence of self-medication during current pregnancy was 69.4%; out of which, 40.6% uses only herbal medicines to self-medicate. Time saving (50.7%) and prior experience of the drug (25.35%) were the main reasons for self-medication using conventional medicines while fewer side effects (59.86%) and effectiveness (35.92%) were the common reasons for self-medication using herbal medicines. Common cold and headache were among the common indications for self-medication. Friends (28.17%) and the pharmacist/druggist (23.94%) were the commonest source of information for conventional medicines while family/friends (69.72%) and neighbors (26.76%) were the common source of information for herbal medicines. Community drug retail outlets and neighbors were the commonly used sources of conventional medicines; while market place and self-preparation were the common sources of herbal medicines. Previous history of self-medication was significantly associated (P < 0.05) with current self-medication with conventional drugs and being a farmer by occupation and poor monthly income were significantly associated with herbal medicine use during pregnancy (P < 0.05). Conclusion: The prevalence of self-medication during pregnancy was very high in this study which showed a need for public trainings for all women of reproductive age about the risks of inappropriate self-medication.
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Affiliation(s)
- Abera Jambo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Getnet Mengistu
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mekonnen Sisay
- Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firehiwot Amare
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dumessa Edessa
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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S. Abd El-Aziz G, N. Mustafa H, Abdulraouf Saleh H, M.O. El-Fark2 M. Zingiber Officinale Alleviates Maternal and Fetal Hepatorenal Toxicity Induced by Prenatal Cadmium. ACTA ACUST UNITED AC 2018. [DOI: 10.13005/bpj/1500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was designed to address the protective effects of Zingiber officinale on the toxic outcomes of prenatal Cadmium administration on pregnancy outcome. Pregnant female Sprague-Dawley rats were randomly divided into four groups (eight rats/each), control group received distilled water, 2nd group treated with 8.8 mg of CdCl2/kg b. wt, 3rd group treated with 250 mg of Zingiber officinale/kg b. wt, and 4th group treated with 250 mg of Zingiber officinale/kg b. wt, followed by 8.8 mg of CdCl2/kg b.wt. Daily body weight of pregnant was recorded from GD1-GD20, and then pregnant rats were sacrificed at GD20. Samples of maternal and fetal livers and kidneys were processed for histological examination. Administration of Cd to pregnant rats showed adverse effects on pregnant mothers and their fetuses; reduced maternal weight gain, reduced absolute organ weights, reduced fetal growth parameters and placental weights together with altered histological appearance of the maternal and fetal livers and kidneys. While co-administration of Zingiber officinale showed an improvement of these toxic alterations. Zingiber officinale through its antioxidant activity could be beneficial against toxic outcomes of Cd exposure during pregnancy.
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Affiliation(s)
- Gamal S. Abd El-Aziz
- Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hesham N. Mustafa
- Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hamid Abdulraouf Saleh
- Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Magdy M.O. El-Fark2
- Department of Anatomy, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Stanisiere J, Mousset PY, Lafay S. How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy? Foods 2018; 7:foods7040050. [PMID: 29614764 PMCID: PMC5920415 DOI: 10.3390/foods7040050] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 01/23/2023] Open
Abstract
Ginger, Zingiber officinale Roscoe, is increasingly consumed as a food or in food supplements. It is also recognized as a popular nonpharmacological treatment for nausea and vomiting of pregnancy (NVP). However, its consumption is not recommended by all countries for pregnant women. Study results are heterogeneous and conclusions are not persuasive enough to permit heath care professionals to recommend ginger safely. Some drugs are also contraindicated, leaving pregnant women with NVP with few solutions. We conducted a review to assess effectiveness and safety of ginger consumption during early pregnancy. Systematic literature searches were conducted on Medline (via Pubmed) until the end of December 2017. For the evaluation of efficacy, only double-blind, randomized, controlled trials were included. For the evaluation of the safety, controlled, uncontrolled, and pre-clinical studies were included in the review. Concerning toxicity, none can be extrapolated to humans from in vitro results. In vivo studies do not identify any major toxicities. Concerning efficacy and safety, a total of 15 studies and 3 prospective clinical studies have been studied. For 1 g of fresh ginger root per day for four days, results show a significant decrease in nausea and vomiting and no risk for the mother or her future baby. The available evidence suggests that ginger is a safe and effective treatment for NVP. However, beyond the ginger quantity needed to be effective, ginger quality is important from the perspective of safety.
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Complementary medicines in pregnancy: recommendations and information sources of healthcare professionals in Australia. Int J Clin Pharm 2018; 40:421-427. [DOI: 10.1007/s11096-018-0608-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 02/15/2018] [Indexed: 12/27/2022]
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O'Donnell A, McParlin C, Robson SC, Beyer F, Moloney E, Bryant A, Bradley J, Muirhead C, Nelson-Piercy C, Newbury-Birch D, Norman J, Simpson E, Swallow B, Yates L, Vale L. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment. Health Technol Assess 2018; 20:1-268. [PMID: 27731292 DOI: 10.3310/hta20740] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. DATA SOURCES MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined. Obstetric Medicine was hand-searched, as were websites of relevant organisations. Costs came from NHS sources. REVIEW METHODS A systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered the implied values of treatments. RESULTS Seventy-three studies (75 reports) met the inclusion criteria. For RCTs, 33 and 11 studies had a low and high risk of bias respectively. For the remainder (n = 20) it was unclear. The non-randomised studies (n = 9) were low quality. There were 33 separate comparators. The most common were acupressure versus placebo (n = 12); steroid versus usual treatment (n = 7); ginger versus placebo (n = 6); ginger versus vitamin B6 (n = 6); and vitamin B6 versus placebo (n = 4). There was evidence that ginger, antihistamines, metoclopramide (mild disease) and vitamin B6 (mild to severe disease) are better than placebo. Diclectin® [Duchesnay Inc.; doxylamine succinate (10 mg) plus pyridoxine hydrochloride (10 mg) slow release tablet] is more effective than placebo and ondansetron is more effective at reducing nausea than pyridoxine plus doxylamine. Diclectin before symptoms of NVP begin for women at high risk of severe NVP recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin. Promethazine is as, and ondansetron is more, effective than metoclopramide for severe NVP/HG. I.v. fluids help correct dehydration and improve symptoms. Dextrose saline may be more effective at reducing nausea than normal saline. Transdermal clonidine patches may be effective for severe HG. Enteral feeding is effective but extreme method treatment for very severe symptoms. Day case management for moderate/severe symptoms is feasible, acceptable and as effective as inpatient care. For all other interventions and comparisons, evidence is unclear. The economic analysis was limited by lack of effectiveness data, but comparison of costs between treatments highlights the implications of different choices. LIMITATIONS The main limitations were the quantity and quality of the data available. CONCLUSION There was evidence of some improvement in symptoms for some treatments, but these data may not be transferable across disease severities. Methodologically sound and larger trials of the main therapies considered within the UK NHS are needed. STUDY REGISTRATION This study is registered as PROSPERO CRD42013006642. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Amy O'Donnell
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine McParlin
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Stephen C Robson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Eoin Moloney
- Health Economics Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Bradley
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Colin Muirhead
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Justine Norman
- North Tyneside Clinical Commissioning Group, Whitley Bay, UK
| | - Emma Simpson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Laura Yates
- UK Teratology Information Service (UKTIS) and Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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Belica AL, Ćetković NB, Milić NB, Milošević NP. Herbal Therapy in Pregnancy-What to Expect when you Expect? Nat Prod Commun 2017. [DOI: 10.1177/1934578x1701201236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The use of herbal therapy in pregnancy is common for pregnancy related nausea, vomiting, gestational diabetes, anxiety, insomnia, and preparation for labor, as well as for treating infections. Many conventional drugs may interfere with fetal development and herbal products are considered to be safe. However, herbal therapy requires competent healthcare professional advice before prescribing. Knowledge about the possible adverse effects of active compounds of the herbs on pregnancy outcome is limited. Interference of herbal ingredients with conventional medication or the ailment should also not be excluded. For many herbal products, the pharmacological effect is not clinically proven, and the safe usage in pregnancy is not guaranteed. Here, based on published clinical trials, an overview is given of the efficacy and safety for fetal development and pregnancy outcome of the most frequently used herbs: ginger, cranberry, echinacea, mint, chamomile, valerian, flaxseed, tea and raspberry leaf.
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Affiliation(s)
- Artur L. Belica
- University of Novi Sad, Faculty of Medicine, Department of Gynecology and Obstetrics, Clinics for Gynecology and Obstetrics, Clinical Centre Vojvodina, Hajduk Veljkova 3-9, Novi Sad, Serbia
| | - Nenad B. Ćetković
- University of Novi Sad, Faculty of Medicine, Department of Gynecology and Obstetrics, Clinics for Gynecology and Obstetrics, Clinical Centre Vojvodina, Hajduk Veljkova 3-9, Novi Sad, Serbia
| | - Nataša B. Milić
- University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Hajduk Veljkova 3, Novi Sad, Serbia
| | - Nataša P. Milošević
- University of Novi Sad, Faculty of Medicine, Department of Pharmacy, Hajduk Veljkova 3, Novi Sad, Serbia
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Ahmed M, Hwang JH, Choi S, Han D. Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review. Altern Ther Health Med 2017; 17:489. [PMID: 29137614 PMCID: PMC5686907 DOI: 10.1186/s12906-017-1995-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
Abstract
Background High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries. Methods Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature. Results This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature. Conclusions Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects. Electronic supplementary material The online version of this article (10.1186/s12906-017-1995-6) contains supplementary material, which is available to authorized users.
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Shawahna R, Taha A. Which potential harms and benefits of using ginger in the management of nausea and vomiting of pregnancy should be addressed? a consensual study among pregnant women and gynecologists. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:204. [PMID: 28390419 PMCID: PMC5385053 DOI: 10.1186/s12906-017-1717-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/01/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Nausea and vomiting of pregnancy (NVP) affect approximately 80-90% of the pregnant women. Ginger (Zingiber officinale Roscoe) is the most widely used herbal therapy in the management of NVP. Like conventional therapies, herbal therapies have potential harms and benefits that patients need to be informed about in order to develop their therapy preferences. The aim of this study was to achieve consensus among women who suffered NVP and physicians often consulted by pregnant women on a core list of potential harms and benefits of using ginger to manage NVP to be addressed during clinical consultations. METHODS In this study, the Delphi technique was used to achieve consensus on a core list of important harms and benefits of using ginger in the management of NVP to be addressed during the clinical consultation. A Delphi process was followed in two panels in parallel sessions. One panel was composed of 50 gynecologists and other physicians who are often consulted by pregnant women suffering NVP and the other panel was composed of 50 women who suffered NVP. RESULTS Consensus was achieved on 21 (75%) of the 28 potential harms presented to the panelists. Panelists agreed that potential harms of the anticoagulant effects of ginger, risk with other co-morbidities, and risk of potential allergic reactions are important to address during the clinical consultation. Of the 14 potential benefits presented to the panelists in both panels, consensus was achieved on 13 (92.9%). Partial consensus on 7 potential harms and 1 potential benefit was achieved in both panels. CONCLUSIONS Addressing important potential harms and benefits of using ginger for the management of NVP during the clinical consultations is important in promoting congruence and reducing patient dissatisfaction in clinical practice. Consensus was achieved on a core list of important harms and benefits of using ginger for the management of NVP to be addressed during the clinical consultations by a panel of women and a panel of physicians. Further studies are still needed to investigate what is being addressed during clinical consultations.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, New Campus, Building: 19, Office: 1340, P.O. Box 7, Nablus, Palestine
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine
| | - Assim Taha
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Odalović M, Milanković S, Holst L, Nordeng H, Heitmann K, Tasić L. Pharmacists counselling of pregnant women: Web-based, comparative study between Serbia and Norway. Midwifery 2016; 40:79-86. [DOI: 10.1016/j.midw.2016.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 05/09/2016] [Accepted: 06/06/2016] [Indexed: 01/21/2023]
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Lete I, Allué J. The Effectiveness of Ginger in the Prevention of Nausea and Vomiting during Pregnancy and Chemotherapy. INTEGRATIVE MEDICINE INSIGHTS 2016; 11:11-7. [PMID: 27053918 PMCID: PMC4818021 DOI: 10.4137/imi.s36273] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/18/2016] [Accepted: 01/29/2016] [Indexed: 01/10/2023]
Abstract
The rhizomes of Zingiber officinale (ginger) have been used since ancient times as a traditional remedy for gastrointestinal complaints. The most active ingredients in ginger are the pungent principles, particularly gingerols and shogaols. Various preclinical and clinical studies have evaluated ginger as an effective and safe treatment for nausea and vomiting in the context of pregnancy and as an adjuvant treatment for chemotherapy-induced nausea and vomiting. Here, we provide an update and analysis of ginger use for the prevention of nausea and vomiting, with a focus on the types and presentations of ginger available. We also examine the pharmacokinetic properties of ginger and highlight the type and posology of ginger and its metabolites.
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Affiliation(s)
- Iñaki Lete
- Clinical Management Unit of Obstetrics and Gynecology, Hospital Universitario Araba, Vitoria, Spain
| | - José Allué
- Plant Physiology Laboratory, Faculty of Biosciences, Universitat Autónoma de Barcelona, Bellatera, Spain
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Heitmann K, Solheimsnes A, Havnen GC, Nordeng H, Holst L. Treatment of nausea and vomiting during pregnancy —a cross-sectional study among 712 Norwegian women. Eur J Clin Pharmacol 2016; 72:593-604. [DOI: 10.1007/s00228-016-2012-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/12/2016] [Indexed: 02/08/2023]
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Mohammed OJ, Latif ML, Pratten MK. Evaluation of embryotoxicity for major components of herbal extracts using the chick embryonic heart micromass and mouse D3 embryonic stem cell systems. Reprod Toxicol 2016; 59:117-27. [DOI: 10.1016/j.reprotox.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/27/2015] [Accepted: 12/14/2015] [Indexed: 12/13/2022]
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Firouzbakht M, Nikpour M, Jamali B, Omidvar S. Comparison of ginger with vitamin B6 in relieving nausea and vomiting during pregnancy. Ayu 2015; 35:289-93. [PMID: 26664238 PMCID: PMC4649576 DOI: 10.4103/0974-8520.153746] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Nausea and vomiting are the most common complicated issues in pregnancy period, but they have not been paid much attention. Herb based formulations can be effectively used for the treatment nausea and vomiting observed during pregnancy. Aim: To investigate the effect of ginger in nausea and vomiting during pregnancy in comparison with vitamin B6 and placebo. Materials and Methods: This is a randomized and double-blind clinical trial. The women who had nausea and vomiting and did not take any medications were included in this study. 120 women were selected by simple random sampling method, and divided into three groups and were given vitamin B6, placebo, and ginger, respectively. 97 women completed the treatment. They were given treatment for 4 days and were followed after a week. The instrument used in this study was a questionnaire, including demographic characteristic and determining severity nausea and vomiting based on the analog visual scale. Data were analyzed with SPSS software and t-test and Kruskal-Wallis test. Results: There was significant difference between groups in severity of nausea and frequency of vomiting (P < 0.001). Conclusion: Ginger was effective in treating nausea and vomiting in pregnancy, but its use needs further studies to determine the proper dosage and the confirmation about the safety of this drug for a pregnant mother and her fetus.
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Affiliation(s)
| | - Maryam Nikpour
- Department of Nursing-Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Bita Jamali
- Department of Nursing-Midwifery, Islamic Azad University, Babol, Iran
| | - Shabnam Omidvar
- Department of Nursing-Midwifery, Babol University of Medical Sciences, Babol, Iran
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Treatment of nausea in pregnancy: a cross-sectional multinational web-based study of pregnant women and new mothers. BMC Pregnancy Childbirth 2015; 15:321. [PMID: 26628289 PMCID: PMC4667480 DOI: 10.1186/s12884-015-0746-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 11/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The factors related to the treatment of nausea during pregnancy have not yet been investigated in several countries simultaneously. The present study aimed to describe differences in self-reported nausea during pregnancy and the patterns of use for both conventional and herbal medicines across countries. The factors related to nausea and its treatment and the relationships between different self-reported co-morbidities and nausea were also investigated. METHODS This cross-sectional study used data collected by a web-based questionnaire distributed between October 2011 and February 2012 in several countries within five regions: Western, Northern, and Eastern Europe, North America, and Australia. Women who were pregnant or had a child less than one year old were eligible to participate. RESULTS A total of 9113 women were included in the study, whereof 6701 (73.5%) had experienced nausea during pregnancy. Among respondents with nausea, conventional medicines were used by 1201 (17.9%) women and herbal medicines by 556 (8.3%) women. The extent of self-reported nausea and its treatment varied by country. Education, working status, and folic acid use were significantly associated with the use of conventional medicines against nausea. Respondents who had nausea also had a high burden of co-morbidity. CONCLUSION The prevalence of nausea was high across all participating countries but its treatment varied, possibly due to cultural differences and differences in attitudes towards medicines. A high degree of co-morbidity was found among respondents with nausea.
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Trabace L, Tucci P, Ciuffreda L, Matteo M, Fortunato F, Campolongo P, Trezza V, Cuomo V. "Natural" relief of pregnancy-related symptoms and neonatal outcomes: above all do no harm. JOURNAL OF ETHNOPHARMACOLOGY 2015; 174:396-402. [PMID: 26325431 DOI: 10.1016/j.jep.2015.08.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/14/2015] [Accepted: 08/27/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In the South of Italy the use of herbal remedies to alleviate pregnancy-related symptoms is very common. OBJECTIVES To investigate the proportion, prevalence of use, attitude and knowledge base in a sample of Italian pregnant women in the South of Italy. To explore the possible influence and risks of herbal consumption on pregnancy and neonatal outcomes. METHODS A retrospective observational study was conducted during the study period November 2010-September 2013. Six hundred and thirty expectant mothers were interviewed within three days after childbirth in a public Hospital in the South of Italy. RESULTS Due to a lack of data, a total of six hundred interviews were considered. Four hundred and eighty six women (81%) reported to have constantly used at least one herbal product throughout the pregnancy period. The study enrolled mostly women between 31 and 40 years of age, with a middle-high level of education, married and employed. The most commonly used herbal products, taken by oral route and for the entire period of pregnancy, were chamomile, fennel, propolis, cranberry, lemon balm, ginger, valerian and mallow. The most relevant source of information for the majority of participants was the doctor (95%), and most of the women (72%) informed their doctors about their use of herbal remedies. CONCLUSIONS The regular chamomile consumption resulted in a higher risk of pre-term delivery, lower birth weight and lower length of the newborn. Also a regular use of fennel resulted in a shorter gestational age. Finally, ginger intake resulted in a shorter gestational age and in a smaller circumference of the newborn's skull.
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Affiliation(s)
- Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71100, Italy.
| | - Paolo Tucci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71100, Italy
| | - Lucia Ciuffreda
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71100, Italy
| | - Maria Matteo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71100, Italy
| | - Francesca Fortunato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71100, Italy
| | - Patrizia Campolongo
- Department of Physiology and Pharmacology, Sapienza, University of Rome, Rome 00185, Italy
| | - Viviana Trezza
- Department of Science, Section of Biomedical Sciences and Technologies, University 'Roma Tre', Rome 00146, Italy
| | - Vincenzo Cuomo
- Department of Physiology and Pharmacology, Sapienza, University of Rome, Rome 00185, Italy
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Marx W, Kiss N, Isenring L. Is ginger beneficial for nausea and vomiting? An update of the literature. Curr Opin Support Palliat Care 2015; 9:189-95. [PMID: 25872115 DOI: 10.1097/spc.0000000000000135] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Nausea and vomiting can pose a significant burden to patients in a variety of clinical settings. Previous evidence suggests that ginger may be an effective treatment for these symptoms; however, current evidence has been mixed. This article discusses recent clinical trials that have investigated ginger as a treatment for multiple types of nausea and vomiting. In addition, the potential mechanisms of action of ginger will be discussed. RECENT FINDINGS This article identified nine studies and seven reviews that investigated ginger for morning sickness, postoperative nausea and vomiting, chemotherapy-induced, and antiretroviral-induced nausea and vomiting. All studies reported that ginger provided a significant reduction in nausea and vomiting; however, the clinical relevance of some studies is less certain. Common limitations within the literature include the lack of standardized extracts, poorly controlled or blinded studies, and limited sample size. In addition, recent evidence has provided further support for 5-HT3 receptor antagonism as a mechanism by which ginger may exert its potentially beneficial effect on nausea and vomiting. SUMMARY The results of studies in this article suggest that ginger is a promising treatment for nausea and vomiting in a variety of clinical settings and possesses a clinically relevant mechanism. However, further studies are required to address the limitations in the current clinical literature before firm recommendations for its use can be made.
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Affiliation(s)
- Wolfgang Marx
- aFaculty of Health Sciences and Medicine, Bond University, Queensland bNutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Victoria, Australia
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Choi JS, Han JY, Ahn HK, Lee SW, Koong MK, Velazquez-Armenta EY, Nava-Ocampo AA. Assessment of fetal and neonatal outcomes in the offspring of women who had been treated with dried ginger (Zingiberis rhizoma siccus) for a variety of illnesses during pregnancy. J OBSTET GYNAECOL 2015; 35:125-30. [PMID: 25093607 DOI: 10.3109/01443615.2014.941342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The present study was designed to investigate if exposure to dried ginger during pregnancy would increase the risk of adverse fetal and neonatal outcomes. Participants consisted of 159 singleton pregnant women who received dried ginger as a herbal medication. We also included a control group of 306 pregnant women who had not been exposed to any herbal medication or any known teratogen. No increased risk of major malformations was detected in exposed women (OR = 4.9; 95% CI 0.9-25.5; p = 0.051). The incidence of stillbirths in the exposed group was marginally higher than in the controls (OR = 7.8; 95% CI 0.9-70.3; p = 0.05). The risk was more evident when the exposed group was compared with the general population in the Republic of Korea (OR = 7.9; 95% CI 2.9-21.4; p < 0.0001). Other fetal and neonatal study outcomes investigated in the exposed group were similar (p > 0.05) to the controls. In conclusion, dried ginger does not appear to be a major teratogen. However, due to the limitations of the study, e.g. the large variability in the dose of dried ginger in the exposed group, as well as the concomitant exposure to other herbal medications, the increased incidence of stillbirths requires confirmation in larger cohort studies.
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Akhandaf Y, De Henauw S, Dofkova M, Ruprich J, Papadopoulos A, Sirot V, Kennedy M, Pinchen H, Blume K, Lindtner O, Brantsaeter A, Meltzer H, Sioen I. Establishing a food list for a Total Diet Study: how does food consumption of specific subpopulations need to be considered? Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2014; 32:9-24. [DOI: 10.1080/19440049.2014.984776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN OBSTETRICS AND GYNECOLOGY 2014; 2014:792708. [PMID: 24944825 PMCID: PMC4040198 DOI: 10.1155/2014/792708] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 03/19/2014] [Indexed: 12/23/2022]
Abstract
Premenstrual syndrome (PMS) is a common disorder. Although the etiology of PMS is not clear, to relieve from this syndrome different methods are recommended. One of them is use of medicinal herbs. This study was carried out to evaluate effects of ginger on severity of symptoms of PMS. This study was a clinical trial, double-blinded work, and participants were randomly allocated to intervention (n = 35) and control (n = 35) groups. To determine persons suffering from PMS, participants completed daily record scale questionnaire for two consecutive cycles. After identification, each participant received two ginger capsules daily from seven days before menstruation to three days after menstruation for three cycles and they recorded severity of the symptoms by daily record scale questionnaire. Data before intervention were compared with date 1, 2, and 3 months after intervention. Before intervention, there were no significant differences between the mean scores of PMS symptoms in the two groups, but after 1, 2, and 3 months of treatment, there was a significant difference between the two groups (P < 0.0001). Based on the results of this study, maybe ginger is effective in the reduction of severity of mood and physical and behavioral symptoms of PMS and we suggest ginger as treatment for PMS.
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Saberi F, Sadat Z, Abedzadeh-Kalahroudi M, Taebi M. Effect of ginger on relieving nausea and vomiting in pregnancy: a randomized, placebo-controlled trial. Nurs Midwifery Stud 2014; 3:e11841. [PMID: 25414888 PMCID: PMC4228518 DOI: 10.17795/nmsjournal11841] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 08/20/2013] [Accepted: 11/27/2013] [Indexed: 11/25/2022] Open
Abstract
Background: Nausea and vomiting are common and unpleasant complications in pregnancy. Although many alternative therapists support the use of ginger for nausea and vomiting of pregnancy, there is currently insufficient clinical evidence to support its use in this condition Objectives: The present study was performed to assess the effectiveness of ginger in the treatment of nausea and vomiting in pregnancy. Patients and Methods: This seven-day clinical trial was performed on 120 eligible pregnant women with symptoms of mild to moderate nausea and vomiting before 16 weeks gestation. They were divided into; ginger, placebo and control groups, by block randomization. Women were asked to record their nausea and vomiting for three days, and then participants received either ginger capsules, or a placebo for four days. No intervention was done with the control group. Data measure was self-recorded symptoms according to the Rhodes Index. Data were analyzed by ANOVA, ANCOVA, Kruskal-Wallis, Chi-square, and Fisher’s exact test, for the quantitative and qualitative variables. Results: There were no statistical differences in the baseline demographics between the three groups apart from age of marriage and wanted or unwanted pregnancy. An ANCOVA test (covariance test) showed significant differences in mean scores after the intervention in the three groups (P < 0.001). Conclusions: Ginger was effective for the relief of mild to moderate nausea and vomiting in pregnant women at less than 16 weeks gestation.
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Affiliation(s)
- Farzaneh Saberi
- Department of Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | | | - Mahboobeh Taebi
- Department of Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
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Abstract
PURPOSE OF REVIEW The aim of this article is two-fold: to report the prevalence of herbal products used by pregnant women and to evaluate the evidence of efficacy and safety of the most popular remedies. RECENT FINDINGS Of the 671 articles identified, 15 randomized controlled trials (RCTs) and 16 non-RCTs were eligible. Ginger was the most investigated remedy and it was consistently reported to ameliorate nausea and vomiting in pregnancy. Although raspberry, blue cohosh, castor oil, and evening primrose oil are believed to facilitate labor in traditional medicine, very few scientific data support such indication. Moreover, they have been associated with severe adverse events. Data on the safety of Hypericum perforatum in pregnancy or lactation are reassuring, whereas efficacy was demonstrated only in nonpregnant individuals. There is still insufficient evidence regarding the efficacy and safety of Echinacea, garlic, and cranberry in pregnancy. SUMMARY Epidemiological studies reported a wide range of use of herbal remedies in pregnancy. Too few studies have been devoted to the safety and efficacy of singular herbs. With the exception of ginger, there are no consistent data to support the use of any other herbal supplement during pregnancy. Severe adverse events have been reported using blue cohosh and evening primrose oil.
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Affiliation(s)
- Giulia Dante
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
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Holst L, Havnen GC, Nordeng H. Echinacea and elderberry-should they be used against upper respiratory tract infections during pregnancy? Front Pharmacol 2014; 5:31. [PMID: 24624087 PMCID: PMC3941201 DOI: 10.3389/fphar.2014.00031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 02/17/2014] [Indexed: 11/20/2022] Open
Abstract
This review evaluates the safety of echinacea and elderberry in pregnancy. Both herbs are commonly used to prevent or treat upper respiratory tract infections (URTIs) and surveys have shown that they are also used by pregnant women. The electronic databases PubMed, ISI Web of Science, AMED, EMBASE, Natural Medicines Comprehensive Database, and Cochrane Library were searched from inception to November 2013. Relevant references from the acquired articles were included. No clinical trials concerning safety of either herb in pregnancy were identified. One prospective human study and two small animal studies of safety of echinacea in pregnancy were identified. No animal- or human studies of safety of elderberry in pregnancy were identified. Twenty clinical trials concerning efficacy of various echinacea preparations in various groups of the population were identified between 1995 and 2013. Three clinical trials concerning efficacy of two different elderberry preparations were identified between 1995 and 2013. The results from the human and animal studies of Echinacea sp. are not sufficient to conclude on the safety in pregnancy. The prospective, controlled study in humans found no increase in risk of major malformations. The efficacy of Echinacea sp. is dubious based on the identified studies. Over 2000 persons were given the treatment, but equal amounts of studies of good quality found positive and negative results. All three clinical trials of Elderberry concluded that it is effective against influenza, but only 77 persons were given the treatment. Due to lack of evidence of efficacy and safety, health care personnel should not advice pregnant women to use echinacea or elderberry against upper respiratory tract infection.
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Affiliation(s)
- Lone Holst
- Department of Global Public Health and Primary Care and Centre for Pharmacy, Faculty of Medicine and Dentistry, University of Bergen Bergen, Norway
| | - Gro C Havnen
- Regional Medicines Information and Pharmacovigilance Centre (RELIS), Oslo University Hospital Oslo, Norway
| | - Hedvig Nordeng
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, School of Pharmacy, University of Oslo Oslo, Norway
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Kennedy DA, Lupattelli A, Koren G, Nordeng H. Herbal medicine use in pregnancy: results of a multinational study. Altern Ther Health Med 2013; 13:355. [PMID: 24330413 PMCID: PMC4029224 DOI: 10.1186/1472-6882-13-355] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 12/09/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of complementary and alternative medicines (CAM) is growing in the general population. Herbal medicines are used in all countries of the world and are included in the top CAM therapies used. METHODS A multinational study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North and South America and Australia. In this study, the primary aim was to determine the prevalence of herbal medicine use in pregnancy and factors related to such use across participating countries and regions. The secondary aim was to investigate who recommended the use of herbal medication in pregnancy. RESULTS There were 9,459 women from 23 countries participating in the study. Of these, 28.9% reported the use of herbal medicines in pregnancy. Most herbal medicines were used for pregnancy-related health ailments such as cold and nausea. Ginger, cranberry, valerian and raspberry were the most commonly used herbs in pregnancy. The highest reported rate of herbal use medicines was in Russia (69%). Women from Eastern Europe (51.8%) and Australia (43.8%) were twice as likely to use an herbal medicine versus other regions. Women using herbal medicines were characteristically having their first child, non-smokers, using folic acid and consuming some alcohol in pregnancy. Also, women who were currently students and women with an education other than a high school degree were more likely to use herbal medicines than other women. Although 1 out of 5 women stated that a physician had recommended the herbal use, most women used herbal medicine in pregnancy on their own initiative. CONCLUSIONS In this multinational study herbal medicine use in pregnancy was high although there were distinct differences in the herbs and users of herbal medicines across regions. Most commonly the women self-medicated with herbal medicine to treat pregnancy-related health ailments. More knowledge regarding the efficacy and safety of herbal medicines in pregnancy is warranted.
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Saberi F, Sadat Z, Abedzadeh-Kalahroudi M, Taebi M. Acupressure and ginger to relieve nausea and vomiting in pregnancy: a randomized study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:854-61. [PMID: 24616799 PMCID: PMC3929824 DOI: 10.5812/ircmj.12984] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 07/21/2013] [Accepted: 08/10/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nausea and vomiting of pregnancy (NVP) is the most common medical condition of pregnancy, affecting up to 85% of expecting mothers. NVP can have serious adverse effects on the quality of a woman's life, social, and domestic functioning, and her general well-being. Therefore, it is very important to treat this condition. OBJECTIVES The effectiveness of ginger and acupressure in the treatment of NVP was compared in the present study. PATIENTS AND METHODS 159 eligible pregnant women with symptoms of mild to moderate nausea and/or vomiting before 16 weeks gestational age participated in a 7-day clinical trial. They were divided randomly into three groups: the acupressure, ginger, and control. Participants did not receive any intervention for three days and interventions were performed for the women in acupressure and ginger groups for four days. No intervention was performed for the control group. Data was collected by self-recorded symptoms according to the Rhodes index. Data was analyzed by ANOVA, Kruskal-Wallis, Chi-square, and Fisher exact tests for quantitative and qualitative variables. RESULTS There were no statistical differences in the baseline demographics between the three groups. ANOVA test showed that there were significantly differences in mean difference Rhodes index scores (vomiting, nausea, retching and total score) in the three groups (P < 0.001). CONCLUSIONS Ginger is more effective than acupressure to relieve mild to moderate nausea and vomiting in symptomatic pregnant women in less than 16 weeks of gestational age.
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Affiliation(s)
- Farzaneh Saberi
- Department of Midwifery, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Zohreh Sadat
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | | | - Mahboobeh Taebi
- Department of Midwifery, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IR Iran
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