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Jatuten N, Piyakunmala P, Budkaew J, Chumworathayi B. Effect of topical Zingiber cassumunar on painful diabetic neuropathy: a double-blind randomized-controlled trial. F1000Res 2023; 12:334. [PMID: 39220605 PMCID: PMC11364968 DOI: 10.12688/f1000research.131344.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 09/04/2024] Open
Abstract
Background Plai or Zingiber cassumunar Roxb. was registered into the Thai Traditional Medicine list since 2011. However, there is limited evidence regarding Plai as a treatment in painful diabetic neuropathy (PDN). Therefore, this study aimed to evaluate the efficacy of topical Zingiber cassumunar. Methods A RCT was conducted in patients with PDN during February to March 2019. All participants received oral gabapentin 300 mg before bed as a standard regimen. The intervention group (n=16) received Plai balm 15%w/w 0.5 gram to apply on their feet three times a day and the control group (n=15) received placebo balm to similarly apply. Pain score at baseline, 2 nd and 4 th weeks were assessed and compared. Patients' quality of life, and adverse events, were collected. Mean pain scores before and after treatment in each group and between groups were also analyzed. Results At the end of week two and week four, the Plai group showed statistically significant lesser mean pain scores than the placebo group by -1.47 (95%CI: -1.96 to -1.30, p-value < 0.001), and by -1.51 (95%CI: -1.92 to -0.13, p-value = 0.027), respectively. Moreover, the Plai group had more cases number/ percentages with at least 50% pain score reduction than the placebo group [12/16 (75%) vs 3/15 (20%), p-value = 0.004]. However, there was no statistically significant difference in quality of life between the two groups (overall p-value = 0.366). Adverse event was not found in any groups. Conclusions Zingiber cassumunar balm (Plai) was efficacious for pain reduction in painful diabetic neuropathy. Registration Registered with the Thai Clinical Trials Registry; TCTR20200221001.
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Affiliation(s)
| | | | - Jiratha Budkaew
- Social Medicine, Khon Kaen Hospital, Muang District, Khon Kaen, 40000, Thailand
| | - Bandit Chumworathayi
- Obstetrics and Gynaecology,, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
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Srivastava S, Girandola RN. Effect of E-PR-01 on Activity-Induced Acute Knee Joint Discomfort in Healthy Individuals: A Randomized, Placebo-Controlled, Double-Blind, Cross-Over Study. J Pain Res 2023; 16:2141-2153. [PMID: 37384126 PMCID: PMC10295599 DOI: 10.2147/jpr.s412018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/12/2023] [Indexed: 06/30/2023] Open
Abstract
Purpose A randomized, double-blind, placebo-controlled cross-over study was conducted to investigate the efficacy and safety of E-PR-01, a proprietary formula containing Vitex negundo and Zingiber officinale, on knee joint discomfort due to pain. Patients and Methods Forty adults aged 20-60 years with self-reported pain score of ≤30 mm at rest and ≥60 mm post-exertion on a 100-mm visual analog scale (VAS) were randomized in a 1:1 ratio to receive either the E-PR-01 (200 mg twice daily) or placebo for 5 days. The primary outcome was time to achieve meaningful pain relief (MPR) (≥40% reduction in post-exertion pain VAS score from baseline) post-single dose of intervention on day 1 compared to placebo. The secondary outcomes were post-exertion pain intensity difference (PID) at 2-, 3- and 4-hours and time-weighted sum of pain intensity difference (SPID) over 4 hours post single dose on day 1; post-exertion VAS score at 4 hours' post-intervention on day 5; percentage of responders on day 1; and physical efficiency as assessed by the total duration of exercise sessions completed after single dose of IP compared to placebo. Results The average time to achieve MPR was 3.38 hours, 32.50% of participants achieved it in the E-PR-01 group post single-dose administration on day 1 as opposed to the placebo where no participant achieved MPR. There were significant intergroup differences in PID (-23.58 vs 2.45 mm) and SPID (-67.48 vs -0.08 mm) at 4 hours of E-PR-01 and placebo administration on day 1. 95% of participants in the IP group experienced some degree of pain relief within 2 hours compared to 37.5% in the placebo group. Conclusion A single dose of E-PR-01 provided a statistically significant as well as clinically meaningful reduction in exercise-induced knee joint discomfort within 4 hours of administration.
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Affiliation(s)
- Shalini Srivastava
- Department of Clinical Development, Enovate Biolife, Wilmington, DE, 19801, USA
| | - Robert N Girandola
- Department of Human Biology, University of South California, Los Angeles, CA, USA
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Dewanjee S, Sohel M, Hossain MS, Ansari F, Islam MT, Sultana F, Al Mamun A, Islam MM, Amin MN. A comprehensive review on clinically proven natural products in the management of nerve pain, with mechanistic insights. Heliyon 2023; 9:e15346. [PMID: 37159686 PMCID: PMC10163606 DOI: 10.1016/j.heliyon.2023.e15346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 03/13/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023] Open
Abstract
Introduction People are treating their neuropathic pain with several approved and licensed pharmacological drugs. But due to having existing limitations like low efficacy with some side effects, there needs to be a more effective alternative and complementary therapeutic options. Purpose s: The study was designed to discuss the mechanistic role of several clinically proven natural products that have been shown to play a significant role against different nerve pain or neuropathic pain. Method ology: Information for this review article was salvaged using several accessible searching databases like SciVerse Scopus ® (Elsevier Properties S. A, USA), Web of Science® (Thomson Reuters, USA), and PubMed® (U.S. National Library of Medicine, USA) considering some search items like - nerve pain, natural products in pain/nerve pain management, clinically proven natural products in pain management, pain-reducing agents and so on. Result Our study reported the therapeutic efficacy of natural products and their possible mechanism against neuropathic pain in the human body. Natural products widely used to treat neuropathic pain include comfrey root extract ointment, lavender oil, Rose Oil, aromatic essential oil, ginger oil, vitex agnus-castus, peganum oil, and ajwain 10%. Some common pathways are involved in pain relief through sensory stimulation, enzymatic, anti-inflammatory, and pain-related receptor regulation. Conclusion The present study suggests that the mentioned natural products can be an appropriate choice for the treatment and management of neuropathic pain.
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Affiliation(s)
- Sanchita Dewanjee
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Md Sohel
- Department of Biochemistry and Molecular Biology, Primeasia University, Banani, Dhaka, 1213, Bangladesh
- Pratyasha Health Biomedical Research Center, Dhaka, 1230, Bangladesh
| | - Md Shahadat Hossain
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230, Bangladesh
| | - Farzana Ansari
- Department of Biochemistry and Molecular Biology, Laboratory of Nutrition and Health Research, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Tofikul Islam
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230, Bangladesh
| | - Farhana Sultana
- Pratyasha Health Biomedical Research Center, Dhaka, 1230, Bangladesh
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230, Bangladesh
| | - Abdullah Al Mamun
- Department of Biochemistry and Molecular Biology, Primeasia University, Banani, Dhaka, 1213, Bangladesh
| | - Md Monirul Islam
- Department of Pharmacy, State University of Bangladesh, Dhaka, 1205, Bangladesh
- Corresponding author.
| | - Mohammad Nurul Amin
- Pratyasha Health Biomedical Research Center, Dhaka, 1230, Bangladesh
- Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230, Bangladesh
- Corresponding author. Department of Pharmacy, Atish Dipankar University of Science and Technology, Dhaka, 1230. Bangladesh.
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Bioactive Compounds from Zingiber montanum and Their Pharmacological Activities with Focus on Zerumbone. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112110205] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The genus Zingiber consists of about 85 species and many of these species are used as food, spices, and medicines. One of the species, Zingiber montanum (J. Koenig) Link ex A. Dietr. is native to Southeast Asia and has been extensively used as traditional medicines and food. The aim of this review was to collect and critically analyze the scientific information about the bioactive compounds and pharmacological activities of Z. montanum with focus on one of the main components, zerumbone (ZER). Various studies have reported the analysis of volatile constituents of the essential oils from Z. montanum. Similarly, many phenylbutanoids, flavonoids and terpenes were also isolated from rhizomes. These essential oils, extracts and compounds showed potent antimicrobial, anti-inflammatory and antioxidant activities among others. Zerumbone has been studied widely for its anticancer, anti-inflammatory, and other pharmacological activities. Future studies should focus on the exploration of various pharmacological activities of other compounds including phenylbutanoids and flavonoids. Bioassay guided isolation may result in the separation of other active components from the extracts. Z. montanum could be a promising source for the development of pharmaceutical products and functional foods.
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Cheshier BC, Jacobson BH, Diehl C. Effect of White Willow Bark on Delayed Onset Muscle Soreness Following Resistance Training: A Pilot Study. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.4.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Delayed onset muscle soreness (DOMS) is discomfort that occurs within 8-24hrs following an unaccustomed bout of physical activity that peaks within 24-27hrs and slowly resolves on its own. White willow bark (WWB) is a nutritional supplement that is believed to have anti-inflammatory and analgesic properties like aspirin but without the risk of GI adverse effects. The purpose of this investigation is to determine the effectiveness of WWB on alleviating the symptoms of DOMS following exercise.METHODS Twenty-five individuals volunteered to participate and were randomly assigned to take WWB (798mg salicin) or placebo for 5 days following a lower body resistance training session which consisted of 5X10 lunges at 40% body weight (BW) and 3X fatigue leg press at 75%BW. Test procedures included visual analog scale (VAS), mid-thigh circumference and pressure pain threshold. VAS was measured pre, all five days of the supplementation period and day 6 (post-supplementation). All other variables were measured at pre, immediate, day 3(72hrs), and day 6 (post-supplementation).RESULTS No condition X time interaction was observed (p > 0.05) for any variable. However, VAS scores were lower in the WWB compared to the placebo for all time frames. There was a significant main effect of time for VAS scores indicating muscle soreness for hamstrings (p < 0.001), gluteal (p < 0.001), gastrocnemius (p < 0.001) and quadriceps (p < 0.001). In addition, there was a significant main effect of time for right midthigh pressure pain threshold (p = 0.02), mid-right (p < 0.001) and mid-left (p < 0.001) thigh circumference.CONCLUSIONS WWB may reduce subjective feelings of muscle soreness and appears to have analgesic properties.
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Rondanelli M, Fossari F, Vecchio V, Gasparri C, Peroni G, Spadaccini D, Riva A, Petrangolini G, Iannello G, Nichetti M, Infantino V, Perna S. Clinical trials on pain lowering effect of ginger: A narrative review. Phytother Res 2020; 34:2843-2856. [PMID: 32436242 PMCID: PMC7754412 DOI: 10.1002/ptr.6730] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 01/01/2023]
Abstract
Ginger has a pain-reducing effect and it can modulate pain through various mechanisms: inhibition of prostaglandins via the COX and LOX-pathways, antioxidant activity, inibition of the transcription factor nf-kB, or acting as agonist of vanilloid nociceptor. This narrative review summarizes the last 10-year of randomized controlled trials (RCTs), in which ginger was traditionally used as a pain reliever for dysmenorrhea, delayed onset muscle soreness (DOMS), osteoarthritis (AO), chronic low back pain (CLBP), and migraine. Regarding dysmenorrhea, six eligible studies suggest a promising effect of oral ginger. As concerned with DOMS, the four eligible RCTs suggested a reduction of inflammation after oral and topical ginger administration. Regarding knee AO, nine RCTs agree in stating that oral and topical use of ginger seems to be effective against pain, while other did not find significant differences. One RCT considered the use of ginger in migraine and suggested its beneficial activity. Finally, one RCT evaluated the effects of Swedish massage with aromatic ginger oil on CLBP demonstrated a reduction in pain. The use of ginger for its pain lowering effect is safe and promising, even though more studies are needed to create a consensus about the dosage of ginger useful for long-term therapy.
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Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino FoundationPaviaItaly
- Department of Public Health, Experimental and Forensic MedicineUniversity of PaviaPaviaItaly
| | - Federica Fossari
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Viviana Vecchio
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Daniele Spadaccini
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | | | | | - Giancarlo Iannello
- General ManagementAzienda di Servizi alla Persona “Istituto Santa Margherita”PaviaItaly
| | - Mara Nichetti
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”University of PaviaPaviaItaly
| | - Vittoria Infantino
- Department of Biomedical Science and Human OncologyUniversity of Bari Aldo MoroBariItaly
| | - Simone Perna
- Department of Biology, College of ScienceUniversity of BahrainZallaqBahrain
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Amalraj A, Divya C, Gopi S. The Effects of Bioavailable Curcumin (Cureit) on Delayed Onset Muscle Soreness Induced By Eccentric Continuous Exercise: A Randomized, Placebo-Controlled, Double-Blind Clinical Study. J Med Food 2020; 23:545-553. [DOI: 10.1089/jmf.2019.4533] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Augustine Amalraj
- R&D Centre, Aurea Biolabs Private Limited, Kolenchery, Cochin, Kerala, India
| | | | - Sreeraj Gopi
- R&D Centre, Aurea Biolabs Private Limited, Kolenchery, Cochin, Kerala, India
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Chongmelaxme B, Sruamsiri R, Dilokthornsakul P, Dhippayom T, Kongkaew C, Saokaew S, Chuthaputti A, Chaiyakunapruk N. Clinical effects of Zingiber cassumunar (Plai): A systematic review. Complement Ther Med 2017; 35:70-77. [PMID: 29154071 DOI: 10.1016/j.ctim.2017.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/28/2017] [Indexed: 01/23/2023] Open
Abstract
Zingiber cassumunar Roxb. known locally as "Plai" in Thai, has been used for treating bruise, sprain and musculoskeletal pain. Several pre-clinical studies demonstrated the anti-inflammatory effect of Plai. However, current evidence of clinical effects of Plai is still unclear. This study aimed to determine the clinical efficacy and safety of Plai among all identified indications. Of the 808 articles identified by a systematic review, six studies were included. Four studies were randomized controlled trials, while two studies were quasi-experimental studies involving 178 patients in intervention group and 177 patients in control group. Duration of treatment ranged from 7days to 2 months. Our findings showed that 14% Plai cream had a strong trend of benefits in pain reduction for muscle pain and ankle sprain. However, evidence supporting the effects of Plai on acne vulgaris treatment and anti-histamine effect are still unclear.
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Affiliation(s)
- Bunchai Chongmelaxme
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Rosarin Sruamsiri
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Piyameth Dilokthornsakul
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Teerapon Dhippayom
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.
| | - Chuenjid Kongkaew
- Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand; Research Department of Practice and Policy, School of Pharmacy, UCL, UK.
| | - Surasak Saokaew
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand.
| | - Anchalee Chuthaputti
- Department for Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand.
| | - Nathorn Chaiyakunapruk
- Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; School of Pharmacy, University of Wisconsin, Madison, USA; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well-being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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