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      Comparison of anti-inflammatory and analgesic effects of Ginger powder and Ibuprofen in postsurgical pain model: A randomized, double-blind, case–control clinical trial

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          Abstract

          Background:

          Ginger has been used as an herbal drug for a long time for the treatment of chronic inflammatory conditions.

          Materials and Methods:

          This randomized, double-blind clinical trial was conducted on 67 healthy adults with at least one impacted lower third molar. Participants were randomly allocated into three groups: Ibuprofen, Ginger, and placebo. Evaluation of inflammation was done by measuring cheek swelling, mouth opening ability, serum C-reactive protein (CRP) levels, and visual analog scale (for pain scoring). The number and the time of using rescue medication were recorded too.

          Results:

          Sixty patients completed the study. In all three groups, there was a significant increase in the mean cheek swelling measures, compared with the baseline, until day 5. The reduction in mouth opening ability was significant in all three groups, compared with the baseline, until day 5. There was no significant difference between ibuprofenand ginger groups in pain scores in all follow-up days. Number of required rescue medication on the day of surgery was significantly more in the placebo group. No significant or strong correlations were found between CRP levels and clinical findings.

          Conclusion:

          Within the limitations of this study, it can ban be concluded that gingerpowder is as effective as ibuprofenin the management of postsurgical sequelae. Furthermore, CRP levels alone are not suggested for the assessment of anti-inflammatory effects of drugs.

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          Most cited references 19

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          Zingiberis rhizoma: a comprehensive review on the ginger effect and efficacy profiles.

          Zingiberis rhizoma is used as a broadspectrum antiemetic. We, therefore, conducted a comprehensive review of the literature to summarize the pharmacological and clinical effects of this popular plant material. Although clinical and experimental studies suggest that ginger has some antiemetic properties, clinical evidence beyond doubt is only available for pregnancy-related nausea and vomiting. Meta-analyses could not demonstrate the postoperative antiemetic effectiveness, and effect in motion sickness or nausea/vomiting of other ethiology. It also remains to be confirmed that proprietary ginger preparations are clinically useful to alleviate osteoarthritic or other pain, although there is no doubt that ginger constituents interfere with the inflammatory cascade and the vanilloid nociceptor. Ginger exerts in vitro antioxidative, antitumorigenic and immunomodulatory effects and is an effective antimicrobial and antiviral agent. Animal studies demonstrate effects on the gastrointestinal tract, the cardiovascular system, on experimental pain and fever, antioxidative, antilipidemic and antitumor effects, as well as central and other effects. The most relevant human pharmacological studies require a confirmatory study to exclude interaction of ginger preparations with platelet aggregation. Pharmacokinetic data are only available for [6]-gingerol and zingiberene. Preclinical safety data do not rule out potential toxicity, which should be monitored especially following ginger consumption over longer periods.
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            Ginger--an herbal medicinal product with broad anti-inflammatory actions.

            The anti-inflammatory properties of ginger have been known and valued for centuries. During the past 25 years, many laboratories have provided scientific support for the long-held belief that ginger contains constituents with antiinflammatory properties. The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin synthesis through inhibition of cyclooxygenase-1 and cyclooxygenase-2. An important extension of this early work was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of inflammation. Such preparations will be useful for studies in experimental animals and humans.
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              Analgesic, antiinflammatory and hypoglycaemic effects of ethanol extract of Zingiber officinale (Roscoe) rhizomes (Zingiberaceae) in mice and rats.

               J A O Ojewole (2006)
              The present study was undertaken to investigate the analgesic, antiinflammatory and hypoglycaemic effects of Zingiber officinale dried rhizomes ethanol extract (ZOE) in mice and rats. The analgesic effect of ZOE was evaluated by 'hot-plate' and 'acetic acid' analgesic test methods in mice; while the antiinflammatory and hypoglycaemic effects of the plant extract were investigated in rats, using fresh egg albumin-induced pedal oedema, and streptozotocin (STZ)-induced diabetes mellitus models. Morphine (MPN, 10 mg/kg), diclofenac (DIC, 100 mg/kg) and chlorpropamide (250 mg/kg) were used as reference drugs for comparison. ZOE (50-800 mg/kg i.p.) produced dose-dependent, significant (p < 0.05-0.001) analgesic effects against thermally and chemically induced nociceptive pain in mice. The plant extract (ZOE, 50-800 mg/kg p.o.) also significantly (p < 0.05-0.001) inhibited fresh egg albumin-induced acute inflammation, and caused dose-related, significant (p < 0.05-0.001) hypoglycaemia in normal (normoglycaemic) and diabetic rats. The findings of this experimental animal study indicate that Zingiber officinale rhizomes ethanol extract possesses analgesic, antiinflammatory and hypoglycaemic properties; and thus lend pharmacological support to folkloric, ethnomedical uses of ginger in the treatment and/or management of painful, arthritic inflammatory conditions, as well as in the management and/or control of type 2 diabetes mellitus in some rural Africa communities. Copyright (c) 2006 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                Dent Res J (Isfahan)
                Dent Res J (Isfahan)
                DRJ
                Dental Research Journal
                Medknow Publications & Media Pvt Ltd (India )
                1735-3327
                2008-0255
                Jan-Feb 2017
                : 14
                : 1
                : 1-7
                Affiliations
                [1 ]Department of Oral and Maxillofacial Surgery, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
                [2 ]Department of Clinical and Anatomical Pathology, Qazvin University of Medical Sciences, Qazvin, Iran
                [3 ]Department of Orthodontics, School of Dentistry, Islamic Azad University of Isfahan, Isfahan, Iran
                Author notes
                Address for correspondence: Dr. Farshid Rayati, Department of Oral and Maxillofacial Surgery, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Bahonar Blvd., Qazvin, Iran. E-mail: frayati@ 123456qums.ac.ir
                Article
                DRJ-14-1
                5356382
                Copyright: © 2017 Dental Research Journal

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                Categories
                Original Article

                Dentistry

                c-reactive protein, ginger, third molar, ibuprofen, surgery

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