Objective:To study the effectiveness of ginger for prevention of nausea and vomiting after gynecological
laparoscopy.
Material and Method: From July 2005 to October 2005, 60 inpatients who underwent laparoscopic operations for non-cancer gynecologic conditions at Bangkok Metropolitan Administration Medical College or Vajira Hospital were randomized into Group A (n = 30) or Group B (n = 30). Group A received 3 capsules of ginger (1 capsule contained 0.5 g of ginger powder) while Group B received 3 capsules of placebo. Both groups received their medicine 1 hour prior the operation. Nausea and vomiting were assessed with the Visual Analogue Scores (VAS) and presence of vomiting at 2 and 6 hours after the operation.
Conclusion: Ginger has shown efficacy for prevention of nausea and borderline significance to prevention
vomiting after gynecological laparoscopy at 6 hour post operation
Ginger is effective for the prevention of nausea and borderline significance to prevent vomiting after gynecological laparoscopy with no significant side effect. Moreover, antiemetic effect on post operative opioid use for severe pain was surprisingly significant. However, the present study compared only a small number of patients and in limited indication of post operative laparoscopic surgery. For further study, the authors need a larger number of patients and more indications are warranted.
Effectiveness of ginger for prevention of nausea and vomiting after gynecological laparoscopy / gingerol, J Med Assoc Thai 2006; 89 (12): 2003-9, Sirirat Apariman MD, Sawinee Ratchanon MD, Budsaba Wiriyasirivej MD

120 patients comparable in age and sex in ASA grade I and II posted for surgeries known to have higher incidence of PONV following general anesthesia were studied . We tested the efficacy of Indian household ginger for prevention of PONV & compared it with other routinely used antiemetics. We also compared the efficacy, cost effectiveness and side effects of these drugs.
We found ginger to be a promising, cost effective antiemelic free from side effects.
The present study indicated ginger to be a very effective drug for prevention of PONV. Also in addition it is relatively cheap with negligible side effects. Ginger is readily available and routinely found in an Indian household.
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A Comparative Study of Ginger and Other Routinely Used Antiemetics for prevention of Post Operative Nausea and vomiting / Gingerol, J Anesth Clin Pharmacology 2007; 23(4) : 405-410

Abstract : Background: Ginger is a spice with a long history of use as a traditional remedy for nausea and vomiting. No data on the efficacy of ginger are presently available for children with vomiting associated with acute gastroenteritis (AGE).
Aim: To test whether ginger can reduce vomiting in children with AGE.
Methods: Double-blind, randomised placebo-controlled trial in outpatients aged 1 to 10 years with AGE-associated vomiting randomised to ginger or placebo. The primary outcome was the occurrence of min. 1 episode of vomiting after the first dose of treatment. Severity of vomiting and safety were also assessed.
Results: Seventy-five children were randomised to the ginger arm and 75 to the placebo arm. Five children in the ginger arm and 4 in the placebo arm refused to participate in the study shortly after randomisation, leaving 70 children in the ginger arm and 71 in the placebo arm (N = 141). At intention-to-treat analysis (N = 150), assuming that all children lost to follow-up had reached the primary outcome, the incidence of the main outcome was 67% (95% CI 56 to 77) in the ginger group and 87% (95% CI 79 to 94) in the placebo group, corresponding to the absolute risk reduction for the ginger versus the placebo group of -20% (95% CI -33% to -7%, P = 0.003), with a number needed to treat of 5 (95% CI 3 to 15).
Conclusion: Oral administration of ginger is effective and safe at improving vomiting in children with AGE.
Effcacy of ginger as antiemetic in children with acute gastroenteritis: a randomised controlled trial, Nocerino R, Cecere G, Micillo M, De Marco G, Ferri P, Russo M, Bedogni G, Berni Canani R, Aliment Pharmacol Ther. 2021 May 21

Summary : The aim of this study was to assess the clinical efficacy and safety of oral ginger for symptomatic treatment of osteoarthritis (OA) by carrying out a systematic literature search followed by meta-analyses on selected studies. Inclusion criteria were randomized controlled trials (RCTs) comparing oral ginger treatment with placebo in OA patients aged min 18 years. Outcomes were reduction in pain and reduction in disability. Harm was assessed as withdrawals due to adverse events. The efficacy effect size was estimated using Hedges' standardized mean difference (SMD), and safety by risk ratio (RR). Standard random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I2). Out of 122 retrieved references, 117 were discarded, leaving five trials (593 patients) for meta-analyses. The majority reported relevant randomization procedures and blinding, but an inadequate intention-totreat (ITT) analysis. Following ginger intake, a statistically significant pain reduction with a low degree of inconsistency among trials, and a statistically significant reduction in disability were seen, both in favor of ginger. Patients given ginger were more than twice as likely to discontinue treatment compared to placebo. Ginger was modestly efficacious and reasonably safe for treatment of OA. We judged the evidence to be of moderate quality, based on the small number of participants and inadequate ITT populations.
Discussion: The present meta-analysis on ginger for OA demonstrated that ginger has a superior effect on OA pain and disability to placebo, and apparently without serious adverse events. As a conclusion, ginger may be considered as part of the treatment of OA, where the patient is motivated for trying this nutraceutical. As with other complementary and alternative therapies, further studies from independent researchers would be able to show if the effects suggested by the present data will stand in the future. Also, as in all treatment of patients which may take other medication, known possible interaction between medicine and nutraceuticals must be considered.
Keywords: Ginger Osteoarthritis Knee Hip Meta-analysis Pain
Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials, E.M. Bartels, V.N. Folmer, H. Bliddal, R.D. Altman, C. Juhl, S. Tarp, W. Zhang, R. Christensen, Osteoarthritis and Cartilage 23 (2015) 13e21

Objective. To evaluate the efficacy and safety of a standardized and highly concentrated extract of 2 ginger species, Zingiber officinale and Alpinia galanga (EV.EXT 77), in patients with osteoarthritis (OA) of the knee.
Methods. Two hundred sixty-one patients with OA of the knee and moderate-to-severe pain were enrolled in a randomized, double-blind, placebocontrolled, multicenter, parallel-group, 6-week study.
After washout, patients received ginger extract or placebo twice daily, with acetaminophen allowed as rescue medication. The primary efficacy variable was the proportion of responders experiencing a reduction in “knee pain on standing,” using an intent-to-treat analysis. A responder was defined by a reduction in pain of min 15 mm on a visual analog scale.
Results. In the 247 evaluable patients, the percentage of responders experiencing a reduction in knee pain on standing was superior in the ginger extract group compared with the control group (63% versus 50%; P = 0.048). Analysis of the secondary efficacy variables revealed a consistently greater response in the ginger extract group compared with the control group, when analyzing mean values: reduction in knee pain on standing (24.5 mm versus 16.4 mm; P = 0.005), reduction in knee pain after walking 50 feet (15.1 mm versus 8.7 mm; P = 0.016), and reduction in the Western Ontario and McMaster Universities osteoarthritis composite index (12.9 mm versus 9.0 mm; P 5 0.087).
Change in global status and reduction in intake of rescue medication were numerically greater in the ginger extract group. Change in quality of life was equal in the 2 groups. Patients receiving ginger extract experienced more gastrointestinal (GI) adverse events than did the placebo group (59 patients versus 21 patients). GI adverse events were mostly mild.
Conclusion. A highly purified and standardized ginger extract had a statistically significant effect on reducing symptoms of OA of the knee. This effect was moderate. There was a good safety profile, with mostly mild GI adverse events in the ginger extract group.
Effects of Ginger on knee pain in patients with Osteoarthritis, Arthritis and Rheumatism, vol 44, No 11, Novembre 2001, pp 2531-5238, American college or Rheumatology, R. D. Altman and K. C. Marcussen

Abstract : The cytoprotective and gastric anti-ulcer studies of ginger have been carried out in albino rats. Cytodestruction was produced by 80% ethanol, 0.6M HC1, 0.2M NaOH and 25% NaCl. Whereas gastric ulcers were produced by ulcerogenic agents including indomethacin, aspirin and reserpine, beside hypothermic restraint stress and by pylorus ligated Shay rat technique. The results of this study demonstrate that the extract in the dose of 500 mg/kg orally exert highly significant cytoprotection against 80% ethanol, 0.6M HCl, 0.2M NaOH and 25% NaCl induced gastric lesions. The extract also prevented the occurrence of gastric ulcers induced by non-steroidal anti-inflammatory drugs (NSAIDs) and hypothermic restraint stress. These observations suggest cytoprotective and anti-ulcerogenic effect of the ginger.
Gastroprotective activity of ginger zingiber officinale rosc., in albino rats,American journal of chinese medecine COl XVII, nos 1-2, pp 51-56 1989;17(1-2):51-6, M A al-Yahya, S Rafatullah, J S Mossa, A M Ageel, N S Parmar, M Tariq

Abstract: High prevalence of asthma require more attention and effective therapies since the current therapeutic approaches have high side effects nowadays new therapies like homeopathy and herbal drugs are more delighted. The study was performed on 92 patients with pure Asthma. The patients were similar concerning the age, wheezing, weekly use of spray and the drug weed. At the beginning, spirometry was done for all the patients. Then of the 1-month the patients were divided into two groups. The first group was given ginger (150 mg) every 8 hours whereas the second group received placebo. After 2 months the patients were tested for spirometry and changes on FEV1, FVC, FEF25-75, stage and clinical symptoms. In the patients (test) group which received ginger with their drugs, 19.5% showed wheezing relief and 52% showed chest tightness relief. Dyspnea was not completely disappeared in the patients. In 8.7% of the patients’ higher stage to lower stage change was observed. Also the mean nocturnal coughs (3.87 to 2.6 times), the mean spray usage (6.34 to 5.04 times weekly) and the mean dyspneic attacks (3.41 to 2.41 weekly) showed clear reduction (P max 0.05). After treatment the test and control groups were analyzed. Dyspnea was 80.4% in test group and 95.6% in control group, wheezing was 78.3% in test group and 100% in control group and chest tightness was 26.1% in test group an 89.1% in control group (P max 0.05). Concerning the stage them was no clear difference between the two groups (p N.S.). After treatment, the coughing attacks in the control group was 3.21 / week and in the test group was 2.61 / week. Also the mean dyspneic attach 100 the control group was 1.89 / week and in the test group was 1.32 / week (P max 0.05). The mean FEV1, FVC and FEF25-75 in the test and control groups were not meaningful statistically (p N.S.). Therefore although the ginger dose and in out study was ½ it’s the therapeutic dose (1-4 gr) the ginger showed effective in reducing the asthmatic symptoms but not effective in changing the stage of the disease and spirometry findings.
Effects of Ginger on the Improvement of Asthma [The Evaluation of Its' Treatmental Effects], gingerol, Pakistan Journal of Nutrition 5 (4): 373-376, 2006 ISSN 1680- 5194

Background: Ginger (Zingiber officinale) extract supplementation has been shown to improve the severity of symptoms and decrease the nonsteroidal antiinflammatory drug (NSAID) requirements in patients with osteoarthritis (OA).
Objective: To assess the effects of ginger extract as an alternative to NSAIDs and as a supplement drug in the symptomatic treatment of OA
Results: The improvement of symptoms (defined as reduction in the mean change) was superior in the ginger extract and ibuprofen groups than the placebo group. VAS scores and gelling or regressive pain after rising the scores were significantly higher in the PL group than both the GE and IBP groups, a month after the treatment (P below 0.0001). However, there was no significant difference in VAS and gelling pain scores between the ginger extract and the ibuprofen groups.
Conclusion: Ginger extract and ibuprofen were significantly more effective than the placebo in the symptomatic treatment of OA, while there was no significant difference between the ginger extract and ibuprofen groups in a test for multiple comparison.
Comparing The Effects Of Ginger (Zingiber Officinale) Extract And Ibuprofen On Patients With Osteoarthritis, Gingerol, Arch Iranian Med 2005; 8 (4): 267 – 27, Masoud Haghighi PhD, Ali Khalvat MD, Tayebeh Toliat PhD, Shohreh Jallaei MSc

Ginger, Zingiber officinale Roscoe (Zingiberaceae), in folk medicine has been used against pain, inflammation, arthritis, urinary infections, and gastrointestinal disorders. The oil of ginger is a mixture of constituents, consisting of monoterpenes (phellandrene, camphene, cineole, citral, and borneol) and sesquiterpenes (zingiberene, zingiberol, zingiberenol, ß-bisabolene, sesquiphellandrene, and others). Aldehydes and alcohols are also present.
Gingerol and its analogs found in rhizome extracts are responsible for many pharmacological activities. Few works have reported the properties of ginger essential oil (GEO). However, several types of terpene compounds are known to present antiinflammatory and antinoceptive activities.
The aim of the present study was to evaluate the antiinflammatory and analgesic effects of GEO administered orally in rodents. Groups of 10 male Swiss mice (25–30 g) and male Wistar rats (190–230 g) were used for evaluation of the antinoceptive and antiinflammatory effects, respectively.
All animals were housed in groups of five and maintained in standardized conditions (12/12 h light/dark cycle, 25°C) with free access to water and food. The protocol for these experiments was approved and was in accordance with the guidelines of the Brazilian Committee of Animal Experimentation.
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Anti-inflammatory and antinociceptive activities of a Zingiber officinale roscoe seential oil in experimental animal models, gingerol, research letter, India J Pharmacology Feb 2006 vol 38 issue 1 58-9

Abstract : Nausea and vomiting of pregnancy (NVP) are often alleviated by eating dried biscuits or foods. Natural products such as ginger have been suggested as herbal remedies for its treatment. The purpose of this study was to determine the effectiveness of ginger in biscuit form for the treatment. Sixty-five women with NVP at or before 17 weeks of gestation, who attended the antenatal clinic of Yahyanejad hospital in Babol town, Northern Iran, during 2005-2006 were included in the study. The subjects were randomized in a double-blind design and divided into two groups to take biscuits. 0.5g of ginger as fine powder was incorporated in each biscuit. Subjects received 5 ginger biscuits per day or an identical placebo biscuit for 4 days. They graded their severity of nausea using visual analog scales (VAS) and recorded the number of vomiting episodes in the previous 24 hours and again during 4 consecutive days. Five-item Likert scales were used to assess the severity of their symptoms. The average VAS scores of day 1 to 4 of post-therapy minus baseline nausea was decreased significantly in ginger (2.6+-1.77) compared with the placebo group (1.4+-1.62) (P=0.01). The number of vomiting episodes was also decreased in ginger (0.96±0.21) and placebo (0.62±0.19), the difference being insignificant. A significant difference was seen in inter-group variations per day in both groups. Likert scale showed an improvement in symptoms in both groups (P=0.43). Therefore, ginger in biscuit form is effective for relieving the severity of nausea and, to some extent, of vomiting in pregnancy
Discussion (partial) : The result of our study showed that ginger is effective for relieving the severity of nausea of pregnancy, which is consistent with previous studies. Since dietary modifications including eating small proportions of food at frequent intervals and ingesting dry toast or crackers are advised, we performed this study and concluded that ginger in biscuit form can be recommended to pregnant women.
The Effect of Ginger Biscuit on Nausea and Vomiting in Early Pregnancy , Tehran University of Medical Sciences, Acta Medica Iranica 2009; 47(1): 51-56 , Zahra Basirat, Ali A. Moghadamnia, Mehrdad Kashifard, Atena Sarifi-Razavi

Abstract : In this study, we evaluated the synergistic effect of ginger and nifedipine on anti-platelet aggregation in normal human volunteers and hypertensive patients. The results showed that the percentage of platelet aggregation induced by collagen, ADP and epinephrine in hypertensive patients was larger than that in normal volunteers. Either aspirin or ginger could potentiate the anti-platelet aggregation effect of nifedipine in normal volunteer and hypertensive patients. These results suggested that ginger and nifedipine possessed synergistic effect on anti-platelet aggregation. A combination of 1 g ginger with 10 mg nifedipine per day could be valuable for cardiovascular and cerebrovascular complication due to platelet aggregation.
Keywords: Ginger; Platelet Aggregation; ADP; Collagen; Epinephrine.
Synergistic Effect of Ginger and Nifedipine on Human Platelet Aggregation A Study in Hypertensive patients and Normal Volunteers, gingerol, American Journal of Chinese Medicine, Vol. 34, No. 4, 545– 551, Haw-Yaw Young, Jung-Chun Liao, Yuan-Shiun Chang, Yen-Lin Luo

Abstract: The present study was designed to compare the antioxidant, anti proliferative and apoptosis effects of ethanolic extract of ginger (Zingiber officinale) with its phenolic component (6)-Gingerol on human hepatorna cell line (HepG2). We found that cytotoxic and anti proliferative effect of ginger extract and (6)-Gingerol could be associated with induction of apoptosis. Both ginger extract and (6)-Gingerol also showed remarkable antioxidant activities in comparison with ascorbic acid and N-acetyl-L-cysteine.
The results of this study indicate that both Zingiber officinale extract and (6)-Gingerol have high DPPH radical scavenging activity. The anticancer effect of Zingiber officinale extract and ( 6)-Gingerol was demonstrated by inhibition of cellular proliferation and induction of apoptosis of hepatorna cells. The antiproliverative and apoptosis effect of ginger extract could be associated mainly with the action of its main phenolic component, (6)-Gingerol. However, ginger extract in its natural form has higher antioxidant, anti.proliferation and apoptotic effect compared to ( 6)-Gingerol.
Antiproliferative, antioxidant and apoptosis effects of Ginger and 6-gingerol on HepG2 cells / Asian journal of Biochemistry 2 (6), 421-426 - Harliansyah, Noor Azian Murad, WanZurinah WanNgah and YasminAnum Mohd Yusof

Abstract : Ginger (rhizome of Zingiber officinale Roscoe) is a widespread herbal medicine mainly used for the treatment of gastrointestinal (GI) disorders including: dyspepsia, nausea and diarrhea. Aromatic, spasmolytic, carminative and absorbent properties of ginger suggest that it has direct effects on the GI tract and anti-ulcerogenic potential. In the present study, the effects of this herbal remedy on an acute model of experimental duodenal ulcer induced by cysteamine was evaluated. Hydroalcoholic extract ofgginger with doses of 100, 350, 700 mg/kg, ranitidine (50 mg/kg), sucralfate (500 mg/kg) and 5 ml/kg of vehicle were administered orally (p.o.) to separate groups of male Wistar rats. Other groups received vehicle (5 ml/kg), extract (300 mg/kg) and ranitidine (50 mg/kg) intraperitoneally (i.p.). After ulcer induction, the number, scoring, area and finally ulcer index were assessed for each duodenum. Administration of extract by i.p. or at chronic doses (350 mg/kg) and ranitidine (p.o. and i.p.) resulted in significant reduction in mucosal damage for the entire ulcer factors which were assessed. Larger doses of extract given p.o. (350 and 700 mg/kg) were effective to reduce both the ulcer area and index but the lowest dose of extract (100 mg/kg) was not effective. Taken together, we conclude that ginger hydroalcoholic extract was effective to protect against duodenal ulceration and for i.p. injection as well as chronic administration, the efficacy was comparable with ranitidine as reference drug.
Keywords: Ginger (Zingiber officinale Roscoe), Duodenal ulcer, Cysteamine, Rats
Anti-Ulcerogenic Effect Of Ginger (rhizome of Zingiber officinale Roscoe) On Cystemine Induced Duodenal Ulcer In Rats, gingerol, DARU Volume 14, No. 2, 2006

Abstract ; To compare the anti-diabetic effects of dietary ginger and garlic, 5-week-old male Sprague-Dawley rats were fed a high-fat (HF) diet (22% fat) for 2 weeks and then randomly divided into six groups of eight animals: Normal Control (NC), Diabetic Control (DBC), Ginger Low (GNL), Ginger High (GNH), Garlic Low (GRL), and Garlic High (GRH) groups. “Low” and “High” indicate addition of 0.5% and 2.0% freeze-dried ginger or garlic powder in their respective diets. Diabetes was induced by an intraperitoneal injection of streptozotocin (40 mg/kg of body weight) in all groups except the NC group. After 4 weeks of feeding of experimental diets, food intake was significantly (P below .05) higher in the GRL group compared to the GRH group. Serum insulin concentrations were significantly higher in the NC and GNH groups compared to the DBC, GNL, and GRL groups, while no significant difference was observed for the GRH group. Better glucose tolerance was observed in the GNH group compared to the DBC and all other ginger- and garlic-fed groups. Final body weight, fasting blood glucose, blood glycated hemoglobin, liver weight, liver glycogen levels, and serum lipid profiles were not influenced by the ginger- or garlic-containing diet. Data of this study suggest that ginger and garlic are insulinotropic rather than hypoglycemic while overall anti-diabetic effects of ginger are better than those of garlic, at least in this experimental condition. Much better anti-diabetic effects of ginger and garlic may be obtained when feeding is with a normal rather than a HF-containing diet
KEY WORDS: garlic, ginger, high-fat diet, rats, type 2 diabetes
Comparative Effects of Dietary Ginger (Zingiber officinale) and Garlic (Allium sativum) investigated in a type 2 diabetes model of rats / Gingerol, JOURNAL OF MEDICINAL FOOD J Med Food 11 (1) 2008, 152– 159 Mary Ann Liebert, Inc. and Korean Society of Food Science and Nutrition

Ginger has long been used as an alternative medication to prevent motion sickness. The mechanism of its action, however, is unknown. We hypothesize that ginger ameliorates the nausea associated with motion sickness by preventing the development of gastric dysrhythmias and the elevation of plasma vasopressin. Thirteen volunteers with a history of motion sickness underwent circular vection, during which nausea (scored 0–3, i.e., none to severe), electrogastrographic recordings, and plasma vasopressin levels were assessed with or without ginger pretreatment in a crossover-design, double-blind, randomized placebo-controlled study. Circular vection induced a maximal nausea score of 2.5 0.2 and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. Ginger also prolonged the latency before nausea onset and shortened the recovery time after vection cessation.
Intravenous vasopressin infusion at 0.1 and 0.2 U/min induced nausea and increased bradygastric activity; ginger pretreatment (2,000 mg) affected neither. Ginger effectively reduces nausea, tachygastric activity, and vasopressin release induced by circular vection. In this manner, ginger may act as a novel agent in the prevention and treatment of motion sickness.
Effects of ginger on motion sickness and gastric slowwave dysrhythmias induced by circular vection, gingerol, Am J Physiol Gastrointest Liver Physiol 284: G481– G489, 2003; 10.1152/ajpgi . 00164 . 2002

Objective: The aim of this study was to specifically determine the impact of a fixed dose of ginger administration, compared with placebo, on the 24-hour postoperative nausea and vomiting. Study design: The design was a systematic review and metaanalysis of trials revealed by searches. in the field. Two reviewers selected studies for inclusion and independently extracted data.
Results: Five randomized trials including a total of 363 patients were pooled for analysis of preventing postoperative nausea and vomiting and postoperative vomiting. The summary relative risks of ginger for postoperative nausea and vomiting and postoperative vomiting were 0.69 (95% confidence interval 0.54 to 0.89) and 0.61 (95% confidence interval 0.45 to 0.84), respectively. Only one side effect, abdominal discomfort, was reported.
Conclusions: This meta-analysis demonstrates that a fixed dose at least 1 g of ginger is more effective than placebo for the prevention of postoperative nausea and vomiting and postoperative vomiting. Use of ginger is an effective means for reducing postoperative nausea and vomiting.
Keywords : Ginger, Postoperative, vomiting, nausea, Zingiber officinale, Meta-analysis, Systematic review
The efficacy of ginger for the prevention of postoperative nausea and vomiting: A meta-analysis, American Journal of Obstetrics and Gynecology (2006) 194, 95–9, Nathorn Chaiyakunapruk, PharmD, PhD, Nantawarn Kitikannakorn, PharmD, Surakit Nathisuwan, PharmD, BCPS, Kittiboon Leeprakobboon, Chutchai Leelasettagool

Objective: To study the efficacy of ginger in prevention of nausea and vomiting after major gynecologic surgery.
Study design: Double blind randomized controlled trial.
Setting: Department of Obstetrics and Gynecology, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand.
Material and Method: From March 2005 to April 2006, 120 patients who underwent major gynecologic surgery were randomized into group A (n = 60) and group B (n = 60). The patients in group A received two capsules of ginger taken one hour before the procedure (one capsule contains 0.5 gram of ginger powder). The patients in group B received the placebo. The visual analog nausea score (VANS) and frequency of vomiting were evaluated at 0, 2, 6, 12, and 24 hours after the operation.
Results: The results demonstrated the statistically significant differences in nausea between group A (48.3%) and group B (66.7%). The VANS was lower in group A compared to group B at 2, 6, 12, and 24 hours. The most statistically significant differences occurred at 2 and 6 hour. The incidence and frequency of vomiting in group A were lower than group B. Side effects caused by ginger were not detected.
Conclusion: Ginger has efficacy in prevention of nausea and vomiting after major gynecologic surgery.
Keywords: Major gynecologic surgery, Ginger, Nausea, Vomiting
The Efficacy of Ginger in Prevention of Postoperative nausea and vomiting after major gynecologic surgery, gingerol, J Med Assoc Thai 2006; 89 (Suppl 4): S130-6, Tongta Nanthakomon MD, Densak Pongrojpaw

Abstract:
Problem statement:The fungal infections could be life-threatening in immunocompromised patients. Candida albicans is the most frequent fungi in the oral cavity.
Approach: The first step for treatment could be done using topical antifungal agents. Nystatine is a choice for mentioned usage but there are some problems in its using including: unfavorite taste, frequency of usage, etc. Finding better replacements is the subject of many studies.
Results: This study was carried out to find an alternative for Nystatine. The study was designed based on laboratory investigations to investigate the antifungal activity of zingiber offcinale (Ginger) on Candida albicans. Candida albicanse (PTCC 5027, ATCC10231) was obtained from Iranian microbial collection and was confirmed by Germ Tube formation test. Ethanolic ginger extract was prepared. The antifungal activity of the extract was determined using Agar dilution and disc diffusion techniques. Data were analyzed by ANOVA test.
Conclusion/ Recommendations: The results showed that the ethanolic extract was effective on Candida albicans (2 mg mL-1) at the concentration of 1:5. The study indicates that ginger extract might have promise in treatment of oral candidiasis
Inhibitory effect on Candida albicans of Ginger Oil, gingerol, American Journal of Applied Sciences 6 (6): 1067-1069, 2009, Zahra Atai, Manijeh Atapour and Maryam Mohseni

Mancozeb is an ethylene- bis- dithio- carbamate fungicide used against a wide range of fungal diseases of field crops and fruits. Treating albino rats with mancozeb induced various histological changes in the liver.These changes include congestion of blood vessels, leucocytic infiltration, cytoplasmic vacuolization of the hepatocytes and pyknosis. Mancozeb also caused significant elevation in serum ALT and AST enzymes. The result of the oxidative stress and antioxidant enzymes in this work revealed that there was a significant increase in malondialdhyde which is lipid peroxidation marker and a significant decrease in the level of serum antioxidant enzyme, superoxide dismutase activity. Treating animals with mancozeb and ginger led to an improvement in the histological liver picture together with significant decrease in ALT and AST activity.Moreover, ginger reduced the level of serum malondialdhyde acting as lipid peroxidation marker and increased the serum level of antioxidant enzyme, superoxide dismutase. The results of the present work indicated that the ameliorative effect of Z.officinale against liver damage induced by mancozeb is mediated by its potent antioxidant activities.
Ameliorative Effect of Ginger (Zingiber officinale ) on Mancozeb Fungicide Induced Liver Injury in Albino Rats, Gingerol, Australian Journal of Basic and Applied Sciences, 1(4): 650- 656, 2007

OBJECTIVES: To estimate whether the use of ginger to treat nausea or vomiting in pregnancy is equivalent to pyridoxine hydrochloride (vitamin B6).
METHODS: A randomized, controlled equivalence trial involving 291 women less than 16 weeks pregnant was undertaken at a teaching hospital in Australia. Women took 1.05 g of ginger or 75 mg of vitamin B6 daily for 3 weeks. Differences from baseline in nausea and vomiting scores were estimated for both groups at days 7, 14, and 21.
RESULTS: Ginger was equivalent to vitamin B6 in reducing nausea (mean difference 0.2, 90% confidence interval [CI] 0.3, 0.8), retching (mean difference 0.3; 90% CI 0.0, 0.6) and vomiting (mean difference 0.5; 90% CI 0.0, 0.9), averaged over time, with no evidence of different effects at the 3 time points.
CONCLUSION: For women looking for relief from their nausea, dry retching, and vomiting, the use of ginger in early pregnancy will reduce their symptoms to an equivalent extent as vitamin B6.
(Obstet Gynecol 2004;103:639–45. © 2004 by The American College of Obstetricians and Gynecologists.)
A Randomized Controlled Trial of Ginger to Treat Nausea and Vomiting in Pregnancy, Gingerol, VOL. 103, NO. 4, APRIL 2004, doi:10.1097/01.AOG. 0000118307. 19798. ec, American College of Obstetricaisn and Gynecologists

Objective: To study the antiemetic effect of ginger root on nausea and vomiting induced by cyclophosphamide.
Methods: A randomized, prospective, cross-over, double-blind study was carried out in patients receiving cyclophosphamide in combination with other chemotherapeutic agents. Patients with atleast two episodes of vomiting in the previous cycle were included. The patients were randomly assigned to receive one of the three antiemetics: ginger, metoclopramide or ondansetron in the first cycle. They were admitted in the ward for 24 h and observed for the incidence of nausea and vomiting and adverse effects if any, were recorded. Patients were crossed over to receive the other antiemetic treatments during the two successive cycles of chemotherapy.
Results: Complete control of nausea was achieved in 62% of patients on ginger, 58% with metoclopramide and 86% with ondansetron. Complete control of vomiting was achieved in 68% of patients on ginger, 64% with metoclopramide and 86% with ondansetron. No adverse effects attributable to ginger were recorded.
Conclusion: Powdered ginger root in the dose used was found to be effective in reducing nausea and vomiting induced by low dose cyclophosphamide in combination with drugs causing mild emesis. The antiemetic efficacy of ginger was found to be equal to that of metoclopramide but ondansetron was found to be superior than the other two.
Ginger as an antiemetic in nausea and vomiting induced by chemotherapy : randomized double blind study, gingerol, Indian Journal of Pharmacology 2003; 35: 32-36, S. Sontakke, V. Thawani, M.S. Naik

Ginger shows promising anticancer properties. No research has examined the pharmacokinetics of the ginger constituents 6-gingerol, 8-gingerol, 10- gingerol, and 6-shogaol in humans. We conducted a clinical trial with 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol, examining the pharmacokinetics and tolerability of these analytes and their conjugate metabolites.
Methods: Human volunteers were given ginger at doses from 100 mg to 2.0 g (N = 27), and blood samples were obtained at 15 minutes to 72 hours after a single p.o. dose. The participants were allocated in a dose escalation manner starting with 100 mg. There was a total of three participants at each dose except for 1.0 g (N = 6) and 2.0 g (N = 9).
Results: No participant had detectable free 6-gingerol, 8-gingerol, 10-gingerol, or 6-shogaol, but 6-gingerol, 8-gingerol, 10-gingerol, and 6-shogaol glucuronides were detected. The 6-gingerol sulfate conjugate was detected above the 1.0-g dose, but there were no detectable 10-gingerol or 6-shogaol sulfates except for one participant with detectable 8-gingerol sulfate. The Cmax and area under the curve values (mean F SE) estimated for the 2.0-g dose are 0.85 F 0.43, 0.23 F 0.16, 0.53 F 0.40, and 0.15 F 0.12 Mg/mL; and 65.6.33 F 44.4, 18.1 F 20.3, 50.1 F 49.3, and 10.9 F 13.0 Mg_hr/mL for 6-gingerol, 8- gingerol, 10-gingerol, and 6-shogaol. The corresponding tmax values are 65.6 F 44.4, 73.1 F 29.4, 75.0 F 27.8, and 65.6 F 22.6 minutes, and the analytes had elimination half-lives max 2 hours. The 8-gingerol, 10-gingerol, and 6- shogaol conjugates were present as either glucuronide or sulfate conjugates, not as mixed conjugates, although 6-gingerol and 10-gingerol were an exception.
Conclusion: Six-gingerol, 8-gingerol, 10-gingerol, and 6- shogaol are absorbed after p.o. dosing and can be detected as glucuronide and sulfate conjugates.
Pharmacokinetics of 6-Gingerol, 8-Gingerol, 10-Gingerol, and 6-Shogaol and Conjugate Metabolites in HealthyHuman Subjects, Cancer Epidemiol Biomarkers Prev 2008;17(8). August 2008, Suzanna M. Zick, Zora Djuric, Mack T. Ruffin, Amie J. Litzinger, Daniel P. Normolle, Sara Alrawi, Meihua Rose Feng, and Dean E. Brenner

ABSTRACT Oxidative modification of LDL is thought to play a key role in the pathogenesis of atherosclerosis.
Consumption of nutrients rich in phenolic antioxidants has been shown to be associated with attenuation of development of atherosclerosis. This study was undertaken to investigate the ex vivo effect of standardized ginger extract on the development of atherosclerosis in apolipoprotein E-deficient (E0) mice, in relation to plasma cholesterol levels and the resistance of their LDL to oxidation and aggregation. E0 mice (n 5 60; 6-wk-old) were divided into three groups of 20 and fed for 10 wk via their drinking water with the following: group i) placebo (control group), 1.1% alcohol and water (11 mL of alcohol in 1 L of water); group ii) 25 mg of ginger extract/d in 1.1% alcohol and water and group iii) 250 mg of ginger extract/day in 1.1% alcohol and water. Aortic atherosclerotic lesion areas were reduced 44% (P max 0.01) in mice that consumed 250 mg of ginger extract/day. Consumption of 250 mg of ginger extract/day resulted in reductions (P max 0.01) in plasma triglycerides and cholesterol (by 27 and 29%, respectively), in VLDL (by 36 and 53%, respectively) and in LDL (by 58 and 33%, respectively). These results were associated with a 76% reduction in cellular cholesterol biosynthesis rate in peritoneal macrophages derived from the E0 mice that consumed the high dose of ginger extract for 10 wk (P max 0.01). Furthermore, peritoneal macrophages harvested from E0 mice after consumption of 25 or 250 mg of ginger extract/day had a lower (P max 0.01) capacity to oxidize LDL (by 45 and by 60%, respectively), and to take up and degrade oxidized LDL (by 43 and 47%, respectively). Consumption of 250 mg of ginger extract/day also reduced (P max 0.01) the basal level of LDL-associated lipid peroxides by 62%. In parallel, a 33% inhibition (P max 0.01) in LDL aggregation (induced by vortexing) was obtained in mice fed ginger extract. We conclude that dietary consumption of ginger extract by E0 mice significantly attenuates the development of atherosclerotic lesions. This antiatherogenic effect is associated with a significant reduction in plasma and LDL cholesterol levels and a significant reduction in the LDL basal oxidative state, as well as their susceptibility to oxidation and aggregation
Ginger Extract Consumption Reduces Plasma Cholesterol, Inhibits LDL Oxidation and Attenuates Development of Atherosclerosis in Atherosclerotic, Apolipoprotein E-Deficient Mice, Gingerol,J. Nutr. 130: 1124–1131, 2000, American Society for Nutritional Sciences, Bianca Fuhrman, Mira Rosenblat, Tony Hayek, Raymond Coleman and Michael Aviram

Abstract: Rhizoma Curcumae longae (Turmeric), Rhizoma zingiberis (ginger root) and Semen lini (linseed) are medicinal plants of which combinations are traditionally used in the treatment of infectious diseases. In this study, methanolic extracts of these plants were assayed for antimicrobial activity against various Gram-negative and Gram-positive bacteria (Bacillus subtilis, Klebsiella pneumoniae, Enterobacter aerogenes, Pseudomonas aeruginosa, Staphylococcus aureus, Listeria monocytogenes, Streptococcus sp., Proteus vulgaris and Escherichia coli). Antimicrobial activity was conducted by the agar well diffusion method. The plant extracts showed various levels of antimicrobial activity on different test microorganisms. The most potent extract was obtained from linseed. But in general, a combination of linseed and ginger root was found to be more effective than they used alone. Turmeric was noneffective on five microorganisms tested. All these results may be, in part, due to the fatty acid content of the plants.
Key words: Antimicrobial activity · medicinal plants · agar diffusion method · turmeric · ginger root · linseed
Antimicrobial Activities and Some Fatty Acids of Turmeric, Ginger Root and Linseed Used in the Treatment of lnfectious Diseases - Seher Gur, Dilek Turgut-Balik and Nazmi Gur - Department of Biology, Faculty of Arts and Sciences, University ofF1rat, 23169 Elazig, Turkey

In the present study, the hypoglycaemic potentials of ginger (Zingiber officinale) were studied in rats. An aqueous extract of raw ginger was administered daily (500 mg/kg, intraperitoneally) for a period of 7 weeks to streptozotocin (STZ)-induced diabetic rats. Fasting blood serum was analysed for blood glucose, cholesterol and triacylglycerol levels. The STZ-injected rats exhibited hyperglycaemia accompanied with weight loss, indicating their diabetic condition. At a dose of 500 mg/kg, raw ginger was significantly effective in lowering serum glucose, cholesterol and triacylglycerol levels in the ginger-treated diabetic rats compared with the control diabetic rats. The ginger treatment also resulted in a significant reduction in urine protein levels. In addition, the ginger-treated diabetic rats sustained their initial weights during the treatment period. Moreover, ginger decreased both water intake and urine output in the STZ-induced diabetic rats. The present results indicate that raw ginger possesses hypo-glycaemic, hypocholesterolaemic and hypolipidaemic potential. Additionally, raw ginger is effective in reversing the diabetic proteinuria observed in the diabetic rats. Thus, ginger may be of great value in managing the effects of diabetic complications in human subjects
Anti-diabetic and hypolipidaemic properties of ginger (Zingiber officinale) in streptozotocin-induced diabetic rats, gingerol, British Journal of Nutrition (2006), 96, 660–666 DOI: 10.1079 /BJN20061849

Plant derived products have been used for medicinal purposes for centuries. At present, it is estimated that about 80% of the world population relies on botanical preparations as medicines to meet their health needs. Herbs and spices are generally considered safe and proved to be effective against certain ailments. They are also extensively used, particularly, in many Asian, African and other countries. In recent years, in view of their beneficial effects, use of spices/herbs has been gradually increasing in developed countries also. Spices and herbs are widely used in phytotherapy, which is using plants and their chemical constituents to eliminate certain health problems. This form of treatment is common in Europe. Among these, Germany holds the largest share (49%). Italy, France and UK hold 10% each; Spain, Netherlands, Belgium 2% each and remaining 15% rest of Europe. About one third of the US adults use herbal remedies. In traditional Indian medicine or Ayurveda, ginger and many other spices have been used as medicine.
Conclusion :
Spices and condiments are an integral part of human diet, particularly in the orient. Besides their use to impart flavour, colour, food preservation and enhance palatability, they have been extensively used in view of their health beneficial effects. Fortunately, even long term consumption of these substances is not known to produce any side effects.
Ginger has been used extensively in folklore medicine to treat common ailments. Now scientific evidences in favour of some of these beneficial properties are emerging which would support their consumption and use to ameliorate certain disorders. Observations from studies on animals suggest that ginger has the ability to stimulate protective enzymes involved in xenobiotic metabolism. Thus, diets rich in some of these phytochemicals can play a major role in providing protection from xenobiotics.
Ginger : its role in xenobiotic metabolism, ICMR Bulletin, June 2003, Vol.33, No.6