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Presented by
Dr. Sudhakar Kokate
Director PPRC, India
About disease
∞ Inflammation of a joint characterised by pain,
swelling and limitation of a joint movement
∞ Osteo-arthrit...
About disease
∞ Rheumatoid arthritis (RA)
- Most common disease

- Affects 1% of world population
- Involves many joints

...
About disease

PPRC/INDIA 03
Drugs in Practice
∞ Non-steroidal anti-inflammatory drugs
(NSAIDS)
…. For symptomatic treatment of
OA and RA
Side effects
...
Side effects of NSAIDS drugs
∞ Propensity to cause stomach ulcers

- GI bleeding
- Perforations
∞ New cox – 2 drugs

- Lon...
Side effects of NSAIDS drugs
∞ USFDA withdrawn from market
∞ Biologics drugs
(Anti-bodies for IL-1, IL-6, TNF-ɑ)
Benefits:...
Disadvantages
∞ Not effective universally
∞ Higher costs

∞ Severe side effects as life – threatening
infections
∞ Increas...
Emerging CAM therapy
∞ CAM: Complementary and Alternative
Medicine
∞ Use of accu-puncture
∞ 60-90% of dissatisfied patient...
Symptoms of Arthritis
∞ Caused due to the aggravation of vata
(air) dosha and accumulation of Ama

(toxins) gets deposited...
Osteoarthritis
∞ Most common joint disease
∞ Women >55 yrs age affected
∞ 12% incidences of Osteoarthritis in India
∞ Cond...
Emerging new trends
in
the development
of
PhytoDrugs
In

Arthritis
PPRC/INDIA 11
Ashwagandha
Withania somnifera

PPRC/INDIA 12
Withania somnifera
• The root contains traces of an essential oil
• It is effective in the treatment of rheumatic

infecti...
Ajwain
Trachyspermum ammi

PPRC/INDIA 14
Trachyspermum ammi
• The seeds are used as a household remedy for
indigestion, colic, diarrhoea, flatulence and asthma

• ...
Alfalfa
Medicago sativa

PPRC/INDIA 16
Medicago sativa
• It contains 1-canavanine, an amino acid causes
curing properties against joint pain

PPRC/INDIA 17
Angelica
Angelica archangelica

PPRC/INDIA 18
Angelica archangelica
• It is used in European folk medicine
• Western

variety

has

12

anti-inflammatory

constituents,...
Black cohosh
Cimicifuga racemosa

PPRC/INDIA 20
Cimicifuga racemosa
• There are five species worldwide that have been
used to treat rheumatism

• It contains aspirin-like...
Celery
Apium graveolens

PPRC/INDIA 22
Apium graveolens
• Eating raw or cooked celery seeds or large amount
of this plant to treat rheumatism arrived in North

A...
Chaparral
Larrea tridentata

PPRC/INDIA 24
Larrea tridentata
• It is widely promoted in health food-stores as a
treatment for arthritis

• Externally as a wash or in...
Cat’s claw
Uncaria tomentosa, Uncaria guianensis

PPRC/INDIA 26
Uncaria tomentosa, Uncaria guianensis
• This plant contains oxindole alkaloids tannis,
quinoxic acid glycosides, flavonoid...
Devdaru
Cedrus deodara

PPRC/INDIA 28
Cedrus deodara
• It is acute and pungent in action
• This is one of the most useful drug

• It is used in combination with...
Ginseng liquor
Panax quinquefolius

PPRC/INDIA 30
Panax quinquefolius
• It contains ginsenosides which has a variety of
pharmacological actions

• It handles a wide variety...
Garlic
Allium sativum

PPRC/INDIA 32
Allium sativum
• It possesses anti-inflammatory anti-arthritic, hypolipidemic, anti-coagulant, hypo-proteomic, hypo-

chol...
Gandhaprasarini
Paederia foetida

PPRC/INDIA 34
Paederia foetida
• This plant exhibits disease modifying antirheumatic activity

• It also helps in treating inflammatory ...
Ginger
Zingiber officinale

PPRC/INDIA 36
Zingiber officinale
• Chromatographic fraction results showed that most
of the fractions containing gingerols / gingerol

...
Green tea
Camellia sinensis

PPRC/INDIA 38
Camellia sinensis
• One of the most commonly consumed beverages in
the world with no side-effects

• Sufficient experiment...
Hop tea
Humulus lupulus

PPRC/INDIA 40
Humulus lupulus
• It contains 32 constituents that have antiinflammatory activities

• 10 out of them may act as sedative
...
Karpura
Cinnamomum camphora

PPRC/INDIA 42
Cinnamomum camphora
• When applied on the affected area camphor may
redden the skin and produce a warm sensation

• When r...
Pepper
Piper nigrum

PPRC/INDIA 44
Piper nigrum
• As an external application, it dilates the superficial
vessels and acts as a counter-irritant

• It is used...
Liquorice
Glycyrrhiza glabra

PPRC/INDIA 46
Glycyrrhiza glabra
• It acts on the body without any harmful side-effects
• It has significant anti-inflammatory and anti-...
Mustard plaster
Brassica alba, Brassica juncea

PPRC/INDIA 48
Brassica alba, Brassica juncea
• Popular counter-irritant treatment for arthritis
• Active principle – allyl-isothiocyanat...
Pineapple
Ananas comosus

PPRC/INDIA 50
Ananas comosus
• Active principle – “Bromelain” helps prevent
inflammation
• Athletic trainers recommend pineapple for ath...
Rosemary
Rosmarinus officinalis

PPRC/INDIA 52
Rosmarinus officinalis
• The leaves of this plant contain carnosal, oleanolic
acid rosmarinic acid and ursdic acid which a...
Red pepper
Capsicum sp.

PPRC/INDIA 54
Capsicum sp.
• It interferes with pain perception
• It contains capsaicin salicylates and others

• These help to relieve ...
Sesame seeds
Sesamum indicum

PPRC/INDIA 56
Sesamum indicum
• Chinese folk medicine to eat seeds

• ½ ounce of the seeds contain 4 gm of essential
fatty acids, 175 mg...
Stinging nettle
Urtica dioica

PPRC/INDIA 58
Urtica dioica
• Official remedy for rheumatism in Germany
• Most important herb to consider for treating early
onset arthr...
Thunder god vine
Tripterygium wilfordii Hook f.

PPRC/INDIA 60
Tripterygium wilfordii Hook f.
• It is a perennial vine-like plant that grows in
Southern China and Taiwan

• Root extract...
Turmeric
Curcuma longa

PPRC/INDIA 62
Curcuma longa
• Curcumin, the yellow pigment of Turmeric has
significant anti-inflammatory action

• Curcumin – effective ...
Wild cucumber bark

PPRC/INDIA 64
Wild cucumber bark
• Best plant for treating rheumatism and arthritis
• It is to be taken in drinking alcohol or tea

PPRC...
Wild yam
Dioscorea villosa

PPRC/INDIA 66
Dioscorea villosa
• Contains “Diosgenin” a steroid constituent with
anti-inflammatory properties
• Wild yam tea popular fo...
Willow
Salix spp.

PPRC/INDIA 68
Salix spp.
• Active principle: “Salicin”
• Pain relieving and anti-inflammatory properties

PPRC/INDIA 69
Wintergreen
Gaultheria procumbens

PPRC/INDIA 70
Gaultheria procumbens
• Chief active principle: Methylsalicylate
• Dried herb is used

PPRC/INDIA 71
Yucca
Yucca filamentosa

PPRC/INDIA 72
Yucca filamentosa
• To reduce arthritic pain
• Saponin

extract

of

Yucca

showed

positive

therapeutic effect
• It decr...
Thank you !!
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Arthritis

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Arthritis is a common problem in winter and in the daily lives of many across the globe. Presenting here few natural medicine for healing and relief from painful moments

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Arthritis

  1. 1. Presented by Dr. Sudhakar Kokate Director PPRC, India
  2. 2. About disease ∞ Inflammation of a joint characterised by pain, swelling and limitation of a joint movement ∞ Osteo-arthritia (OA) – Knee and hip…debilitating disease affected – More in women than male – Increases with ageing PPRC/INDIA 01
  3. 3. About disease ∞ Rheumatoid arthritis (RA) - Most common disease - Affects 1% of world population - Involves many joints PPRC/INDIA 02
  4. 4. About disease PPRC/INDIA 03
  5. 5. Drugs in Practice ∞ Non-steroidal anti-inflammatory drugs (NSAIDS) …. For symptomatic treatment of OA and RA Side effects risk in use - many limitations PPRC/INDIA 04
  6. 6. Side effects of NSAIDS drugs ∞ Propensity to cause stomach ulcers - GI bleeding - Perforations ∞ New cox – 2 drugs - Long term use may increase the risk of stroke and heart attack PPRC/INDIA 05
  7. 7. Side effects of NSAIDS drugs ∞ USFDA withdrawn from market ∞ Biologics drugs (Anti-bodies for IL-1, IL-6, TNF-ɑ) Benefits: - Reduce inflammation - Joint destruction PPRC/INDIA 06
  8. 8. Disadvantages ∞ Not effective universally ∞ Higher costs ∞ Severe side effects as life – threatening infections ∞ Increases risk of malignances PPRC/INDIA 07
  9. 9. Emerging CAM therapy ∞ CAM: Complementary and Alternative Medicine ∞ Use of accu-puncture ∞ 60-90% of dissatisfied patients use this therapy PPRC/INDIA 08
  10. 10. Symptoms of Arthritis ∞ Caused due to the aggravation of vata (air) dosha and accumulation of Ama (toxins) gets deposited in the weak areas of the body ∞ Weak digestion, constipation, overeating and little physical activity PPRC/INDIA 09
  11. 11. Osteoarthritis ∞ Most common joint disease ∞ Women >55 yrs age affected ∞ 12% incidences of Osteoarthritis in India ∞ Condition of synovial joints characterised by cartilage loss with peri-articular response PPRC/INDIA 10
  12. 12. Emerging new trends in the development of PhytoDrugs In Arthritis PPRC/INDIA 11
  13. 13. Ashwagandha Withania somnifera PPRC/INDIA 12
  14. 14. Withania somnifera • The root contains traces of an essential oil • It is effective in the treatment of rheumatic infections • The water soluble portion of the root extract contains indefinite amorphous substances and a quantity of sugar PPRC/INDIA 13
  15. 15. Ajwain Trachyspermum ammi PPRC/INDIA 14
  16. 16. Trachyspermum ammi • The seeds are used as a household remedy for indigestion, colic, diarrhoea, flatulence and asthma • In arthritis it is quite effective • Ref. The Ayurvedic Pharmacopoeia of India, New Delhi Part I, Vol. I, II • Waltis T.E. - Textbook of Pharmacogney PPRC/INDIA 15
  17. 17. Alfalfa Medicago sativa PPRC/INDIA 16
  18. 18. Medicago sativa • It contains 1-canavanine, an amino acid causes curing properties against joint pain PPRC/INDIA 17
  19. 19. Angelica Angelica archangelica PPRC/INDIA 18
  20. 20. Angelica archangelica • It is used in European folk medicine • Western variety has 12 anti-inflammatory constituents, 10 anti-spasmodic constituents and 5 anodyne ones • Chinese species is sold in North America in the name of dang guei or dang quai PPRC/INDIA 19
  21. 21. Black cohosh Cimicifuga racemosa PPRC/INDIA 20
  22. 22. Cimicifuga racemosa • There are five species worldwide that have been used to treat rheumatism • It contains aspirin-like substances and the root of the plant is very beneficial • Other anti-inflammatory and anti-spasmodic constituents PPRC/INDIA 21
  23. 23. Celery Apium graveolens PPRC/INDIA 22
  24. 24. Apium graveolens • Eating raw or cooked celery seeds or large amount of this plant to treat rheumatism arrived in North America • Celery is rich in minerals • 1 cup of celery contains 350 mg of potassium PPRC/INDIA 23
  25. 25. Chaparral Larrea tridentata PPRC/INDIA 24
  26. 26. Larrea tridentata • It is widely promoted in health food-stores as a treatment for arthritis • Externally as a wash or internally as a tea PPRC/INDIA 25
  27. 27. Cat’s claw Uncaria tomentosa, Uncaria guianensis PPRC/INDIA 26
  28. 28. Uncaria tomentosa, Uncaria guianensis • This plant contains oxindole alkaloids tannis, quinoxic acid glycosides, flavonoids and sterols • Extract of this herb is effective in arthritis PPRC/INDIA 27
  29. 29. Devdaru Cedrus deodara PPRC/INDIA 28
  30. 30. Cedrus deodara • It is acute and pungent in action • This is one of the most useful drug • It is used in combination with other anti-pyretics PPRC/INDIA 29
  31. 31. Ginseng liquor Panax quinquefolius PPRC/INDIA 30
  32. 32. Panax quinquefolius • It contains ginsenosides which has a variety of pharmacological actions • It handles a wide variety of stresses effective in rheumatism PPRC/INDIA 31
  33. 33. Garlic Allium sativum PPRC/INDIA 32
  34. 34. Allium sativum • It possesses anti-inflammatory anti-arthritic, hypolipidemic, anti-coagulant, hypo-proteomic, hypo- cholesterolemic, anti-bacterial, anti-fungal, antihypersensitive and hypo-glycaemic action PPRC/INDIA 33
  35. 35. Gandhaprasarini Paederia foetida PPRC/INDIA 34
  36. 36. Paederia foetida • This plant exhibits disease modifying antirheumatic activity • It also helps in treating inflammatory disorders PPRC/INDIA 35
  37. 37. Ginger Zingiber officinale PPRC/INDIA 36
  38. 38. Zingiber officinale • Chromatographic fraction results showed that most of the fractions containing gingerols / gingerol derivatives were excellent inhibitors of LPS-induced PGE-2 production • Ginger extract when administered daily for 4 weeks caused significant reduction in PGE-2 levels in rats PPRC/INDIA 37
  39. 39. Green tea Camellia sinensis PPRC/INDIA 38
  40. 40. Camellia sinensis • One of the most commonly consumed beverages in the world with no side-effects • Sufficient experimental proof on the effect of Green tea’s anti-inflammatory and chondro- protective properties at molecular level PPRC/INDIA 39
  41. 41. Hop tea Humulus lupulus PPRC/INDIA 40
  42. 42. Humulus lupulus • It contains 32 constituents that have antiinflammatory activities • 10 out of them may act as sedative • It is popular remedy for rheumatism PPRC/INDIA 41
  43. 43. Karpura Cinnamomum camphora PPRC/INDIA 42
  44. 44. Cinnamomum camphora • When applied on the affected area camphor may redden the skin and produce a warm sensation • When rubbed into painful, stiff joints, ligaments and muscles, it provides soothing “camphor-ice” relief PPRC/INDIA 43
  45. 45. Pepper Piper nigrum PPRC/INDIA 44
  46. 46. Piper nigrum • As an external application, it dilates the superficial vessels and acts as a counter-irritant • It is used as an analgesic liniment for myalgia and rheumatic pains PPRC/INDIA 45
  47. 47. Liquorice Glycyrrhiza glabra PPRC/INDIA 46
  48. 48. Glycyrrhiza glabra • It acts on the body without any harmful side-effects • It has significant anti-inflammatory and anti-allergy activity • It has been historically in the treatment of inflammation, allergy and asthma PPRC/INDIA 47
  49. 49. Mustard plaster Brassica alba, Brassica juncea PPRC/INDIA 48
  50. 50. Brassica alba, Brassica juncea • Popular counter-irritant treatment for arthritis • Active principle – allyl-isothiocyanate • Crush the seeds in grinder, moisten the mixture with vinegar and sprinkle the flour. Spread mixture on cloth and place it on skin for > 20 mins. After removal, wash the affected area PPRC/INDIA 49
  51. 51. Pineapple Ananas comosus PPRC/INDIA 50
  52. 52. Ananas comosus • Active principle – “Bromelain” helps prevent inflammation • Athletic trainers recommend pineapple for athletes to prevent and treat sports injury • Bromelain help the body to get rid of immune antigen complex compounds that are implicated in arthritic conditions PPRC/INDIA 51
  53. 53. Rosemary Rosmarinus officinalis PPRC/INDIA 52
  54. 54. Rosmarinus officinalis • The leaves of this plant contain carnosal, oleanolic acid rosmarinic acid and ursdic acid which acts as an anti-inflammatory activity PPRC/INDIA 53
  55. 55. Red pepper Capsicum sp. PPRC/INDIA 54
  56. 56. Capsicum sp. • It interferes with pain perception • It contains capsaicin salicylates and others • These help to relieve arthritis PPRC/INDIA 55
  57. 57. Sesame seeds Sesamum indicum PPRC/INDIA 56
  58. 58. Sesamum indicum • Chinese folk medicine to eat seeds • ½ ounce of the seeds contain 4 gm of essential fatty acids, 175 mg of calcium, 64 mg of magnesium, 0.73 mg of copper • Increased copper intake may be important during arthritis attacks • A rind ½ ounce of seeds & sprinkle on food PPRC/INDIA 57
  59. 59. Stinging nettle Urtica dioica PPRC/INDIA 58
  60. 60. Urtica dioica • Official remedy for rheumatism in Germany • Most important herb to consider for treating early onset arthritis • Contains anti-inflammatory component similar to that of steroid drugs • Dose: 1 tablespoon juice thrice a day, freeze the juice if needed PPRC/INDIA 59
  61. 61. Thunder god vine Tripterygium wilfordii Hook f. PPRC/INDIA 60
  62. 62. Tripterygium wilfordii Hook f. • It is a perennial vine-like plant that grows in Southern China and Taiwan • Root extract is for treatment of various autoimmune and inflammatory diseases including RA PPRC/INDIA 61
  63. 63. Turmeric Curcuma longa PPRC/INDIA 62
  64. 64. Curcuma longa • Curcumin, the yellow pigment of Turmeric has significant anti-inflammatory action • Curcumin – effective as cortisone in inflammation • Dosage: 400-600 mg thrice a day • Non-toxic dietary pigment quite useful in arthritis • It is effective in liver infections PPRC/INDIA 63
  65. 65. Wild cucumber bark PPRC/INDIA 64
  66. 66. Wild cucumber bark • Best plant for treating rheumatism and arthritis • It is to be taken in drinking alcohol or tea PPRC/INDIA 65
  67. 67. Wild yam Dioscorea villosa PPRC/INDIA 66
  68. 68. Dioscorea villosa • Contains “Diosgenin” a steroid constituent with anti-inflammatory properties • Wild yam tea popular folk remedy for muscular rheumatism • Dosage: 1 ounce of wild yam root + 1 ginger root = fill jar with boiling water – mixture at room temp. Drink 2 – 3 cups / day PPRC/INDIA 67
  69. 69. Willow Salix spp. PPRC/INDIA 68
  70. 70. Salix spp. • Active principle: “Salicin” • Pain relieving and anti-inflammatory properties PPRC/INDIA 69
  71. 71. Wintergreen Gaultheria procumbens PPRC/INDIA 70
  72. 72. Gaultheria procumbens • Chief active principle: Methylsalicylate • Dried herb is used PPRC/INDIA 71
  73. 73. Yucca Yucca filamentosa PPRC/INDIA 72
  74. 74. Yucca filamentosa • To reduce arthritic pain • Saponin extract of Yucca showed positive therapeutic effect • It decreases bacterial endotoxin absorption thus reducing inhibition of cartilage synthesis PPRC/INDIA 73
  75. 75. Thank you !!

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