ROS (Reactive Oxygen Species) and Nature

Active is used Abstract Oxidative stress, defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses, is discussed in relation to its possible role in the production of tissue damage in diabetes mellitus. Important free radicals are described and biological sources of origin discussed, together with the major antioxidant defense mechanisms. Examples of the possible consequences of free radical damage are provided with special emphasis on lipid peroxidation. Ginger (Zingiber officinale), a member of the Zingiberaceae family, is a popular spice used globally especially in most of the Asian countries. Chemical analysis of ginger shows that it contains over 400 different compounds. The major constituents in ginger rhizomes are carbohydrates (50-70%), lipids (3-8%), terpenes, and phenolic compounds. Terpene components of ginger include zingiberene, β-bisabolene, α-farnesene, β-sesquiphellandrene, and α-curcumene, while phenolic compounds include gingerol, paradols, and shogaol. These gingerols (23-25%) and shogaol (18-25%) are found in higher quantity than others. Besides these, amino acids, raw fiber, ash, protein, phytosterols, vitamins (e.g., nicotinic acid and vitamin A), and minerals are also present. We selected its hypolipidemic and weight lost effects in primary and secondary hyperlipidemic patients. Type of Research study: It was placebo-controlled study. Area of research: Research was conducted in Jinnah hospital, Lahore, Pakistan. Duration of study: It was three months, from January 2018 to June 2018. Material, Method and Results: Already well understood, clearly explained written consent was taken from sixty hyperlipidemic patients age range from 18 to 70 years. Both gender male and female patients were enrolled. Patients were randomly divided in two groups, 30 patients drug ginger pasted-powder advised 5 grams in divided doses with their normal diet for the period of three months. Thirty patients were on placebo pasted-wheat powder, with same color as of ginger powder, to 5 grams in divided doses with normal diet for the period of three months. Their base line lipid profile and body weight was recorded at start of treatment and were advised to come for check-up, fortnightly. When of study over, lipid profile and body weight was measured and compared statistically with pre-treatment values.

laxative and antacid medication. It is also used to warm the body for boosting the circulation and lowering high blood pressure.
Because of its warming effect, ginger acts as antiviral for treatment of cold and flu. Ginger is also used as a flavoring agent in foods and beverages and as a fragrance in soaps and cosmetics. Cardiovascular diseases and stroke are complication of hyperlipidemia, diabetes mellitus, hypertension [1]. Many hypolipidemic drugs have already been proved to be useful in lowering serum lipid levels in patients.
However, its side effects in long term treatment were more reported and its prices were still expensive. Thus, efforts to develop effective and better hypolipidemic drugs had led to the discovery of natural medicinal herbs [2]. The beneficial uses of medicinal plants in traditional system of medicine of many cultures are extensively documented [3]. Several plants have been used as dietary adjuvant and in treating the number of diseases even without any knowledge on their proper functions and constituents [4]. Over 80% of the world population uses natural remedies as medicine and over 70% of doctors in Germany prescribe plant-based medicines [5].
Ginger (Zingiber officinale) is a natural dietary component, which has hypolipidemic, antiplatelet aggregation, antioxidant and anticarcinogenic properties [6]. Ginger is indigenous to southern China, spreading eventually to the Spice Islands, other parts of Asia and subsequently to West Africa and the Caribbean [7].
Ginger was exported to Europe via India in the first century AD as a result of the lucrative spice trade. India remains the largest producer of ginger [8]. Hypolipidemic and antiplatelet therapy is an effective approach for preventing coronary heart disease [9]. Ginger components are suggested as a potential new class of plateletactivation inhibitors without the potential side effects of aspirin, which is most commonly used in this approach. In a comparison of gingerols and analogs with aspirin, ginger compounds were found to be less potent compared to aspirin in inhibiting arachidonic acidinduced platelet release and aggregation and COX activity. However, several analogs had a significant inhibitory effect, suggesting that further development of more potent gingerol analogs might have value as an alternative to aspirin therapy in preventing ischemic heart disease [10,11]. Mechanism by which ginger may lower cholesterol is well understood by scientists and other researchers [12].

Material and Method
Research study was conducted at Jinnah hospital Lahore Pakistan, from January 2018 to June 2018. Written consent was taken from sixty hyperlipidemic patients age range from 18 to 70 years. Both gender male and female patients were enrolled. Patients were randomly divided in two groups, 30 patients were on drug ginger pasted-powder advised to take 5 grams in divided doses with their normal diet for the period of three months. Thirty patients were on placebo pasted-wheat powder, with same color as of ginger powder, advised to take 5 grams in divided doses with their normal diet for the period of three months. Their base line lipid profile (for total serum cholesterol, LDL-cholesterol ) and body weight was recorded at start of treatment and were advised to come for check-up, fortnightly. When duration of study was over, their lipid profile and body weight was measured and compared statistically with pre-treatment values. Serum total cholesterol was estimated by the enzymatic calorimatic method. Serum LDL-cholesterol was calculated by Friedwald formula (LDL-Cholesterol=Total Cholesterol-(Triglycerides/5 +HDL-Cholesterol). Body weight was determined by conventional method of usual weight machine Data were expressed as the mean ± SD and paired "t" test was applied to determine statistical significance as the difference. A probability value of <0.05 was considered as non-significance and P<0.001 was considered as highly significant change in the results.

Results
Three months treatment with 5 grams of Ginger reduced LDL-cholesterol from 185.21±2.01 to 157.72±1.90mg/dl, which is highly significant change in the parameter (p-value <0.001). Serum total cholesterol at baseline was 251.11±2.00mg/dl, which reduced to 230.71±1.77mg/dl. This change is highly significant statistically, with p-value <0.001. Mean body weight decreased from 79.01±kg to 77.32±2.61kg in three months therapy. All changes are highly significant statistically, having p-value <0.001. In placebo group LDL-Cholesterol, serum total cholesterol and body weight reduction was 0.18, 0.77, and 0.22 % respectively. All these changes are non-significant (p-value >0.05). Detailed changes are shown in following.

Key
If ± indicates standard error of mean, p-value >0.05 indicates non significant and P<0.001 indicates highly significant change in lipid profile. LDL-C means low density lipoprotein cholesterol 0mg/ dl, T-C means total serum cholesterol mg/dl, and body weight is measured in kg.

Discussion
Oxidative stress, defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses, is discussed in relation to its possible role in the production of tissue damage in diabetes mellitus, hyperlipidemia, hypertension etc. In our research study ginger was used in thirty male and female hyperlipidemic patients for three months, which reduced LDL- observed less effect on LDL-cholesterol, i.e.; from 179.57±2.29mg/ dl to 176.92±2.11mg/dl when they used three grams of ginger for the period of 6 months in 82 hyperlipidemic subjects (Table 1).