Ginkgo Group Research Articles

A Comparative Analysis of the Efficacy of Ginkgo Biloba and Caroverine in the Management of Idiopathic Tinnitus.

The sound sensation that is experienced in the ears or brain and is unrelated to any external sources of stimulus is known as tinnitus. Tinnitus Functional Index (TFI) is used to establish the presence of the condition and determine symptom severity, its impact on the patient's quality of life, thus in this study, we aim to compare the efficacy of caroverine and Ginkgo Biloba in the management of idiopathic tinnitus using TFI. This clinical study was conducted in at a tertiary care hospital in North India, for a duration of one year, among patients with chronic tinnitus. The sample size for this study consisted of 60 patients in each of three groups (caroverine, gingko biloba, and multivitamin). Assessments of TFI and pure-tone audiometry were performed to evaluate the efficacy of the two medications. The information pertaining to the subjects was kept anonymous and confidential. During data analysis, an association was significant for p value < 0.05. The patients in three groups were matched for the age, gender and duration of tinnitus. At 6 months of medication with Ginkgo Biloba, patients experienced a significant (p < 0.0001) decrease of 50.0% in tinnitus of moderate severity, and a complete resolution of severe tinnitus symptoms with a percentage change of -100.0%. In our study, Ginkgo Biloba Group has significantly improved the severity of idiopathic tinnitus. Tinnitus has diverse underlying mechanisms, can be a symptom of various underlying diseases, and is challenging to measure. Further research is warranted to validate and explore these treatment options further.

Effects of Aerobic Interval Training Along with Ginkgo biloba Supplementation on Passive Avoidance Memory and GDNF Gene Expression in Alzheimer Rats

Background: Alzheimer's disease (AD) represents the most prevalent form of dementia, characterized by memory loss, and is a complex, progressive neurodegenerative condition. Objectives: This study aimed to explore the impact of aerobic interval training (AIT) combined with Ginkgo biloba (GB) supplementation on passive avoidance memory function and the expression of the glial cell-derived neurotrophic factor (GDNF) gene in rats afflicted with AD. Methods: A total of forty-four male Wistar rats, each weighing approximately 250 ± 20 g, were maintained in a controlled environment at a specified temperature. Over 8 weeks (5 days per week), they underwent AIT and received GB supplements at a dosage of 100 mg/kg. The rats were randomly assigned into six groups: Healthy control (HC) with 7 rats, AD control (AC) with 8 rats, amyloid-β (Aβ) injection plus GB supplement (Aβ + GB) with 8 rats, Aβ injection plus GB supplement plus AIT (Aβ + GB + AIT) with 8 rats, Aβ injection plus AIT (Aβ + AIT) with 8 rats, and sham surgery (SS) with 5 rats. The shuttlebox apparatus was utilized to assess the effect of Aβ on passive avoidance memory and to confirm disease induction. GDNF gene expression was measured using the qRT-PCR method. Results: The study found significant improvements in passive avoidance memory in the Aβ + AIT and Aβ + GB + AIT groups compared to the AC group after 8 weeks of AIT and GB supplementation (P = 0.02 and P = 0.000, respectively). Long-term memory performance was notably enhanced in the Aβ + GB + AIT group (P = 0.000). Additionally, GDNF expression significantly increased in the Aβ + GB + AIT and Aβ + GB groups in comparison to the AC group (P = 0.000 and P = 0.01, respectively). Conclusions: A synergistic effect of AIT and GB supplementation was observed, leading to an increase in GDNF gene expression and improvements in both passive avoidance memory and long-term memory in male rats with AD.

Study of the effect of bezafibrate with ginkgo biloba extracts in an animal model of hepatotoxicity induced by doxorubicin

This study aimed to evaluate the hepatoprotective effect of combining bezafibrate with ginkgo biloba in doxorubicin-induced hepatotoxicity in rats. Thirty Wister albino rats were allocated into five groups: The negative control group, the positive control group, both received 1 ml of D.W, bezafibrate group received (100 mg/kg), ginkgo biloba group received (60 mg/kg) and the fifth group received bezafibrate + ginkgo biloba. All the treatments were for 14 days along with doxorubicin on days 11–14 except for the negative control. Blood samples were used for the measurement of ALT, AST, ALP, total protein, total bilirubin, albumin, globulin, GSH, catalase, and IL-6. Liver tissue was sent for histopathological examination. The combination of ginkgo biloba and bezafibrate significantly decreased AST, ALP, AST/ALT ratio, albumin/globulin ratio, and IL-6 with significant elevations of catalase, and GSH. The combination group produced more hepatoprotection. This could be attributed to the additive anti-inflammatory and antioxidant effects of the combination.

The clinical efficacy and safety of Ginkgo biloba in vertigo patients: A meta-analysis

ObjectiveWe detected the clinical efficacy and safety of Ginkgo biloba in vertigo patients through a meta-analysis method. MethodPubMed, Web of Science, Embase, Cochrane, EBSCO, CBM, CNKI, and Wanfang databases were searched for randomized controlled trials. Data about the clinical efficacy and safety of vertigo patients were collected. The Ginkgo biloba groups were pooled to compare with the control groups and obtain the pooled odds ratios and associated 95 % confidence interval. ResultsWe retrieved 25 randomized controlled studies enrolling 1209 patients. The addition of Ginkgo biloba improved vertigo in patients with vertebrobasilar artery insufficiency, cervical vertigo, and not-specific-disease vertigo but not in BPPV and Meniere’s disease. The incidence of adverse reactions such as headache, gastrointestinal discomfort, and skin rashes in the Ginkgo biloba group did not differ significantly from that of the control group. ConclusionThe addition of Ginkgo biloba had better clinical efficacy in patients with vertebrobasilar artery insufficiency, cervical vertigo, and not-specific-disease vertigo but not in BPPV and Meniere’s disease, and the Ginkgo biloba group had no significant differences in adverse reactions compared with the control group.

Evaluating the role of Ginkgo biloba extract in the secondary prevention of acute ischemic stroke with cerebral microbleeds by quantitative susceptibility mapping (QSM)

Background EGb 761, a standardized dry extract of Ginkgo biloba leaves, has certain anti-inflammatory and thrombotic effects and can be used to treat cerebrovascular diseases. Methods A total of 49 patients were randomly assigned to the Aspirin group (24 cases in Controlled group) and the Aspirin + Ginkgo biloba group (25 cases in Treatment group). The quantitative magnetic sensitivity and venous oxygen saturation of cerebral microbleeds were analyzed at admission, discharge, and after follow-up for 3 and 6 months. Results The demographic details age, gender, and admission to NIHSS were not significantly different between the two groups (p < 0.05). Quantitative susceptibility mapping (QSM) showed that the magnetic sensitivity of patients in both groups remained stable after 3 and 6 months of follow-up, while the venous oxygen saturation of the Treatment group increased. The venous oxygen saturation at 3 and 6 months of follow-up was negatively correlated with the modified mRS grade score. Conclusions QSM can be used as a quantitative follow-up tool in monitoring both oxygen saturation and Magnetic susceptibility of microbleeds noninvasively in ischemic stroke patients with cerebral microbleeds. EGB combined with Aspirin can improve blood oxygen saturation in those patients and this effect is particularly significant in the long-term efficacy of secondary prevention.

Naoxin'an capsules protect brain function and structure in patients with vascular cognitive impairment.

Introduction: Vascular cognitive impairment (VCI) is one of the most common types of dementia. Naoxin'an capsule (NXA), a traditional Chinese medicine compound, has been used to treat VCI for a long time in the clinic. Previous studies proved that the NXA capsules could ameliorate the cerebral mitochondrion deficits of VCI animals. This study aimed to investigate the protectiveness of NXA on human brain structure and function in patients with VCI. Methods: In total, 100 VCI patients were enrolled in this 24-week trial and randomly divided into the NXA capsules group (n = 50) and the ginkgo biloba capsules control group (n = 50). Before and after the treatment, cognitive behavior tests and multimodal brain magnetic resonance imaging were analyzed to comprehensively evaluate the effectiveness of NXA treatment on VCI patients after 24 weeks. Results: We found that the NXA group significantly improved overall cognitive ability (Alzheimer's Disease Assessment Scale-Cognitive section, p = 0.001; Mini-Mental Status Examination, p = 0.003), memory (Rey-Osterrieth Complex Figure test, p < 0.001) and executive function (Trail Making Test-A, p = 0.024) performance after treatment compared with the control group. For brain function, the degree of centrality in the left middle frontal gyrus, right postcentral gyrus, and left supplementary motor area increased in the NXA group and decreased in the ginkgo biloba group after treatment. The fractional amplitude of low-frequency fluctuation (fALFF) of the left precentral and right superior parietal gyrus increased, and the fALFF of the right parahippocampal and left inferior temporal gyrus decreased in the NXA group after treatment. For brain structure, the gray matter density of the left postcentral gyrus increased in the NXA group after treatment, and the total volume of white matter hyperintensity showed a decreasing trend but was not statistically significant. Furthermore, the improvement effect of NXA on executive function was associated with changes in brain function. Conclusion: These findings suggest that the NXA capsules improved cognitive performance and multiregional brain function, as well as gray matter structure in the postcentral gyrus.

Protective effect of Ginkgo biloba and Olive oil on the reproductive performance of male albino rats exposed to oxidative stress induced by Potassium dichromate

The present study is designed to demonstrate the effect of Ginkgo biloba and Olive oil on the reproductive performance of male rats exposed to oxidative stress induced by Potassium dichromate with respect to male sex hormones, semen parameters and testicular antioxidant system,. Forty Wister albino rats were distributed into four groups and each group have ten rats, control group, Potassium dichromate group (Potassium dichromate 24 mg/kg administered with gavage for 2 month), Potassium dichromate treated with Ginkgo biloba group (Potassium dichromate and Ginkgo biloba 40 mg/kg administered at half an hour interval for 2 months) and Potassium dichromate treated with olive oil group (Potassium dichromate and Olive oil 1 ml/kg administered at half an hour interval for 2 months). The statistical analysis of results showed a significant (P&lt;0.05) decrease in sperms count, the percentage of sperms viability, the level of sex hormones, ceruloplasmin, glutathione concentration, and superoxide dismutase activity, antioxidant activity (AOA), germinal epithelium height and diameter of seminiferous tubules and a significant increase of sperm percentage abnormalities, dead sperm, malondialdelyde (MDA), peroxynitrite (ONOO-) in Potassium dichromate group, compared with control group. The administration of Potassium dichromate with Ginkgo biloba and Olive oil separately result in a significant increase of sperms count, sperms viability, sex hormones levels, ceruloplasmin, glutathione concentration , superoxide dismutase and antioxidant activity, germinal epithelium height and diameter of seminiferous tubules and a significant decrease of sperm abnormalities, dead sperm percentage, MDA, ONOO-. In conclusion the levels of antioxidant parameters, sperm count and sperm viability were restored to normal values when Potassium dichromate administered in combination with Ginkgo biloba or with Olive oil therefor Ginkgo biloba and Olive oil may be beneficial for improving reproductive performance of male rats.

The Effect of Guilingji Capsules on Vascular Mild Cognitive Impairment: A Randomized, Double-Blind, Controlled Trial.

Guilingji capsules (GLJC) have been shown to have antiaging effects and improve cognitive function. The aim of this study was to evaluate the clinical efficacy and safety of GLJC for the treatment of vascular mild cognitive impairment (VaMCI). A total of 96 patients with VaMCI (aged 60–85 years) were enrolled in this 24-week, randomized, double-blind, controlled clinical trial. The patients were randomly assigned to a GLJC group (n = 48) or a Ginkgo group (n = 48). Patients in the GLJC group were treated using GLJC, whereas those in the Ginkgo group received Ginkgo extract tablets. We evaluated the participants at baseline and after a 12- and 24-week treatment period using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Chinese Medicine Symptom Scale (CM-SS). The serum acetylcholine (Ach), acetylcholinesterase (AchE), homocysteine (Hcy), and high-sensitivity C-reactive protein (hs-CRP) serum levels of the patients were measured before and after 24-week treatment. Analysis of the results of both groups showed that both interventions significantly increased the MoCA and MMSE scores of the patients and decreased their ADAS-Cog and CM-SS scores (P < 0.05). The GLJC group showed greater improvement in MoCA, MMSE, and CM-SS scores than the Ginkgo group (P < 0.05). However, both groups showed a significant increase in serum Ach and a decrease in serum AchE, Hcy, and hs-CRP levels (P < 0.05). Furthermore, serum Ach increased and Hcy decreased more significantly in the GLJC group than in the Ginkgo group (P < 0.05). These findings indicate that GLJC can improve the cognitive function, cholinergic system, and inflammatory cytokine levels of patients with VaMCI. Furthermore, this treatment can improve symptoms of syndromes diagnosed according to traditional Chinese medicine practice in patients with VaMCI.

Reducing effects of ginkgo biloba (egb761) extract on skeletal muscle ischemia-reperfusion injury in rats

Aim: The restoration of circulation following a period of ischemia results in the release of the metabolites that accumulate in the ischemic tissue into circulation with untoward effects on the organs. Many studies have been conducted to date into the prevention of such ischemia-reperfusion injuries. Ginkgo Biloba extract is known to have antioxidant effects, although there is a lack of data on its effects on a skeletal muscle ischemia-reperfusion model. The present study investigates the use of Ginkgo biloba extract (egb761) for the reduction of experimentally-induced skeletal muscle ischemia-reperfusion injury. Material and Methods: A total of 32 Sprague-Dawley rats were divided into four groups as follows: Group 1 (n=8), control group; Group 2 (n=8), limb ischemia model; Group 3 (n=8), ischemia-reperfusion model; and Group 4 (n=8), Ginkgo biloba group. After the models were created in each group, soleus muscle, lung and liver tissues were removed. Tissue malondialdehyde (MDA) levels were measured biochemically to demonstrate lipid peroxidation. The percentage of viable cells in the soleus muscle was calculated through a histochemical examination. Results: The comparison of soleus muscle MDA levels revealed no statistically significant difference between Group 1 and Groups 2 and 3, whereas the levels were significantly lower in Group 1 than those in Group 4 (p&lt;0.05). Similarly, there was a significant reduction in Group 4 than in Group 3 (p&lt;0.05). The analysis of lung tissue MDA levels revealed no significant difference between Group 1 and Group 2, whereas MDA levels were significantly increased in Group 3 than in Group 1 (p&lt;0.05), while there was no difference between Group 1 and Group 4. The analysis of liver tissue MDA levels showed significantly increased levels in Groups 3 and 4 than in Group 1 (p&lt;0.05). The percentage of viable cells was significantly decreased in Groups 2 and 3 than in Group 1 (p&lt;0.05). There was a significant reduction in Group 4 than in the control group. Conclusion: The results of the present study suggest that Ginkgo biloba (EGb761) extract may be used to reduce the local and systemic effects occurring after the restoration of blood flow following acute arterial occlusion. There is, however, an apparent need for large-scale, prospective, randomized trials to demonstrate the efficacy of Ginkgo biloba treatment.

The influence of Ginkgo Biloba on hepatic gene expression of (PGC1-α, PPAR-α and GLUT-2), liver, kidney functions, hematological and lipid profile in type I diabetic rats

Ginkgo biloba is one of a well-known medicinal plant worldwide, where is prescribed in working on various diseases, such as diabetes mellitus type I and II, peripheral vascular abnormalities, and neurodegenerative illnesses like Alzheimer's disease . The purpose of this study was to know how oral Ginkgo biloba administration affected the liver, kidneys, hematological parameters, lipid profile, and hepatic gene expression in type I diabetic rats. Seventy-five male adult Sprague Dawely rats were allocated into five equal groups 15 rats each, 1st group; control group, 2nd group; diabetic group, 3rd group; Ginkgo biloba group, 4th group; Diabetic treated group received single oral dose of Ginkgo biloba after diabetic induction as a treatment and 5th group; rats were administered daily single oral dose of Ginkgo biloba as a protective dose from the 1st day of the study prior to diabetes induction and continued after the diabetes induction till the end of the work. The results of study revealed that Ginkgo biloba actions in modulating of hepatic key genes GLUT-2 (glucose transporter-2), PPAR-α (Peroxisome proliferator-activated receptor alpha),and PGC1-α (The peroxisome proliferator-activated receptor gamma coactivator-1).Also, Ginkgo biloba possesses antihyperlipidemic activities, supports liver and kidney functions and improves glucose metabolism, storage and utilization in liver by enhancing its key genes. based on the outcomes of current study Ginkgo biloba is an effective food supplement or a supportive treatment for type I diabetes mellitus..

The Role of Ginkgo biloba Extract as Monotherapy in Improving the Outcomes of Patients with Metabolic Syndrome: A Pilot Comparative Study with Metformin

The present study evaluates the effects of Ginkgo biloba extract as monotherapy on the glycemic status, insulin resistance (IR), body mass index (BMI), and visceral adiposity index (VAI), in addition to the inflammatory markers, oxidative status and leptin level in patients with metabolic syndrome in comparison with metformin.&#x0D; The study is a randomized, double-blind pilot study conducted during the period May to September, 2020. Fifty patients were recruited in the study and they were allocated into two groups (25 per each group): Ginkgo biloba and Metformin groups, they received (120 mg Ginkgo biloba extract/ capsule) and (500 mg Metformin/ capsule) respectively; orally as a single dose for 90 days. Blood samples were taken at zero time and after 90 days and utilized for analysis of blood glucose, HbA1c, insulin and leptin levels, lipid profile, TAOS, hsCRP, TNF

Evidence of Cochlear Synaptopathy and the Effect of Systemic Steroid in Acute Idiopathic Tinnitus With Normal Hearing.

To evaluate the electrophysiologic evidence of cochlear synaptopathy and the effects of systemic steroids in acute idiopathic tinnitus with normal hearing. Retrospective review of medical data. Tertiary referral center. Fifty-nine patients who experienced acute-onset idiopathic tinnitus (within 12 weeks) with normal hearing and the same number of age- and pure-tone threshold-matched control groups. Electrophysiologic studies of the auditory pathway, oral steroids, and ginkgo biloba. Pure-tone thresholds, wave I and wave V amplitudes of the auditory brainstem response (ABR), tinnitus handicap inventory (THI), and visual analog scale (VAS). Significantly reduced ABR wave I amplitude and wave I/wave V ratio were found in the tinnitus group compared with the no tinnitus group. Age and pure-tone threshold were significantly correlated with reduced wave I amplitude and small wave I/wave V ratio. The THI and VAS scores were decreased at 3 and 12 weeks after steroid administration; however, overall changes in THI and VAS scores were not significantly different between the steroid and ginkgo biloba groups. Potential cochlear synaptopathy was suspected in the early stage of acute idiopathic tinnitus, even in patients with normal hearing. Age and hearing threshold were potentially associated with the development of cochlear synaptopathy. Low-dose oral steroids and ginkgo biloba induced early subjective relief of tinnitus, which maintained up to 12 weeks, however, those changes did not differ between groups.

Analysis of the domestic pharmaceutical market of psychostimulants and nootropic drugs of N06BX group

Aim. To study the nomenclature of synthetic and herbal N06BX group, presented on the pharmaceutical market ofUkraine.Results. According to the State Expert Center of the Ministry of Health of Ukraine, the pharmaceutical market of Ukraine presents 14 international non-proprietary names (INN) of drugs or 214 trade names of drugs, including forms of release registered as of the classification of ATC; December, 2019. The range of these drugs has been represented by drugs analogues, both synthetic and herbal. In total, according to the list of N06BX group, there are 29 countries producing drugs of this group.Conclusions. The market of N06BX group inUkraine has been analyzed and it has been established that drugs of domestic production occupy 52.91 %, foreign – 39.68 %, joint ventures of Ukrainian producers with foreign – 7.41 %. The main market share in the general nomenclature of the N06BX group belongs to the following manufacturers: PJSC Farmak, LLC Pharmaceutical Company Zdorovya and PJSC Pharmaceutical Firm Darnytsia. Among foreign manufacturers, the leaders are – manufacturers fromLatvia,Poland andHungary. It should be noted that pharmaceutical market ofUkraine presents 5 joint ventures with foreign countries producing drugs of N06BX group. As active substances used: citicoline, vinpocetine, piracetam, phenibut, mebicar and herbal preparations of the Ginkgo Biloba group. Release forms: solutions for injections, drops for oral use, tablets, capsules. Taking into account the lack of registered dosage forms of n-phenyl-acetyl-L-prolylglycine on the domestic market, as well as the prospects of using a nasal dosage form for transporting the active substance directly into the brain, it is advisable to conduct further research.

Ginkgo biloba Alleviates Cisplatin-Mediated Neurotoxicity in Rats via Modulating APP/Aβ/P2X7R/P2Y12R and XIAP/BDNF-Dependent Caspase-3 Apoptotic Pathway

Neurotoxicity is an obvious adverse effect in Patients encountering a complete course of chemotherapy. The present work is conducted to evaluate the neuroprotective effect of Ginkgo biloba (Ginkgo) against the neurotoxicity induced by Cisplatin (Cis) in rats. Forty male Wistar albino rats were arranged into four groups: (1) Control group, rats were given saline; (2) Cis group, rats were injected by Cis 2 mg/kg body weight i.p., twice a week starting on the fifth day for thirty days; (3) Ginkgo group, rats were administered Ginkgo (50 mg/kg orally) daily for thirty days; and (4) Ginkgo+Cis group, rats received Ginkgo (50 mg/kg orally) daily and on the fifth day, rats were injected with Cis (2 mg/Kg body weight i.p.) twice a week for thirty days. Cis significantly increased Gamma glutamyltransferase (GGT) and Acetyl Cholinesterase (CHE) as compared to the control group and also disturbed cerebral oxidative/antioxidant redox. Co-administration of Ginkgo and Cis reversed the adverse effect of Cis on the brain tissue. Moreover, co-administration of Ginkgo and Cis ameliorated Cis induced brain damage by reducing Amyloid precursor protein (APP), amyloid β (Aβ), P2Y12R and P2X7R mRNA expressions and proteins. Furthermore, Ginkgo regulated XIAP/BDNF expressions with a consequent decrease of caspase-3 and DNA fragmentation%. The current results concluded that concurrent treatment with Ginkgo can mitigate neurotoxicity mediated by Cis in experimental animals through exhibiting antioxidant effect by restoring cerebral oxidative/antioxidant redox and anti-apoptotic effect via regulating cerebral APP/Aβ/P2Y12R/P2X7R and XIAP/BDNF signaling pathways.

Shenmayizhi Formula Combined with Ginkgo Extract Tablets for the Treatment of Vascular Dementia: A Randomized, Double-Blind, Controlled Trial.

Shenmayizhi formula (SMYZF) has been shown to have an effect on vascular dementia (VaD) in previous studies. The aim of this study was to evaluate whether a combination of SMYZF with Ginkgo extract tablets improves mild-to-moderate VaD. In this 12-week, randomized, double-blind, controlled study, we randomly assigned 196 patients with VaD (aged 50–85 years) to either the SMYZF group (n = 98) or the Ginkgo group (n = 98). All patients received Ginkgo extract tablets as a basic treatment, while the SMYZF group also received SMYZF treatment. We evaluated the participants at baseline and after 12 weeks of the intervention for the following: the Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), activities of daily living (ADL), Chinese Medicine Symptom Scale (CM-SS) scores, serum endothelin-1 (ET-1), nitric oxide (NO), vascular endothelial growth factor (VEGF), von Willebrand factor (vWF), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), and homocysteine (Hcy) serum levels. Both interventions significantly increased MMSE scores and decreased NIHSS, ADL, and CM-SS scores. The SMYZF group showed greater improvement in MMSE, NIHSS, and CM-SS scores. Both groups showed a significant decrease in serum ET-1 and an increase in serum VEGF. Furthermore, serum NO increased, and vWF decreased significantly in the SMYZF group. Changes in serum ET-1 and NO were greater in the SMYZF group. Both groups showed a significant increase in serum BDNF and a decrease in serum NSE and Hcy. Improvement in serum NSE and BDNF was greater in the SMYZF group. SMYZF combined with Ginkgo extract tablets improved vascular endothelial and cognitive functions, as well as the syndromes diagnosed based on the traditional Chinese medicine in patients with VaD.

Randomised Controlled Clinical Study of Injection Caroverine and Ginkgo Biloba Extract in Cochlear Synaptic Tinnitus.

Tinnitus, also known as phantom auditory perception, is an annoying symptom and 13-17% of population reports bothersome tinnitus. Cochlear synaptic tinnitus is the most common type. Many treatments have been tried but none is yet considered to be well established. To evaluate effect of Inj.Caroverine and Ginkgo Biloba extract in cochlear synaptic tinnitus in terms of improving tinnitus grading, tinnitus matching and quality of life of patient. It is Randomised controlled study, conducted in department of ENT, on 86 patients, who met inclusion criteria, divided into 4 groups. Gr1-Inj Caroverin, Gr2-Inj Placebo, Gr3-Ginkgo Biloba extract, Gr4-Placebo as extract. A single dose infusion of caroverine immediately improves tinnitus grading and matching and provides immediate relief in reducing severity of tinnitus in 54.54% cases but improvement was not sustained in caroverine group at 3month and 6month follow-up after infusion. Ginkgo biloba also is effective in improving tinnitus grading and matching in 31.8% cases and improvement was sustained in ginkgo biloba group even after 3month of cessation of treatment i.e. at 6month follow-up. It is suggested that Inj.Caroverine as intravenous infusion should be given in severe cases of tinnitus to reduce its severity immediately and then patient should be put on Tab.Ginkgo biloba for a period of 3months to provide sustained and long lasting relief. Thus combination therapy of Inj.Caroverin and Tab.Ginkgo Biloba, appropriately tailored to the need of patient will provide better results in greater majority of patients.

What is the combined effect of intense intermittent exercise and Ginkgo biloba plant on the brain neurotrophic factors levels, and learning and memory in young rats?

The present study was conducted to investigate the effect of intense intermittent exercise and Ginkgo biloba on the hippocampal levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-4 (NT-4) and also memory and learning in young rats. Forty two eight-week-old rats were randomly divided into six groups including control, low dose of Ginkgo biloba (65 mg/kg), high dose of Ginkgo biloba (100 mg/kg), exercise, exercise + low dose of Ginkgo biloba, exercise + high dose of Ginkgo biloba. The exercise protocol or Ginkgo biloba administration was six days a week for six weeks. The hippocampal levels of BDNF and NT-4 were measured by ELISA method, and learning and memory were evaluated by Morris water maze test in all groups. Data were analyzed using SPSS software. Increase in hippocampal levels of BDNF and NT-4 appeared following exercise (p < 0.01). The levels do not change following exercise + Ginkgo biloba administration. However, the NT-4 level decreased in the high dose of Ginkgo biloba group (p < 0.01). Disorder in learning and memory was indicated following the use of low dose of Ginkgo biloba or exercise + low dose Ginkgo biloba administration (p < 0.001). Learning elevated in the exercise group (p < 0.05). Exercise in young rats may increase brain neurotrophin levels and lead to improved learning. The preventative or protective role of Ginkgo biloba against some diseases has been suggested, but its consumption in young athletes is recommended with caution.

Role of Ginkgo biloba for controlling residual dizziness after successful treatment of benign paroxysmal positional vertigo: Our experiences at a tertiary care teaching hospital of Eastern India

OBJECTIVES: Canalith repositioning therapy (CRP) is usually effective treatment in benign paroxysmal positional vertigo (BPPV). However, still, some patients present residual dizziness after successful and effective repositioning maneuver. The objective of this study was to evaluate the therapeutic effect of Ginkgo biloba extract on residual dizziness after canalith repositioning maneuver in patients of BPPV. G. biloba is a phytomedicine which enhances the blood supply to inner ear and brain. MATERIALS AND METHODS: Ninety-two patients with BPPV were divided into two treatment groups, Ginkgo biloba group and Non-Ginkgo biloba group. In this prospective study, the Ginkgo biloba group received the similar CRP as the non-Ginkgo biloba group, with addition of G. biloba treatment after CRP. The duration of residual dizziness of Ginkgo biloba group and non-Ginkgo biloba group were compared. The scores of dizziness handicap inventory of these two groups were also compared. RESULTS: The duration of residual dizziness of Ginkgo biloba group was shorter than non-Ginkgo biloba group. There were no significant differences in the dizziness handicap inventory scores in the 1st week, whereas many significant differences in 2nd, 3rd, 4th, 5th, 6th, 7th, and 8th weeks. CONCLUSION: This study demonstrates that G. biloba can significantly minimize the residual dizziness after successful therapy with repositioning maneuver in patients of BPPV.

Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network Meta-analysis

OBJECTIVETo assess the clinical effectiveness and safety of injections of ginkgo (GI) combined with Western Medicine (WM) for cerebral infarction (CI). METHODSRandomized controlled trials (RCTs) of CI treated by GI were searched in China National Knowledge Infrastructure Database, Wanfang, China Science and Technology Journal Database, Web of Science, Cochrane library, Embase, PubMed and Chinese Biomedical Literature Database, with the publication data no later than April, 2016. The Cochrane risk of bias method was used to evaluate the methodological quality of the RCTs. The data were analyzed by Review Manager 5.3, Stata 13.0, and WinBUGS 14 software. RESULTSTotally 37 RCTs involving 4330 patients were included. By direct comparison, the results of GI group were significantly superior to the routine WM group in the total effective rates [OR = 3.61, 95% CI (2.93, 4.44), P < 0.0001], the neural function defect score (NFDS) [MD = − 4.39, 95% CI (− 5.47, − 3.32), P < 0.0001]. Network Meta-analysis (NMA) results showed that, between 5 GIs in efficacy, the difference comparing ginaton injections (GbE) to ginkgo-dipyidamolum injections (GD) [OR = 1.74, 95% CI (0.73, 3.65)], shuxuening injections (SXN) [OR = 1.06, 95% CI (0.609, 1.697)] or ginkgolides injections (GK) [OR = 4.711, 95% CI (1.178, 13.21)] reach statistical significance; the difference comparing GD to GK reach statistical significance [OR = 2.791, 95% CI (0.866, 6.908)]; the difference comparing SXN to GK reach statistical significance [OR = 4.537, 95% CI (1.203, 12.41)]. Besides, there was no difference between 4 GIs in NFDS. Probability ranking result showed a great possibility for GK [Surface under the Cumulative Ranking curve (SUCRA) = 80.3%] in improving the total effective rates, which were followed by GD (SUCRA = 73.34%), SXN (SUCRA = 46.59%), GbE (SUCRA = 45.46%), floium ginkgo extract and tertram ethypyrazine sodium chloride injections (FT) (SUCRA = 35.64%). However, GK (SUCRA = 80.3%) or GbE (SUCRA = 69.4%) was better than other GIs in reducing NFDS.GK + WM is the best treatment measures to reduce NFDS in cerebral infarction, which were followed by SXN + WM (SUCRA = 51.6%), GD + WM (SUCRA = 48.1 %). CONCLUSIONGIs was more effectiveness on CI than the routine Western Medicine. But based on the limitations of the study, more high-quality randomized controlled trials will be necessary.

1. CLINICAL STUDY OF EFFECTS OF INJ.CAROVERINE AND GINKGO BILOBA EXTRACT IN COMHLEAR SYNPATIC TINNITUS

Tinnitus (ringing in the ear), is the most common problem encountered in every day of otolaryngology practices. Considerable variations exist in tinnitus prevalence with gender and age. It affects patient's life-style, general health as well as emotional status. The most common variety of tinnitus, cochlear synaptic tinnitus is diagnosed with the help of various audiological tests. There is no standardised treatment till date yet Tinnitus Retraining Therapy, medical therapy in form of psychotherapy or pharmacological therapy are commonly used one. Ginko biloba extract suggest greater and faster relief as compared to placebo. Recently Caroverine, a spasmolytic drug, having glutamate antagonistic activity is used for Tinnitus treatment. A randomised comparative study was designed to establish effects of Caroverine and Ginko biloba extract in treatment of Cochlear Synaptic Tinnitus. METHOD: 86 diagnosed patients of cochlear synaptic Tinnitus were treated with Inj Caroverine (group 1, n=22) and placebo (group 2, n=21), Ginkgo biloba extract ( group 3, n=22) and placebo (group 4, n=21) and followed up at 1 month ,3 months and 6 months and improvements were evaluated in terms of Tinnitus Grading and Tinnitus Matching. Statistical analysis was done using statistical software SPSS. The baseline profile and any improvement after treatment between groups were compared using paired/ANOVA test. RESULT: In our study 54.4% (12 out of 22.) patients responded immediately after infusion of Caroverine and remained effective at end of 1,3 and 6 months after drug infusion while 13.6% (3 out of 21) patients responded in placebo group and reverted back to pretreatment level on subsequent follow ups. In Ginkgo biloba group 31.8% (7 out of 22) patients responded at one month followup, while none responded in placebo group. These responders showed further improvement in Tinnitus Matching and Tinnitus Grading at 3 months but a plateau occurred at followup at 6 month without further improvement. Two patients were cured in group 3 (Gingko biloba). CONCLUSION: Caroverine immediately improves tinnitus grading and matching and provides immediate relief in reducing the severity of tinnitus. Ginkgo biloba extract takes longer time to improve tinnitus but it provides greater relief on long term follow-up It is finally suggested that inj. Caroverine should be given in severe cases of tinnitus to reduce its severity immediately and then patient should be put on Ginkgo biloba extract for a period of 3 months to provide sustained and long lasting relief. KEY WORDS: Cochlear Synaptic Tinnitus, Tinnitus Matching. Tinnitus Grading, Caroverine, Ginko biloba.