Literature review 1

Mintz, M. L. (Ed.). (Year). Current Clinical Practice: Disorders of the

Respiratory Tract: Common Challenges in Primary Care. Humana Press
provides valuable insights into the diagnosis and management of various
respiratory tract disorders encountered in primary care settings. One such
condition that frequently prompts visits to healthcare providers is
pharyngitis, characterized by inflammation of the throat and tonsils. This
prevalent ailment accounts for approximately 2% of ambulatory visits in the
United States annually. Despite the predominantly viral nature of acute
pharyngitis, the prescribing patterns of antibiotics remain high, even though
their efficacy is limited in most cases. Alarming statistics from the National
Ambulatory Medical Care Survey revealed that in 1996 alone, a staggering
18 million patients sought medical care for sore throat in the US, with
unnecessary antibiotics being prescribed to around 75% of them (Mintz,
Year). This raises concerns about the appropriate management of
pharyngitis and highlights the need for evidence-based approaches to guide
primary care practitioners in delivering optimal care for this common
respiratory condition.

This overprescription of antibiotics for pharyngitis has significant

implications. Aside from the potential side effects of medications, the
widespread use of antibiotics has contributed to the emergence of antibiotic-
resistant bacterial strains. Upper respiratory infections, including
pharyngitis, are the leading cause of illness in the United States, with an
average of 6.5 million adults presenting as outpatients with sore throat
complaints during the 1990s. Children are even more susceptible, with
Streptococcus pyogenes (Group A Streptococcus or GAS) accounting for 15-
36% of paediatric pharyngitis cases.

The prevalence of upper respiratory infections among young children,

particularly those in daycare settings, is striking. It has been estimated that
children between 6 months and 2 years of age who attend daycare
experience an upper respiratory infection approximately every three weeks, a
significant proportion of which are attributed to pharyngitis.
These statistics highlight the magnitude of the problem and emphasize that
the management of pharyngitis is a major contributor to the excessive use of
antibiotics in the United States. To address this issue, a more prudent
approach to antibiotic prescribing, focusing on accurate diagnosis and
appropriate treatment, is crucial.

Reference: Mintz, M. L. (Ed.). (Year). Current Clinical Practice: Disorders of

the Respiratory Tract: Common Challenges in Primary Care. Humana Press

Literature review 2

From the article clinical medicine 2022; 48: 101458 Published online 20
May 2022 "The global burden of sore throat and Group A Streptococcus
Pharyngitis: A systematic review and Meta-analysis" by Kate M. Miller,
Jonathan R. Carapetis, Chris A. Van Beneden, Daniel Cadarette, Jessica N.
Daw, Hannah C. Moore, David E. Bloom, and Jeffrey W. Cannon, clinical
medicine 2022; 48: 101458 Published online 20 May 2022 the need for
contemporary data on the global burden of sore throat and group A
Streptococcus (Strep A) pharyngitis arises to understand the prevalence of
the disease and develop effective strategies for Strep A vaccines.
In their study, the researchers utilized Clarivate Analytics' Web of Science
platform to search multiple databases, including WoS core collection,
PubMed, Medline, data citation index, KCI-Korean Journal Database,
Russian Science Citation Index, and the SciELO Citation Index. The search
spanned from January 1, 2000, to February 15, 2021, encompassing
articles from any country and in any language. The JBI critical appraisal
checklist was employed to assess the risk of bias in the included studies.
Out of the 5,529 articles initially identified, 26 studies met the inclusion
criteria, but only two of them provided data on the incidence among adults.
The pooled incidence rate, calculated for children only, indicated an
estimated 82.2 episodes of sore throat per 100 child-years (95% CI
25.2−286.3, I2 = 100%), as well as 22.1 episodes of Strep A sore throat per
100 child-years (95% CI 14.7−33.1, I2 = 98%), based on seven studies
(7,964 person-years) and nine studies (15,696 person-years), respectively.
Furthermore, the cumulative incidence rate of sore throat, extracted from
five studies, was found to be 31.9 per 100 children. However, significant
methodological and statistical heterogeneity was observed among the
included studies, and several studies had a risk of bias score below five.
In conclusion, the study emphasizes the substantial global burden of Strep
A sore throat, while underscoring the need for methodologically
standardized studies to accurately quantify the burden, analyze variations
in rates across different populations, and evaluate the potential impact of
future Strep A vaccines.

Literature Review

In the revived and revised Review Article by Parle Milind* and Khanna
Deepa Pharmacology Division, Dept. Pharm. Sciences (Accredited by NBA),
Guru Jambheshwar University of Science and Technology, Hisar, Haryana,
India

Published in Parle Milind et al / IJRAP 2011, 2 (1) 47-5 published and

made available online by www.ijrap.net. Titled as “International Journal of
Research in Ayurveda & Pharmacy, 2(1), Jan-Feb 2011 47-54
“CLOVE: A CHAMPION SPICE” by Parle Milind* and Khanna Deepa
Pharmacology Division, Dept. Pharm. Sciences (Accredited by NBA), Guru
Jambheshwar University of Science and Technology, Hisar, Haryana”
The antimicrobial and anti-inflammatory activities of clove make it a
promising natural remedy for pharyngitis. Its effectiveness in treating
various bacterial and viral pathogens, including Streptococcus pyogenes,
suggests its potential role as an alternative or adjunct therapy to
conventional antibiotics. Additionally, the availability and affordability of
clove make it an accessible option for individuals seeking natural remedies
for pharyngitis. Furthermore, clove has been found to possess anti-
inflammatory effects. It inhibits the release of pro-inflammatory cytokines
and mediators, thereby alleviating the inflammation associated with
pharyngitis. The analgesic properties of clove can also provide relief from
throat pain and discomfort. The article also states as Chewing roasted clove
is a wonderful medicine in case of pharyngitis

Literature review

On 20 July 2016 in International Journal of Herbal Medicine 2014; 2(2):

132-136 published “ Glycyrrhiza glabra (Liquorice) - a potent medicinal
herb” by Monica Damle SVKM’s Dr Bhanuben Nanavati College of
Pharmacy Gate No.1, 1st Floor, Mithibai College Campus, V.M. Road, Vile
Parle (West), Mumbai 400 056, India. Says
In traditional medicine, liquorice has been recommended as a prophylactic
agent for gastric and duodenal ulcers. It is employed in dyspepsia as an
anti-inflammatory agent during allergenic reactions. It is used as a
contraceptive, laxative, anti-asthmatic, emmenagogue, galactagogue, and
antiviral agent in folk therapy. Glycyrrhiza roots are useful for treating
cough because of their demulcent and expectorant property. It is also
effective against anaemia, gout, sore throat, tonsillitis, flatulence, sexual
debility, hyperdypsia, fever, skin diseases, and swellings. Liquorice is
effectively used in acidity, leucorrhoea, bleeding, jaundice, hiccough,
hoarseness, bronchitis, vitiated conditions of Vata dosha, gastralgia,
diarrhoea, fever with delirium and anuria. It is a vital ingredient in
medicinal oils used for the treatment of rheumatism, haemorrhagic
diseases, epilepsy and paralysis. It has been proved by several years of
research that, glycyrrhizin breaks down in the gut and exerts anti-
inflammatory action similar to hydrocortisone and other corticosteroid
hormones. The effect is due to the stimulation of hormone production by
adrenal glands and reduction in the breakdown of steroids by the liver and
kidneys. The effectiveness of glycyrrhizin in the treatment of chronic
hepatitis and liver cirrhosis is proven. Glycyrrhiza glabra is considered one
of the best remedies for relieving pain and other symptoms such as
discomfort caused by acrid matter in the stomach. It alleviates the irritating
effects of acids in a better way than alkalis. It is an excellent tonic and is
also used as a demulcent in catarrh of the genitourinary passages
Literature Review 5 honey

In a RESEARCH ARTICLE Role of Honey as adjuvant therapy in patients

with a sore throat a study was conducted by the Department of
Otolaryngology and the Department of Medicine Head and Neck Surgery,
Maharishi Markandeshwar Medical College and Hospital, Kumarhatti,
Solan, Himachal Pradesh, India, A total of 200 patients who gave consent
were enrolled this study. All the patients had complaints of sore throat. Data
were collected and analysed. Patients above the age group of 18 years were
taken in the study. There was an equal incidence of sore throat in all the age
groups. Male and female patients were almost equal (Table 1).

About 200 patients with sore throats were taken up for the study. 100
patients in the study group were given one tablespoon of honey twice a day
along with anti-inflammatory drugs, antibiotics, and antiseptic gargles. The
remaining 100 patients in the control group were given other same
medications without honey. Patients were evaluated after 5, 10 and 15 days
for throat congestion, fever, pain, patient satisfaction, and other criteria.
There was a faster recovery from sore throat in the study group using honey
than in the control group (Table 2).

Regarding individual signs and symptoms, there was a much faster recovery
from fever within 5 days in the study group as compared to the control
group (Table 3).

The signs of oropharyngeal congestion also had faster recovery in the study
group. There was no significant difference in patients lost to follow-up in
both groups (Table 3).

Regarding complications of sore throat, an almost equal number of patients

in both groups needed hospitalization due to high-grade fever, severe
odynophagia, dehydration, or other upper respiratory tract complications .
Regarding patient satisfaction, patients in the study group with honey were
more satisfied as compared to the control group. These results were more
evident at the first follow-up visit after 5 days (Table 4). There were no side
effects noted of honey patients using honey in the study group.

Fig Need for hospitalization

Literature Review 6 Tulsi

In a review article submitted in July 2016 by Sumit Summy And
Priya Patil published in the International Journal of innovative
pharmaceutical science and Research www.ijipsr.com with the title OCIMU
SANCTUM (TULSI) “ QUEEN OF ALL MEDICINAL HERBS” a review state as
Tulsi, also known as Holy Basil, holds a revered place in traditional
medicine systems such as Ayurveda and Siddha. It has earned the
reputation of being "the elixir of life" due to its numerous health benefits
and promotion of longevity. Various parts of the Tulsi plant are utilized for
preventive and curative purposes, providing relief from a wide range of
illnesses and common ailments. One of the most well-known uses of Tulsi is
in managing respiratory issues. It is commonly employed in treating the
common cold, cough, flu, sore throat, bronchitis, and asthma. Tulsi's
expectorant properties help to alleviate congestion, while its antimicrobial
effects assist in combating infections. Its ability to reduce inflammation and
promote healing makes it beneficial for treating earaches and relieving
symptoms associated with bronchial disorders.
In addition to its respiratory benefits, Tulsi possesses hepatoprotective
properties, making it effective in managing hepatic diseases. It is also used
in the treatment of malaria fever and is recognized as an antidote for snake
bites and scorpion stings. Tulsi aids in digestion by alleviating flatulence
and addressing digestive disorders. It can provide relief from colic pain and
is known to have a positive impact on conditions like diarrhoea and
influenza.
Tulsi has been found to possess analgesic properties, making it useful
in managing migraines, headaches, and general fatigue. It is known to
promote relaxation, alleviate stress, and improve sleep, offering relief from
insomnia. Tulsi's anti-inflammatory and antioxidant properties contribute to
its effectiveness in managing arthritis and reducing symptoms associated
with skin diseases.
The leaves of Tulsi are considered beneficial for the nervous system
and are believed to enhance memory and cognitive function. Chewing Tulsi
leaves not only freshens breath but also aids in the healing of ulcers and
mouth infections. It has been traditionally used for wound healing, with its
antimicrobial and anti-inflammatory effects helping to prevent infections
and promote faster recovery.
Overall, Tulsi is a versatile herb with a wide range of medicinal uses.
Its efficacy in managing various ailments and promoting overall well-being
has made it an integral part of traditional medicine practices. As with any
herbal remedy, it is recommended to consult with a healthcare professional
before incorporating Tulsi or any other herb into your healthcare routine.

Literature Review
 On 03 june 2014 in the article GINGER: A FUNCTIONAL HERB
Publish by Neeru Bhatt, Mostafa I. Waly, Mohamed M Essa, and Amanat
Ali*
From Department of Food Science and Nutrition, College of
Agriculture and Marine Sciences, Sultan Qaboos University, Al Khoud,
Muscat, Sultanate of Oman available online
at: https://www.researchgate.net/publication/257416254
Ginger, a widely used spice with a long history of medicinal use, offers
various health benefits, including its potential as an expectorant and its
ability to control symptoms associated with the common cold and flu.
Ginger is believed to possess properties that can help alleviate respiratory
congestion, promote mucus clearance, and provide relief from cough and
cold symptoms.
One popular home remedy for cough is a combination of ginger juice
and honey. Ginger juice acts as an expectorant, which means it helps to
thin and loosen mucus in the respiratory tract. This makes it easier to expel
mucus and phlegm, providing relief from cough and congestion. Honey,
known for its soothing and antimicrobial properties, further complements
ginger’s effects by relieving cough irritation and helping to suppress cough
reflexes.
The common cold is often caused by viral infections, with the
rhinovirus being one of the primary culprits. Studies have shown that dried
ginger, in particular, exhibits potent antiviral activity against the rhinovirus.
This is attributed to the presence of a compound called β-
sequiphellandrene, which is a sesquiterpene found in ginger. β-
sequiphellandrene has been found to effectively inhibit the replication of the
rhinovirus, thus reducing the severity and duration of cold symptoms.
In addition to its antiviral properties, ginger helps to alleviate
congestion. Congestion occurs when the nasal passages become swollen and
blocked due to inflammation. Ginger possesses anti-inflammatory properties
that can help reduce nasal swelling, thereby facilitating easier breathing and
relieving congestion. Consuming ginger tea or inhaling steam infused with
ginger can help open up the airways and alleviate congestion, providing
relief from the discomfort associated with respiratory congestion.
Moreover, ginger tea is known to have soothing effects on sore throats.
Ginger's anti-inflammatory and analgesic properties can help reduce throat
inflammation and alleviate pain. Sipping on warm ginger tea can provide
relief from sore throat discomfort and promote overall throat health.
Overall, ginger's expectorant properties, antiviral activity against the
rhinovirus, ability to alleviate congestion, and soothing effects on a sore
throat make it a valuable natural remedy for cough and cold symptoms.
However, it is important to note that while ginger can provide symptomatic
relief, it does not cure the underlying viral infection. If symptoms persist or
worsen, it is advisable to seek medical attention for proper diagnosis and
treatment.