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REVIEW ARTICLE
Year : 2010  |  Volume : 2  |  Issue : 2  |  Page : 93-99 Table of Contents     

Khamiras, a natural cardiac tonic: An overview


1 Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard, New Delhi- 110 062, India
2 Department of Ilmul Advia, Faculty of Medicine, Jamia Hamdard, New Delhi- 110 062, India
3 CCRUM, Janakpuri, New Delhi, India

Date of Submission22-Apr-2010
Date of Decision04-May-2010
Date of Acceptance21-May-2010
Date of Web Publication2-Aug-2010

Correspondence Address:
Sayeed Ahmad
Department of Pharmacognosy and Phytochemistry, Faculty of Pharmacy, Jamia Hamdard, New Delhi- 110 062
India
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DOI: 10.4103/0975-7406.67009

PMID: 21814439

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   Abstract 

The Unani system of Medicine (Unanipathy), which originated in Greece, is based on the principles proposed by Galen, a Greek practitioner. Since then, many Arab and Persian scholars have contributed to the system. Among them Ibn-e-Sina, an Arab philosopher and Physicist who wrote 'Kitab-al-shifa' are worth mentioning. This system has an extensive and inspiring record in India. It was introduced in India around the tenth century A.D with the spread of Islamic civilization. At present, Unanipathy has become an important part of the Indian system of Medicine. Unani medicines have been used since ancient times, as medicines for the treatment of various ailments. In spite of the great advances observed in modern medicine in recent decades, Unani drugs still make an important contribution to healthcare. The Unani system of medicine is matchless in treating chronic diseases like arthritis, asthma, mental, cardiac, and digestive disorders, urinary infections, and sexual diseases. The medicines administered go well with the temperament of the patient, thus speeding up the process of recovery and also reducing the risk of drug reaction. The Unani system of medicine recognizes the influence of the surroundings and ecological conditions on the state of health of human beings. The system aims at restoring the equilibrium of various elements and faculties of the human body. It has laid down six essential prerequisites for the prevention of diseases and places great emphasis, on the one hand, on the maintenance of proper ecological balance, and on the other, on keeping water, food, and air free from pollution. These essentials, known as 'Asbab-e-Sitta Zarooriya', are air, food, and drink, bodily movement and repose, psychic movement and repose, sleep and wakefulness, and excretion and retention. The Unani system is a secular system in temperament and is popular among the masses. In Unani medicine, although the general preference is for single drugs, compound formulations are also used in the treatment of various complex and chronic disorders. In the light of the present knowledge, this review is a small effort to discuss the efficacious nature of 'Khamira', a semi-solid preparation, which is traditionally used for cardiac ailments, such as, palpitations, weakness of the heart, and so on. On the basis of their constituents these are named as, Khamira Aabresham, Khamira Gaozaban, Khamira Marwareed, and so on. Khameeras are also used as general tonics for other vital organs like the liver and brain. In view of the increasing number of cardiac diseases, a thorough evaluation of this ancient work on Khamira is of special significance.

Keywords: Cardiotonic, khameera, Unani system of medicine


How to cite this article:
Ahmad S, Rehman S, Ahmad AM, Siddiqui KM, Shaukat S, Khan MS, Kamal Y T, Jahangir T. Khamiras, a natural cardiac tonic: An overview. J Pharm Bioall Sci 2010;2:93-9

How to cite this URL:
Ahmad S, Rehman S, Ahmad AM, Siddiqui KM, Shaukat S, Khan MS, Kamal Y T, Jahangir T. Khamiras, a natural cardiac tonic: An overview. J Pharm Bioall Sci [serial online] 2010 [cited 2014 Aug 21];2:93-9. Available from: http://www.jpbsonline.org/text.asp?2010/2/2/93/67009

Unani drugs have been an integral part of treatment therapies of various diseases. In spite of the great advances observed in modern medicine in recent decades, unani drugs still make an important contribution to healthcare. Especially in countries like India many of the unani drugs and formulations are used in different practices of treatment, such as, Unani, Ayurveda, and Sidha. In this modern era people have started preferring unani drugs more because of its lower side effects, holistic approach, psychological dimensions, and qualitative action of weather and seasonal requirement. Unani system of medicine is unmatched in treating chronic diseases such as arthritis, asthma, mental, cardiac, and digestive disorders, urinary infections, and sexual diseases. Different types of formulations are used in the Unani system of medicine. For example solid preparations: Habb, Qurs, Shyaf, Sanoon; semi-solid preparations: Majoon, Itrifal, Jawarish, Khamira, and liquid preparations like Maul jubn, Maul-asl, as well as gaseous drugs like Bakhoor and so on. [1],[2]

The word Khamira in the Unani system of medicine indicates fermented confection, first introduced by the Hakeem of the Mogul period. Khamira is a semi-solid preparation - a type of Majoon, which is prepared by adding a decoction of herbal drugs or powdered drugs to a base (Qiwam) made up of sugar or sugar with honey. Other than herbal ingredients, animal and mineral origin drugs are also mixed, either by making solution in aqua or as a micro-fine powder, [1],[2],[3] Scented drugs such as saffron and musk are mixed when the decoction gives a white fermented appearance. Drugs used for the heart are made in such a form so that they are easily absorbed and can produce rapid action. These Khamiras have been named on the basis of constituents used for the preparation like Khamira Aabresham, Khamira Gaozaban, Khamira Marwareed, Khamira Sandal, and so on. Khamiras usually act as a cardio-tonic, that is, a tonic for vital organs such as the brain, liver, and stomach, and is also used for various other ailments like palpitations, weakness of heart, weakness of principal organs, cough, cold, catarrh, including respiratory and nervous disorders. [3],[4],[5] In view of the increasing number of cardiac problems all over the world, a thorough evaluation of this ancient study on Khamira used in cardiac disorders is of special significance. The present exhaustive review of cardio active Khamiras, collected from different ancient literatures, will be useful for a large population of the world for the treatment of cardiac problems, without any significant side effects, using natural remedies. This can also be taken as a lead by researchers and medical practitioners for development of new drugs using ancient information. The various active ingredients used in these Khamiras have established cardioprotective activities. Ischemic heart diseases remain the leading cause of death in most developed countries, as seen over the past quarter-century. Reducing the mortality rate and prevention of myocardial infarction (MI) are of utmost importance. Arq gauzaban (a clear aqueous distillate of the plant Onosma bracteatum), a unani product, has been extensively studied as a heart tonic. [6] The Unanipathy authoritative text 'Bayaz-e-Kabir' quotes a number of therapeutic indications for arq gauzaban. However, no pharmacological evaluation of the cardiovascular system has been reported prior to Bheemachari et al., 2005. [6] Several scientists have worked on these plants and have shown in their studies that, individually, these ingredients have antioxidant and anti-inflammatory activities. [7] The use of traditional unani medicinal drugs for the treatment of hypertension, congestive heart failure and post MI, are widely accepted. Dietary supplementation with polyphenolic antioxidants to animals has been seen to be associated with inhibition of LDL oxidation and macrophage foam cell formation, and attenuation of atherosclerosis development. [8]


   Khamiras Used in Cardiac Disorders Top


  1. Khamira Aabresham Sada
  2. Khamira Aabresham Sheerah Unnab Wala
  3. Khamira Aabresham Ood Mastagi Wala
  4. Khamira Sandal Sada
  5. Khamira Sandal Tursh Warq-e-Tila Wala
  6. Khamira Gaozaban Sada
  7. Khamira Gaozaban Ambari
  8. Khamira Gaozaban Ambari Jadwar Ood Saleeb wala
  9. Khamira Gaozaban Ambari Jawahar Wala
  10. Khamira Marwareed
  11. Khamira Marwareed Ba Nuskha Khas
  12. Khamira Marwareed Ba Nuskha Kalan
  13. Khamira Yaqoot
  14. Khamira Yashab
  15. Khamira Zehar Mohra
  16. Khamira Zamarrud
  17. Khamira Khas



   Methods of Preparation and Other Descriptions of Several Khamiras Top


Khamira Aabrasham Hakim Arshad Wala [4],[5]

Compound unani formulation mentioned in Bayiaz-e-Kabir, Makhazanul Murakkebat, and National formulary of unani medicine contains - 17 constituents of plant origin, five constituents of animal origin, and four constituents of mineral origin [Table 1].

Khamira Aabresham Sada [4]

Compound Unani formulation mentioned in Bayiaz-e-Kabir containing - seven constituents of plant origin, two constituents of animal origin, and one constituent of mineral origin [Table 2].

Khamira Aabresham Sada [9],[10]

Compound Unani formulation mentioned in NFUM and Qarabadeen-e-Sarkari containing - eight constituents of plant origin, one constituent of animal origin, and one constituent of mineral origin [Table 3].

Khamira Aabresham Sheerah Unnab Wala [4],[5]

Compound Unani formulation mentioned in Bayiaz-e-Kabir and Makhazanul Murakkebat containing - 12 constituents of plant origin and three constituents of animal origin [Table 4].

Khamira Aabresham Ood Mastagi Wala [4],[5]

Compound Unani formulation mentioned in Bayaz-e-Kabir and Makhazanul Murakkebat containing - six constituents of plant origin, five constituents of animal origin, and two constituents of mineral origin [Table 5].

Khamira Sandal Sada [4],[5],[9],[10],[11]

Compound Unani formulation mentioned in Bayiaz-e-Kabir, Makhazanul Murakkebat, NFUM and Qarabadeen-e-Azam containing only two constituents of plant origin [Table 6].

Khamira Sandal Tursh Warq-e-Tila Wala [4],[5]

Compound Unani formulation mentioned in Bayiaz-e-Kabir and Makhazanul Murakkebat containing - eight constituents of plant origin, one constituent of animal origin, and three constituents of mineral origin [Table 7].

Khamira Gaozaban Sada [9],[10]

Compound Unani formulation mentioned in NFUM and Qarabadeen-e-Sarkari containing - nine constituents of plant origin and one constituent of animal origin [Table 8].

Khamira Gaozaban Ambari [4],[5]

Compound Unani formulation mentioned in Bayiaz-e-Kabir and Makhazanul Murakkebat containing - 13 constituents of plant origin, two constituents of animal origin, and two constituents of mineral origin [Table 9].

Khamira Gaozaban Ambari Jadwar Ood Saleeb Wala [4]

Compound Unani formulation mentioned in Bayiaz-e-Kabir containing - 15 constituents of plant origin, two constituents of animal origin, and two constituents of mineral origin [Table 10].

Khamira Gaozaban Ambari Jawahar Wala [9],[10]

Compound Unani formulation mentioned in NFUM and Qarabadeen-e-Sarkari containing - seven constituents of plant origin, three constituents of animal origin, and four constituents of mineral origin [Table 11].

Khamira Marwareed [4]

Compound Unani formulation mentioned in Bayaz-e-Kabir containing - 11 constituents of plant origin, three constituents of animal origin, and one constituent of mineral origin [Table 12].

Khamira Marwareed [9],[12]

Compound Unani formulation mentioned in NFUM and Ilaj-ul-Amraz containing - four constituents of plant origin, two constituents of animal origin [Table 13].

Khamira Marwareed Ba Nuskha Khas [4]

Compound Unani formulation mentioned in Bayiaz-e-Kabir containing - six constituents of plant origin, one constituent of animal origin, and three constituents of mineral origin [Table 14].

Khamira Marwareed Ba Nuskha Kalan [4]

Compound Unani formulation mentioned in Bayiaz-e-Kabir containing - seven constituents of plant origin, one constituent of animal origin, and three constituents of mineral origin [Table 15].

Khamira Yaqoot [4],[5]

Compound Unani formulation mentioned in Bayiaz-e-Kabir and Makhazanul Murakkebat containing - seven constituents of plant origin, one constituent of animal origin, and three constituents of mineral origin [Table 16].

Khamira Yashab [9],[10]

Compound Unani formulation mentioned in NFUM and Qarabadeen-e-Sarkari containing - one constituent of plant origin, one constituent of animal origin, and two constituents of mineral origin [Table 17].

Khamira Zehar Mohra [9],[13]

Compound Unani formulation mentioned in NFUM and Qarabadeen-e-Azam-o-Akmal containing - five constituents of plant origin and two constituents of mineral origin [Table 18].

Khameera Zamarrud [5]

Compound Unani formulation mentioned in Makhazanul Murakkebat containing - six constituents of plant origin and four constituents of mineral origin, and two constituents of animal origin [Table 19].

Khamira Khas [5]

Compound Unani formulation mentioned in Makhazanul Murakkebat containing - one constituent of plant origin [Table 20].


   Results and Discussion Top


Various studies have been carried out thus far, to investigate the protective potential of Khamira in different ailments. [14] Khamira Abresham Uood Mastagiwala (KAUM) was studied for the activity of antioxidant enzymes, glutathione reductase (GR), glutathione S-transferase (GST), glutathione peroxidase (GPx), catalase (CAT), and the content of glutathione (GSH) and thiobarbituric acid reactive substances (TBARS), in the middle cerebral artery occlusion (MCAO) of rats, after 15 days of treatment (200 mg/kg body weight (b.wt.), orally) with Khamira Abresham Uood Mastagiwala. The activity of GPx, GST, GR, catalase, and the content of GSH had decreased significantly in the MCAO group as compared to the sham. The rats of the MCAO + KAUM groups had shown significant protection of the activity of the above-mentioned antioxidant enzymes and content of glutathione when compared to the MCAO group. The significantly elevated level of TBARS in the MCAO group was depleted significantly by the pretreatment of the animals with KAUM in the MCAO group. The neurobehavioral assessment has also strengthened the above biochemical data, thereby indicating that the therapeutic intervention of KAUM, which is a potent cardiac and melancholic tonic, can be used to prevent or reduce the deterioration caused by free radicals, thereby preventing subsequent pathological and biochemical changes, which occur during cerebral ischemia. [14],[15] Khamira Abresham Hakim Arshad Wala (KAHAW) is an effective and potent cardiac tonic with well-known antioxidant properties. The cognitive impairment was developed by giving a single intracerebroventricular injection of 1.5 mg/kg body weight of streptozotocin (STZ) bilaterally. An increased latency and path length was observed in cognition in the STZ group as compared to the control group and these were restored significantly in the STZ group pretreated with KAHAW (700 mg/kg body weight for 15 days). The activity of the antioxidant enzymes, namely, glutathione reductase, glutathione S-transferase, glutathione peroxidase, and superoxide dismutase had decreased in the STZ group as compared to the control group and pretreatment of the STZ group with KAHAW had protected their activities significantly. Moreover, the significantly depleted content of reduced glutathione and significantly elevated level of thiobarbituric acid reactive substances (TBARS) in STZ group were protected significantly with KAHAW. The study concludes that the therapeutic intervention of KAHAW may be used to prevent or to decrease the deterioration of cognitive function and neurobehavioral activities, often associated with the generation of a free radical. [16],[17]

An attempt has been made to evaluate the effect of various samples of Khamira Abresham Hakim Arshadwala on myocardial necrosis in rats. The parameters include serum free fatty acids, cardiac glycogen, serum GOT, GPT, LDH, Cholesterol, Sodium, and Potassium. Khamira at a dose of 1 g/kg body wt. has shown a significant protective effect against isoproterenol-induced myocardial cell damage. [18],[19]

Khamira Abresham Hakim Arshad Wala (KAHAW) at a dose of 800 mg/kg/day has significantly reversed a majority of hemodynamic and antioxidant derangements. The protective role of KAHAW on ISO-induced myocardial necrosis has been further confirmed by histopathological and ultrastructural examination. [16],[17] KAHAW also protects against cognitive impairment induced by giving a single intracerebroventricular injection of 1.5 mg/kg body weight of streptozotocin (STZ) bilaterally. KAHAW may be used to prevent or to decrease the deterioration of cognitive function and neurobehavioral activities, often associated with the generation of free radicals. [15]

Khamira Marwareed (KM) showed a significant increase in the relative organ (spleen and thymus) weight. Cellularity of the spleen and bone marrow also increased significantly. Groups receiving KM for 10 and 15 days showed an increase in hemoglobin, red blood cells (RBCs), and total white blood cells (WBCs). The humoral immune response, evaluated by the plaque-forming cell (PFC) assay after challenging the mice with goat RBCs, was better in all the treated groups, when compared to controls. The maximum hemagglutination titer was obtained in mice treated with KM for 15 days. Ovalbumin-specific serum IgG levels in the treated mice also increased, suggesting an immunopotentiating effect of the preparation. Administration of KM resulted in elevated levels of IgG2a and IgG2b. A comparison of anti-ovalbumin IgE and IgG was also conducted; anti-ovalbumin IgE decreased, with a concomitant increase in anti-ovalbumin IgG. Administration of KM for 10 or 15 days elicited an increase in the delayed-type hypersensitivity (DTH) response. Taken together, the results suggested an immunostimulatory effect for KM through a mechanism, leading to a Th1-dominant immune state. [20]

Although, a lot of study has been carried out so far with respect to Unani drugs and other natural plant products, unfortunately, due to lack of literature and research in this field, no mechanism of action related to the cardio-protective nature of these 'Khamiras: natural cardiotonics' is known.

Our laboratory has planned to study this virgin area of research, we would like to search for pathways that are targeted by these cardio-protectors and further research will be carried out to check their effect at molecular and genetic levels.


   Conclusion Top


In view of the increasing number of cardiac diseases a thorough evaluation of this ancient work on Khamira is of special significance. The above article gives information about Khamiras, which can be used in cardiac and associated diseases. The article gives information about different Khamiras used in the Unani system of medicine and their composition, which will be helpful for Unani scholars and researchers, to gather information about the Khamiras mentioned in Unani Medicine. Carrying out such attempts will be helpful in exploring the scope of Unani medicine and it will lead to better healthcare professionals.


   Acknowledgment Top


The authors are thankful to Central Council for Research in Unani Medicine (CCRUM), Delhi, for financial support and Prof. M. S. Y. Khan for his guidance.

 
   References Top

1.Rehman HZ. Dawa Sazi. Delhi: Nomani Press; 1985. p. 130-1.   Back to cited text no. 1      
2.Khan AS. Misbahul Advia. Delhi: Ajaz Publishing House; 2000. p. 134-5.   Back to cited text no. 2      
3.Rehman HZ. Kitabul Murakkebat. Aligarh: Litho Colour Prints; 1991. p. 65.  Back to cited text no. 3      
4.Uddin MK. Bayaz-e-Kabir. Vol. 2. Delhi: Dafter-ul-Masehi; 1967. p. 55-67.  Back to cited text no. 4      
5.Khan GJ. Makhazanul Murakkebat. Delhi: Ajaz Publication House; 1995. p. 104-10.   Back to cited text no. 5      
6.Bheemachari J, Ashok K, Suresh DK, Gupta VRM, Narsimhachar J. Effect of Arq Gauzaban a Unanipathy product on the isolated frog heart. Acta Pharma Turc 2005;47:159-64.   Back to cited text no. 6      
7.Hussain SJ, Jahan M, Asif M. Effect of khamira abresham hakim arshad wala on cardiac metabolism in experimental myocardial necrosis. Hamdard Med 1989;32:50-8.   Back to cited text no. 7      
8.Khan MB, Hoda MN, Yousuf S, Ishrat T, Ahmad M, Ahmad AS, et al. Prevention of cognitive impairments and neurodegeneration by khamira abresham hakim arshad wala. J Ethnopharmacol 2006;108:68-73.   Back to cited text no. 8  [PUBMED]  [FULLTEXT]  
9.National Formulary of Unani Medicine (NFUM). Part I, New Delhi: Central Council for Research in Unani Medicine; 2006. p. 108-13.  Back to cited text no. 9      
10.Qarabadeen-e-Sarkari. Part II, Hyderabad: Indian Medicine Dept. Govt. of Andhra Pradesh; 1967. p. 58-62.   Back to cited text no. 10      
11.Khan MA. Qarabadeen-e-Azam. Kanpur: Nizami Press; 1302H. p. 66.   Back to cited text no. 11      
12.Khan MS. Ilaj-ul-Amraz (Persian). Delhi: Barqi Press; 1921. p. 125.   Back to cited text no. 12      
13.Khan MA. Qarabadeen-e-Azam-o-Akmal. Delhi: Siidiqui Press; 1315H. p. 107.  Back to cited text no. 13      
14.Yousuf S, Salim S, Ahmad M, Ahmed AS, Ansari MA, Islam F. Protective effect of khamira abresham uood mastagiwala against free radical induced damage in focal cerebral ischemia. J Ethnopharmacol 2005;99:179-84.   Back to cited text no. 14  [PUBMED]  [FULLTEXT]  
15.Sun J, Tan BK, Huang SH, Whiteman M, Zhu YZ. Effects of natural products on ischemic heart diseases and cardiovascular system. Acta Pharmacol Sin 2002;23:1142-51.   Back to cited text no. 15  [PUBMED]    
16.Khan MB, Hoda MN, Yousuf S, Ishrat T, Ahmad M, Ahmad AS, et al. Prevention of cognitive impairments and neurodegeneration by Khamira Abresham Hakim Arshad Wala. J Ethnopharmacol 2006;108:68-73.  Back to cited text no. 16  [PUBMED]  [FULLTEXT]  
17.Jameel S, Pillai KK, Hussain SZ, Imran M. Influence of 'Khamira Abresham Hakim Arshadwala' on adriamycin induced toxicity in rats. Indian Drugs 1992;29:686-90.   Back to cited text no. 17      
18.Thippeswamy BS, Thakker SP, Tubachi S, Kalyani GA, Netra MK, Patil U, et al. Cardioprotective Effect of Cucumis trigonus Roxb. on isoproterenol-induced myocardial infarction in rat. Am J Pharmacol Toxicol 2009;4:29-37.   Back to cited text no. 18      
19.Goyal S, Siddiqui MK, Siddiqui KM, Arora S, Mittal R, Joshi S, et al. Cardioprotective effect of 'Khamira Abresham Hakim Arshad Wala' a Unani formulation in isoproterenol-induced myocardial necrosis in rats. Exp Toxicol Pathol 2010;62:61-74.   Back to cited text no. 19  [PUBMED]  [FULLTEXT]  
20.Khan F, Ali S, Ganie BA, Rubab I. Immunopotentiating effect of Khamira Marwarid, an herbo-mineral preparation. Methods Find Exp Clin Pharmacol 2009;31:513-22.  Back to cited text no. 20  [PUBMED]  [FULLTEXT]  



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13], [Table 14], [Table 15], [Table 16], [Table 17], [Table 18], [Table 19], [Table 20]


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