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Original Research (Original Article) 


Ali Hassan A. Ali et al, 2020;4(2):280–285.

International Journal of Medicine in Developing Countries

Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study

Ali Hassan A. Ali1,2, Sameer Al-Ghamdi3*, Ghanem G. Alanazi4, Muath A. Alsomait4, Abdulaziz N. Alaskar4, Abdulmohsen K. El-Enazi4, Hisham M. Alashqar4, Gulfam Ahmad5

This article has been retracted.

Correspondence to: Sameer Al-Ghamdi

*Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University Al Kharj, Saudi Arabia.

Email: sam3443 [at] gmail.com

Full list of author information is available at the end of the article.

Received: 23 May 2019 | Accepted: 23 December 2019


ABSTRACT

Background:

Cyclophosphamide (CP) is a widely used medication in chemotherapy and can cause oxidative stress. Oxidative stress can affect testicular functions by reducing the sperm motility and concentration, changing the sperm morphology, and increasing deoxyribonucleic acid fragmentation in sperm. Ginger is one of the most widely used spices in various foods and is used as an herbal medicine in many countries due to its antioxidant effects. We aim to study the protective effects of ginger against CP-induced testicular toxicity in rats.


Methods:

The study was performed on 30 male albino rats with body weights of 300–350 g. The animals were divided into the following three groups (10/cage): Group 1 (control, untreated group), Group 2 (CP group, received a single dose of CP at 100 mg kg−1 of BW intraperitoneally), and Group 3 (CP + ginger, received ginger extract orally at 500 mg/kg for 35 days after CP injection). The morphological and histological structures of the testes were compared in the different groups of rats.


Results:

The CP-treated group showed a disorganized germinal epithelium compared with those of the controls. The CP + ginger-treated group showed a significant recovery of the organization of the germinal epithelium and the cellular attachments. Caspase-3-positive cells were significantly higher in the CP group and had remarkably lower levels in the CP + ginger-treated group. A reduction in the diameter of the seminiferous tubules and the destruction of connective tissue were observed in the CP-treated group; these changes were improved in the CP + ginger-treated group.


Conclusion:

Ginger extract can protect reproductive functions against CP-induced toxicity in rats.


Keywords:

Ginger extract, antioxidant, cyclophosphamide, rat, testes.


Introduction

Ginger rhizome is a flowering plant, and the rhizome is ginger root, or simply ginger, which is used worldwide as a spice and folk medicine. The antioxidative and androgenic activities of ginger have been reported in animal models [1]. The characteristic fragrance and flavor of ginger result from volatile oils that compose 1%–3% of the weight of fresh ginger. It also contains acids, resins, vitamin C, and folic acid. In addition, it contains moderate amounts of vitamin B6 and dietary minerals, including magnesium and manganese, but is otherwise low in nutrient content [2]. Ginger has a strong antioxidant effect and may either relieve or rule out the generation of free radicals. It is considered as an important herbal medicine that only has a few negative side effects if consumed in reasonable quantities [3]. The antioxidant action of ginger has been proposed as one of the major possible mechanisms for the protective effects against radiation toxicity [4,5] and several toxic agents, such as carbon tetrachloride and cisplatin [6]. The inhibition of xanthine oxidase activity that is responsible for the generation of reactive oxygen species, such as superoxide anions, has been documented with gingerol [7]. The levels of superoxide dismutase and catalase enzymes, which are important components of enzymatic antioxidative defenses, were significantly stimulated in the liver tissues of rats that were fed ginger at all levels [8]. Cyclophosphamide (CP), also known as cytophosphane, is a medication that is used as a chemotherapy treatment and to suppress the immune system. It is used extensively as an antineoplastic agent for the treatment of various cancers, multiple sclerosis, systemic lupus erythematosus, and other benign tumors [9]. As an immune suppressor, it is used in the treatment of nephrotic syndrome and following an organ transplant. CP treatment is associated with oligospermia and azoospermia, as well as biochemical and histological alterations in the testis and epididymis of humans and rats [1012]. This study was conducted to investigate the role of ginger in preventing cyclophosphamide-induced adverse effects on the testicular histology of CP-treated male rats.


Subjects and Methods

CP was purchased from Baxter Oncology GmbH, Frankfurt, Germany. Ginger Tablets (500 mg) that were produced by Arab Co. Pharmaceuticals (El Asher Men Ramadan City, Egypt) and Medical Plant MEPACO (Nasr City, Cairo, Egypt) were tested. The tablets were ground into a fine powder. After being milled, the ginger powder was macerated in distilled water to be a ginger extract [13]. In this study, 30 healthy, adult, male Wistar albino rats (300–350 g, 3-month old) were used. They were obtained from an animal house at the College of Pharmacy, Prince Sattam Bin Abdulaziz University, KSA. They were maintained under controlled standard animal housing conditions (temperature: 26°C–28°C; photoperiod: 12 hours natural light and 12 hours dark; and humidity: 80%–90%) with access to food and water ad libitum at the Animal Care Facility at the Department of Clinical Pharmacy at Prince Sattam bin Abdulaziz University. The pellet diet consisted of 23% protein, 5% lipids, 4% crude fiber, 8% ash, 1% calcium, 0.6% phosphorus, 3.4% glucose, and 55% nitrogen-free extract (carbohydrates). The rats were kept under observation for approximately 2 weeks before the start of the experiments to allow for adaptation. All procedures that were performed in this study that involved animal models were in accordance with the ethical standards of the Institutional Ethics Committee of Prince Sattam bin Abdulaziz University and the Animal House Committee (IRB, PSAU-2017 ANT 1/34PI). The rats were randomly divided into three groups of 10 as follows: Group 1: The control group received a single intraperitoneal injection of isotonic saline solution (1 ml). Group 2: The CP group received a single dose of CP (100 mg kg−1 BW) intraperitoneally. One hundred milligrams of CP was chosen for our study, but before starting our study, we injected 100 mg kg−1 BW of CP into four rats to ensure significant histological changes in the testis. The dose was chosen based on previous studies [9,14]. Group 3 (CP + ginger) received ginger extract orally 500 mg/kg per day for 35 days after a cyclophosphamide injection (100 mg kg−1 BW) intraperitoneally.

Histological and histochemical studies

After 1 month, the rats from the control and treated groups were anesthetized by intraperitoneal injection with 1% pentobarbital sodium (0.4 ml/100 g, ip). Then, the rats were sacrificed by cervical dislocation. The testes were removed and washed with ice-cold normal saline (0.9%) to remove the blood. The testicular samples were taken for histological and histochemical studies. The specimens were prepared via fixation in 10% neutral buffered formalin and Carnoy’s fluid. For the histological study, the paraffin sections were stained with Harriss hematoxylin and eosin (H&E) [15]. For the detection of collagen fibers, the paraffin sections were stained using Mallory’s trichrome stain [15]. For the histochemical study, the paraffin sections that were 5 μm thick were prepared and stained with Feulgen stain [15]. Later, the stained sections were examined via light microscopy and were photographed. All the detected variations between the three groups from the microscopic findings were scientifically discussed.

Immunohistochemical study

Sections of testes were deparaffinized with xylene, followed by antigen retrieval by heating in citrate buffer (10 mM, 20 minutes). This was followed by endogenous peroxidase blocking in 3% H2O2 for 10 minutes and incubation with the anti-caspase-3 antibody (1:100; Abcam, Ab4051). After washing the slides with phosphate-buffered saline, the sections were incubated with the appropriate secondary antibodies at room temperature for 1 hour, followed by detection with 3-amino-9-ethylcarbazole, a chromogen. The slides were mounted with paramount aqueous mounting medium.

Statistical analyses

The data are presented as the mean ± SEM (standard error of the mean). Additionally, the statistical analyses were carried out using analysis of variance; Statistical Package for Social Sciences-PC, version 24.0, and a p-value of < 0.05 was considered as statistically significant.


Results

Histological results

The testicular sections from the control adult albino rats showed normal morphology, and all structures were arranged in a normal pattern ( Figure 1). The histological sections from the CP-treated group exhibited an irregularity of the seminiferous tubule (ST) structures with a significant decrease in the diameters compared with those of the control group (Figure 2A and B). The germinal epithelium was disorganized and showed abnormal cellular attachment. Spermatogonia were the major cell type observed. Multinucleated cells were also observed in the CP-treated group (Figure 2B). The third group (CP + ginger) showed a significant recovery of the ST diameters in comparison with those from the rats treated with CP (Figure 2C and D). The interstitial connective tissue showed marked destruction of the connective tissues with the subsequent widening of the interstitial tissue (IT) spaces compared with those from the control group (Figure 3A and B). The group that was treated with ginger extract showed a considerable recovery of the interstitial connective tissue to normal levels and a significant increase in the amount of the collagen fibers compared with those from the CP group (Figure 3A and B).

Immunohistochemical results

In the CP group, a marked increase in the number of caspase-3 positive cells was observed in the STs in comparison with those from the control group (Figure 4A and B). An increase in the number of caspase-3-positive cells was also observed in the STs in the third group (CP + ginger) in comparison with those from the controls (Figure 4C and D). The mean diameters of STs, the number of pyknotic and caspase-3-positive cells are given in Table 1.


Discussion

This study was designed to investigate the protective effects of ginger extract on cyclophosphamide-induced oxidative stress in rat testes. It is a fact that the cyclophosphamide is used in chemotherapeutic regimens. On the one hand, it has a positive implication against cancer, but at the same time, it puts the body under oxidative stress and reproductive deformities. The deleterious effects of CP have been well documented, and some agents, such as Phyllanthus fraternus Webster, have been used to protect the testicular structure of CP-treated mouse testes [16]. One study reported the protective effects of ginger on the sperm characteristics and epididymal morphology in rats treated with CP [17]. However, this study tested the combined effects of ginger and pumpkin seed extracts, and it is not clear if the protective effects were greater because of the ginger extract or the pumpkin seed extract. In this continuation of the previous work, we conducted this study to determine the direct effects of ginger extract on the histological changes of rat testes. Our results showed that there was a deterioration of testicular structures, especially in the diameter of STs. The injection of ginger extract significantly improved the histology of the testes in rats. Caspase-3 is an apoptotic marker of programmed cell death. In our study, the number of caspase-3-positive cells was significantly higher in the CP-treated group, while it was lower in the ginger-treated groups. The effects of ginger on testicular histology are scarcely reported. Vitamin C has also shown protective effects against CP-induced rat testicular toxicity [18]. Likewise, diallyl disulfide also improved testicular functions in rats treated with CP [19]. Others have reported that the long-term use of CP as a chemotherapeutic agent can reduce the body weight and damage the reproductive organs in male rats. This can lead to atrophy of the testes, epididymides, and consequently, fertility impairment [1921]. It has been documented in various experimental studies that effective anticancer therapies with cytotoxic drugs, such as CP, are limited by their side effects, including reproductive toxicity [9]. Our findings support the results of Ilbey et al. [9], who reported irregular and diminished STs that contained only a few germ cells in the CP-induced group and that ginger has both antioxidative and androgenic activities in animal models [22]. However, the results of the current study are in line with the study of Zahedi et al. [23], who explained that the administration of ginger can overcome the reproductive toxicity of gentamicin. Similarly, Shalaby et al. [24] declared that the oral administration of the ginger extract at 250 and 500 mg/kg body weight for 65 days lead to the improvement of spermatogenesis in diabetic male rats. The deleterious effects of A1C13 have also been improved with ginger administration. The findings of this study should be translated to humans with caution. Furthermore, the use of specific concentrations of other antioxidants is recommended in future studies. These results further suggest that studies should use ginger as a drug to protect patients from the side effects of chemotherapy. To attain better results, further investigations should be carried out on this subject. However, comprehensive chemical and pharmacological research is required to determine the exact mechanism of ginger on the testis and to identify the active ingredient responsible for this effect [25].

Figure 1. A light photomicrograph of a section of a rat testicular tissue from the control group shows the normal association of the germ cells and the normal architecture of the IT. G = Spermatogonium, P = Spermatocytes, D = Spermatid, SP = Sperm, S = Sertoli cells, Ly = Leydig cells. H&E staining (400×).

Figure 2. (A) A light photomicrograph of a section of a rat testicular tissue from the control group. The STs have an ordinary shape. The ST epithelium is structurally intact and shows a normal association with germ cells. (B) A light photomicrograph of a section of rat testicular tissue from rats that were treated with cyclophosphamide. The STs have irregular shapes, and the germinal epithelium is disorganized. The depletion of germ cells, pyknotic germ cells (black arrow), and karyolysis (blue arrow) can be seen. The giant cell formation with two or three nuclei (red arrow) is seen in the lumen of the irregularly shaped ST. (C and D) A light photomicrograph of a section of a rat testicular tissue from rats that were treated with ginger extract. The STs have a partial recovery to the normal structure. H&E staining (400×).

Figure 3. (A) A light photomicrograph of a section of a rat testicular tissue from the control group shows the normal distribution of collagen fibers in the IT around the STs. (B) A light photomicrograph of a section of a rat testicular tissue from rats that were treated with cyclophosphamide shows a marked reduction of collagen fibers in the IT around the STs, and causes an increase in the diameter of the interstitial spaces. (C and D) A light photomicrograph of a section of a rat testicular tissue from rats that were treated with ginger extract shows a similar distribution of collagen fibers in the IT around the STs in comparison with those from the control group. Mallory’s trichrome staining (200×).

Figure 4. (A) A light micrograph of testicular tissue of a rat from the control group. The ST germ cells show the mild expression of caspase-3 with immunostaining (black arrows). (B) A light micrograph of testicular tissue of a rat treated with CP. The ST germ cells show the marked expression of caspase-3 with immunostaining (black arrows). (C) A light photomicrograph of a section of a rat testicular tissue from rats that were treated with ginger extract shows the mild expression of caspase-3 with immunostaining (black arrows) in the ST germ cells. D) A light photomicrograph of a section of a rat testicular tissue from rats that were treated with ginger extract shows the moderate expression of caspase-3 with immunostaining (black arrows) in the ST germ cells. Caspase-3 immunostaining (400×).

Table 1. Mean± SD diameters of the seminepherous tubules, number of pyknotic and caspse 3 +ve cells in differen study groups.

Parameters Diameters of the seminepherous tubules Myknotic cells caspase-3+ve cells
Study Groups
Group 1 (Control) 178.11±13.92 29.073±1.48 12.00±1.94
Group 2
(CP)
122.61±32.17* 15.08±4.02* 36.81±2.78*
Group 3
(ginger+ CP)
189.78±10.67** 24.75±6.28** 15.00±3.31**

*Significantly different from the control group (P < 0.05).

**Significantly different from CP group (P<0.05)


Conclusions

In conclusion, the present study has demonstrated that ginger possesses antioxidant activities and reduces the side effects of CP on testicular structures. The results of this study may advocate the use of ginger by patients receiving anticancer therapy. However, this speculation warrants randomized, controlled trials on a large human population.


Acknowledgments

The authors would like to thank the laboratory technicians for their help in conducting this study.


List of Abbreviations

CP Cyclophosphamide

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this article.


Funding

None.


Consent for publication

Informed consent was obtained from all the participants.


Ethics approval

The study was approved by the Ethics Committee of Prince Sattam bin Abdulaziz University Institutional Review Board (IRB, PSAU-2017 ANT 1/34PI).


Author details

Ali Hassan A. Ali1,2, Sameer Al-Ghamdi3, Ghanem G. Alanazi4, Muath A. Alsomait4, Abdulaziz N. Alaskar4, Abdulmohsen K. El-Enazi4, Hisham M. Alashqar4, Gulfam Ahmad5

  1. Anatomy Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
  2. Anatomy Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
  3. Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University Al Kharj, Saudi Arabia
  4. College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
  5. Department of Physiology, University of Health Sciences, Lahore, Pakistan

References

  1. Arash Khaki D, Fathiazad F, Nouri M, Afshin A, Hamadeh D. The effects of ginger on spermatogenesis and sperm parameters of rat. Iranian J Reprod Med. 2009;7:7–12.
  2. Morakinyo OA, Achema P, Adegoke O. Effect of zingiber officinale (Ginger) on sodium arsenite induced reproductive toxicity in male rats. Afr J Biomed Res. 2010;13:39–45.
  3. Dawson E, Harris W, Teter M, Powell L. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil Steril. 1992;58:1034–9. https://doi.org/10.1016/S0015-0282(16)55456-9
  4. Jagetia C, Rajanikant GK, Rao SK, Baliga MS. Alteration in glutathione, glutathione peroxidase, superoxide dismutase, and lipid peroxidation by ascorbicacid in the skin of mice exposed to fractionated gamma radiation. Clin Chem Acta. 2003;332:111–21. https://doi.org/10.1016/S0009-8981(03)00132-3
  5. Haksar A, Sharma A, Chawla R, Kumar R, Arora R, Sharma RK. Zingiber officinale exhibits behavioral radioprotection against radiation. Pharmacol Biochem Behav. 2006;84:179–88. https://doi.org/10.1016/j.pbb.2006.04.008
  6. Yemitan OK, Izegbu MC. Protective effects of Zingiber officinale (Zingiberaceae) against carbon tetrachloride and acetaminophen induced hepatotoxicity in rats. Phytotherapeutic Res. 2006;20:997–1002. https://doi.org/10.1002/ptr.1957
  7. Chang WS, Chang YH, Lu FJ, Chiang HC. Inhibitory effects of phenolics on xanthine oxidase. Anticancer Res. 1994;14:501–6.
  8. Kota N, Krishna M, Polasa K. Alterations in antioxidant status of rats following intake of ginger through diet. Food Chem. 2008;106:991–6. https://doi.org/10.1016/j.foodchem.2007.07.073
  9. Ilbey YO, Ozbek E, Simsek A, Otunctemur A, Cekmen M, Somay A. Potential chemoprotective effect of melatonin in cyclophosphamide-and cisplatin-induced testicular damage in rats. Fertil Steril. 2009;92:1124–32. https://doi.org/10.1016/j.fertnstert.2008.07.1758
  10. Kirkland RT, Bongiovanni AM, Cornfeld D, McCormick JB, Parks JS, Tenore A. Gonadotropin responses to luteinizing releasing factor in boys treated with cyclophosphamide for nephrotic syndrome. J Pediatr. 1976;89:941–4. https://doi.org/10.1016/S0022-3476(76)80600-2
  11. Kaur R, Sangha G, Bilaspuri G. Cyclophosphamide induced structural and biochemical changes in testis and epididymidis of rats. IJEB. 1997;35:771–5.
  12. Masala A, Faedda R, Alagna S, Satta A, Chiarelli G, Rovasio PP, et al. Use of testosterone to prevent cyclophosphamide-induced azoospermia. Ann Intern Med. 1997;126:292–5. https://doi.org/10.7326/0003-4819-126-4-199702150-00005
  13. Sutyarso, Muhartono, Susianti, Hendri Busman, Mohammad Kanedi. Testicular Function of Rats Treated with Water Extract of Red Ginger (Zingiber officinale var.rubrum) Combined with Zinc. J Food Nutr Res. 2016;4(3):157–62.
  14. Rong X, Peng G, Suzuki T, Yang Q, Yamahara J, Li Y. A 35-day gavage safety assessment of ginger in rats. Regul Toxicol Pharmacol. 2009;54(2):118–23. https://doi.org/10.1016/j.yrtph.2009.03.002
  15. Bancroft D, Gamble M. Bancroft’s theory and practice of histological techniques. 6th ed. Edinburgh, UK: Elsevier, Churchill Livingstone; 2008. pp 178–86, 221–4.
  16. Singh S, Lata S, Tiwari KN. Antioxidant potential of Phyllanthus fraternus Webster on cyclophosphamide induced changes in sperm characteristics and testicular oxidative damage in mice. Indian J Exp Biol. 2015;53(10):647–56.
  17. Aghaie S, Nikzad H, Mahabadi JA, Taghizadeh M, Azami-Tameh A, Taherian A, et al. Protective effect of combined pumpkin seed and ginger extracts on sperm characteristics, biochemical parameters and epididymal histology in adult male rats treated with cyclophosphamide. Anat Sci Int. 2016;91(4):382–90. https://doi.org/10.1007/s12565-015-0314-x
  18. Shabanian S, Farahbod F, Rafieian M, Ganji F, Adib A. The effects of Vitamin C on sperm quality parameters in laboratory rats following long-term exposure to cyclophosphamide. J Adv Pharm Technol Res. 2017;8(2):73.
  19. Kim SH, Lee IC, Baek HS, Moon C, Kim SH, Kim JC. Protective effect of diallyl disulfide on cyclophosphamideinduced testicular toxicity in rats. Lab Anim Res. 2013;29:204–11. https://doi.org/10.5625/lar.2013.29.4.204
  20. Le XY, Luo P, Gu YP, Tao YX, Liu HZ. Interventional effects of squid ink polysaccharides on cyclophosphamide-associated testicular damage in mice. Bratisl Lek Listy. 2015;116:334–9. https://doi.org/10.4149/BLL_2015_063
  21. Lu WP, Mei XT, Wang Y, Zheng YP, Xue YF, Xu DH. Zn (II)-curcumin protects against oxidative stress, deleterious changes in sperm parameters and histological alterations in a male mouse model of cyclophosphamide-induced reproductive damage. Environ Toxicol Pharmacol. 2015;39(2):515–24.
  22. Arash Khaki D, Fathiazad F, Nouri M, Afshin A, Hamadeh D. The effects of ginger on spermatogenesis and sperm parameters of rat. Iranian J Reprod Med. 2009;7:7–12.
  23. Zahedi A, Khaki A, Ahmadi-Ashtiani HR, Rastegar H, Rezazadeh SH. Zingiber officinale protective effects on gentamicin, s toxicity on sperm in rats. J Med Plants. 2010;9:93–8.
  24. Shalaby M, Mouneir SM. Effect of Zingiber officinale roots and cinnamon zeylanicum bark on fertility of male diabetic rats. Global Vet. 2010;5:341–7.
  25. Moselhy WA, Helmy NA, Abdel-Halim BR, Nabil TM, Abdel-Hamid MI. Role of ginger against the reproductive toxicity of aluminium chloride in albino male rats. Reprod Domestic Anim. 2012;47(2):335–43. https://doi.org/10.1111/j.1439-0531.2011.01878.x


How to Cite this Article
Pubmed Style

Ali AHA, Al-Ghamdi S, Alanazi GG, Alsomait MA, Alaskar AN, El-Enazi AK, Alashqar HM, Ahmad G. Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. IJMDC. 2020; 4(2): 280-285. doi:10.24911/IJMDC.51-1558600986


Web Style

Ali AHA, Al-Ghamdi S, Alanazi GG, Alsomait MA, Alaskar AN, El-Enazi AK, Alashqar HM, Ahmad G. Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. https://www.ijmdc.com/?mno=50271 [Access: October 15, 2021]. doi:10.24911/IJMDC.51-1558600986


AMA (American Medical Association) Style

Ali AHA, Al-Ghamdi S, Alanazi GG, Alsomait MA, Alaskar AN, El-Enazi AK, Alashqar HM, Ahmad G. Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. IJMDC. 2020; 4(2): 280-285. doi:10.24911/IJMDC.51-1558600986



Vancouver/ICMJE Style

Ali AHA, Al-Ghamdi S, Alanazi GG, Alsomait MA, Alaskar AN, El-Enazi AK, Alashqar HM, Ahmad G. Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. IJMDC. (2020), [cited October 15, 2021]; 4(2): 280-285. doi:10.24911/IJMDC.51-1558600986



Harvard Style

Ali, A. H. A., Al-Ghamdi, . S., Alanazi, . G. G., Alsomait, . M. A., Alaskar, . A. N., El-Enazi, . A. K., Alashqar, . H. M. & Ahmad, . G. (2020) Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. IJMDC, 4 (2), 280-285. doi:10.24911/IJMDC.51-1558600986



Turabian Style

Ali, Ali Hassan A., Sameer Al-Ghamdi, Ghanem G. Alanazi, Muath A. Alsomait, Abdulaziz N. Alaskar, Abdulmohsen K. El-Enazi, Hisham M. Alashqar, and Gulfam Ahmad. 2020. Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. International Journal of Medicine in Developing Countries, 4 (2), 280-285. doi:10.24911/IJMDC.51-1558600986



Chicago Style

Ali, Ali Hassan A., Sameer Al-Ghamdi, Ghanem G. Alanazi, Muath A. Alsomait, Abdulaziz N. Alaskar, Abdulmohsen K. El-Enazi, Hisham M. Alashqar, and Gulfam Ahmad. "Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study." International Journal of Medicine in Developing Countries 4 (2020), 280-285. doi:10.24911/IJMDC.51-1558600986



MLA (The Modern Language Association) Style

Ali, Ali Hassan A., Sameer Al-Ghamdi, Ghanem G. Alanazi, Muath A. Alsomait, Abdulaziz N. Alaskar, Abdulmohsen K. El-Enazi, Hisham M. Alashqar, and Gulfam Ahmad. "Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study." International Journal of Medicine in Developing Countries 4.2 (2020), 280-285. Print. doi:10.24911/IJMDC.51-1558600986



APA (American Psychological Association) Style

Ali, A. H. A., Al-Ghamdi, . S., Alanazi, . G. G., Alsomait, . M. A., Alaskar, . A. N., El-Enazi, . A. K., Alashqar, . H. M. & Ahmad, . G. (2020) Protective effects of ginger extract against the toxicity of cyclophosphamide on testes: an experimental laboratory-based study. International Journal of Medicine in Developing Countries, 4 (2), 280-285. doi:10.24911/IJMDC.51-1558600986