Revival of Complementary and Alternative Herbal Medicines

Herbal medicines, complementary or alternative medicines is a wide term for the therapies that are not part of standard care but it has many theories regarding efficacy based on personal experiences, history and common knowledge. It has long been used since ancient times since the beginning of human civilization. Its use had caught much attention in the early 1800s, with the development in the science of chemistry, a new era in pharmacotherapeutics and the use of active chemical ingredients in plants which were known to produce favorable therapeutic effects, were explored, active compounds were extracted, purified and their structure was revealed. This advancement paved the way towards modern pharmaceutical therapy. The modern drugs are based on these herbal medicines, after extracting the active and pure chemical compounds. Pharmacokinetics and physicochemical properties of the active ingredients was explored. It lead to the better understanding of efficacy and safety profile of these drugs and first choice for treatment of various diseases. At the same time, the herbal medicines were considered as secondarily important. After approximately two centuries, the use of herbal medicines have seen a revival globally both in developing as well as developed countries. In the past few years, the practice of using herbal medicines as an alternative and complementary health medicine has gained more importance. Herbal medicines are common for treatment of various ailments including cancer, digestive disorders, pain related disorders, neuropathic ailments and cardiac arrhythmias etc. Even it has been used by pregnant females and mostly perceived as safe. Its use has gained more attraction due to its ‘natural’ approach and lesser side effects. Their use if often overlooked but physicians should pay attention to these medicines. There is lack of familiarity, standardization of the drug components, unproven therapeutic effects in various diseases, unexplored toxicology, pharmacokinetics, drug-drug interactions, and compatibility in patients with varying medical, genetic and demographic history. There are serious concerns regarding the safety, efficacy and quality of herbal products and nutraceuticals. Accidental contamination and deliberate adulteration are assumed to be the main cause of the side effects. Much of the herbal medical knowledge is scattered in different regions of the world and mostly available at family, community and local level and mostly in any native languages. There is need of coherent sources, knowledge, and exploration of these medicines across the world. The herbal medicine has varying diversity in different geological regions and they should be investigated. There should be a regional or national body to control and approve the herbal medicines. Proper documentations on these medicines and food supplements should also be done.

Expression Patterns of P53 and Her2/Neu in Primary Ovarian Carcinomas

Background: Ovarian tumours are common neoplasms of the female genital tract and a leading cause of cancer mortality among women. There is paucity of local Kenyan data on the morphologic subtypes of ovarian tumours and the expression of select prognostic markers in ovarian carcinomas has not been previously investigated. The aim of this study was to determine the frequency and describe the patterns of p53 and HER2/neu expression in primary ovarian carcinomas and to describe the clinical and pathologic features of ovarian tumours diagnosed at the Pathology Laboratory of the Aga Khan University Hospital Nairobi. Methodology: A cross-sectional descriptive study was undertaken. Electronic histopathology reports of all ovarian tumours diagnosed over a three year period in the Histopathology department at the Aga Khan University Hospital Nairobi Laboratory were retrieved. Clinical and pathologic data were recorded. Haematoxylin-eosin stained slides of the ovarian carcinomas were reviewed and appropriate paraffin-embedded blocks selected and retrieved from the archives for immunohistochemistry. Additional paraffin blocks of primary ovarian carcinomas diagnosed consecutively over a 2 year period from the Aga Khan Hospital Kisumu, and the AICKijabeHospital were included in the study after review of haematoxylin-eosin stained slides. Sections were cut from all the selected ovarian carcinoma blocks and stained for HER2/neu and p53 using standard immunohistochemical techniques. The data were analyzed using SPSS version 17 and are presented in tables and charts. Results: Three-hundred and seventy-four ovarian tumours were diagnosed at Aga Khan University Hospital Nairobi during the study period. The median age for malignant tumours was 51.1 years. The most common benign tumour was mature cystic teratoma (44.3% 95%CI ±5.68%). The most common malignant tumour was serous carcinoma (44.7% 95%CI ±11.43%). Forty-three point three percent (95%CI 32.1-55.2%) of carcinomas were positive for p53 and 13.4% (95%CI 7.2-23.6%) were positive for HER2/neu. Serous carcinoma (61.1% 95%CI±15.9%) and adenocarcinoma, not otherwise specified (33.3% 95%CI ±11.3%) were more likely to be positive for p53. There was no association noted between the histologic grade or pathologic stage and positivity for p53. There was no association noted between staining for HER2/neu and histologic type, histologic grade or pathologic stage of carcinoma. Conclusion: The proportion of histologic subtypes of primary ovarian tumours that were diagnosed is similar that described in literature. There is no significant difference in the expression patterns of both p53 and HER2/neu from that described in literature.