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.

Prevalence of Non-Alcoholic Fatty Liver Disease in Overweight and Obese Children Seeking Ambulatory Health Services in Nairobi

Introduction: Non-alcoholic fatty liver disease is often an asymptomatic condition one of the leading causes of chronic liver disease and is associated with an increase in cardiovascular morbidity. Being overweight or obese has been positively linked to non-alcoholic fatty liver disease in children. There is evidence to show that when detected early, non-alcoholic fatty liver disease is reversible primarily upon institution of lifestyle changes targeted at weight reduction. Establishing the prevalence of non-alcoholic fatty liver disease in overweight and obese Kenyan children would serve as a benchmark for long term monitoring of associated morbidity and guide in public health policies aimed at early screening and intervention. Objectives: The aim of this study was to investigate prevalence of non-alcoholic fatty liver disease in overweight and obese children aged between six and eighteen years using liver ultrasonography. Methodology: A descriptive cross sectional study was carried out in 103 overweight and obese school aged children aged six to eighteen years seeking ambulatory health care services in Nairobi. Consent was obtained from the primary caregivers. A questionnaire was administered to collect information on bio data. Blood pressure readings were taken and plotted in age and gender specific charts and a liver ultrasound was done to assess and grade fatty changes. Data Analysis: Statistical analyses were conducted using SPSS version 11.5 (SPSS, Chicago, IL, USA). Categorical variables were analyzed using median (IQR) and summarized using frequency counts and percentages. Chi-square test was used to determine odds ratios for association between presence of fatty liver and other categorical variables using 2x2 tables. All clinically important variables were then included in multiple logistic regression model adjusting for age and sex to find if there was any association with fatty liver. All analyses were two-tailed and P-value less than 0.05 was considered statistically significant. Results: A total of 103 children were recruited in the study. The prevalence of fatty liver change was 26.2% (27/103; 95%CI=18.0%-35.8 %). There was no association between sex and fatty liver disease (OR=1.13, p=0.82; 95%CI=0.4-3.2) Obese children were four times more likely to have fatty liver compared to overweight children (OR=4.52 p=0.02, 95%CI=1.4-19.0). Slightly more than a third of the children, 40.8% (n=41) had elevated blood pressure. However, there was no association between elevated blood pressure and fatty liver disease (OR=2.06; p=0.27; 95%CI=0.6-7.6). Older children (13-18 years) were four times more likely to have fatty liver vi