Monthly Archives: October 2020

Dear South African Government, Decolonise COVID19 Treatment.

by Vuthlarhi Shirindza

Yes, I know, yet another COVID19 article. But this time the decolonised treatment version. Coronavirus disease, COVID-19, has caused an international outbreak of acute respiratory illness. Currently, there are no specific therapeutic agents for this disease, due to its broad clinical spectrum. But four researchers knew that herbal medicine has played an important role in controlling infectious diseases. So one day, they sat together and wondered what the effectiveness and adverse events of herbal medicines for the treatment of COVID-19 were. Interesting, right?

To answer this very pertinent question, they searched through twelve databases for eligible randomized controlled trials (RCTs) to provide the answer. They found seven RCTs, with a total of 855 patients, which compared the combined therapy of herbal medicine with Western medicine to Western medicine alone. They conducted a systematic review and meta-analysis of these RCTs.

The results showed that the combined therapy significantly improved the total effective rate, cough symptom disappearance rate, and sputum production symptom disappearance rate. The beneficial effects of the combined therapy were also seen through a reduced severity score on the most common symptoms such as cough, fever, dry and sore throat, and fatigue. Much to the dismay of ‘anti-herbalists’, no serious adverse events were reported. “Significant effects of the combined therapy of herbal medicine with Western medicine were found, and this has revealed the potential role of herbal medicine in treating COVID-19”. That was the concluding statement by the researchers, but one that will most probably never be echoed by western governments or the WHO.

The main findings from the research paper is that herbal medicine in combination with Western medicine improves and reduces the symptoms of COVID19 patients.

The researchers mentioned that the Chinese National Health Commission has declared the use of herbal medicine combined with Western medicine as a treatment for COVID-19, and has issued many guidelines on herbal medicine-related therapy. As a country enriched by an array of biomes, from Fynbos to the Karoos, you would assume that plants sourced from our backyards would form part of the recommended treatment of COVID19 in this country, but it does not.  Herbal medicine has always been viewed as taboo through western lenses- the dangerous stepsibling to the beloved and trusted Western medicine. Sadly, our South African national authorities have also fallen trap to this Western doctrine and brainwashing. Although the general South African public can attest to taking herbal medication and can confirm its efficacy, this same narrative does not stretch into government policy.

Understandably, the risk of side effects due to the potency of herbal medication is a major concern and drug-drug interactions need to be considered, especially for non-scientifically evaluated herbal medication. However, there is surely enough laboratory methodologies, expertise and funding to produce or verify clinically safe, efficacious and approved herbal medications. Why is South Africa and other African countries not running trials to see the efficacy of Africa-endemic herbal treatment on COVID19 patients, as was recommended by the researchers?

The South African Department of Health has the liberty to treat hospitalised patients with herbal medication and to advocate for the use of pharmacy- bought herbal medication under various trade names. To our detriment, African governments are too focused on copying the trends of more European countries instead of using our own expertise and X-factor ingredients to champion the fight against COVID19 in a decolonised fashion.

Dear South African government, decolonise COVID19 treatment.


Ang L, Song E, Lee HW, Lee MS. Herbal Medicine for the Treatment of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med. 2020;9(5):1583. Published 2020 May 23. doi:10.3390/jcm9051583

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Don’t Mind the Gap: The Truth About Cape Town’s Passion Gap

By Abduraghmaan Fisher

The most stereotypical identifying trait of Coloured people has to the ‘Passion Gap’: the absence of the top front teeth (Figure 1). This unusual ‘trend’ often puzzles many non-locals, and people living on the Cape Flats (where the practice take place) know very little about the practice, just that it exists. Some say it originated as a way to silence slaves in the Cape, while others say it offered a sexual advantage to prisoners (hence the term Passion Gap).

But what is the actual story surrounding this seemingly bizarre practice; what would be the motivation behind purposefully removing one’s front teeth and how common is it? These were the questions posed by Dr Jacqui Friedling and those she set out to find the answers to. Any correlations between the practice of this form of dental modification and age, gender, race, and socio-economic class were also investigated.

A survey was performed in the Northern Suburbs of the Cape Town Metropole in the Western Cape. The survey was conducted by means of a questionnaire. The sample population had a wide age range of 15 to 83 years old. A total of 2167 individuals participated in this study, 1196 females and 971 males.

The questionnaire was answered anonymously. It included questions revolving around dental modification, such as whether they themselves or family members had their teeth extracted, which teeth they had extracted, who extracted the teeth, at what age they had their teeth extracted and why they had their teeth extracted. It also included questions pertaining to self-identification such as race and religion, as well as socio economic class (housing type, salary bracket, highest academic standard achieved).

A total of 888 (41%) individuals in the study population had modified their teeth. More males (44,8%) than females (37,9%) were involved in this practice of dental modification. The average age of extraction is in the late teens, about 17-18 years old. There were four reasons in the study for dental extraction: peer pressure, fashion, gang-related and medical or other reasons (Figure 2). Peer pressure (42,6%) was the main reason for dental extraction and followed by fashion (36,3%). This was followed by medical or other (11%) and gangsterism (10,1%). None of the individuals in the study group stated ‘better sex/ kissing’ as a reason for extraction.

Figure 2: A comparison of male and female data, with respect to the four main reasons given for dental extraction (Friedling & Morris 2007)

The motivation for dental extraction is overwhelmingly peer pressure and fashion during adolescence. This is supported by the fact that majority of the individuals who had their teeth extracted done so before the age of 20. Therefore, removal of the front teeth can be seen as a rite of passage in the poor socio-economic communities of the Cape Flats. This study debunked the myth that individuals have their teeth extracted for ‘better sex/kissing’

Despite the recent decline in the practice and the present-day negative attitude toward it, the Passion Gap will always remain a part of the Coloured identity and culture.  The study done by Dr Friedling was only just the beginning of research into understanding the practice from an anthropological viewpoint.


Friedling, L. J. & Morris, A. G. (2007). Pulling teeth for fashion: dental modification in modern day Cape Town, South Africa: scientific. South African Dental Journal62(3): 106-113.


by Amahle Mfinwana

Androgenetic alopecia (AGA) is the most common form of hair loss, and it occurs mostly in genetically predisposed persons more sensitive to the androgen hormone, testosterone. It affects both males and females and occurs in a patterned form of scalp hair loss. AGA is not a fatal disorder, but may impair the quality of life, especially if the individual is younger or female. Hair is an essential feature of a person’s image and serves as a symbol of beauty and pride. Hair loss can therefore result in poor self-esteem and lack of confidence. The hair growth cycle consists of three phases namely, anagen (growing phase), catagen (involution phase) and telogen (resting phase).

The molecular pathway that leads to AGA involves the conversion of the hormone, testosterone to dihydrotestosterone (DHT) which is catalysed by the enzyme 5-alpha reductase (5AR). So far, three distinct isoenzymes exist namely type I, II, and III and are differentially expressed in different regions of the human body. The type II is responsible for initiating AGA , and is expressed mainly in androgen-dependent tissues such as the prostate, epididymis, and hair follicle, and it is also a main form in the dermal papilla cells, hence its pivotal role in initiating the hair loss. Targeting this enzyme is therefore essential in developing AGA therapeutics.

For decades, there have been many research studies geared towards AGA therapeutics. However, only two drugs have so far been approved by the FDA to treat AGA- Finasteride and Minoxidil. These drugs have very low cure rates (>50%) and side effects such as irritation, increasing growth or darkening of fine body hairs, allergic contact, and dermatitis. Today’s open access paper, they came up with a treatment that will prevent hair loss and promote hair growth. Recent studies have shown that a combination of 5AR inhibition and the use of hair growth promoters can treat AGA. The main area of research was to investigate the ability of bee venom to prevent hair loss to promote hair growth exhibiting low toxicity compared to synthetic drugs.

In the paper the researchers used both mice (C57BL/6J mice) and cells (human dermal papilla cells) as their models. The C57BL/6J mice were housed under constant environmental conditions. After adaptation for 1week hair skin dorsal were removed. Mice were divided into five groups (n=6) and were treated with Minoxidil (2%), bee venom with different concentrations (0,001, 0,005 and 0,01%) and other group was vehicle treated (distilled water, ethanol, and polyethylene glycol-negative control). This was done to investigate the hair growth during anagen phase. They also evaluated the inhibitory effect of bee venom on the induction of catagen phase. Animal were divided into six groups (n=6): the negative control (vehicle treated), the dexamethasone (0,1%), positive control (2% minoxidil and 0,1% dexamethasone) and three bee venom concentrations which are the same as the above and 0,1% dexamethasone. Dexamethasone was applied to induce catagen phase. They also performed cell culture and cell proliferation assay using the HDPCs. They investigated the effect of bee venom on hair growth in C57BL/6 Mice and human dermal papilla cell growth.

Figure 1: The effect of Bee Venom on hair growth (A) and on the histological appearance of hair follicles (B). (A) Minoxidil and Bee venom were applied to the mouse dorsal skin for 19days. In bee venom treated mice, hair growth increased significantly, and dose dependently compared with the control group. (B) The hair follicles were elongated in a dose-dependent manner in bee venom-treated mice compared with the control group.


Figure 2: The Effect of Bee Venom on the Prevention of Hair Loss in Catagen-Induced C57BL/6 Female Mice. (A) NC, treated vehicle only; (B) dexamethasone (DM) treated; (C) DM+2% minoxidil; (D) DM+0.001% bee venom; (E) DM+0.005% bee venom; and (F) DM+0.01% bee venom.




Figure 3: The effect of bee venom on the proliferation of human dermal papilla cells (hDPCs).

Bee venom promoted proliferation of HDPCs and elongated hair follicles, thereby preventing AGA. Bee venom did not cause irritation, erythema instead stimulated proliferation of hDPCs. Bee venom was more effective at promoting hair growth than minoxidil. In catagen phase-induced mice, bee venom reduced hair loss and stimulated new hair growth. Therefore, bee venom might be developed as a therapeutic agent for hair loss given its ability to promote hair growth by inhibiting the development of the catagen phase, and its ability to prevent hair loss by inhibiting the expression


  1. Park S, Erdogan S, Hwang D, Hwang S, Han EH, Lim Y-H. Bee venom promotes hair growth in association with inhibiting 5α-reductase expression. Biological and Pharmaceutical Bulletin. 2016;39(6):1060-8.
  2. Jang S, Lee Y, Hwang SL, Lee MH, Park SJ, Lee IH, et al. Establishment of type II 5alpha-reductase over-expressing cell line as an inhibitor screening model. The Journal of steroid biochemistry and molecular biology. 2007;107(3-5):245-52.


Diagnosis of Breast Cancer in Males

by Jastina Modise

Breast cancer is a type of cancer that develop in breast cells and can be seen through an x-ray or by a lump forming. Breast cancer is most common in females with approximately 1.7 million new cases and 522 000 deaths recorded every year globally, with only 1% cases recorded every year in males [1]. To this day, many people are still under the impression that breast cancer in males does not exist and those that know about the disease tend to misunderstand it. Currently, there are fewer studies that base findings on the diagnosis of breast cancer because of the uncommonness of the disease in early stages [2].

Researchers are currently faced with a dilemma of what stage of diagnosis is breast cancer in males more advanced. Data analysis was done in a cross-sectional study where a total of 93 737 breast cancer patients participated in the study from the Hospital Cancer Registry of the Oncocentro Foundation of Sao Paulo (HCR-OFSP). The clinical stages were grouped and both sexes were compared using a Mann-Whitney test [1].

The researchers found that stage III and IV cancer at diagnosis are the most common in males than in females, this shows that breast cancer in males can only be diagnosed at later stages than early stages. Table 1 indicates the prevalence of clinical stages at diagnosis in comparison between males and females [1].

Table 1. The clinical stages of breast cancer comparison between the two sexes.

The findings open up to new discoveries of diagnostic tests and possibly newer treatment for breast cancer in males. With Africa having little to no studies on breast cancer in males, let this research be the gateway for the African researchers to assist in discovering therapeutic ways to defeat this type of cancer.

“Once I overcame breast cancer,

 I wasn’t afraid of anything anymore”

Melissa Etheridge


  1. Spreafico, F. S; Cardoso-Filho, C; Cabello, C; Sarian, L. O; Zeferino, L. C and Vale, D. B. 2020. Breast Cancer in Men: Clinical and Pathological Analysis of 817 Cases. Review of American Journal of Men’s Health. 1-6.
  2. George, J; Albach, A; Robinson, A. S; Dixon III, L and Nguyen, Q. D. 2020. Diagnosis, Prognosis, and Management of Breast Cancer in an 81-Year-Old Male Patient. Cureus 12(5): e8277. DOI 10.7759/cureus.8277.
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