Tuesday, 10 April 2018

On the health benefits of Pimenta racemosa

A reader (Lary Hirabedian) left me with a question as a comment "On the allergenic potential of bay leaf" about two months ago. I have been so busy with work and my children that it was almost impossible to dedicate any time whatsoever to researching properly and responding to Lary. He asked me if I could comment on Pimenta racemosa vs bay laurel, i.e., establishing a comparative efficacy, health benefits against, for example, cholesterol reduction, diabetes, pain reduction, antiviral and antibacterial effects, etc. He also suggested that Pimenta racemosa in the shape of oil or infusion can be more effective than bay laurel.

I'd like to reinforce that I am not a plant biotechnologist and I am not a plant physiologist, actually I am quite far from enjoying the study of plants per se. My interest lays on the different substances that exist in the world (plant, animal or inorganic) as a scientist interested in those that have a toxicological potential or health benefit to all of us. Having said that, I think I'd like to contribute with a few lines to help responding to this question without presenting a dispute between these two plants. I prefer to provide you with what is out there, literature-wise, concerning the different molecules present in Pimenta racemosa.

But to start with, let's try and understand exactly what plant are we talking about. Pimenta racemosa is the scientific name for the plant that is commonly known as Bay-rum tree, others call it malagueta, and I am sure other people worldwide call it different names for this plant is quite widespread through Asia and Africa. The plant belongs to the Myrtaceae family and is famous for its essential oil with 'alleged' curative properties. That is what we will try to unfold in the coming lines.

In the article by Contreras (2014) [1] one can find a long list of different research studies on the  putative pharmacological effects and biochemical agents of the different Pimenta species, like for example the capacity to repel insects and its mosquito larvicidal and nematicidal properties, the capacity to reduce/inhibit pain (for example pain associated to dysmenorrhea), anti-inflammatory effects (possibly due to flavonoids, tannins, polyphenols), the capacity to counteract fever (possibly due to quinones), antimicrobial properties (e.g., flavonoids, tannins, triterpenes, steroids), antioxidant properties (e.g., flavonoids, saponins, polyphenols), antimutagenic effects (e.g., flavonoids, tannins, saponins), as an antidote against cobra venom and so on and so forth to a very detailed biochemical level. It is just a matter of getting that article and read thought the other references for the specific effect one is trying to learn more about.

Another very composed article [2] identified 52 components (where 1,8-cineole was the major one) present in the flower itself of this plant, after gas chromatography assays.  But the most interesting observation I could personally identify in this article was the cytotoxic activity against a panoply of human cell lines and the antimicrobial activity against Geotrichum candidum and bacillus subtilis - part of the human microbiome, and where the identified minimum inhibitory concentration  [MIC] is exactly the same as for the common antibiotics applied against these bacteria, Ampicillin and Amphotericin B, respectively. Actually, this article is a great add-up to the Alitonou et al (2012) [3]  where essential oils compositions of Pimenta racemosa from two different sites in Benin were studied thus unveiling the same antimicrobial, antioxidant and even acaricide properties, but only this time no anti-inflammatory effects were recognised.

In fact, great literature is starting to emerge on this topic and it is just a matter of looking in the right articles for gaining the adequate knowledge. Finally, the food industry will definitely want to look into this essential oils for its antioxidant properties, as well as the phamaceutical industry into all the different pharmacological effects identified.

Image kindly taken from Plantogram, Leon Bay Rum Tree, [https://plantogram.com/product/bay_rum_lemon/], last visited on the 10th of April 2018, last update unknown.

[1] Contreras, B. (2014). "Preliminary phytochemical screening of pimenta racemosa var. racemosa (Myrtaceae) from Tachira - Venezuela". Pharmacologyonline, 2, pp. 61-68.

[2] Al-Gendy, A. A., Moharram, F. A., Zarka, M. A. (2017). "Chemical composition, antioxidant, cytotoxic, and antimicrobial activities of Pimenta racemosa (Mill.) J. W. Moore flower essential oil". Journal of Pharmacognosy and Phytochemistry, 6(2), pp. 312-319. 

[3] Alitonou, G. A., Noudogbessi, J-P., Sessou, P. et al (2012). "Chemical composition and biological activities of essential oils of Pimenta racemosa (Mill.) J. W. Moore from Benin". International Journal of Biosciences, 2(9), pp. 1-12.

Thursday, 29 March 2018

Nature's alternative to EpiPen?!

This article is the second part of the original post you can find HERE.

The risk of self-medicating is a serious hazard and can endanger lives, so the acceptable attitude is not to do it and always consult with your GP. But if you're in the middle of the Amazonian jungle being hunt down by wild pumas that haven't eaten for two weeks, and at the same time you are undergoing a really serious anaphylatic shock because of an Africanised honey bee sting (hold your breath!), with no medical staff around, no EpiPen on sight and struggling to breath (hold your breath again!!) ... and the bee division just got some backup reinforcements... what can you do? What can the natural elements of this beautiful organic pharmacy called Mother Earth can do for you?

With neither phones available nor rapid access from and to a hospital, you have to trust the handy plants you are surrounded by. However, it is likely the action of any plant with positive effects on allergies to be quite slow and mild compared to the urgency of an anaphylatic shock. And considering everyone is intelligent enough to try their best to avoid exposure to a known allergen, the only medical response to an anaphylatic shock is indeed an epinephrine injection commercially known as EpiPen. Even though there are other more affordable epinephrine auto-injectors, i.e., the class of drugs EpiPen is part of. Remember, I am not publicising any of these products but just informing you of their existence, I wish I was cashing something for advertising these products, the reality is that I'm not. But due to high-profile complaints regarding the ever increasing price of the most famous epinephrine auto-injector [1] I honestly believe that knowing of alternative products is a public responsibility. In fact, there are other alternatives available, like the Adrenaclick [2] or the Auvi-Q [3], and an article from 2006 predicted yet another one, tailored for those afraid of needles - the Epi-Pill [4]. For more information on commercial alternatives you can access the sub-page of the Division of the Asthma and Allergy Foundation of America entitled "Kids with Food Allergies". There you can find a very professional comparison between several other commercially available epinephrine auto-injectors with different aspects put into perspective, not solely price!!! [A]

So that you know and allow me to reinforce it once again, no herbs can do the magic trick so quickly and effectively whilst saving crucial time until further medical assistance is made available. Many websites talk about miraculous responses and dwell on the most fantasist first-aid cures for an anaphylatic shock. They irresponsibly promote the use of plant and homeopathic preparations based on Eucaliptus, Lavender, Lemon, Quercetins (a plant flavonoid with antioxidant and anti-inflammatory effects, however still to be fully studied for its safety and efficacy as an anaphylaxis antagonist) [5], Aconitum napellus, Apis mellifica, Cantharis, Carbolicum acidum, Hypericum, Ledum palustre, Urtica urens, etc etc etc... but we are not talking about tackling a mild allergy, we are talking about the need for an immediate life-saving approach that can promptly rescue a person until professional medical assistance is made available. Not some alleviation of mild symptoms!!!!!! All those plants and powders and miraculous herbs widespread mentioned through million websites with no scientific referencing whatsoever, will not do the job at all!!! The suggested immediate treatment to anaphylaxis is still epinephrine followed by a professional medical follow-up, as suggested by the World Allergy Organisation on their 2015 update on the evidence base [6]. And if you don't have the courage to read through 16 pages just jump straight to the "Initial Treatment To Anaphylaxis" on page 7 that reads:

"Anaphylaxis is a life-threatening medical emergency in which prompt intervention is critical. Principles of treatment remain unchanged; however, recommendations for treatment are based on evidence of increasingly high quality".

And maybe then also read the very important statement on page 8's Section "Long-term management of anaphylaxis in community settings: self treatment". This is the least one should do to be aware of the best present prophylactic and/or management methodologies. 

Have a shocking safe Easter!

[A] Epinehrine auto-injector available with a prescritpion in the United States,  Kids with Food Allergies, [http://www.kidswithfoodallergies.org/page/epinephrine-and-anaphylaxis-food-allergy.aspx#eai], last access on the 29th of March 2018, last update on February 2014.

[1] US Senator Charles Grassley's complaint letter, from the 22nd of August 2016  [https://www.grassley.senate.gov/sites/default/files/constituents/upload/2016-08-22%20CEG%20to%20Mylan%20(EpiPen).pdf], last accessed on the 29th of March 2018.

[2] Adrenaclick for anaphylatic emergencies, [http://adrenaclick.com/], last accessed on the 29th of March 2018, last update unknown.

[3] Auvi-Q epinephrine injection, [https://www.auvi-q.com/], last accessed on the 29th of March 2018, last update unknown. 

[4] An under-the-tongue alternative to EpiPen (2006), Harvard Health Letter, [https://www.health.harvard.edu/newsletter_article/an_under-the-tongue_alternative_to_epipen], last accessed on the 29th of March 2018.

[5]  Chirumbolo, S. (2011). "Quercetin as a potential anti-allergic drug: which perspectives", Iranian Journal of Allergy, Asthma and Immunology; 10(2), pp. 139-140.

[6] Simmons, F. E. R., Ebisawa, M. Sanchez-Borges, M. et al (2015), "2015 update on the evidence base: World Allergy Organisation Anaphylaxis Guidelines". World Allergy Organisation Journal, 8(32), pp. 1-16.

Wednesday, 21 March 2018

No Blacks, No Jews, No Gipsies, No Children, No Pets

The housing market in the UK has become an issue with no active solutions on sight. And there is only two things to blame: the lacking of political drive and the construction companies backing the lack of political drive (meaning, the lobby). There isn't much to analyse and even though the House of Commons (at least they have a house, poor ones) decided to approach the issue and discuss the very important housing problem in the UK, there is noticeably very little will from the people in power to do things differently and sort this malfunction once for all.

The Members of Parliament sat for hours discussing the housing unavailability and the lack of incentive to build affordable houses, and finally analyse what really promotes the nonexistence of houses and how to tackle the problem, so the present and future generations can have something so basic as a safe place to live.

This political (alleged) initiative is more than welcome, but sitting for hours clapping your members' frigid speeches (from both political arms) to come to the conclusion that:

1) There is a housing problem in the UK, no affordable houses are being built and the current prices are unbearable for the mid-class pockets;

2) There is an emergent epidemics of people sleeping rough, and maybe... just maybe that is also arising from and going to add a few additional points to the housing-problem debate.

Two assumptions any of us could have made without having to belong to any political arm, without having to major in an Oxbridge Campus on degrees that just because they're 'Oxbridgian' will fly you to a very successful career and few concerns about one's future.

However, the real world, the world made of mid-class people who really struggle to afford to pay increasing insane mortgages or rents for houses that arbor many other problems, like the lacking of space - I have never seen in my whole life houses with rooms so tiny as in England that would be called food storage cupboards anywhere else in Europe - or poor construction quality, is here to last.

By the end of my street, in an area known to Nottingham as one of the poorest and more socially complicated, the council is building affordable houses!!!, so affordable that the space takes on the conceptional affordability of the idea and is ever so small. But the prices are not affordable at all, they are £200K a piece and any mid-class family with two kids would struggle to save enough for even initiating the mortgage process. Two blocks away there is another area I don't want to name, but lives on this rhetorical assumption that it is an incredible place to live due to the social fabrics that inhabit it (basically cocky arrogant people with wages well-above the mean who behave like they're the best thing in the world after the invention of the microwave). A 3-bedroom house in this fallacy of heaven costs half a million pounds to buy! Half a million! Super affordable. Anyone can go pick a Neymar Jr. from their bank accounts and personal savings and just pawn their existence like that. Easy!!!

I can understand that the housing issue is now a monster so difficult to resolve that could take longer than a decade to actually see some positive changes. Shared ownership is a fantastic idea, seldom promoted by councils but a great idea indeed. In the meantime, in cities so academic like Nottingham is, the housing market became ever more complicated for families because increasing numbers of students rent basically everywhere, houses that accommodate many people but are framed and shaped for quick occupancy. Not a legacy for the future with family and familiar environments. When looking for a house to rent, like we as a family have been doing for about 5 years now, you have narrow options and must accept conditions you wouldn't normally accept for the fact that if you do not want to live under such conditions, you won't have a place to live at all. There is a queue waiting for those four walls with a roof on top and the landlords are thriving on this market. 

A month ago we visited a house in that same complicated area of Nottingham that I referred to, above. One with mold everywhere, rusty pipes, lacking space for a normal living and there was humidity and holes (serious holes) on the ceiling - £700 they asked for a place that shouldn't be charging more than $400-£450 considering the area and the quality.

I'm not even mentioning London, that is a bubble on itself obeying to much stricter/ridiculous conditions. This is East Midlands where people still want to live in normal, acceptable, safe, affordable houses. Not zoo cages!

Landlords got to a point where they can demand obnoxious things fully accepted by the regulators. Things embedded in such prejudice that any normal government would determine these as unlawful and criminal. The last agency we contacted didn't even book us a house viewing because the landlord clearly stated he wanted No Children. The moment we said we were a family of working parents with money to pay the monthly rent, this person 'cryed' No Children allowed in the house. Like if he was talking about some family of wild boars with cubs ready to destroy a house the moment they were granted access. Like if he wasn't protected by a deposit safeguarding scheme and a contract that makes tenants responsible for any damage on the property. The reason for that is just quick quid, making money easy on students and making sure that the house is for a tenant-in tenant-out system whilst collecting deposits based on some ridiculous structural assumptions. I know what I am saying as I had to 'battle' my share of rogue landlords and their greedy claims when I was a student myself.

If the local councils and even the national government allow such 'legal' prejudice we will return to wild times where landlords could clearly and lawfully announce on their property doors "No Blacks, No Jews, No Gipsies, No Children, No Pets". Can anyone else see the incredible prejudice that is emerging once again from a problem that is itself a prejudice against the mid-class people? Can this be more blatant than what it already is?

Wednesday, 14 March 2018

Stephen Hawking: Visionary physicist dies aged 76

Read original piece at http://www.bbc.co.uk/news/uk-43396008

Read about the only book I read from his genius HERE.

Friday, 2 March 2018

Why is adrenaline prescribed in an anaphylactic shock crisis?

As a Medical Information Officer I am constantly bombarded with situations where, among several other possibilities, allergic reactions are eventually reported as adverse events. However, I never got to be confronted with a patient undergoing anaphylactic shock. What I realised though is that most people out there do not have a precise or at least mildly accurate idea of what an anaphylactic shock is. They just know the term but lack the understanding. In addition, if you ask most of your friends and relatives why medical doctors prescribe adrenaline (epinephrine) to counteract an anaphylactic shock crisis, well above 90% will roll their shoulders in ignorance.

It's understandable that we cannot know it all about everything, but I have always been a curious bee. And the moment this question popped up in my head a few years ago, I had to research to address it immediately. By surprise, it happened to me today to find someone (outside work) who didn't know about the reason behind the use of epinephrine (adrenaline) as an antagonist of such systemic allergic chain of events.

As usual, I don't dwell on questions that have been vastly and adequately addressed in different websites through the Internet. When that is the case I refrain to comment on the matter. But this time I decided to just simplify the very good explanations you can find online, so that even those not naturally versed in the slightest medical science and terms, can make sense of all the jargon and conceptualizations involved. Thus, quite simply put, let us imagine:

  • A bee stings your child in the neck... let's go for neck rather than hand to add a bit of a physical oddness and proximity with the heart that will enhance the emotional atmosphere of scare.

  • Your child is allergic to the substances present in the bee sting injection and the body starts producing an allergic reaction. Don't forget that an allergy is just the immune system considering a substance to be foreign to the system and therefore an attack on that substance (known as allergen) is initiated. But sometimes the response is inappropriate and imbalanced leading to a systemic chain of events that put the whole cardio-respiratory system in alert.

  • What happens next in the hypersensitive body is an anaphylactic response that, by means of biochemical and physiological procedures in your child's body, will try and block the access of that substance (allergen) to the vital organs. 

  • Naturally, your child's body produces adrenaline that will ease the physiological extreme responses of her/his body to the allergen, meaning his/her body will try and block the effects of the allergen by reducing the blood flow and consequently constricting the airways. However, in a person with hypersensitive immune system the body needs a lot more adrenaline because it is in severe shock already, hence an immediate action is deemed necessary.

  • The only available option is the epinephrine injection that is usually administered to the patient as an urgent first aid approach. 

  • Why an injection? Simply because adrenaline is a natural hormone produced in humans and is easily degraded by the stomach acids. In the event of an anaphylactic shock your child will need higher doses of adrenaline than normal, and quickly accessed. The intramuscular injection of adrenaline with what is known as an EpiPen operates miracles.

  • What does it do? Adrenaline will reduce the throat swelling and open your child's airways allowing him/her to breath naturally, it will normalise your child's blood pressure and overtime bring your child's impaired cardio-respiratory system to a normal point where medical intervention (if necessary) will be monitoring his/hr health.

I hope this quick-fix worked as an EpiPen for your questions in case you had any! Thanks for visiting The Toxicologist Today. Now, do you know what you can use if you're in the wild and have no access to a much needed EpiPen? Stick around and you'll find out in the coming post.

1st image kindly taken from EpiPen prescribing information, [https://www.epipen.com/hcp/about-epipen-and-generic.aspx].

2nd image kindly taken from The Telegraph, [https://www.telegraph.co.uk/news/health/news/8796536/Bee-sting-vaccine-on-the-NHS.html].

Thursday, 1 March 2018

Status of EU citizens in the UK: what you need to know

Information for European Union citizens living in the UK.

Published 7 April 2017
Last updated 28 February 2018 — see all updates

Tuesday, 6 February 2018

Nine years helping change lives

Today at Kiva we celebrate YOU!
Nine years ago today, you joined Kiva to change lives around the world.
A cake to celebrate your Kiva anniversary
Your commitment to Kiva’s mission is a cause for celebration!