Auxiliadora Obando

Auxiliadora, also known as Chilo, is one of our newer students in the Casa Esther girls home. She is from near where Sergio is from about 3 hours from our town of Jinotepe. She is in the adaptation process of our program and hopes to study a technical career related to business.

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Does chamomile have the same potential to cause methemoglobinemia as benzocaine orajel

On the 21st of November 2013 Vashra asked me about the potential of chamomile to cause methemoglobinaemia, apparently the same effect produced by benzocaine/orajel. Well, I always love to help, but my free time is nearly null, and now with a child making me change nappies and feed him every 2 to 3 hours, is ever more complicated. Nevertheless, I want to maintain the blog as active as possible and I am now using a few moments of my paternity leave to read a little more about what is bugging my readers brains. For starters, let me assume my ignorance and state that there are a lot of things here I am not familiar with, thus I decided to learn about them to make a little sense before thinking of researching adequate answers. 

Methemoglobinaemia - "is a blood disorder in which an abnormal amount of methemoglobin -- a form of hemoglobin-- is produced. Hemoglobin is the molecule in red blood cells that distributes oxygen to the body. Methemoglobin cannot release oxygen. In methemoglobinemia, the hemoglobin is unable to release oxygen effectively to body tissues." [1]

Benzocaine -  "Benzocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body. " [2]

Orajel - a pharmaceutical used in adult and child oral care to counteract pain generated by infection and/or teething. [3]

So basically what Vashra wants to ask is if chamomile can cause a blood disorder in which an abnormal amount of methemoglobin is incapable of adequate releasing of oxygen into body tissues, apparently an effect previously observed as result of using Benzocaine. Benzocaine being the active substance of the pharmaceutical Orajel used, for the sake of the example, in calming teething pain in children.

By searching the web I came across a page referring the Food and Drugs Administration website, where one can find the immediate awareness alarm to several gels and liquids containing benzocaine and the observed cases of teething children poisoned by this substance. It occurs that benzocaine reduces the oxygen available in the blood stream and symptoms can  appear at any time point [4]. There is a special danger with over-the-counter products containing benzocaine as they are readily available, therefore it is quite important to reassure parents that there are different options on the market that can help relieve pain in children and toddlers.

Hot and cold gel packs mold themselves and fit various parts of the body, septic raw honey (not manufactures honey) is a potent anti-infection and anti-inflammatory natural product [5]. There are many folk remedies available, some might have a scientific explanation where others might live on myth passed from generation to generation.

When it comes to chamomile, it is known to help children suffering from colic and teething pain, but what about side effects associated to this natural plant? Well, I could find a few but nothing mentioning methemoglobinemia. I found mainly four toxic effects in humans caused by chamomile, 1) the normal allergic reaction in some individuals, 2) anaphylaxis (a life-threatening allergic reaction in people allergic to plants in the daisy family), 3) drowsiness, and 4) contact dermatitis [6].

Perhaps the biggest risk associated to the use of chamomile and vascular imbalance is the presence of coumarin (organic chemical compound) for its thinning effects. Coumarin has very mild blood thinning effects, though! Overall, I wasnt able to find any relation between methemoglobinemia and the use of chamomile.

If you know more about this issue, please help us build good knowledge on it by sharing your opinion in the comments section.

Cheers.

[1] Methemoglobinemia - Medline Plus, [http://www.nlm.nih.gov/medlineplus/ency/article/000562.htm], last visited on the 05th of December 2013, last update on the 31st of October 2013.

[2] Benzocaine topical - Drugs.com, [http://www.drugs.com/mtm/benzocaine-topical.html], last visited on the 05th of December 2013, last updated on the 01st of December 2013.

[3] Orajel, [http://www.orajel.com/], last visited on the 05th of December 2013, last update unknown.

[4] FDA warns... do not use this pain reliever... you could turn blue and die - Mercola], [http://articles.mercola.com/sites/articles/archive/2011/04/25/warning--fda-issues-alert-that-topical-anesthetics-may-kill-you.aspx], last visited on the 05th of December 2013, last update unknown.

[5] This bee product has enormous benefits for your health - Mercola, [http://articles.mercola.com/sites/articles/archive/2009/11/17/This-Bee-Product-Has-Enormous-Benefits-for-Your-Health.aspx], last visited on the 05th of December 2013, last update unknown.

[6] Integrative Medicine for Children, edited by May Loo, MD - June 2008.

[7] Web MD - Chamomile Herbal Information, [http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/supplement-guide-chamomile], last visited on the 05th of December 2013, last update on the 13th of October 2012.

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Alma Bonilla

Alma is another one of our Nursing students. She was able to get into the local nursing school as a technician and is in her first year of school, with two more to go. Her long term plans are to become a licensed Nurse which is a 5 year course of study.  Alma is 18 years old and is from a rural community about 4 hours away by bus in the State of Leon.

She is a very happy young lady who loves her career and shows appreciation constantly. Her classes are all day long and when school is on break, she volunteers at the local health clinic or hospital a the direction of her school.

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What about the toxicology of burning bay leaf wood as a source of fuel

On the 18th of January 2015, a blog visitor known as TheRegulator posted a real interesting question in the most famous blog entry Ive written so far, the one on the toxicity of Bay Leaf. His/Her question was:

"I would like to pose a question of a different focus regarding bay leaf. Your article, questions and comments all focus on the leaf. But what about the toxicology of burning bay leaf wood as a source of fuel? The burning of certain tree woods are more toxic than others. One specie of tree, for example, is so toxic that the inhalation, ingestion or touch poses a health risk."

Incredibly juicy this question!!! Had I some more free time and Id be researching this topic like a mole on steroids, but my work has forced me to look very briefly into it. TheRegulator could have helped by stating exactly the name of the species that is known to release extremely toxic fumes when burned. But I did not quit and I found it.

I investigated, during the very limited free time I have in between the final year of my PhD, nappies and my own business, and I found some nice literature on the topic:

Polyciclic aromatic hydrocarbons (PAHs) - molecules present in Laurus Nobilis leaves that have been utilised as indicators of air pollution in Tuscany (for example). The mean PAH foliar levels in laurel leaves are well correlated with PAH air concentration [1], thus providing a good estimate of the PAHs respiratory burden. But this did not provide me with the necessary information. I was inclined to believe that any toxicity derived from burning bay leaf wood would have to do with the combustion of the oils/volatile compounds found in its composition. But apart from L. Nobilis antibacterial and fungicidal properties [2] I could not find any information pointing to toxicity of combustion fumes. In fact, Laurus Nobilis is my favourite bronchopulmonary disinfectant.

But then suddenly my research offered me some interesting and scary results. Camphor Laurel!!!! Camphor Laurel, scientifically known as Cinnamomum camphora, when burned produces significant amounts of many chemicals believed to be toxic and even carcinogenic [3]. There are studies that report this plants combustion smokes as responsible for many animal deaths, especially in Australia [3]:

A less lethal species, the Cherry Laurel - Prunus laurocerasus can also be seen as incredibly dangerous if combusted as it contain cyanolipids that release cyanide and benzaldehyde (toxic agents).

There are anecdotal reports all over the internet of common people burning laurel prunings without any issues. But what laurel prunings??? That is the RIGHT question! Most of us are worried about the hydrogen cyanide that is released during the combustion, due to cyanogenic glycosides present in the leaves of the Cherry Laurel. During its combustion/maceration, the cyanogenic glycosides will become hydrogen cyanide, glucose and benzaldehyde [4]. Cyanide kills by starving the central nervous system of oxygen and has been used by entomologists to kill insects without inflicting physical pain. Benzaldehyde...

In summary:

Combustion fumes from Camphor laurel wood = Extremely dangerous, especially if youre in Australia!

Combustion fumes from Prunus laurocerasus wood = Very dangerous. Avoid whenever possible;

Combustion fumes from Laurus Nobilis wood = Unlikely to cause any harm if handled properly, but it is better to avoid exaggeration.

[1] Lodovici, M., Akpan, V., Casalini, C., Zappa, C., Dolara, P. (1998). "Polyciclic aromatic hydrocarbons  in Laurus Nobilis leaves as a measure of air pollution in urban and rural sites of Tuscany". Chemosphere, 36(8), pp.1703-1712.

[2] Bay Laurel, Laurus Nobilis, leaves, [http://quickbooker.org/kunden/wildherbsofcrete_com/pages/portraits-of-our-essential-oils-from-wild-herbs-of-crete/laurus-nobilis.php], last visited on the 21st of January 2015, last update unknown.

[3] Camphor Laurel - NSW Scientific Committee - final determination, [http://www.environment.nsw.gov.au/determinations/camphorlaurelktp.htm], last visited on the 21st of January 2015, last update on the 28th of February 2011.

[4] The MAK collection for Occupational Health and Safety, Benzaldehyde, [http://onlinelibrary.wiley.com/doi/10.1002/3527600418.mb10052e0017/pdf], last visited on the 21st of January 2015, last updated on the 15th of october 1998.

1st image kindly taken from frametoframe, [http://frametoframe.ca/2013/10/poison-garden-blarney-castle-ireland/].

2md image taken from Camphor Laurel Menace, [http://www.camphorlaurel.com.au/].

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Our students as of June 2012

Since acquiring the property we call El Trillo, we have since been able to construct a Rancho, or covered meeting area that has no walls. Our rancho can fit about 35 people comfortable for meetings with our students and also we loan it to the local church where our student receive discipleship training and have home group. We have had numerous get togethers with our students. In the spring we got together for a dinner and some training.  The pictures of our boys from the Casa Juan Marcos, and our girls from the Casa Esther are shown here.  

Almost all of our students come from poor to extremely poor homes. Most are also from deep into the countryside where transportation limits their ability to get to a University or Vocational school. For this reason we have homes located in Jinotepe, where both Universities and Vocational schools are readily available.

In this group we have student engineers in many disciplines (Agricultural, Industrial, Mechanical, Computer Science) and we have 4 in Medicine (both nursing and PhD.) We have Business administration and Accounting. We also have a handful of auto-mechanics.

Our program is not easy to participate in. These young people are required to set high goals, be productive and give voluntarily to others.

We believe that in the rural areas, as well as the cities, there are many young leaders who are overlooked because of a lack of opportunities. Our program mines these exceptional kids and offers an opportunity not only to achieve a career, but to be a standout in life. In a country that overlooks these kinds of young people, and excellence in general, we believe our students have the potential to stand above the crowd. They are the future of Nicaragua.

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Erling Jose Perez

At 19 years of age, Erling came to us a few months ago with hopes of studying medicine. His goal is to be a Doctor of Surgery. He still needs to take the entrance exam and pass with very high scores if he is to continue in our program. Presently he is volunteering a lot of time at the old folks home during the morning hours and studying for the exam in the afternoons. Erling is also very involved in the youth movement at church. He is a solid kid who comes from a very poor home south of Rivas about 2 and a half hours away.

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