Chloroquine to Treat Corona Virus?

There has been a lot of video claims that is being circulated around lately that anti-malarial drug already showing resistance to malaria can now be used  instead  to treat deadly corona virus pandemic

This has caused death instead. Read here:

https://www.freemalaysiatoday.com/category/world/2020/03/22/nigeria-reports-chloroquine-poisonings-after-trump-says-it-treats-covid-19/

Do NOT use any drug that has not been tested or approved and try it as a  home remedy for SARS-CoV2 (Covid19).

It takes a minimum of 10 years for any drug to be  approved after undergoing various phrases of testing from lab studies to phrase 1, 2, 3 clinical trials followed continuously by pharmacovigilance even approval and license has been given.

Granted chloroquine has already been well studied and evaluated against malaria, and has long since been licensed and marketed as an antimalarial drug.

We already know the pharmacodynamics of chloroquine on malarial parasites by its inactivation of their cytochrome P450 2D6 (CYP2D6), the dose, duration and the toxicity levels

This need not be studied again to shorten the time for chloroquine to be used.

But we have completely no data on its mechanisms on the coronavirus and the counter effects on the virus against the drug although some have postulated, but  those explanation  do not seem plausible to me from my understanding in molecular pharmacology  

This needs to be studied and evaluated first in lab studies and in multiple clinical trials before this therapeutic regimen can be safely trusted 

Even if chloroquine is effective, we do not know at what dose to give it, and the duration to be given? We have no clue

Given at under dose, it may cause the corona virus to mutate into a very virulent strain which the body immunological defense may no longer be able to handle.

Given at high dose it can be fatal. The lethal dose for chloroquine has been recorded at 4 – 5 g

Ref  : https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1678465&blobtype=pdf

Currently our own human immune system is being challenged by this virus, and it is doing a very, very good job with many having recovered from this infection on their own

Let our own immune system endowed to us by Nature to do this job for us, and it is now doing this very effectively with very low mortality ratio, increasing recovery rates compared to over 15 times the rate of new infections.

This recovery ratios speaks volumes how Nature is currently doing its job for us.

The corona virus is already been defied by our own immune system, and in response,  the virus too is trying to fight back by its own genetic mutation into more hardier strain as evidenced by the previous milder SARS CoV to the current more defiant Covid-19 strain  

Take  chloroquine as a clear example how the Plasmodium spp (malarial parasites) mutated against this antimalarial drug. Chloroquine is no more effective against malaria as much as corona virus is going to mutate against it

But if we start to challenge it further with unapproved chloroquine or its derivatives, what happens is the virus is being attacked by both sides – our own immune system on one side -  which is already doing a very noble job for us, and the drug on the opposite side.

This is similar to the misuse of antibiotics causing antibiotics resistant superbugs to emerge

This same scenario will surface with the present Covid-19 if we challenge it with an under-dose of chloroquine. 

Just do NOT put yourself between the Devil and the deep blue sea with an agent yet to be evaluated by large-scale clinical trials before approval.

The virus can undergo speciation by Natural Selection very rapidly due to it very simple genomic chain (< 3,000 base) and they can turn very, very nasty after that after being  confronted on both sides – one by our own immunological system and the other some drugs for which we have no understanding   its mode of action

We can see this very clearly with SARS CoV that changed into Covid-19 after apparently lying very low for 16 years after being challenged by our collective human immunological defenses passed on from person-to-person by immune memory cells

If we have studied and understand evolutionary biology or evolutionary medicine we see how life evolved so rapidly during the Cambrian Radiation soon after the first RNA chemistry came into place followed by very rapid changes in the mutation of DNA in the bacteria into higher species due to very rapid environmental challenges 3,000 million years ago

Respect that observation.  It is purposely premeditated there by the Designer.

Respect Him (God) , and  the virus He created, and  do not try to be smarter than the Designer  by using unapproved chloroquine as some home remedy to challenge a highly potential genetic mutation

We have already leant our lesson using all kinds of antibiotics to fight bacterial infections causing the bacteria to mutate into superbugs for which increasing generations of new anti-bacteria has no effect

Ignore Trump.  He is fickle-minded and keeps changing his words. He is a politician without any direction, let alone any clue about evolutionary biology, virology, medicine or medical sciences  

Trust me with my down-to-earth layman explanation reachable to all.

Hope this helps

Lim jb

Steam Inhalation to kill Corona Viruses

There has been some debate among the Minister of Health Malaysia, the Director-General of Health and former Deputy of Health Malaysia, other doctors and members of the public as well, whether drinking warm water recommended by the current Minister of Health helps kill the corona virus?

Read here their quarrels :

https://www.malaymail.com/news/malaysia/2020/03/21/asked-if-warm-water-kills-covid-19-health-d-g-says-only-subscribes-to-evide/1848795

Let me now join in this interesting  debate as a former  senior  medical researcher and multi-disciplinary  scientist

There is scientific truth that viruses cannot withstand high temperature.  I shall explain.   

This is one of the reasons why the body response with a fever when infected by Covid19 or any viral or bacterial infections

This immunological response designed by the body of generating a high temperature (fever) is gospel truth and nobody can deny this

However, I do doubt if the warm water temperature is high enough (at least 75 degrees C), or can be drunk or maintained long enough (at least for 20 minutes) to inactivate the viral RNA and its outer protein envelop?

At such high temperatures of 75 degrees C it will instantly scald the throat, let alone maintain it for 20 minutes. Throat reflex will instantly throw out the hot water

Furthermore Covid19 is primarily a respiratory tract and not esophageal- gastro tract infection.  These are two separate anatomical systems.

Any water drunk can only enter the stomach, and not into the windpipe

How then could any water hot or cold enter from the throat into the windpipe, airways and into lungs instead of into the esophagus  when it is blocked by the epiglottis in the throat when food is eaten, water drunk?

The reason given by the Minister of Health is correct in that viruses are intolerant to high temperatures and I concur with him. 

But there is a catch here:

Frigid of Space where Viruses Lurk in Suspended Animation:

We scientists trained and qualified in astrobiology and astronomy knows that there are untold quantities of pre-life molecules, biomolecules, viruses lurking out there in space in the interstellar clouds that literally remain there for hundreds of thousands of years in the frigid and darkness of space

They can withstand horrendously long journeys lasting thousands of light years in suspected animation because they are not activated yet into life in a  frigid and dark environment of interstellar space  where the temperature is  only a little above 3 Kelvin (3 degrees above absolute zero)

This is the temperature as CMB (Cosmic Microwave Background), the remnant temperature from the Big Bang when the Universe was first created along with pre-life such as RNA molecules and viruses  soon after the Big Bang. The searing temperatures from the Big Bang then dropped to almost absolute zero soon after

Pre-life molecules like RNA are synthesized soon after

That how the viruses are kept in suspended animation at such low temperatures where all molecular movements including viral RNA freezes to almost zero and remain motionless  for thousands of millions of years without needing any living host, oxygen, nutrients, or any life-sustaining molecules etc. simply because all molecular motions and movements  is zero or almost zero

Now after this astrobiological explanation from me, we now know why viruses cannot tolerate high temperatures in Earth’s hot environment or in the fever of an infected person as they are used to almost absolute zero Kelvin found  in deep, deep space for thousands of millions of years from where they originate

Having explained that, let now go back to what the Minister of Health recommended

The Minister of Health advice is to drink warm water to kill the corona virus

I do not agree with him that drinking warm (not hot) water can inactivate the corona virus in the respiratory tract.

However I would like to use his idea to work it  in another way.

Alternative Therapeutic Modality: Based on Space Science: 

Since corona viruses, and for that matter all viruses like cold environment, and are heat labile, let me use this scientific truth to recommend   all suspected corona viral infected patients to inhale HOT steam for at least 20 – 30 minutes.

Repeat this procedure as many times as they can inhale except take care not to flood the bronchioles and lungs with condensed stream, or they may be drowned by the condensed steam – caution.  Aspirate excess water in the airways using postural drainage often.  This is physiotherapy that does not require harmful and unnecessary drugs  

Anti-viral Oil:

If they like, enhance that anti-viral steam-inhaling therapy with anti-viral essential oils such as from star anise, camphor, eucalyptus oils, and  all oils rich in powerful anti-virals phenylpropanoids and sesquiterpenes.

Add about 5 mls. of these anti-viral essential aromatic oils into the boiling water, and inhale the steam

Steam together with all these anti-viral aromatic oils will enter into the respiratory tract and fight the virus. Steam can NEVER into the stomach

Mechanisms of Hot Steam on Airways:


The action of  steam inhalation is not just that alone. Warm steam when inhaled will trigger off the following mechanisms

1.       Liquidize any thick mucus (mucins which are heavily glycosylated proteins) trap in bronchus and bronchioles along with the virus for easy expectorant effect and expulsion from the airways.  Retinol from cod liver oil accelerates the airways ciliary sweep as the primary mechanism for mucus clearance along with the trapped viruses.

2.       Warmth is not a conducive environment for viruses. They die very easily in hot and warm surroundings since they are pre-life RNA particles that “thrive” under the frigid cosmic background temperature of nearly minus 273 degrees C (3 Kelvin) where they remain in suspended animation for at least 4 billon years in torridly-chilly inter-stellar space before arriving on Earth.

At that temperature near 0 K (−273.15 °C; −459.67 °F), nearly all molecular motion ceases where mathematically ΔS = 0 for any adiabatic process, and where S is the entropy according to the laws of thermodynamics of near absolute zero.

3.       The heat of the steam above body temperature (37 ⁰ C) will cause bronchial dilation and angio-vascular dilation and  vascular injection over the area bringing in immune bodies such as  cytotoxic  T cells seeking for any kind of viral infections via their toxic mediators.

Cytotoxic T cells have specialized proteins called T cell receptors (TCRs)  tagged on their surfaces  that help them to recognize virally-infected cells.

Each cytotoxic T cell has a TCR that can specifically recognize a particular antigenic peptide bound to an MHC molecule.

If the T cell receptor detects a peptide from a virus (example corona viruses), it alerts its T cell of a pathogenic invasion.

The T cell then releases cytotoxic factors to destroy the plague-ridden cell and, consequently prevent the survival of the invading virus

This is natural medicine (naturopathic medicine), a field among others, I am also well-trained and also well- qualified. These quarrelling  doctors can learn quietly from me.  

That will INSTANTLY SOLVE all the quarrels among the top experts on health and medicine.

I hope they, all including all specialists doctors too will read my explanation and suggestion

Hope this helps to settle their disputes

Lim ju boo

BSc PG Dip MSc MD PhD FRSPH FRSM

Postdoctoral CE in:

Astronomy / Astrobiology (University of  Oxford)

Evolution and Mystery of Life (University of Cambridge)

Forensic Science (Toxicology) (Cambridge)

War of The Worlds : Corona viruses or The Human Race?

Dear all in this WhatsApp Chat and Other Readers 

I would like to ask a question about this corona virus invasion on Earth.

The question is down below.

But before that, let me give you some information to mull  about the size and numbers of this virus:

The size of viruses can range from about 20 to 400 nanometres in diameter (1 nanometre = 10^-9 meters).

The corona viruses have a genome size of approximately 27 to 34 kilobases which is the largest among known RNA viruses (1).  

The estimated size of Covid19 is about 300 nanometer or 3 x 10 -7 meters (0.0,000,003 metres) based on an estimated calculation I made

(The smallest bacteria are about 400 nanometres in size)

The Radius of Earth is 6.371 million metres

Hence surface area of Earth is A = 4πr2 = 5.1 x 10^14 square metres (510.1 trillion m²).

Suppose we now  assume the present Covid19 began to invade the entire surface of Earth either by:

1.       By human-to human transmission as most virologists believe, or  

2.       By seeding from comet’s debris coming from the Oort’s Cloud beyond the Solar System between 0.03 to 3.2 light-years away from the Sun as proposed by Sir Fred Hoyle and Nobel Prize Laureate Chandra Wickramasinghe (born 1939) who showed the correlation between the passage of comets near the vicinity of Earth and influenza pandemic on Earth.

This was also theorized by Steven Hawking.  All 3 of them were world-renown scientists from the University of Cambridge.

They contended that life forms continue to enter the Earth's atmosphere, and may be responsible for epidemic outbreaks, new diseases, and the genetic novelty necessary for macroevolution in an Origins Symposium presentation on April 7, 2009 (2).

In such a scenario we can expect the entire Earth surface will be peppered by:

5.1 x 10^14 / 3 x 10 -7 meters = 1.7 x 10^21 (17 followed by 20 zeros) corona viruses

The reference human body has a surface area of about 1.9 m^2

This means there will be a minimum of 1.9 / 3 x 10-7 = 6 million viruses covering over the outer part of  our body alone if they rained down from us  from space, rather than transmitted by human-to-human social contacts (assuming the surface area of corona viruses is about the same as its total linear size of 0.0,000,003 metres).

Translated to the world’s population of 7.8 billion (7800 million), this means if everyone is covered on the outside of his  body alone without the viruses  entering into his or her body to multiply, there will be:

4.68 x 10^16 Covid19 over the entire human body on Earth, or 2.75 X 10-3 % (0.0027 %) of what the entire Earth gets if the spread continues

Having now given you all the calculations and the info

My question now is:

Who is going to win the War of the Worlds?

1.       The human race with our preventive and advanced technology or

2.       The tiny, tiny, tiny Coronavirus invading Earth from Outer Space

Give us your thoughts. This is a question based on the Survival of the Fittest by Natural Selection as an extension of Charles Darwin’s theory on:

The Origin of the Species

(when I did my postdoctoral further education course on Evolution and the Mystery of Life at Cambridge, and later on Astronomy at Oxford, and later back again to Cambridge to complete my course in Forensic Toxicology, these were the typical type of forum questions assigned in their tens of dozens in every  course by both universities  for  us  students to answer

They just want to test our analytical and intellectual ability). 

Let’s see how we tackle this question I ask in return

Share with us your thoughts. It can be fun

Thank you 

Lim jb  

References:

1.       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984655/

2.       Fred Hoyle; Chandra Wickramasinghe & John Watson (1986). Viruses from Space and Related Matters. University College Cardiff Press.

Legal System in Malaysia

Dear friends in this Whatsapp Chat Group 

Our tutor Dr. Susan Gurney at the University of Cambridge has asked us students from various countries around the world to write a summary of the legal system in each of our respective country.

This is just as one of the many daily and weekly tasks  we need to undertake and submit as part of our course in forensic investigation (forensic toxicology)

This is a wake up call for me as I have no clue myself, and I am sure you too have not much clue as most of us are not in the legal profession

So I like to share my knowledge with you to wake you up also.

This is the beauty of a chat group where we can share knowledge after a research

Unfortunately a lot send rubbish and videos to us in chat groups.

So I need to neutralize them with something that is solidly academic.

Legal System in Malaysia (Part 1)

by Lim Ju Boo - Saturday, 15 February 2020, 7:15 PM

Dear Dr. Susan

You have asked me a very difficult question as I am not in the legal field, and I really do not have much idea how our legal system in Malaysia works.

But I shall try my level best using plain simple language from sources I read here and there and understand.

The legal system in my country, Malaysia is very complex

It is mainly based on the common law legal system.

But there are also state laws enacted by the State Legislative Assemblies which applies in the particular state.

The constitution of Malaysia also provides for a unique dual justice system—the secular laws (criminal and civil) and sharia (Islamic) laws even though there a controversy whether or not Malaysia is a secular or an Islamic country since it is a multiracial country for sure with many types of religion being practiced here even though the majority of the population are Muslims

The reason why the law of Malaysia is mainly based on the common law legal system was because it is the direct result of the colonization of Malaya, Sarawak, and North Borneo by Britain between the early 19th century to 1960s.

However, the supreme law of the land is the Constitution of Malaysia that sets out the major legal framework and rights of all Malaysian citizens.

The Federal laws are enacted by Parliament of Malaysia and this applies throughout the country even though it may have a dual system.

Then there are also state laws enacted by the State Legislative Assemblies which applies in the particular state

On the dual system of law in this country this is provided in Article 121(1A) of the Constitution of Malaysia.

Article 3 also provides that Islamic law is a state law matter with the exception for the Federal Territories of Malaysia.

 Islamic law refers to sharia law, and in Malaysia it is known and spelled as syariah. The court is known as the Syariah Court.

Looking at the Malaysian legal system as a whole, sharia law plays a relatively small role in defining the laws on the country. It only applies to Muslims.

With regards to civil law, the Syariah courts has jurisdiction in personal law matters, for example pertaining to marriage, inheritance, and apostasy.

In some states there are sharia criminal laws, for example there is the Kelantan Syariah Criminal Code Enactment 1993.

Their jurisdiction is however limited to imposing fines for an amount not more than RM 5000 (925.33 Pound sterling) and imprisonment to not more than 3 years.

They cannot impose capital or death sentence on any criminal or murder cases such as in Alex and Linda hypothetical murder case Cambridge University gave us. 

Such cases has to be referred to the High Court, then  to the Appeal Court and finally the Federal (Supreme) Court that will have the final say by applying the Federal Constitution, the highest Constitution of the land that applies to all major criminal and murder cases

 In August 2007, the then Chief Justice of Malaysia proposed to replace the current common law application in Malaysia with sharia law, but this was turned down

I am a long retired medical researcher, not in the legal profession. So I hope I have summarized something out of my field to the best of my ability.

Thank you

--------------------------------------

Dear Dr. Susan,

Part 2

Just some further information on what I have written earlier at the 5^th week  student forum

The hierarchy of courts in this country (Malaysia) begins from the lowest court, namely the Magistrates' Court where minor offences like stealing, traffic offences, burning rubbish in public, and owners of dogs allowing them to chase and bite others are heard here.

The next higher court is the Sessions Court where cases on civil matter involving motor vehicle accidents, disputes between landlord and tenant and distress action and other matters where the amount in dispute does not exceed RM 250,000.00 are heard here.

In the Malaysian legal system, for more serious offenses such as drug and human trafficking, and murder cases that may result in a capital punishment (death sentence) they are then referred to the High Courts

If a convicted person is not happy with the sentence hand down by a High Court, he / she may appeal to the next highest court which is the Court of Appeal where the sentence of the lower court (magistrate and session courts) may be upheld or overturned

If he is still not satisfied, he / she may also have his / her case heard in the highest court that is, the Federal Court which is the apex or the Supreme Court of the land

But if any judgment by the apex court (Federal Court) is handed down, then there is no more further avenues available for him / her to appeal. Then that sentence including a death sentence is confirmed

In Malaysia currently death sentence is imposed for drug trafficking, murder, kidnapping, human smuggling, treason against the King and country, and other similar serious offences

However they are now trying to have the capital sentence (death sentence) abolished

But this has caused a tremendous outcry among some sectors of the public especially among members of families whose loved ones were murdered - quite understandable.

In fact some families publicly said that if the death sentence is abolished, and if the murderer of their family members was let off the gallows, they themselves would personally kill the murderer. They blamed government as insensitive 

So the decision whether or not to abolish the death sentence in this country is still being debated, maybe abolished only for some other offences such as for drug offences

In Malaysia we currently do not have a jury system anymore.

We had one but it was abolished in 1995

Hence if a death sentence is heard in the apex court (Federal Court), instead of a jury, 2 or 3 or even more senior judges will sit on the bench to make the decision

That sentence will be final

Thank you for your question.  It has helped me to learn something about our own legal system which I never knew before

Therapeutic and fatal doses of drugs

Below is one of the many countless student discussions posted by this author as a current student in Forensic Toxicology in during the 3^rd week into the course at the University of Cambridge

Q. What is a toxin?

A. A toxin is a poison of biological origin, normally a protein expressed by the organism

For instance, botulinum toxin is a neurotoxic protein produced by the bacterium Clostridium botulinum.

 Another example, is tetanus toxin, an extremely potent neurotoxin produced by Clostridium tetani  in anaerobic conditions and this toxin causes tetanus (lock jaw in humans)

Other examples are mycotoxins, for instance aflatoxin B and G expressed by the microfungi , Aspergillus flavus, that in small doses over long exposure can cause liver cancer, and in large doses in one sitting causes acute liver failure

Others are the different types of neurotoxins and haematoxins expressed by vipers and cobras. The list goes on and on.

 

Q. What are the therapeutic and fatal doses of the various poisons and drugs given in the list 

A. As far as the therapeutic and lethal doses of other poisons and drugs are concerned here are just two examples

Poison                                 Therapeutic dose                                                                             Lethal dose

Arsenic                                 Arsenic trioxide 0.15 mg/kg IV                                                    70 to 200 mg mg/kg/day

Paracetmaol                       1-2 tablets bd – tds (twice or three times a day                  10–15 g (20–30 tab)

For arsenic this is found in a few medicinal preparations

For instance, Salvarsan, an organic arsenical, was introduced in 1910 by Nobel laureate, physician and founder of chemotherapy, Paul Ehrlich. His compound, which was one of 500 organic arsenic compounds, cured syphilis.

Today, arsenic compound is still used in the treatment of trypanosomiasis. Therapeutic doses of these compounds depends on the formulation and preparation

For instances for acute promyelocytic leukemia (APL), arsenic trioxide at a dose of 0.15 mg/kg body weight is given IV until bone marrow remission; not to exceed 60 days.

Other formulation such as Tretinoin is given at 22.5 mg/m²

Arsenic exerts its toxicity by inactivating up to 200 enzymes, especially those involved in cellular energy pathways and DNA synthesis and repair.

But what is more important is the long term exposure to arsenic in the soil and drinking water

WHO estimated through drinking water, more than 200 million people globally are exposed to higher than safe levels of arsenic (1). The areas most affected are Bangladesh and West Bengal (1). Exposure is also more common in people of low income and minorities (2).

 Acute poisoning is uncommon (1). The toxicity of arsenic has been described as far back as 1500 BC in the Ebers papyrus (3).

The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg or 1 mg/kg/day (4)

As far as paracetamol is concerned, the therapeutic dose as an analgesic is normally 1 -2 tablets x tds. But this depends on age

An overdose of 10–15 g (20–30 tablets) of paracetamol can result in fatal hepatotoxicity (5, 6).

Patients who are malnourished, have been fasting, take enzyme inducing drugs, or regularly drink alcohol to excess are at higher risk of liver damage.

Again the fatal dose depends on a person's body weight, age and other drug interaction. For instance if a person takes 5 g of paracetamol together with alcohol, that dose probably would be the lethal dose for him, especially if he / she is a small child.

Similarly, if he already has a liver disorder, and his kidneys are already compromised with low GFR, low creatinine and urea clearance,  the lethal dose for paracetamol can be would be much lower than 20 -30 tablets in one dose.  It all depends on the patho-physiology state of an individual

The same can be said for strychnine.   A few minutes after ingestion, strychnine is excreted unchanged in the urine, and accounts for about 5% of a sublethal dose given over 6 hours (Boyd et al., (1983)

Higher doses over a longer period are fatal. Again this depends on the body weight

I think it is very difficult to give any strict and specific values for all these drugs / poisons especially the lethal doses because it is not possible for us to carry studies on lethal doses using human subjects.

Most of toxicological studies are done using animal models, and their lethal dosage per kg of body weight are then extrapolated into humans

Then again, the biochemistry and genetic make-up of animal models may not necessary be the same for humans. But that is the best we can do. We can’t carry out toxicological trails on humans

There are many other methods used for evaluating toxicity. One common method is to determine the LD 50 (lethal dosage of a substance that kills 50 % of a population in experimental animals),

Toxicologists can also use cell cultures and cell lines studies  in vivo exposure, skin sensitization tests, Draize test, open epicutaneous test, optimization test, split adjuvant test, guinea pig maximization test (GPMT), Buehler test, and murine local lymph node assay (LLNA)…etc. etc.

Normally we would use some of these studies such as developmental toxicology in embryotoxicity studies, genetic toxicity testing, neuro-toxicological evaluation,  two-generation reproduction toxicity studies, carcinogenicity testing, subchronic oral toxicity testing to better understand their toxico dynamics and toxicokinetics (how they act on the body). The list goes on.

Most of these we would focus on the various experimental animal models and methods used for toxicity testing. It depends what we want to evaluate

These pre-clinical toxicity testing helps the toxicologist to calculate out “No Observed Adverse Effect Level” which is needed to initiate the clinical evaluation of  products under investigation such as a novel drug to be marketed much later after 10 - 15 years from cell-lines studies on toxicity, clinical efficacy, to various phrases of clinical trials. It takes a very long time at high cost in R & D before approval by FDA can be obtained

On the issue of adverse drug reaction and toxicity, post marketing pharmaco vigilance is still observed and in place

So I cannot tell you exactly what each dose, therapeutic, fatal or otherwise would be for the various poisons and drugs given in the list because of so many confronting factors 

Some poisons like arsenic, lead and mercury are accumulative at very low doses over many years, or they can also be acute at high doses if administered in a single dose

I would like to leave this very complicated and very lengthy subject here as this is a very complicated and controversial issue

There are already too many studies and published literature on this with some studies contradicting each other.

            

References:

1. Naujokas, Marisa F.; Anderson, Beth; Ahsan, Habibul; Aposhian, H. Vasken; Graziano, Joseph H.; Thompson, Claudia; Suk, William A. (3 January 2013). "The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem". Environmental Health Perspectives. 121 (3): 295–302.

2.  Joca, L; Sacks, JD; Moore, D; Lee, JS; Sams R, 2nd; Cowden, J (2016). "Systematic review of differential inorganic arsenic exposure in minority, low-income, and indigenous populations in the United States". Environment International. 92-93: 707–15.

3.  Howie, Frank (2013). Care and Conservation of Geological Material. Routledge. p. 135. ISBN 9781135385217. Archived from the original on 2017-09-10.

4. https://pmj.bmj.com/content/79/933/391.full

5.            Prescott LF. Paracetamol overdosage: pharmacological considerations and clinical management, Drugs, 1983, vol. 25 (pg. 290-314)

Google ScholarCrossrefPubMed

6              BMJ Group, British National Formulary 59 March 2010, 2010LondonBMJ Group; Pharmaceutical Press

7.  Boyd RE, Brennan PT, Deng JF, Rochester DF & Spyker DA (1983). Strychnine poisoning.  Am. J. Med., 74: 507-512.

Forensic Toxicology

A question was asked in our Academic Forum Discussion in Forensic Toxicology Course at the University of Cambridge what caused Alex Death?

Today is the 3rd week into our course. I have already written out over 10 discussion tropics in the last two weeks. This is my 12th assignment

This is interesting question. Here's what I think as a student when I typed this on the 3rd Day of Chinese New Year 2020  (Tuesday, 28 January, 2020) sacrificing my Chinese New Year forever learning new disciplines.   

First of all, I have to admit this is the first time in my life I have been asked to solve a death mystery.


I am far from being a police officer, a crime investigator or a forensic scientist

But I shall try.

 Linda Watson is course Alex’s wife and works as a management consultant and lives with victim.

But she was away on business at the time of her husband’s death. Without her physical presence at the crime scene and at the time of Alex’s death, how could she be directly involved, unless she hired someone else to be the killer?

Clare Watson is Alex sister. Clare found Alex's body, and but claimed she has no alibi what actually happened when she visited the house on her own.

Furthermore, she lives a few streets away, but has the keys to her brother’s house. But it is not clear if Clare entered her brother’s house at the time of his death?

It may be yes, it may be no?  We don’t have the hard evidence. So we cannot work on assumption.  Clare works part-time at a local shop which has no relevance to the case.

The only human left to suspect is Stuart Thompson, Alex’s business partner as co-owner of Chemical Distribution Ltd. This is interesting as they deal with chemicals.

But what sort of chemicals it is not stated  – toxic chemicals like arsenic, cyanide, mercury, strychnine, ethylene glycol, pesticides like paraquat, or pharmaceuticals like cardiac drugs, example digoxin or what?

Even all drugs are just doll-up and refined names for chemicals, some highly toxic like cytotoxic agents used in cancer management, others are relatively “harmless” like aspirins and paracetamol, yet in high doses combined with alcohol they can kill.

So the first thing we need to ask is, what kind of chemicals were Alex and Stuart manufacturing? We have no clue.

Our question now is, was  the same chemicals or drugs they were manufacturing found on Alex’s internal body – blood, lymph, tissues, urine samples, stomach, intestines, liver (site of detoxification) or in the parenchyma of his kidneys (route of excretion)? This is a vital question.

However, Stuart claimed he was at work with his colleagues on Thursday 28th February. This can easily be confirmed with his colleagues. It is not a problem here.

Working with his colleagues at the time and date during Alex’s death again may not necessary mean Stuart has nothing to do with his death. 

He could have poisoned Alex’s food at the correct lethal dose when they went for dinner hours earlier or the previous night? Think of that possibility?

Drugs and poisons take time to be absorbed, distributed and excreted – pharmacodynamics and pharmacokinetics of drugs and poisons

Still, if the same chemicals or drugs were found in Alex’s body during autopsy we need to investigate Stuart further

Stuart lives 10 miles away from the victim’s house has no relevance to the case. He can live 100 miles away. That does not mean he cannot travel by car or other means of transport.

Now the other “chap” left that needs to be investigated was some poisonous insects such as harvester ants, and brown recluse spider or some poisonous snakes like vipers and cobras that bit Alex and ran away through the back door.  That is a very interesting proposition.  

Frankly this proposal gave me a silent smile when I read it.

But it is not stated the country where Alex was found dead. Some of these poisonous insects or snakes are not found in some countries. So we need to rationalize.

Even if Alex was bitten by a less poisonous animal that ran away that does not mean it was not the “poison’ that killed him.

In medicine we have to think of allergic reactions, and anaphylactic shock that follows. Even the slightest allergenic insults to someone who is sensitive, could result in fatal angioedema to the airways. He could have died of suffocation? Did we look into that?

Another possibility, could Alex have died of AMI (acute myocardial infraction – heart attack)?  

Only an autopsy can demonstrate the cause of the death, not necessary some poisonous chemicals, natural or synthetic or overdose of some lethal drugs, or blame it on his business partner or family members.

We need to send Alex body for post mortem for a definitive cause(s).  We cannot assume anything before a post mortem and confined by toxicological analysis. Initially we can only look at suspicious clues. They are not even evidence(s).  

If I were to be asked to investigate in such circumstances, firstly I would take samples of blood, saliva, biological fluids, urine, tissues, especially from the liver and kidneys for analysis.

ELISA is very useful in such cases, easy to use, rapid with high sensitivity and specificity if it involves a biological bite from some animals that triggers off an antigen-antibody reaction unlike chemicals whose toxicodynamics may be through other biochemical pathways.

If no insect or animal bite were found that may elicit a serological / immunological response, then we need to interview all the 3 suspects again, especially Stuart, Alex’s business partner.

This is just my amateurish “detective work”

I admit I may be off tangent. After all I am just a student in this forensic toxicology course.

In that case please forgive me else I would not be taking this course out of curiosity

Thank you dear course mates at the University of Cambridge for listening

lim ju boo

Malaysia

ELISA in Forensic Toxicology