Old Herb, 'New' Purpose: A Preliminary Analysis of Marijuana as a Medicine in Barbados / Hierba vieja, 'propósito nuevo': un análisis preliminar de la marihuana como medicina en Barbados

ABSTRACT Barbadians, like their Caribbean neighbours, are not newcomers to using herbs for medicinal purposes. It has been suggested that prior to the 1930s and beyond, the herb Cannabis sativa was being used for various ailments. Much of the present debate in Barbados revolves around the increasing recognition that the condemned plant seen as injurious to society, especially the youth, represents a potential treatment for several illnesses. This article specifically examines the social construction of marijuana as a drug or substance of abuse versus its use as a medicine and the impact of the present prohibitionist policy on its use especially as a medicine.

RESUMEN Los barbadenses, al igual que sus vecinos caribeños, no son advenedizos en cuanto al uso de hierbas con propósitos medicinales. Se ha sugerido que antes y después de la década de 1930, la hierba Cannabis sativa era ya utilizada para tratar varias dolencias. Gran parte del actual debate en Barbados gira en torno al creciente reconocimiento de que dicha planta - condenada por considerársele perjudicial para la sociedad y especialmente para la juventud - representa hoy un tratamiento potencial de varias enfermedades. Este artículo examina específicamente la construcción social de la marihuana como droga o sustancia de abuso, frente a su uso como medicamento. Asimismo, se aborda el impacto de la políticas prohibicionistas actuales sobre su uso, especialmente como medicamento.

The Development of Public Policies to Address Non-communicable Diseases in the Caribbean Country of Barbados: The Importance of Problem Framing and Policy Entrepreneurs.

BACKGROUND: Government policy measures have a key role to play in the prevention and control of non-communicable diseases (NCDs). The Caribbean, a middle-income region, has the highest per capita burden of NCDs in the Americas. Our aim was to examine policy development and implementation between the years 2000 and 2013 on NCD prevention and control in Barbados, and to investigate factors promoting, and hindering, success. METHODS: A qualitative case study design was used involving a structured policy document review and semi-structured interviews with key informants, identified through stakeholder analysis and 'cascading.' Documents were abstracted into a standard form. Interviews were recorded, transcribed verbatim and underwent framework analysis, guided by the multiple streams framework (MSF). There were 25 key informants, from the Ministry of Health (MoH), other government Ministries, civil society organisations, and the private sector. RESULTS: A significant policy window opened between 2005 and 2007 in which new posts to address NCDs were created in the MoH, and a government supported multi-sectoral national NCD commission was established. Factors contributing to this government commitment and funding included a high level of awareness, throughout society, of the NCD burden, including media coverage of local research findings; the availability of policy recommendations by international bodies that could be adopted locally, notably the framework convention on tobacco control (FCTC); and the activities of local highly respected policy entrepreneurs with access to senior politicians, who were able to bring together political concern for the problem with potential policy solutions. However, factors were also identified that hindered multi-sectoral policy development in several areas, including around nutrition, physical activity, and alcohol. These included a lack of consensus (valence) on the nature of the problem, often framed as being predominantly one of individuals needing to take responsibility for their health rather than requiring government-led environmental changes; lack of appropriate detailed policy guidance for local adaptation; conflicts with other political priorities, such as production and export of alcohol, and political reluctance to use legislative and fiscal measures. CONCLUSION: The study's findings indicate mechanisms to promote and support NCD policy development in the Caribbean and similar settings.

EFFECTS OF "SWIM WITH THE TURTLES" TOURIST ATTRACTIONS ON GREEN SEA TURTLE (CHELONIA MYDAS) HEALTH IN BARBADOS, WEST INDIES.

Along the West Coast of Barbados a unique relationship has developed between endangered green sea turtles (Chelonia mydas) and humans. Fishermen began inadvertently provisioning these foraging turtles with fish offal discarded from their boats. Although initially an indirect supplementation, this activity became a popular attraction for visitors. Subsequently, demand for this activity increased, and direct supplementation or provisioning with food began. Food items offered included raw whole fish (typically a mixture of false herring [Harengula clupeola] and pilchard [Harengula humeralis]), filleted fish, and lesser amounts of processed food such as hot dogs, chicken, bread, or various other leftovers. Alterations in behavior and growth rates as a result of the provisioning have been documented in this population. The purpose of this study was to determine how tourism-based human interactions are affecting the overall health of this foraging population and to determine what potential health risks these interactions may create for sea turtles. Juvenile green sea turtles (n=29) were captured from four sites off the coast of Barbados, West Indies, and categorized into a group that received supplemental feeding as part of a tour (n=11) or an unsupplemented group (n=18) that consisted of individuals that were captured at sites that did not provide supplemental feeding. Following capture, a general health assessment of each animal was conducted. This included weight and morphometric measurements, a systematic physical examination, determination of body condition score and body condition index, epibiota assessment and quantification, and clinical pathology including hematologic and biochemical testing and nutritional assessments. The supplemented group was found to have changes to body condition, vitamin, mineral, hematologic, and biochemical values. Based on these results, recommendations were made to decrease negative behaviors and health impacts for turtles as a result of this provisioning.

Feasibility of an electrostimulation system treatment for wound healing: a case series of patients with chronic ulcers in Barbados.

Major advances have been made in the development of new therapies for chronic wounds. Fenzian™, an electrostimulation system (ES), has been clinically used for a variety of conditions. The ES was recently tested in the Barbadian population for tolerability and acceptability by asthma patients, with encouraging results. Barbados has an estimated 170 people with diabetes having some form of lower-extremity amputation annually. Here, we describe a case series of 21 chronic ulcer patients with diabetes recruited as inpatients (n = 10) and outpatients (n = 11) in a pilot study to evaluate the feasibility and acceptability of ES in the Barbadian population. Results showed statistically significant improvement among those in the inpatient- versus outpatient-recruited group for wound perimeter (P = 0·04), wound surface area (P = 0·03) and wound volume (P = 0·08). We also demonstrate that the improvement continued after cessation of ES treatment. Participants reported increased levels of pain at the end of treatment, and there was no statistically significant change in the reported quality of life. Our results showed greater improvements in reduction of ulcer size for participants from the inpatient- versus outpatient-recruited group.

The application of HPLC ESI MS in the investigation of the flavonoids and flavonoid glycosides of a Caribbean Lamiaceae plant with potential for bioaccumulation.

As part of an exchange technology program between the government of Barbados and Environment Canada, methanolic and aqueous extracts from the flavonoid-rich Lamiaceae family were characterized using negative-ion electrospray mass spectrometry. The species investigated is part of the Caribbean Pharmacopoeia, and is used for a variety of health issues, including colds, flu, diabetes, and hypertension. The extracts were investigated for structural elucidation of phenolics, identification of chemical taxonomic profile, and evidence of bio-accumulator potential. The methanolic and aqueous leaf extracts of Plectranthus amboinicus yielded rosmarinic acid, ladanein, cirsimaritin, and other methoxylated flavonoids. This genus also shows a tendency to form conjugates with monosaccharides, including glucose, galactose, and rhamnose. The aqueous extract yielded four isomeric rhamnosides. The formation of conjugates by Plectranthus amboinicus is thus evidence of high bioaccumulator significance.

Prevalence and profile of herbal medicine use in persons with diabetes and hypertension: data from the Barbados risk factor survey 2007

BACKGROUND: This paper seeks to determine the prevalence of herbal medicine use in persons with diabetes and hypertension; and to identify the demographic and socioeconomic profile of persons using such therapies. DESIGN AND METHODS: Secondary data analysis was done using the Barbados Behaviour Risk Factor Survey 2007. The prevalence of herbal medicine use was determined. Crude and adjusted odds ratios were generated for the relationship between these outcomes and age, sex, employment status; marital status; educational level and ethnicity. RESULTS: Herbal use was found to be 7.4% (2.9% to 11.9%) among diabetics, 4.5% (2.3% to 6.7%) among hypertensive persons, and 5.5% (3.2% to 7.8%) among all persons who were either diabetic and or hypertensive. A statistically significant association was seen between herbal use and age only (age 60 years and over compared to age < 60 years adjusted OR 4.0 95%CI 1.3 to 12.3). CONCLUSIONS: Though older persons were more likely to use herbal medicines, this study suggests a rather low prevalence of such practices. A more comprehensive assessment of socioeconomic status and of herbal medicine use is warranted.

Radioprotective effect of the Barbados Cherry (Malpighia glabra L.) against radiopharmaceutical iodine-131 in Wistar rats in vivo.

BACKGROUND: The increasing consumption of fruits and vegetables has contributed to the improvement of populational health, due in part, to the abundance of antioxidants in these foods. Antioxidants reduce the level of oxidative damage to DNA caused by free radicals and ionizing radiation, including the radioisotope iodine-131 (131I). This isotope is used for the diagnosis and treatment of thyroid injuries, such as hyperthyroidism and cancer. METHODS: This study aimed to evaluate the radioprotective and cytotoxic activity of acute and subchronic treatments with Barbados Cherry (BC) (Malpighia glabra L.) fruit juice (5 mg), which is rich in potent antioxidants such as vitamin C, phenols, carotenoids, anthocyanins and yellow flavonoids and its activity against the mutagenic activity of the therapeutic dose of 25 µCi of radioiodine for hyperthyroidism. The test system used was the bone marrow cells of Wistar rats (Rattus norvegicus) that were treated in vivo by gavage. RESULTS: BC showed radioprotective activity in acute treatments, which is most likely due to the joint action of its antioxidant components. In subchronic treatments, the continuous treatment presented an effective radioprotective activity, which was significantly different from treatment with the radiopharmaceutical only. Treatment with BC prior to (PRE) and simultaneous with (SIM) ionizing radiation decreased the number of induced chromosomal alterations, while post-treatment produced no protective effect. In addition, BC exhibited no cytotoxic activity. CONCLUSIONS: These data serve as evidence that BC can be used as a preventive health measure to improve public health quality by countering the action of inevitable exposure to mutagens, such as 131I.

Clinical findings associated with homozygous sickle cell disease in the Barbadian population--do we need a national SCD registry?

BACKGROUND: Comprehensive care in homozygous sickle cell disease (HbSS) entails universal neonatal screening and subsequent monitoring of identified patients, a process which has been streamlined in the neighbouring island of Jamaica. In preparation for a similar undertaking in Barbados, we have developed a database of persons with known HbSS, and have piloted processes for documenting clinical manifestations. We now present a brief clinical profile of these findings with comparisons to the Jamaican cohort. METHODS: HbSS participants were recruited from clinics and support groups. A history of select clinical symptoms was taken and blood and urine samples and echocardiograms were analysed. A re-analysis of data from a previous birth cohort was completed. RESULTS: Forty-eight persons participated (32 F/16 M); age range 10-62 yrs. 94% had a history of ever having a painful crisis. In the past year, 44% of participants had at least one crisis. There were >69 crises in 21 individuals; 61% were self-managed at home and the majority of the others were treated and discharged from hospital; few were admitted. The prevalence of chronic leg ulceration was 27%. Forty-two persons had urinalysis, 44% were diagnosed with albuminuria (urinary protein/creatinine ratio ≥30 mg/g). Thirty-two participants had echocardiography, 28% had a TRJV ≥ 2.5 m/s. Re-analysis of the incidence study revealed a sickle gene frequency (95% CI) of 2.01% (0.24 to 7.21). CONCLUSION: Although we share a common ancestry, it is thought that HbSS is less common and less severe in Barbados compared to Jamaica. The Jamaican studies reported a sickle gene frequency of 3.15 (2.81 to 3.52); the prevalence of chronic leg ulcers and albuminuria was 29.5% and 42.5% respectively. These comparisons suggest that our initial thoughts may be speculative and that HbSS may be an underestimated clinical problem in Barbados. A prospective neonatal screening programme combined with centralized, routine monitoring of HbSS morbidity and outcomes will definitively answer this question and will improve the evidence-based care and management of HbSS in Barbados.

The antimicrobial screening of a Barbadian medicinal plant with indications for use in the treatment of diabetic wound infections / Tamizaje antimicrobiano de una planta medicinal Barbadense con indicaciones para su uso en el tratamiento de infecciones de heridas en diabéticos

OBJECTIVE: Diabetes mellitus is a chronic noncommunicable disease with high prevalence in the North American and Caribbean region. Diabetic Foot Syndrome which is an associated complication can lead to the development of wounds and ulcers which can become infected. Justicia secunda, a plant known locally in Barbados as Bloodroot used in folklore for wound healing, was selected to test its ability to aid diabetic wound healing by antimicrobial activity. It was therefore tested against the bacteria Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, and Enterococcus feacalis (clincal strain) which are commonly found in diabetic wounds. METHODS: The plant was collected by local users. Methanol and acetone extracts of the plant were prepared with use of soxhlet extraction. The antimicrobial activity was assessed with the use of a modified KirbyBaurer method. Concentrations of 200 mg/ml, 100 mg/ml, 10 mg/ml, and 1 mg/ml of the extract were used, with a standard ciprofloxacin 5 µg positive control, and a 5% dimethyl sulfoxide (DMSO) solution negative control. RESULTS: The J secunda methanol and acetone extracts with an extraction yield of 15.3% and 0.75%, respectively yielded no activity within the concentration range against the three strains of bacteria tested. In comparison with the positive control, relative inhibition zone diameter (RIZD) values of 0% resulted for both the negative control and the extracts, with the positive control having a value of 100%. CONCLUSION:The in vitro screen of the extracts prepared from J secunda, yielded no antimicrobial activity against the three strains of bacteria tested and therefore does not support the folklore claims by this mechanism of action.

OBJETIVO: La diabetes mellitus es una enfermedad crónica no transmisible, de alta prevalencia en la región de Norte América y el Caribea. El síndrome de pie diabético es una complicación asociada, que puede llevar al desarrollo de heridas y úlceras, con la consiguiente posibilidad de infección. Justicia segunda es una planta conocida localmente en Barbados como "bloodroot" (sanguinaria canadensis) y usada en la medicina folklórica para la curación de heridas. Esta planta fue seleccionada para analizar su capacidad de ayudar a curar las heridas de diabéticos por su actividad antimicrobiana. Por lo tanto, se la sometió a prueba frente a bacterias Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, y Enterococcus feacalis (cepa clínica) que normalmente se encuentran en las heridas del diabético. MÉTODOS: La planta fue proporcionada por usuarios locales. Usando un extractor Soxhlet, se prepararon extractos de metanol y acetona a partir de la planta. La actividad antimicrobiana se evaluó mediante el método de KirbyBauer modificado. Se usaron concentraciones de 200 mg/ml, 100 mg/ml, 10 mg/ml, y 1 mg/ml del extracto, con un control positivo de 5 µg de ciprofloxacina estándar, y un control negativo de una solución de dimetil sulfóxido (DMSO) al 5%. RESULTADOS: Los extractos de metanol y acetona de J secunda con un rendimiento de extracción de 15.3% y 0.75% respectivamente, no arrojaron actividad alguna dentro del rango de la concentración contra las tres cepas de bacterias sujetas a prueba. Comparado con el control positivo, el diámetro de la zona de inhibición relativa (RIZD) arrojó valores de 0%, tanto para el control negativo como para los extractos, con un valor de 100% para el control positivo. CONCLUSIÓN: El tamizaje in vitro de los extractos preparados de J secunda, no arrojó actividad antimicrobiana alguna contra las tres cepas de bacterias analizadas, y por consiguiente no sustenta la afirmación de la medicina folklórica en relación con este mecanismo de acción.

The impact of the healthcare system in Barbados (provision of health insurance and the benefit service scheme) on the use of herbal remedies by Christian churchgoers.

AIM: To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. METHODS: The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. RESULTS: More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. CONCLUSIONS: The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in the use of herbal remedies in the age group 71-80 years could be due to primarily a lower response rate from this age group, and secondarily due to the Benefit Service Scheme offering free medication to persons who have passed the age of 65 years.

A comparison of the chemical constituents of Barbadian medicinal plants within their respective plant families with established drug compounds and phytochemicals used to treat communicable and non-communicable diseases.

OBJECTIVE: Barbados has a strong base in the practice of folklore botanical medicines. Consistent with the rest of the Caribbean region, the practice is criticized due to lack of evidence on the efficacy and safety testing. The objectives of this review article are i) to categorize and identify plants by their possible indications and their scientific classification and ii) to determine if the chemical constituents of the plants will be able to provide some insight into their possible uses in folklore medicine based on existing scientific research on their chemical constituents and also by their classification. METHOD: A review of the folklore botanical medicines of Barbados was done. Plants were primarily grouped based on their use to treat particular communicable and non-communicable diseases. Plants were then secondarily grouped based on their families. The chemical profiles of the plants were then compared to established drug compounds currently approved for the conventional treatment of illnesses and also to established phytochemicals. RESULTS: The extensive literature review identified phytochemical compounds in particular plants used in Barbadian folklore medicine. Sixty-six per cent of reputed medicinal plants contain pharmacologically active phytochemicals; fifty-one per cent of these medicinal plants contain phytochemicals with activities consistent with their reported use. CONCLUSION: Folklore botanical medicine is well grounded on investigation of the scientific rationale. The research showed that fifty-one per cent of the identified medicinal plants have chemical compounds which have been identified to be responsible for its associated medicinal activity. To a lesser extent, approved drug compounds from drug regulatory bodies with similar chemical structure to the bioactive compounds in the plants proved to validate the use of some of these plants to treat illnesses.

The impact of the healthcare system in Barbados (Provision of health insurance and the Benefit Service Scheme) on the use of herbal remedies by Christian churchgoers / El Impacto del sistema de salud en Barbados (Provisión de seguro de salud y Plan de Servicios y Beneficios) sobre el uso de remedios herbarios por parte de los feligreses Cristianos

AIM: To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. METHODS: The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. RESULTS: More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender. The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. CONCLUSIONS: The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in the use of herbal remedies in the age group 71-80 years could be due to primarily a lower response rate from this age group, and secondarily due to the Benefit Service Scheme offering free medication to persons who have passed the age of 65 years.

OBJETIVO: Investigar si el Seguro de Saludy el Plan de Servicios y Beneficios del Gobierno - un sistema que proporciona medicina libremente para tratar principalmente enfermedades crónicas en personas de 16 a 65 anos de edad - influyen en el uso de remedios herbarios por los feligreses cristianos en Barbados. MÉTODOS: Se realizó un muestreo en once provincias de Barbados por un período de seis semanas, usando como instrumento una encuesta desarrollada y probada durante un período de cuatro semanas antes de ser aplicada. Se le pidió participación a distintas personas y luego de obtener el consen-timiento informado por escrito, las mismas fueron entrevistadas por el equipo de investigación. Los datos fueron analizados mediante la versión 19 de IBM SPSS. Todos los datos eran nominales, de modo que se calcularon las estadísticas descriptivas, incluyendo conteos, frecuencia, cociente de probabilidades (odds ratio), y porcentajes. RESULTADOS: Más de la mitad de los participantes (59.2%) eran mujeres; poco menos de un tercio (29.9%) eran hombres; y una décima parte de los participantes (10.9%) no indicó su sexo. La mayoría de los participantes se encontraban entre las edades de 41 y 70 anos, para un rango de edad de 51-60 anos que comprendía el 26.1% de la muestra entrevistada. Casi todos los participantes nacieron en Barbados (92.5%). Aproximadamente 33% de los entrevistados indicaron que usaban remedios herbarios para tratar varias dolencias, incluyendo condiciones crónicas. El odds ratio de las personas que usan remedios herbarios y poseen seguro de salud es 1.01 (95% CI 0.621, 1.632). Seprodujo un aumento en el número de entrevistados que usaban remedios herbarios, según aumentaba su edad. Esta tendencia continuó hasta el grupo etario de 71-80 anos, el cual mostró una reducción en el uso de remedios herbarios, 32.6% de los entrevistados en comparación con el 38.3% de los entrevistados en la categoría de los 61-70 anos. CONCLUSIONS: Los datos mostraron que sólo una tercera parte de la población está usando remedios herbarios para sus dolencias. El seguro de salud no fue un indicador ni influyó sobre el uso de remedios herbarios por los entrevistados. El uso de remedios herbarios no puede asociarse con la afluencia. La reducción en el uso de remedios herbarios en el grupo etario 71-80 anos podrían deberse principalmente a una tasa de respuesta más baja de este grupo etario, y secundariamente al Plan de Servicios y Beneficios que ofrece medicamentos gratuitamente a personas que han pasado la edad de 65 anos.

A comparison of the chemical constituents of Barbadian medicinal plants within their respective plant families with established drug compounds and phytochemicals used to treat communicable and non-communicable diseases / Una comparación de los elementos constitutivos químicos de las plantas medicinales Barbadenses dentro de sus respectivas familias de plantas, con los compuestos medicinales convencionales y los fitoquímicos usados para tratar las enfermedades comunicables y las no comunicables

OBJECTIVE: Barbados has a strong base in the practice of folklore botanical medicines. Consistent with the rest of the Caribbean region, the practice is criticized due to lack of evidence on the efficacy and safety testing. The objectives of this review article are i) to categorize and identify plants by their possible indications and their scientific classification and ii) to determine if the chemical constituents of the plants will be able to provide some insight into their possible uses in folklore medicine based on existing scientific research on their chemical constituents and also by their classification. METHOD: A review of the folklore botanical medicines of Barbados was done. Plants were primarily grouped based on their use to treat particular communicable and non-communicable diseases. Plants were then secondarily grouped based on their families. The chemical profiles of the plants were then compared to established drug compounds currently approved for the conventional treatment of illnesses and also to established phytochemicals. RESULTS: The extensive literature review identified phytochemical compounds in particular plants used in Barbadian folklore medicine. Sixty-six per cent of reputed medicinal plants contain pharmacologically active phytochemicals; fifty-one per cent of these medicinal plants contain phytochemicals with activities consistent with their reported use. CONCLUSION: Folklore botanical medicine is well grounded on investigation of the scientific rationale. The research showed that fifty-one per cent of the identified medicinal plants have chemical compounds which have been identified to be responsible for its associated medicinal activity. To a lesser extent, approved drug compounds from drug regulatory bodies with similar chemical structure to the bioactive compounds in the plants proved to validate the use of some of these plants to treat illnesses.

OBJETIVO: Barbados tiene una sólida base en la práctica de las medicinas botánicas del folklore De conformidad con el resto de la región caribeña, la práctica se critica debido a la falta de evidencia sobre la eficacia y la seguridad. Los objetivos de este artículo de revisión son (i) categorizar e identificar las plantas por sus posibles indicaciones y su clasificación científica, y (ii) determinar si los elementos constitutivos químicos de las plantas podrían proporcionar algún entendimiento de sus posibles usos en la medicina de folklore, a partir de la investigación científica existente sobre sus elementos químicos constitutivos, y también de su clasificación. MÉTODO: Se realizó una revisión de las medicinas botánicas folklóricas de Barbados. Las plantas fueron agrupadas principalmente a partir de su uso para tratar enfermedades comunicativas y no comunicativas específicas. Se agruparon entonces secundariamente sobre la base de sus familias. Se procedió entonces a comparar los perfiles químicos de las plantas con los compuestos medicinales establecidos, aprobados corrientemente para el tratamiento convencional de enfermedades. Igual procedimiento se realizó con los fitoquímicos establecidos. RESULTADOS: La extensa revisión de la literatura identificó compuestos fitoquímicos en plantas específicas usadas en la medicina folklórica de Barbados. Sesenta y seis por ciento de las plantas medicinales que gozan de reputación contienen elementos fitoquímicos farmacológicamente activos; el cincuenta y un por ciento de estas plantas medicinales contiene fitoquímicos con principios activos correspondientes al uso reportado. CONCLUSIÓN: La medicina botánica folklórica está bien cimentada en la investigación de los principios científicos. La investigación mostró que el cincuenta y un por ciento de las plantas medicinales identificadas tienen compuestos químicos que han sido identificados como responsables de la actividad medicinal asociada. En menor grado, los compuestos medicinales aprobados - provenientes de las instituciones que regulan los medicamentos con estructuras químicas similares a los compuestos bioactivos de las plantas - han servido como pruebas que validan el uso de algunas de estas plantas en el tratamiento de ciertas enfermedades.

The antimicrobial screening of a Barbadian medicinal plant with indications for use in the treatment of diabetic wound infections.

OBJECTIVE: Diabetes mellitus is a chronic non-communicable disease with high prevalence in the North American and Caribbean region. Diabetic Foot Syndrome which is an associated complication can lead to the development of wounds and ulcers which can become infected. Justicia secunda, a plant known locally in Barbados as Bloodroot used in folklore for wound healing, was selected to test its ability to aid diabetic wound healing by antimicrobial activity. It was therefore tested against the bacteria Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, and Enterococcus feacalis (clincal strain) which are commonly found in diabetic wounds. METHODS: The plant was collected by local users. Methanol and acetone extracts of the plant were prepared with use of soxhlet extraction. The antimicrobial activity was assessed with the use of a modified Kirby-Baurer method. Concentrations of 200 mg/ml, 100 mg/ml, 10 mg/ml, and 1 mg/ml of the extract were used, with a standard ciprofloxacin 5 microg positive control, and a 5% dimethyl sulfoxide (DMSO) solution negative control. RESULTS: The J secunda methanol and acetone extracts with an extraction yield of 15.3% and 0.75%, respectively yielded no activity within the concentration range against the three strains of bacteria tested. In comparison with the positive control, relative inhibition zone diameter (RIZD) values of 0% resulted for both the negative control and the extracts, with the positive control having a value of 100%. CONCLUSION: The in vitro screen of the extracts prepared from J secunda, yielded no antimicrobial activity against the three strains of bacteria tested and therefore does not support the folklore claims by this mechanism of action.

Assessing cost effectiveness of empirical and prophylactic therapy for managing leptospirosis outbreaks.

This study evaluates the utility and cost effectiveness of empirical and prophylactic antibiotic treatment of leptospirosis compared with conventional management. We developed decision trees comparing empirical antibiotic treatment (within 4-7 days of symptom onset) or prophylaxis to conventional antibiotic treatment (initiated 7 days post-onset). Costs were calculated using both US and Barbados pricing. Empirical treatment provided slightly lower probability of survival, while prophylactic treatment resulted in slightly higher survival rates. Antibiotic treatment initiated after 4-7 symptomatic days was ineffective in preventing serious health outcomes, but cost less with the exception of azithromycin (US pricing). Empirical treatment in Barbados cost less than conventional treatment. Prophylaxis reduced rare serious health outcomes and resulted in significant cost savings for the United States and Barbados. Prophylactic therapy for high-risk individuals or prompt diagnosis and early treatment (before 4 days of symptoms) appear to be cost-effective approaches to prevent severe complications of leptospirosis.

Tirucallane, apotirucallane, and octanorapotirucallane triterpenes of Simarouba amara.

A chemical investigation of the bark of Simarouba amara, collected in Barbados, resulted in the isolation of six new triterpenes (3-8), in addition to two known compounds, 3-oxatirucalla-7, 24-dien-23-ol (1) and niloticin (2). Compound 3 is a tirucallane triterpene, while compounds 4-7 are apotirucallane derivatives containing an epsilon-lactone in ring A. Compounds 6 and 7 were obtained as a mixture that could not be separated, while compound 8 is an octanorapotirucallane derivative that lacks the C(8) side chain. The structures of all compounds were determined by interpretation of physical data.

Open-system coral ages reveal persistent suborbital sea-level cycles.

Sea level is a sensitive index of global climate that has been linked to Earth's orbital variations, with a minimum periodicity of about 21,000 years. Although there is ample evidence for climate oscillations that are too frequent to be explained by orbital forcing, suborbital-frequency sea-level change has been difficult to resolve, primarily because of problems with uranium/thorium coral dating. Here we use a new approach that corrects coral ages for the frequently observed open-system behavior of uranium-series nuclides, substantially improving the resolution of sea-level reconstruction. This curve reveals persistent sea-level oscillations that are too frequent to be explained exclusively by orbital forcing.

Labdane diterpenes of Leonurus sibiricus.

Seven new labdane diterpenes, sibiricinones A-E (1-4, 6) and 15-epi-sibiricinones D and E (5 and 7), and the flavone genkwanin were isolated from the aerial parts of Leonurus sibiricus. Sibiricinone D (4) and 15-epi-sibiricinone D (5), and sibiricinone E (6) and 15-epi-sibiricinone E (7), respectively, were isolated as C-15 epimeric pairs. These secondary metabolites were identified on the basis of 1D and 2D NMR including (1)H-(1)H COSY, HSQC, and HMBC spectroscopic techniques. The stereochemical configurations of compounds 4-7 were assigned through 2D T-ROESY and selective NOE experiments.

Cassane diterpenoids of Caesalpinia pulcherrima.

Five new cassane diterpenoids (1-5) were isolated from the roots of Caesalpinia pulcherrima, along with the known isovouacapenol C (6), pulcherrimin A (11), and 6beta-cinnamoyl-7beta-hydroxyvouacapen-5alpha-ol (12). Compounds 3-5 possess the alpha,beta-butenolide moiety, whereas compounds 1 and 2 contain a more usual 2,3-disubstituted furan unit. Compounds 7 and 8 were derived from hydrolysis of 6, while 9 and 10 were derived from acetylation and oxidation of 6, respectively. The (1)H and (13)C NMR spectra of all compounds were completely assigned using a combination of 2D NMR experiments, including (1)H-(1)H COSY, HSQC, HMBC, and T-ROESY sequences.