Arsenic

Have not blogged for a few days, was very busy running from one meeting to the next. I never realised how tiring meeting people and making decisions could be.
Some good news, Narain has secured his Formula One drive. He is the first driver for the Jordan team and partners Portugal's Tiago Monteiro. Other sports news, the second ODI between SA and England was a tie. SA are the biggest choker in the game,they should have easily won this match but messed it up. Reminds you of Allan Donald running down the pitch against Australia in the 1999 World Cup, one of the most unforgettable pictures in cricket history.

I attended this really interesting talk by a SpR in Haematology. As part of the medical grand rounds on Thursday he spoke about Acute Promyelocytic Leukemia. This slightly rare condition makes up about 10% of all Acute Leukemias and is usually treated by chemotherapy and ATRA(All-trans retinoic acid). However, in refractory cases and relapses, ATRA and chemo does not show good rates of complete remission, so they decided to POISON the LEUKEMIA.
They used ARSENIC as a form of treatment. Now, before you go,"Oh! My God!", arsenic has been used in ancient times as forms of treatment and is also used in Uclerative Colitis nowadays. Obviously, they use a different chemical form of Arsenic than the one that is poisonous.

Arsenic Trioxide acts as a anti-neoplastic agent, by activation of differentiation and apoptosis in a dose-dependent manner. It is very good in relapses and refractory cases giving a CR rate of ~ 75% in most studies conducted, compared with a rate of 20% with chemo and ATRA. For more details, look up this article.

But, this has obviously led me to do some serious research on arsenic poisoning and arsenic. I remember learning about arsenic in second year forensic medicine and it was an examination favourite because of two reasons.
1. It is considered as the ideal homicidal poison, for the following reasons :
a. It is tasteless, white in colour, dissolves in milk and is cheap, available as rat-poison.
b. the symptoms of the poisoning mimic natural diseases, acute arsenic poisoning mimics
gastro-enteritis, and chronic mimics dermatitis and peripheral neuritis.
It was known as the "king of poisons" and in France was known as poudre de succession, for obvious reasons. In fact in the good old days before chemistry took off, arsenic was a favourite poison as it was impossible to detect and the only way to detect poisons was to feed the remnants to an animal, of which they were very few( where were the animal rights activists then??). Then came the MARSH test and it became easier to detect Arsenic from dead bodies.

Anyway, the other reason it was a favourite was that the poison arsenic oxide is different from the chronic poisoning that is prevalent across the world especially in South East Asia. In fact there is a group at Harvard which is working on the effects on chronic arsenic poisoning as a result of contaminated drinking water. The examiners loved to confuse us by asking what are the effects of Arsenic (contaminated DW) vs this white powder (poisonous arsenic oxide).

Ok, before you begin to believe that I am some morbid sociopath murderer, let me change the topic to happier issues (now I cant think of something happy, but that doesn't prove anything!)

Let us end today on this awkward note:

"To a suicide: You just poisoned the wrong person"