This year has been full of doubts and tears for me. I honestly still feel like I did not make the right study choice. I’d be lying if I can say I am enjoying my honors year. It comes as a surprise if a day goes without me shedding a tear, crying, and screaming in my room alone.
I’d be lying if I can say there is something I really find so easy in my honors. I struggled from day one until today. My mental health has been compromised like never before. I have repeated my experiment more than eight times which just demotivate me even worse. I still get shocked on how I have managed to keep up until this time of a year.
Soon I’ll be required to submit my project thesis draft which seem to be confusing me each day. I question myself about it every day. I still don’t understand what my it is all about, but as confused as I am, I can still be able to wake up each morning and go the lab even though the confusion gets worse each day. I used to understand the quote “nothing comes easy in life”, but I’ve never imagined the kind of struggle that I am through this year. It is so unmeasurable sometimes unbearable.
Let me take you through my short life story, having to adapt to this big city called Cape Town coming from different city, different university has been challenging. Still challenging. Let alone the gap year I took last year, I had to adjust my mentality back into the student mode. I wish someone could have tipped me off on what to expect maybe I could have been prepared myself mentally.
Honors is challenging. Some days you feel like packing your stuff and quit. Some days you don’t feel like waking up because it can really take a lot from a person. I’d say taking a break and taking care of yourself and your mentally health is a necessity in an honors year. Having supportive friends and reaching out for help can never be wrong. I also believe we are different, hence our copying mechanisms, and how we see things and handle things is different.
Psychedelic-assisted Therapy: Emerging treatment in Mental Health Disorders
by Sanelisiwe Fourteen
“Nineteen-year-old Alice returns to the magical world from her childhood adventure, where she reunites with her old friends and learns of her true destiny.”
It’s not new that kids novels are centred around fantasies and mysteries, however they always seem to convey a valuable lesson at the end. After being one of the most successful novels written by Lewis Carrol in 1865, a lot of psychoanalytic papers have been written about this fantasy novel to examine the psychedelic undertones. The plot of the story has always been linked to being “disjointed in reality”. This is because Alice encounters a magic mushroom that can make her change in size. The “magical” properties of this mushroom are said to have been inspired by the hallucinogenic effect of the Amanita Muscaria, popularly known as the fly agaric mushroom.
The correlation of Alice’s “trip” to Wonderland and hallucinogenic drugs has been debated by many, but many psychedelic influences have been pointed out in the book.
“You are off on a trip . . . with no baggage, no destination, and no compass.”
Psychedelics, known as hallucinogens are psychoactive substances thought to “expand consciousness”, they improve mood in psychiatric conditions . They wield a range of neurochemical and neuromodulatory, effects on the brain. Psychedelics include plant/fungi derivatives psilocybin, ayahuasca, peyote, iboga and laboratory synthesized LSD (ergot fungi) and 3,4-methylenedioxymethamphetamine (MDMA).
Subjective effects of psychedelics may include the following:
Open- or closed-eye imagery.
Acute emotional experiences.
Anti-amnesic effects.
Although psychedelics are not yet approved by the U.S. Food and Drug Administration (FDA), over 70 clinical trials are currently being conducted across the globe using psychedelic-based therapies for mood disorders. Hard-to-treat psychiatric conditions like severe depression, anxiety, alcohol and nicotine dependence and OCD (obsessive compulsive disorder) have been the target for most psychedelic-assisted therapy. Particularly for individuals that have found other treatments ineffective.
Psilocybin being the centre of most research, is a naturally occurring psychedelic prodrug compound found in over 200 species of fungi. It is structurally similar to serotonin; a human neurotransmitter that regulates mood, cognition and perception. Psilocybin was granted breakthrough therapy status by the FDA for treatment-resistant depression in 2018 and for major depressive disorder (MDD) in 2019.
MDMA is currently in a phase 3 clinical trial as an adjunct to psychotherapy for posttraumatic stress disorder (PTSD). A randomized controlled trial pooled analysis showcased that 54.2% of patients treated with MDMA-assisted psychotherapy for PTSD no longer met the diagnostic criteria for PTSD. It allowed patients with PTSD to better tolerate the examination of traumatic material in therapy, anxiety, fatigue, headache and loss of appetite; which are the most common adverse effects of PTSD.
The greatest concern and the reason why psychedelic studies were halted in the past is because of the 1970 Controlled Substances Act where psychedelics were considered drugs of abuse than potential therapies. However, in an Australian Drug Harms Ranking Study(2019), they identified psilocybin and MDMA as two of the five least harmful drugs out of 22 investigated drugs, scoring 5 and 7, respectively. Alcohol was found to be the most harmful scoring 71. The negative outcomes reported with recreational use have not been observed in any therapeutic study.
When administered in clinical settings with psychological support (nurses), early clinical trials have shown that psychedelics may be a safe and effective treatment for many mental health disorders. Some experiences are quite intense hence nurses play a critical role in this healing process. The knowledge, skills and values nurses bring to patient care in psychedelic-assisted psychotherapy is critical and is well translated. They bring in the physical, emotional, mental and even spiritual levels of support whilst patients undergo therapeutic psychedelic experiences; they take the patients through the “trip”.
Figure 1. MDMA therapy session is conducted by researchers Marcela Ot’alora, MA, LPC, and Bruce Poulter, MPH, RN (Multidisciplinary Association for Psychedelic Studies)
Psychedelics have deep effects on understanding of self and the world around us, demonstrating enhanced insight and personal growth. Psychedelic-assisted therapy offers a great potential to relieve suffering and encourage healing and peace amidst illness when used in a clinical setting.
References
Penn, Andrew MS, NP, PMHNP-BC; Dorsen, Caroline G. PhD, FNP-BC; Hope, Stephanie DNP, RN, NC-BC; Rosa, William E. PhD, MBE, AGPCNP-BC, FAANP, FAAN. CE: Psychedelic-Assisted Therapy. AJN, American Journal of Nursing: June 2021 – Volume 121 – Issue 6 – p 34-40
Sarris, J., Pinzon Rubiano, D., Day, K., Galvão-Coelho, N. L., & Perkins, D. (2022). Psychedelic medicines for mood disorders: current evidence and clinical considerations. Current opinion in psychiatry, 35(1), 22–29.
2022. A year with a lot of change, but change is necessary to grow, to experience, to learn and to mature.
I have lived at home my entire life with little to no freedom or independence, so moving to a new city to complete my Honours degree was like having my tectonic plates shifted with a massive earthquake, and when it was over my life had completely changed in almost every way. I remember the first day I landed in Cape Town. It felt so surreal as if I was dreaming and all I could feel around me was magic. It took me a long time to get into a routine with a new flat, transport arrangements and a massive campus that I knew nothing about. Responsibility definitely grows but I suppose the hardest change was being in a place where I didn’t know a single person. As an introvert you can see how that was my Mount Everest. The first 6 months was the most difficult time in my life. The demanding workload and no break lead to a constant burnout state, and being away from my family’s support structure and feeling alone almost every day made me feel like I wasn’t going to make it to the end of the year. But as each week ended I ticked it of my year schedule and at some point I looked at it and was surprised by how far I’ve come. We always underestimate our capabilities. It took some time but I began to make friends and started feeling truly happy again. I could have completed my Honours degree at home but I chose to challenge myself. So many of us choose our path out of fear disguised as practicality. Change is scary but sometimes you just have to be like a bison and withstand any storm that comes your way.
What do starfish, chestnut trees, and Wolverine have in common? Stumped? While humans’ regenerative capacity is largely limited to liver and skin cells, they all have the capability to re-grow entire functional limbs. This regenerative potential is one that is highly sought after, as worldwide more than 57 million people live with the loss of a limb. Although prosthetic technologies have advanced, the mechanism behind limb regrowth remains frustratingly elusive, and as of yet doctors have been unable to induce the generation of human limbs from previously amputated sites. This is partially because our wounds tend to scar over, which is great for preventing blood loss and infection, but not ideal for regenerative growth.
Luckily for us, scientists are closer than ever to conquering this biomedical frontier. A study published earlier this year offers new hope in the form of glassy-eyed frogs, which face the same limitations we do. Using a wearable hydrogel cap – the BioDome – infused with a potent cocktail of drugs, Harvard researchers were able to successfully stimulate the regrowth of surgically amputated legs in adult African clawed frogs. This distinction is important, as unlike tadpoles, adult frogs are normally unable to muster a regenerative response.
In the experiment, the adult frogs’ right hindlimbs were amputated before exposure to one of three treatments: the BioDome alone, the Biodome with the cocktail, or a control treatment with neither. The cocktail consisted of five pro-regenerative drugs designed to facilitate regrowth processes, such as the suppression of collagen production (which causes scarring), the regulation of inflammation, and the promotion of neuromuscular repair, blood vessel integration, and tissue outgrowth. In all cases the treatments were applied within 24 hours of amputation, and then removed 24 hours later. Over the next 18 months, the amputation site were regularly assessed for soft tissue repatterning, bone regrowth, and sensory-motor reflexes.
Incredibly, the drug-infused BioDome was able to restore what was lost, regrowing hindlimbs containing a rich complement of nerves, tissue, muscle and bone similar to its natural state. Although the stubby toes lacked webbing or a supportive bone structure – and it certainly wouldn’t win any beauty pageants – the regrown limbs were sensitive enough to respond to external stimuli and robust enough to allow the frogs to carry on with their usual amphibious activities. The hindlimbs treated with the BioDome only also exhibited a regenerative response, albeit not as strongly as the drug enhanced version. It would appear that although the BioDome created the nurturing micro-environment necessary for scarless wound healing, the brief exposure to the drug-cocktail provided the molecular triggers essential for the regrowth of the limb. Their data would concur, as exploration into the mechanisms responsible for this process revealed that the drug-cocktail stimulated molecular pathways normally active in developing embryos as they take shape.
While of course we are not frogs, this milestone result has encouraged the researchers, who plan to optimise the treatment for use in mice, with hopes of producing more structurally and functionally complete limbs. Being mammals, mice models are more applicable to the human condition, and so success could potentially lead to human trials. While limbs that have already been lost sadly could not be regrown, use of the treatment in hospital settings could allow the regeneration of human limbs lost to trauma or illness provided it is applied soon after the injury occurs. This might offer an alternative to prosthetics, which in their current state provide minimal limb function restoration. Furthermore, effective regenerative treatments developed for amputated human limbs could potentially be co-opted for the regrowth of other human organs in the future, which is currently in scarce supply.
It’s the stuff of science fiction, but one that is edging closer and closer to a reality.
References • McDonald CL, Westcott-McCoy S, Weaver MR, Haagsma J, Kartin D. Global prevalence of traumatic non-fatal limb amputation. Prosthetics and Orthotics International. 4 December 2020. doi: 10.1177/0309364620972258. • Nirosha J. Murugan, Hannah J. Vigran, Kelsie A. Miller, Annie Golding, Quang L. Pham, Megan M. Sperry, Cody Rasmussen-Ivey, Anna W. Kane, David L. Kaplan, Michael Levin. Acute multidrug delivery via a wearable bioreactor facilitates long-term limb regeneration and functional recovery in adult Xenopus laevis. Science Advances, 2022; 8 (4) DOI: 10.1126/sciadv.abj2164
The term “healthy vaginas” has a certain cringe factor for obvious reasons: it suggests that some women might have “unhealthy vaginas”! This is an example of medical colloquialism at its most harmful. “Healthy vaginas” actually refer to the bacteria present in the female genital tract (FGT), where some species are beneficial as they keep the pH of the FGT within the acidic range which is harmful to invading bacteria and viruses. These types of bacteria are called Lactobacillus and they are not only harmless but also protective against infections. However, sometimes there can be an imbalance where Lactobacillus stops growing, and other bacteria begin to overgrow. The displacement of Lactobacillus with other harmful bacteria results in a vaginal infection called bacterial vaginosis. Research has shown that the symptoms associated with BV, which include abnormal vaginal discharge and odour, negatively impacts women’s self-esteem and sex lives as these symptoms made women feel “embarrassed” and “dirty” (Bilardi et al., 2013). It is important to note that BV is not a sexually transmitted infection (STI). However, BV place’s women at a higher risk of contracting STI’s such as HIV, as well as infertility, pelvic inflammatory disease and adverse pregnancy outcomes such as preterm birth.
Interestingly, BV was originally called Gardnerella vaginitis as it was believed that the bacterium, Gardnerella vaginalis (G. vaginalis), was the cause of the vaginal infection (Kairys et al., 2002). However, G. vaginalis was later identified to be the initial bacteria that adhere to vaginal epithelial cells, and is assisted by other harmful bacteria to promote the development of BV. G. vaginalis is believed to be the major contributor to BV due to its ability to form biofilms and produce proteins such as sialidase and vaginolysin. Sialidase breaks down sugars in the FGT and by doing so provides an important source of nourishment to G. vaginalis and other BV-associated bacteria. Vaginolysin forms holes within the lining of the FGT which results in inflammation due to the further tissue destruction created by the body’s immune response. Currently, the standard treatment for BV is associated with antibiotic resistance. It has been suggested that the ability of G. vaginalis to form biofilms, which are thick layers of bacteria and cell debris which allows bacteria to grow undercover, are responsible for the treatment failure and reoccurrence of BV.
In this article Qian et al. investigated whether the introduction of a high number of Lactobacillus could outgrow G. vaginalis,and restore the FGT to its healthy state. To accomplish this, the authors looked at the applicability of three Lactobacillus strains (Lactobacillus delbrueckii DM8909, Lactiplantibacillus plantarum ATCC14917 and Lactiplantibacillus plantarum ZX27) to outcompete G. vaginalis. Several experiments were performed to determine whether the Lactobacillus species prevented the growth, adhesion, biofilm formation and inhibited sialidase and vaginolysin activity of G. vaginalis.
The authors concluded that all three Lactobacillus species were able to inhibit growth, reduce adherence, inhibit biofilm formation, as well as decrease sialidase and vaginolysin levels. Based on the effect of the Lactobacillus species on G. vaginalis adhesion and biofilm formation it can be concluded that the use of probiotics as a daily supplement can benefit women as an adjuvant treatment or preventative. The results identified Lactiplantibacillus plantarum ZX27 as the most protective strain against G. vaginalis as it was able to decrease the pH to a much greater extent due to its high lactic acid production. It is thus possible that vaginas could be restored to their healthy state by the mere introduction of Lactiplantibacillus plantarum ZX27 into the FGT, hopefully reducing the shame associated with BV and leaving women with sweet smelling vaginas.
References
Bilardi, J.E., Walker, S., Temple-Smith, M., McNair, R., Mooney-Somers, J., Bellhouse, C., Fairley, C.K., Chen, M.Y. and Bradshaw, C., 2013. The burden of bacterial vaginosis: women’s experience of the physical, emotional, sexual and social impact of living with recurrent bacterial vaginosis. PloS one, 8(9), p.e74378.
Kairys, N. and Garg, M., 2017. Bacterial vaginosis. StatPearls.
Qian, Z., Zhu, H., Zhao, D., Yang, P., Gao, F., Lu, C., Yin, Y., Kan, S. and Chen, D., 2021. Probiotic Lactobacillus sp. Strains Inhibit Growth, Adhesion, Biofilm Formation, and Gene Expression of Bacterial Vaginosis-Inducing Gardnerella vaginalis. Microorganisms, 9(4), p.728.
For the longest time, I’ve always worked towards perfection and made sure that I get the outcome I want. Sometimes I just feel like I was able to accomplish perfection because all the materials have been handed out to me but this year has been different. I visited my childhood traumas unconsciously. It’s been a really emotionally and mentally draining year but I’ve learnt that we really choose which part of our lives we want in control, one wouldn’t be the happiest if one chose the dark part of them to outweigh the other parts. I mean every part of our lives is responsible for the person we become but that doesn’t mean we have to let or instead allow ourselves to be defined by the parts that bring out the worst in us. We cannot change the circumstances that are responsible for the dark side but we definitely choose to be happy and that means letting go or instead resting our troubled sides. And by rest I don’t mean boxing our wounds without going back to them to heal them, even if it takes time, heal them because boxing them before they become scars still gives them a chance to come back and hurt us.
Health Science Reviews 