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Honey is a mixture of sugars, H2O, and other compounds, the specific composing depending mostly on the mix of flowers consumed by the bees. It has been reported that about 181 substances are present in honey ( Terrab et al. , 2003 ) . A typical honey analysis is shown in Figure 1 harmonizing to the U.S. National Honey Board, where it has an mean composing of fructose 38.2 % , glucose 31 % , sucrose 1.5 % , maltose 7.2 % and 17-20 % H2O. In add-on, acids, minerals, enzymes, vitamins and proteins besides found ( Sharquie & A ; Najim, 2004 ) . About 18 free amino acids are known to happen in honey. However, they are present in little sums although proline is the most common ( White, 1979 ; Atrouse et al. , 2004 ) .

The composing of honey is changing from honey to other depending on several factors. These factors are the flowered beginning as the nectar from different workss will incorporate different composing of the chief sugars and the hint elements. These composing are influenced by dirt type, clime conditions and the environment environing the works ( Crane, 1975 )

Many workss like flowers and trees are first-class beginnings of nectar for honey. The coloring material and spirit of honey can change depending on the nectar beginning. Colours scope from about H2O white to dark brown as darker honey has more antioxidant potency and strong spirit. The spirits vary from delectably mild to distinctively bold, depending on where the Apis melliferas worked ( hypertext transfer protocol: //www.fao.org ) .

Figure 1: Diagram represents the chemical composing of U.S honey

( Adopted from the website hypertext transfer protocol: //www.nhb.org )

Composition

Raw honey contains several enzymes that help in its digestion. These enzymes are invertase ( that converts sucrose into glucose and fructose ) , amylase ( diastase ) and glucose oxidase ( that produces gluconic acid and H peroxide from glucose in diluted honey ) . Other enzymes which besides present in the honey are catalase and acerb phosphatase. In add-on, honey contains several B vitamins such as vitamin B2, niacin, folic acid, and B6. Antioxidants and hints of pollen besides present in the honey ( Atrouse et al. , 2004 ) . Furthermore, honey contains a figure of minerals such as Ca, Fe, Zn, K, P, Mg, Se, Cr and manganese ( White, 1975 ; Atrouse et al. , 2004 ) .

Evidence of Antimicrobial Activity of Honey

The antibacterial activity of honey was foremost recognised in 1892, by Van Ketel ( Dustmann, 1979 ) . Since so there have been many researches proved the antibacterial activity of honey against many bacterial pathogens and Fungis ( Efem 1992, Molan, 1992a, Cooper 1999 ) .

A study of 345 samples of New Zealand honey was carried out to measure the antibacterial activity of honey. Four types of honey were shown to hold high antibacterial activity equivalent to phenol criterion. In this check most of the honeys showed no noticeable antibacterial activity when catalase was added to take H peroxide. However, manuka and vipers bugloss honeys showed mensurable sum of H peroxide which believed to help antibacterial activity ( Allen et al. , 1991 )

Efem ( 1992 ) found that undiluted honey prevented the growing of Candida albicans. Wahdan ( 1998 ) showed that undiluted honey could be used in the intervention of superficial fungous infections such as tinea and superficial candidiases.

Cooper ( 1999 ) showed that honey has a important antibacterial activity against the major lesion infecting species including methicillin-resistant Staphylococcus aureus ( MRSA ) . In the same twelvemonth Cooper et al. , compared grazing land and manuka honey and found out that the antibacterial activity of honey against Staph.aureus was non entirely due to its high osmolarity. It has been shown that there is non much different in sensitiveness to honey between methicillin-sensitive and methicillin-reisitant staphylococcus. In 2000 Cooper et. , Al besides reported the sensitiveness of multi-resistant strains of Burkholderia cepacia isolated from cystic fibrosis patients to manuka honey at concentrations below 6 % ( v/v ) . Six commercial honey samples were tested against control beings, Staph.aureus, Escherichia coli, Pseudomonas aeruginosa and assorted clinical isolates it was found that some samples have high broad- spectrum disinfectant activity which resist infrigidation temperature for six months and being boiled for 15 proceedingss ( Nezeako & A ; Hamdi 2000 )

Cooper et Al ( 2002b ) showed the antimicrobic activity of manuka and grazing land honey against 18 strains of MRSA isolated from lesions and strains of vancomycin-sensitive enterococci ( VSE ) . MIC for both honeys was below 10 % ( v/v ) compared to unreal honey, which required a concentration 3 times higher to suppress the growing. In 2002c Cooper et Al compared the antimicrobic activity of two honeys, a grazing land and manuka honey against 17 strains of Pseudomonas aeruginosa isolated from Burnss. Both honeys maintained disinfectant activity when diluted more than 10-fold.

Al-Jabri et Al ( 2002 ) compared the antibacterial activity of 16 honeys from different parts of Oman and 8 from different states in Africa against three control organisms Staph.aureus, Escherichia coli, Pseudomonas aeruginosa. It was found that Dhofar honey ( Oman ) and Eucalyptus honey ( Uganda ) had highest degree of activity against all the three control beings.

Anti-Staphylococcal activity of 30 types of Omani honey was tested entirely and in combination with Garamycin. It was observed 13 of the Omani honey showed first-class anti-Staphylococcus aureus activity. The best honey had killing rate of 38 % of Staphylococcus aureus at 50 % concentration in 30 proceedingss. Gentamicin ( 4Aµg/ml ) killed 70 % while the killing rate for the combination of honey and Garamycin was superior with 92 % violent death in the same continuance ( Al-Jabri et al. , 2005 )

The first Study of the ability of honey to forestall bacterial attachment in vitro was done by Al-Naqdy et al. , 2005. Four different types of Omani honey were used to in this survey for growing suppression. Bacterial attachment was assayed utilizing of Salmonella interitidis cells that had been incubated first with honey and so with enteric epithelial cells. Consequences showed decreased in figure of bacteriums attached to the treated epithelial cells from 25.6A±6.5 to 6.7A±3.3 bacteriums per epithelial cell ( P & lt ; 0.001 ) .

Wound infections:

The primary host defense mechanism is the physical barrier afforded by the tegument and mucose membrane ; one time this barrier is breached it provides a path for entry of bacteriums into the organic structure. Infection can be from patients ain vegetations, infective stuff from bearers or other septic persons that may make the lesion. Microorganisms associated with lesion infection could be bacteriums, Fungis or viruses. The most often isolated lesion pathogens are Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa and Enterobacteroceas ( Bowler et al. , 2001 ) . A survey done on the prevalence of lesion infection showed that surgical lesions and skin infections were two of four largest classs of infirmary acquired infections ( Emmerson et al. , 1996 ) . The direction of septic lesions costs a considerable sum of money, Plowman et al. , ( 2000 ) reported that the cost per instance of hospital-acquired infection ranges between ?1,618 and ?2,398 per individual.

Honey and wound mending procedure:

Honey is an effectual intervention of lesions because it is non- irritating, non-toxic, self-sterile, easy and simple application, bactericidal, anti-inflammatory, alimentary, and more comfy than other dressings.

Clinical Evidence of Effectiveness:

In order to whether honey does excite wound mending an probe was undertaken and grounds has been derived from several beginnings: animate being surveies, cell line in vitro surveies, clinical observations with instance surveies, cohorts of patients and clinical trails.

Honey has been used to handle infections in a broad scope of lesion types. These include Burnss, leg ulcers, diabetic pes ulcers and force per unit area sores. Cavanagh et Al. ( 1970 ) observed 12 instances of lesion harm after extremist vulvectomy being dressed with honey. The lesions became unfertile after 3-6 yearss. In ( 1981 ) Salem performed a clinical test of 45 patients diagnosed with indigestion improved after intervention with lone 30mls of honey before each repast. Emarah ( 1982 ) observed betterment of patients enduring from oculus infection after using honey as an oculus unction. Furthermore, Honey reported to cut down the continuance of diarrhea in clinical tests done for babies with stomach flu in which honey was used insted of glucose in rehydration fluid ( Haffejee & A ; Moosa 1985 )

In 1988, Efem reported first big clinical cohort survey affecting 59 patients who had a assortment of lesions runing from Fournier ‘s sphacelus, Burnss and a scope of ulcers. Unprocessed honey was applied on cleaned wound daily. The usage of honey on these patients resulted successful lesion healing and clearance of infection. Suprahmanyam ( 1993, 1994. 1996 & A ; 1998 ) reported a clinical tests on Burnss patients with honey compared to different interventions e.g. polyurethane movie ( Opsite ) , potato desquamations and amnionic membrane. Honey was superior to all other interventions and mending clip was shorter. Tonks et Al ( 2001 ) showed that grazing land and manuka honey were found to toss off modulate the ROIs ( reactive O intermediate ) synthesis from MM6 cells. ROIs are known as toxic byproducts of assorted cellular O2 devouring oxidation-reduction procedures which are responsible for doing symptoms of oxidative harm if ROI production exceeds the capacity of ROI scavenging reactions. Honey AIDSs in commanding the ROIs which required for lesion healing.

How does honey advance wound mending?

Although the H2O activity of honey is really low it provides a moist environment for optimal curative conditions. The tissue does non acquire dehydrated because of the osmotic consequence of honey it draws the fluid through the lesion tissue from the underlying circulation ( Chirife et al. , 1983 ) . The topical application of foods to lesions has been shown to increase the growing rate of granulation tissue ( Kaufman, 1984 ) . The viscousness of honey provides a protective barrier to forestall cross-infection of lesion ( Efem, 1988 ) . Honey has been proved to hold a deodorizing belongings on lesion. It thought to be due to high glucose content consumption by infecting bacteriums as an option to amino acids, ensuing in production of lactic acid instead than malodourous compounds such as ammonium hydroxide, sulfur compounds and aminoalkanes ( Molan, 1998 ) . Furthermore, acidification of lesion ( pH 3-4 ) causes more O to be released from hemoglobin, therefore promotes mending ( Efem, 1988 ) .

Some research workers observed that honey promotes tissue regeneration through stimulation of angiogenesis and the growing of fibroblasts and epithelial cells ( Efem 1988, 1993 & A ; Subrahmanyam 1994, 1998 ) , hence speedy healing can understate the demand for tegument transplant ( Subrahmanyam 1998 ) .

Due to hapless blood supply that limited handiness of O and foods to the cells in a skin necrotic lesion. The osmotic consequence ( high glucose ) and mixture content of vitamins, minerals and aminic acids in honey plays a function to get the better of these restrictions ( Molan, 1999 ) .

In add-on, after honey is applied to the lesion it forms a movie of liquid between the lesion and the dressing that prevents the dressing from lodging to the lesion without hurting and without damaging the freshly formed cells. As honey has no inauspicious effects on tissue, it can be used safely on lesion and present into pits and fistulas to clear infection ( Molan, 2000 ) .

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