Press release: Natural doesn’t mean safe – herbal medicines found to contain steroids

The Medicines and Healthcare products Regulatory Agency is warning people who may have purchased a “natural” Chinese herbal medicine, Yiganerjing Cream, as a treatment for skin conditions to stop using it immediately as it has been found to contain an undisclosed steroid and two antifungal ingredients.

MHRA officials have been acting to stop the sale of this cream and have had it withdrawn from many websites and on-line market places but people may have purchased it in the past and still be using it.

Yiganerjing Cream is not a licensed medicine and has been marketed in the UK as a “natural” Chinese herbal medicine for the treatment of a range of skin conditions, most commonly eczema, psoriasis and rosacea.

Our analysis found the presence of the steroid clobetasol propionate. This steroid is the active ingredient in Prescription-Only Medicines used for the treatment of a range skin conditions such as psoriasis and eczema. Creams containing steroids should be used sparingly and as directed by the prescriber. It is contraindicated in children under 1 year of age.

We are also aware of the use, via a herbal clinic, of a product called Penny Orange Cream which has also been found to contain clobetasol propionate. While this product is no longer available, and we are not aware of its widespread use, it did contain an undisclosed steroid and should not be used.

If you are unsure about the safety of a medicine claiming to be “natural” or “herbal” you should check for a Marketing Authorisation (MA) or Product Licence (PL) number or Traditional Herbal Registration (THR) number / the THR logo. This means the product has been assessed by MHRA for safety and has been manufactured correctly. For more information, visit NHS Choices.

Dr Chris Jones, Manager of the Medicines Borderline Section at MHRA said:

The sale of potent steroid creams directly to the public is illegal for good reason. If used without medical supervision these medicines can be dangerous.

Steroids must be prescribed by healthcare professionals who follow strict criteria when prescribing them and monitoring patients using them. They can suppress the skin’s response to infection, can cause long-term thinning of the skin, and if applied long term over a wide area, particularly in babies and children, can cause other medical problems.

Our advice to anyone who is using Yiganerjing Cream, particularly on young children and babies, is to discontinue use immediately. If you have any questions, please contact your healthcare professional.

If you are aware of Yiganerjing cream being sold, please report it to MHRA at Borderline_medicine@mhra.gov.uk.

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Link: Press release: Natural doesn’t mean safe – herbal medicines found to contain steroids
Source: Gov Press Releases

Press release: Report 04/2018: Freight train derailment at Lewisham

180228_R042018_Lewisham

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Summary

At about 05:30 hrs on 24 January 2017 two wagons within an aggregate train derailed on newly-laid track at Courthill Loop South Junction in Lewisham, south-east London. The first of the wagons ran derailed, damaging the track, then overturned spilling its payload of sand. There was major disruption to rail services while the wagons were recovered and the infrastructure reinstated. No-one was injured.

The new track had been installed during renewal w
ork on the weekend of 14 and 15 January 2017. It was made up of separate panels of switch and crossing track, comprising the rails, point and crossing components and the supporting concrete bearers. Most of these track panels had been brought to site pre-assembled. A mechanical connector, known as a ‘bearer tie’, was used to join the concrete bearers that were designed to support rails on more than one panel. Network Rail originally developed the concept for this type of track in the mid-2000s; it is referred to as ‘modular S&C’.

Planned follow-up engineering work was undertaken on the subsequent weekend. The derailment happened on the day after hand-back checks on completion of this work had confirmed that the track geometry was suitable for the passage of trains. It occurred because the first of the two derailed wagons, which was probably carrying an uneven payload, encountered a significant track twist, resulting in there being insufficient wheel load at the leading left-hand wheel to prevent its flange climbing over the rail head.

The track twist had developed rapidly following the hand-back because:

  • the support offered by the track bed to the concrete bearers was poor
  • the inherent flexibility of the bearer ties located between the two running rails made one side of the track more susceptible to the poor track bed support than the other

Network Rail’s engineering processes for specifying and developing modular S&C layouts were an underlying factor, in that they were inadequate for controlling the risks associated with flange climb derailment.

Recommendations

The RAIB has made five recommendations:

  • Four are directed to Network Rail, concerned with:

    • the processes it uses to identify and manage risks associated with vertical track geometry features following track renewal and heavy maintenance

    • the design and validation of its modular S&C layouts

  • One is directed to RSSB concerned with understanding and managing the derailment risks associated with uneven loading of bulk hopper wagons

The RAIB has additionally identified learning points concerning the management and planning of track installation work, and procedures for the routine maintenance of railway vehicles.

Simon French, Chief Inspector of Rail Accidents said:

Derailments of freight trains on the main line are not very common, but when they occur they have the potential to cause very serious consequences, as well as huge disruption to other services. The accident at Lewisham in January 2017 resulted in days of cancellations and delayed trains on some of the busiest commuter routes in the country. If there had been another train nearby when the accident happened, the subsequent collision could have been disastrous.

This accident was particularly disappointing because it happened immediately after the renewal of the track at a complex junction, which had been done with the latest design of modular, pre-assembled switches and crossings. The designers of the new layout had not fully understood how this type of assembly could behave if the track bearers were not fully supported by the ballast. The track was poorly supported when it was handed back for traffic on the day before the derailment, because there had not been time for the machines to finish tamping the ballast, and manual consolidation work was ineffective. The effect of all these deficiencies was to create a situation in which, when it was handed over for traffic the track had, or very rapidly developed, geometry faults. These created the conditions for the wheels of a freight train with a slightly offset payload to climb over the head of the rail.

RAIB has investigated this interaction between poor track geometry and unevenly loaded trains several times before. In reports on investigations published in 2009 and 2014 we have recommended action to deal with the problem. It is of concern to me that, although the railway industry has established a working group to examine these issues, it remains unclear how its findings will be translated into actions to mitigate the risk of freight train derailment.


Link: Press release: Report 04/2018: Freight train derailment at Lewisham
Source: Gov Press Releases

The Value Added Tax (Amendment) Regulations 2018

These Regulations, which come into force on 1st April 2019, amend Part 5 (accounting, payment and records) of the Value Added Tax Regulations 1995 (S.I. 1995/2518: “the Principal Regulations”). They have effect from 1st April 2019 for those taxpayers who have a prescribed accounting period beginning on that date and otherwise from the first day of a taxpayer’s first prescribed accounting period beginning after that date.

Link: The Value Added Tax (Amendment) Regulations 2018
Source: Legislation .gov.uk

The Higher Education and Research Act 2017 (Commencement No. 3) Regulations 2018

These Regulations are the third commencement Regulations made under the Higher Education and Research Act 2017 (c. 29), and commence provisions of that Act relating to the Office for Students and the establishment and operation of United Kingdom Research and Innovation.

Link: The Higher Education and Research Act 2017 (Commencement No. 3) Regulations 2018
Source: Legislation .gov.uk