Detection of adulterated drugs in traditional Chinese medicine and dietary supplements using hydrogen as a carrier gas

Utilizing experimental design and desirability function in optimizing RP-HPLC method for simultaneous determination of some skeletal muscle relaxants and analgesics

An experimental design and response surface methodologies using Plackett-Burman and Box-Behnken designs were applied for selecting and optimizing the most appropriate parameters which significantly affect the separation and quantitative estimation of five skeletal muscle relaxants and four analgesic drugs (baclofen, methocarbamol, dantrolene sodium, orphenadrine citrate, cyclobenzaprine hydrochloride, ketoprofen, etoricoxib, ibuprofen, and mefenamic acid) with a relatively short duration of analysis in a single run. For the separation of the nine drugs, an INERTSIL ODS-V3-5 µm C18 column (250 × 4.6 mm I.D.) was used with the optimum mobile phase conditions (45.15 mM ammonium acetate buffer pH 5.56 adjusted with acetic acid, acetonitrile, and methanol in a ratio of 30.5:29.5:40, v/v/v with a flow rate of 1.5 mL/min) and UV-detection at 220 nm. The optimized method was successfully subjected to the validation steps as described in ICH guidelines for linearity, precision, accuracy, robustness, and sensitivity. The optimized and validated method was effectively applied to determine the content of the studied drugs in their pharmaceutical preparations and to expand its applicability to the counterfeit estimation of etoricoxib in different brands of tablet dosage forms.

GC-MS Analysis of Primary Aromatic Amines Originated From Azo Dyes in Commercial Textile or Leather Products Using Helium Alternative Carrier Gases

BACKGROUND

In recent years, due to the global shortage of helium gas, the development of gas chromatography (GC) analytical methods using alternatives to helium carrier gases is necessary.

OBJECTIVE

The objective of this study was to examine the applicability of hydrogen and nitrogen as alternative carrier gases using the test method for azo compounds in the Act on Control of Household Products Containing Harmful Substances of Japan.

METHOD

The gas chromatograph mass spectrometer (GC-MS) analytical method using hydrogen and nitrogen as alternative carrier gases was compared with a method using helium for 26 primary aromatic amines (PAAs) originated from azo dyes.

RESULTS

When hydrogen and nitrogen were used as carrier gases under the same conditions used during analysis using helium (same column, gas flow rate, oven temperature conditions, etc.), sufficient peak separation of 26 PAAs was obtained. The sensitivities of the methods using helium and hydrogen were comparable, whereas the sensitivity was lower when nitrogen was used, with the detection limits ranging from 1/220 to 1/25. However, all carrier gases achieved quantification at concentrations below the standard value (30 μg/g) of the Act on Control of Household Products Containing Harmful Substances, and the results were in agreement with the standard value for the target product.

CONCLUSIONS

Our results indicated that hydrogen or nitrogen can be used as alternative carrier gases to helium for GC-MS analysis of azo compounds producing specific aromatic amines.

HIGHLIGHTS

Using hydrogen or nitrogen as an alternative carrier gas to helium, azo compounds could be quantified with excellent accuracy.

Cross-sectional survey and Bayesian network model analysis of traditional Chinese medicine in Austria: investigating public awareness, usage determinants and perception of scientific support

OBJECTIVES

Despite the paucity of evidence verifying its efficacy and safety, traditional Chinese medicine (TCM) is expanding in popularity and political support. Decisions to include TCM diagnoses in the International Classification of Diseases 11th Revision and campaigns to integrate TCM into national healthcare systems have occurred while public perception and usage of TCM, especially in Europe, remains undetermined. Accordingly, this study investigates TCM's popularity, usage and perceived scientific support, as well as its relationship to homeopathy and vaccinations.

DESIGN/SETTING

We performed a cross-sectional survey of the Austrian population. Participants were either recruited on the street (in-person) or online (web-link) via a popular Austrian newspaper.

PARTICIPANTS

1382 individuals completed our survey. The sample was poststratified according to data derived from Austria's Federal Statistical Office.

OUTCOME MEASURES

Associations between sociodemographic factors, opinion towards TCM and usage of complementary medicine (CAM) were investigated using a Bayesian graphical model.

RESULTS

Within our poststratified sample, TCM was broadly known (89.9% of women, 90.6% of men), with 58.9% of women and 39.5% of men using TCM between 2016 and 2019. Moreover, 66.4% of women and 49.7% of men agreed with TCM being supported by science. We found a positive relationship between perceived scientific support for TCM and trust in TCM-certified medical doctors (ρ=0.59, 95% CI 0.46 to 0.73). Moreover, perceived scientific support for TCM was negatively correlated with proclivity to get vaccinated (ρ=-0.26, 95% CI -0.43 to -0.08). Additionally, our network model yielded associations between TCM-related, homeopathy-related and vaccination-related variables.

CONCLUSIONS

TCM is widely known within the Austrian general population and used by a substantial proportion. However, a disparity exists between the commonly held public perception that TCM is scientific and findings from evidence-based studies. Emphasis should be placed on supporting the distribution of unbiased, science-driven information.

DoE Screening and Optimization of Liquid Chromatographic Determination of Nicotinic Acid and Six Statins: Application to Pharmaceutical Preparations and Counterfeit Detection

An isocratic reversed-phase high performance liquid chromatographic method has been developed and validated to simultaneously determine nicotinic acid, pravastatin sodium, rosuvastatin calcium, atorvastatin calcium, pitavastatin calcium, lovastatin sodium and simvastatin sodium in focus on counterfeit drug detection. Thin-layer chromatography, nuclear magnetic resonance and mass spectrometry have been additionally performed to verify the identification of adulterants of counterfeit herbal medicines. Chromatographic separation was carried out on Inertsil® ODS-3 C18 (4.6 × 150 mm, 5 μm) with isocratic mobile phase elution containing a mixture of acetonitrile: methanol: 25 mM potassium dihydrogen phosphate buffer, pH 2.86 adjusted with 0.1 M o-phosphoric acid (48: 30: 22, v/v/v), at a flow rate of 1 mL/min and with UV detection at 238 nm. The design of experiment methodology, Plackett-Burman and Box-Behnken designs, was used to screen and optimize the mobile phase composition. The validation of the method was also carried out under the International Conference on Harmonization guidelines. The developed method was sensitive, accurate, simple, economical and highly robust, in addition to the comprehensiveness and novelty of this method for separating the seven drugs. The results were statistically compared with the reference methods used Student's t-test and variance ratio F-test at P < 0.05.

How older adults’ health beliefs affect intention to perform COVID-19 self-examination: A reasoned action approach

BACKGROUND: COVID-19 self-examination is a significant part of the national recovery plan against the virus. Although it is easier to perform COVID-19 self-examination (CSE), only a small percentage of people prefer it. There are no precise statistics on CSE in Malaysia, but informal data from news agencies imply low CSE. Lack of awareness and conflicting information about the reliability of CSE results may have raised concerns about CSE’s efficacy and effectiveness. OBJECTIVE: This study investigates how Malaysian older adults’ health beliefs influence their intention to perform CSE. The study developed a framework combining illness threats (ITH), perceived barriers (PBA), medical motivations (MMO), and control over illness (COI) from the Health Belief Model (HBM) with the Reasoned-Action Approach’s attitude (ATT), perceived control (PCO), and intention (INT). METHODS: Structural Equation Modelling (SEM) analyses were conducted with AMOS 26 software to determine the influence of HBM on older adults’ attitude, perceived control, and intention. The study collected 200 data for the pilot study and 400 data for hypotheses testing. RESULTS: ITH, MMO, and COI have positive effects, whilst PBA affects ATT negatively. ITH and COI positively impact PCO, and PCO has a greater significant effect on INT than ATT. CONCLUSION: Given the HBM’s role in influencing older adults’ intention to perform COVID-19 self-examination, providing different levels of care and emphasising the perception of knowledge of illness are especially beneficial. Several recommendations are made to ensure that CSE remains relevant for older adults’ well-being, although COVID-19’s impact has become more stabilised.

Recent Analytical Method for Detection of Chemical Adulterants in Herbal Medicine

Herbal medicine has become popular in recent years as an alternative medicine. The problem arises when herbal medicines contain an undeclared synthetic drug that is illegally added, since it is a natural product that does not contain any chemical drugs due to the potential cause of harmful effects. Supervision of herbal medicines is important to ensure that these herbal medicines are still safe to use. Thus, developing a reliable analytical technique for the determination of adulterated drugs in herbal medicine is gaining interest. This review aims to provide a recent analytical method that has been used within the past 5 years (2016-2021) for the determination of chemical adulterants in herbal medicine.

A Rapid Screening Method for Sibutramine Hydrochloride in Natural Herbal Medicines and Dietary Supplements

Herbal weight loss drugs are becoming more widely used in the fight against obesity, but ineffective regulation of these products have resulted in harmful additives. These products may contain adulterants such as sibutramine hydrochloride that may result in serious adverse health events including death. This work established a color precipitation reaction-based rapid screening method for illegal adulteration of sibutramine hydrochloride in natural herbal medicines (NHM) and dietary supplements (DS). While a variety of chromatography- and electrophoresis-based systems have been reported to measure this analyte, they generally suffer from high costs, complicated sample preparation, and a costly analytical infrastructure. In contrast, we present a simple, handheld kit to assay for sibutramine. The performance metrics of this tool include an average detection time of approximately 3 minutes, which is markedly shorter than conventional methods (HPLC or HPLC-MS, etc.), a detection limit of 0.1 mg per aliquot, and an accuracy of 99.02% (n = 820). More strikingly, the sensitivity is 100% (n = 278), and the specificity is 98.52% (n = 542). The rapid test kit developed from this screening method was evaluated by FDA. In summary, this screening method is a rapid, simple, and low-cost tool for the detection of sibutramine in NHM and DS with superior selectivity and sensitivity. For these reasons, this method is especially suitable for underdeveloped settings because it can be employed onsite without any instrumentation. In addition, this approach could rapidly exclude most of the negative samples to boost efficiency in large-scale samples assay. If necessary, positive samples can undergo further alternate testing methods to confirm the positive results of sibutramine hydrochloride content.

Methods for quantifying phenolphthalein in slimming tea

Because of increasing levels of obesity and the development of social network platforms, the online sale of slimming beverages has become very common. However, such beverages are often reported to contain hazardous drugs, such as phenolphthalein. In the present study, we established a rapid and sensitive immunochromatography gold-labeled monoclonal antibody (mAb) (IGM) method and a fluorescence-labeled mAb (IFM) method for determining phenolphthalein in ten types of slimming tea. The monoclonal antibodies and coating antigens were produced in our laboratory. Under optimal conditions, the cut-off limits were 250 ng mL-1 (IFM strip) and 500 ng mL-1 (IGM strip) in both 0.01 M phosphate-buffered saline (PBS) and samples of slimming tea. The mean recoveries were 96.2 to 104.7% for the IGM strip and 90.7 to 104.7% for the IFM strip. The data showed that the IFM strip was more sensitive than the IGM strip and that results could be generated within 10 min. Consequently, this novel technique represents a rapid and convenient method with which to detect phenolphthalein.

A critical comparison of vacuum UV (VUV) spectrometer and electron ionization single quadrupole mass spectrometer detectors for the analysis of alkylbenzenes in gasoline by gas chromatography: Experimental and statistical aspects

Recent advances in benchtop vacuum ultraviolet (VUV) spectrometers have yielded effective universal detectors for gas chromatography (GC). The ability of these detectors to acquire absorbance spectra from 125 nm to 430 nm poses an alternative to the gold standard of mass spectrometry (MS) as a sensitive and selective GC detector. The applications of GC/VUV extend into many areas. Featured here is the potential application of GC/VUV to the analysis of ignitable liquids, which may be found on debris from suspected arson fires. A particular compound class of interest is the alkylbenzenes, as they are a significant component in fuels such as gasoline, petroleum distillates, and aromatic solvents such as degreasers and cleaning solvents. To measure the sensitivity, selectivity and specificity of GC-VUV and GC-MS for alkylbenzenes we employed both library search methods and chemometric analysis using discriminant analysis. The GC-VUV detector was found to have superior specificity to the GC-MS detector in full scan mode. The GC-VUV detector was able to identify all alkylbenzenes correctly, including the correct identification of all structural isomers. LODs for both GC-VUV and GC-MS were found to be picograms on column.

A critical examination of the main premises of Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) consists of a plethora of therapeutic approaches aiming to both characterize and treat diseases. Its utilization has gained significant popularity in the western world and is even backed by the World Health Organization's decision to include TCM diagnostic patterns into the new revision of the International Classification of Diseases code, the global standard for diagnostic health information. As these developments and potentially far-reaching decisions can affect modern healthcare systems and daily clinical work as well as wildlife conservation, its underlying factual basis must be critically examined. This article therefore provides an overview of the evidence underlying the basic TCM concepts, such as Qi, meridians, acupuncture, pulse and tongue diagnostics as well as traditional herbal treatments. Moreover, it discusses whether scientific literature on TCM reflects the current standard for evidence-based research, as described in good scientific practice and good clinical practice guidelines. Importantly, misinformation regarding the therapeutic efficacy of animal-derived substances has lead and currently leads to problems with wildlife preservation and animal ethics. Nevertheless, the (re-)discovery of artemisinin more than 50 years ago introduced a novel development in TCM: the commingling of Eastern and Western medicine, the appreciation of both systems. The need for more rigorous approaches, fulfilment of and agreement to current guidelines to achieve high-quality research are of utmost relevance. Thereby, ancient knowledge of herbal species and concoctions may serve as a possible treasure box rather than Pandora's box.

A case of unexplained duodenal ulcer and massive gastrointestinal bleed

A 73-year-old man was displaying symptoms of massive gastrointestinal (GI) bleed. Surgical actions were performed to control the bleed caused by an erosive duodenal ulcer with duodenal perforation. When investigating the culprit of this case, the pain medications prescribed two weeks prior by a traditional Chinese medicine doctor raised attention. The patient's admission serum sample and the pain medications from unknown sources were analyzed using a clinically validated liquid chromatography-high-resolution mass spectrometry (LC-HRMS) method. The NSAIDs diclofenac, piroxicam, and indomethacin were identified, as well as some other synthetic drugs and natural products. The patient's concurrent exposure to multiple NSAIDs significantly increased the risk of upper GI complications. It is reasonable to argue that the high-dose use of the NSAIDs was a major cause of the duodenal ulcer and GI bleed. In addition, the identified natural products such as atropine and ephedrine have well-documented toxicities. It is important to increase the visibility of unregulated medications, and the capability to perform untargeted mass spectrometry analysis provides a unique diagnostic advantage in cases where exposure to toxic substances is possible.