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Reihani A, Marboutian F, Aghebat–bekheir S, Reyhani A, Akhgari M. Diagnostic Aspects of Paraquat in the Forensic Toxicology: A Systematic Review. Acad Forensic Pathol 2024; 14:51-61. [PMID: 38778898 PMCID: PMC11107435 DOI: 10.1177/19253621231214008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Background Paraquat (N, N-dimethyl-4,4-bipyridinium dichloride) is a nonselective, fast-acting, and contact chemical herbicide used extensively for weed control. It has high acute oral toxicity, the ability to accumulate in the lungs, and a high potential for pulmonary fibrosis after its intoxication. The present systematic review focuses on evaluating diagnostic aspects of paraquat (PQ) in forensic toxicology. Methods Evaluation of the literature according to the following criteria: only human studies published from February 1971 to March 2022 which are in English on the following databases: 1) Medline/PubMed/MeSH search words: ((Methyl viologen [Title/Abstract]) OR (paraquat [MeSH Terms])) AND (forensic [Title/Abstract]); 2) Scopus Keywords related to the study aim included forensic toxicology, paraquat, Methyl viologen; 3) Web of Science. Keywords related to the study aim included forensic toxicology, paraquat, and Methyl viologen. Results Thirty full-text articles were included. The results of our review indicate plasma and urine are more used for identifying PQ, and liver, lung, and gastric fluid are important in postmortem cases. Preparation methods, including liquid-liquid extraction (LLE), solid-phase extraction, and acetonitrile-precipitated protein, are often required for removing interfering substances. Chromatographic methods, among other analytical techniques, are more sensitive, specific, and applicable. Conclusion Our review suggests that plasma, urine, and lungs should be prioritized in sampling. Solid-phase extraction has better recovery than LLE in many samples. Colorimetric methods are not used much today, and radioimmunoassay (RIA) has limited application despite its high sensitivity. Gas and liquid chromatography methods appear to offer the best approach for the analysis of PQ.
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Affiliation(s)
| | | | | | | | - Maryam Akhgari
- Maryam Akhgari, Pharm D, PhD, Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran,
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Mahdavi SA, Zamani N, McDonald R, Akhgari M, Kolahi AA, Gheshlaghi F, Ostadi A, Dehghan A, Moshiri M, Rahbar-Taramsari M, Delirrad M, Mohtasham N, Afzali S, Ebrahimi S, Ziaeefar P, Khosravi N, Kazemifar AM, Ghadirzadeh M, Farajidana H, Barghemadi T, Sadeghi F, Hadeiy SK, Hadipourzadeh M, Mesbahi J, Malekpour MR, Arabi M, Jamshidi F, Dadpour B, Hovda KE, Hassanian-Moghaddam H. A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic. Sci Rep 2022; 12:9741. [PMID: 35697919 PMCID: PMC9189800 DOI: 10.1038/s41598-022-14007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19–91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)—equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.
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Affiliation(s)
| | - Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rebecca McDonald
- SERAF, Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Gheshlaghi
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Ostadi
- Department of Internal Medicine, Sina Medical Research & Training Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Dehghan
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Morteza Rahbar-Taramsari
- Department of Forensic Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Delirrad
- Department of Forensic Medicine, School of Medicine, Food and Beverages Safety Research Center, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Neda Mohtasham
- Department of Pediatric Clinical Toxicology, Abuzar's Children Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Afzali
- Department of Forensic Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sara Ebrahimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Ziaeefar
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navid Khosravi
- Department of Emergency Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Hoorvash Farajidana
- Department of Emergency Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Tahereh Barghemadi
- Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farangis Sadeghi
- Clinical Development Research Unit, Seyad Shirazi Hospital, Golestan University of Medial Sciences, Gorgan, Iran
| | - Seyed Kaveh Hadeiy
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hadipourzadeh
- Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammad-Reza Malekpour
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Arabi
- Department of Family Medicine, Sari Medical School, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farkhondeh Jamshidi
- Department of Forensic Medicine and Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bita Dadpour
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Knut Erik Hovda
- The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Loghman-Hakim Hospital Poison Center, South Karegar Street, Kamali St, Tehran, Iran.
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Isazad M, Amirzehni M, Akhgari M. Highly efficient dispersive liquid-liquid microextraction assisted by magnetic porous carbon composite-based dispersive micro solid-phase extraction for determination of tramadol and methadone in urine samples by gas chromatography-mass spectrometry. J Chromatogr A 2022. [DOI: https://doi.org/10.1016/j.chroma.2022.462989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Isazad M, Amirzehni M, Akhgari M. Highly efficient dispersive liquid-liquid microextraction assisted by magnetic porous carbon composite-based dispersive micro solid-phase extraction for determination of tramadol and methadone in urine samples by gas chromatography-mass spectrometry. J Chromatogr A 2022; 1670:462989. [DOI: 10.1016/j.chroma.2022.462989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/19/2022] [Indexed: 12/13/2022]
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Hassanpour N, Zamani N, Akhgari M, Salimi A, Ahangar H, Phillips S, Hedayatshodeh M, Hassanian-Moghaddam H. Post-mortem blood lead analysis; a comparison between LeadCare II and graphite furnace atomic absorption spectrometry analysis results. J Forensic Leg Med 2022. [DOI: https://doi.org/10.1016/j.jflm.2022.102317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hassanpour N, Zamani N, Akhgari M, Salimi A, Ahangar H, Phillips S, Hedayatshodeh M, Hassanian-Moghaddam H. Post-mortem blood lead analysis; a comparison between LeadCare II and graphite furnace atomic absorption spectrometry analysis results. J Forensic Leg Med 2022; 86:102317. [DOI: 10.1016/j.jflm.2022.102317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/25/2022]
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Shadnia S, Shojaei Arani L, Bahmani K, Akhgari M, Farajidana H, Ghadirzadeh M, Hajiesmaeili M, Rezaie Mirghaed O. Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran. IJMTFM 2022. [DOI: https://doi.org/10.32598/ijmtfm.v12i1.36171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Outbreaks of methanol poisoning were observed during the COVID-19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluated demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran from March to April 2020. Methods: This cross-sectional study was accomplished at the Loghman-Hakim Hospital in Tehran on 80 patients who died of methanol toxicity. Demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests. Results: Men were significantly more involved than women (%85 vs. %15). There were no significant differences between other characteristics of male and female patients, including the time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain CT, and Intracerebral Hemorrhage ( ICH). Blood sugar, serum potassium, and liver function tests were higher than average in most of the patients. Conclusion: Our study showed that this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormalities in Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and Prothrombin Time (PT) were seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication.
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Shadnia S, Shojaei Arani L, Bahmani K, Akhgari M, Farajidana H, Ghadirzadeh M, Hajiesmaeili M, Rezaie Mirghaed O. Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran. IJMTFM 2022. [DOI: 10.32598/ijmtfm.v12i1.36171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Outbreaks of methanol poisoning were observed during the COVID-19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluated demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran from March to April 2020. Methods: This cross-sectional study was accomplished at the Loghman-Hakim Hospital in Tehran on 80 patients who died of methanol toxicity. Demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests. Results: Men were significantly more involved than women (%85 vs. %15). There were no significant differences between other characteristics of male and female patients, including the time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain CT, and Intracerebral Hemorrhage ( ICH). Blood sugar, serum potassium, and liver function tests were higher than average in most of the patients. Conclusion: Our study showed that this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormalities in Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and Prothrombin Time (PT) were seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication.
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Etemadi-Aleagha A, Akhgari M. Psychotropic drug abuse in pregnancy and its impact on child neurodevelopment: A review. World J Clin Pediatr 2022; 11:1-13. [PMID: 35096542 PMCID: PMC8771314 DOI: 10.5409/wjcp.v11.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/21/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023] Open
Abstract
Substance abuse by women of child-bearing age and fetal in utero drug exposure has increased in the number of infants born with health issues. Prenatal exposure to psychoactive substances can lead to neurological and neurodevelopmental deficits later in life. Useful data concerning the effects of psychoactive drugs on fetal neurodevelopmental status are sparse. Understanding the neurodevelopmental consequences of prenatally drug-exposed children has become a pressing global concern. The aim of this review is to gather current evidence and information on neurodevelopmental outcomes of in utero drug exposure. A literature search was performed on the PubMed, Scopus, and Google Scholar databases using the terms “psychotropic drugs”, “neurodevelopmental consequences”, “prenatal drug exposure”, and “pregnancy”. Available studies on in utero drug exposure were reviewed and found to support the idea that some degree of health issues are present in fetuses and children. Different psychoactive substances have profound neurodevelopmental consequences, such as structural brain changes, poor attention span, Down syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, imbalances in neurotransmitter levels, and many structural deficits. The pervasive use of psychoactive drugs in women of child-bearing age is an important health concern. Further scientific efforts are needed to investigate the effect of prenatal exposure to psychoactive drugs on children.
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Affiliation(s)
- Afshar Etemadi-Aleagha
- Department of Anesthesiology and Intensive Care, Tehran University of Medical Sciences, Tehran 1145765111, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran 1114795113, Iran
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Mahdavi SA, Kolahi AA, Akhgari M, Gheshlaghi F, Gholami N, Moshiri M, Mohtasham N, Ebrahimi S, Ziaeefar P, McDonald R, Tas B, Kazemifar AM, Amirabadizadeh A, Ghadirzadeh M, Jamshidi F, Dadpour B, Mirtorabi SD, Farnaghi F, Zamani N, Hassanian-Moghaddam H. COVID-19 pandemic and methanol poisoning outbreak in Iranian children and adolescents: A data linkage study. Alcohol Clin Exp Res 2021; 45:1853-1863. [PMID: 34487368 PMCID: PMC8653331 DOI: 10.1111/acer.14680] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023]
Abstract
Background During the first wave of COVID‐19, many Iranians were poisoned by ingesting hand sanitizers and/or alcoholic beverages to avoid viral infection. To assess whether the COVID‐19 pandemic resulted in an increased prevalence of accidental hand sanitizer/alcoholic beverage exposure in children and adolescents, we compared pediatric hospitalization rates during COVID‐19 and the previous year. For poisoning admissions during COVID‐19, we also evaluated the cause by age and clinical outcomes. Methods This retrospective data linkage study evaluated data from the Legal Medicine Organization (reporting mortalities) and hospitalization data from nine toxicology referral centers for alcohol‐poisoned patients (age 0 to 18 years) for the study period (February 23 to June 22, 2020) and the pre‐COVID‐19 reference period (same dates in 2019). Results Hospitalization rates due to ethanol and methanol exposure were significantly higher in 2020 (n = 375) than 2019 (n = 202; OR [95% CI] 1.9 [1.6, 2.2], p < 0.001). During COVID‐19, in patients ≤15 years, the odds of intoxication from hand sanitizers were significantly higher than from alcoholic beverages, while in 15‐ to 18‐year‐olds, alcoholic beverage exposure was 6.7 times more common (95% CI 2.8, 16.1, p < 0.001). Of 375 children/adolescents hospitalized for alcoholic beverage and hand sanitizer exposure in 2020, six did not survive. The odds of fatal outcome were seven times higher in 15‐ to 18‐year‐olds (OR (95% CI) 7.0 (2.4, 20.1); p < 0.001). Conclusion The Iranian methanol poisoning outbreak during the first wave of COVID‐19 was associated with significantly increased hospitalization rates among children and adolescents—including at least six pediatric in‐hospital deaths from poisoning. Public awareness needs to be raised of the risks associated with ingesting alcoholic hand sanitizers.
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Affiliation(s)
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Farzad Gheshlaghi
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Gholami
- Department of Pediatrics, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Mohtasham
- Department of Pediatric Clinical Toxicology, Abuzar's Children Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sara Ebrahimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pardis Ziaeefar
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rebecca McDonald
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Basak Tas
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Alireza Amirabadizadeh
- Cardiovascular Disease Research Center, Birjand University of Medical Sciences, South Khorasan, Iran
| | | | - Farkhondeh Jamshidi
- Department of Forensic Medicine and Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bita Dadpour
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Fariba Farnaghi
- Department of Pediatrics, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mahdavi SA, Kolahi A, Akhgari M, Gheshlaghi F, Gholami N, Moshiri M, Mohtasham N, Ebrahimi S, Ziaeefar P, McDonald R, Tas B, Kazemifar AM, Amirabadizadeh A, Ghadirzadeh M, Jamshidi F, Dadpour B, Mirtorabi SD, Farnaghi F, Zamani N, Hassanian‐Moghaddam H. COVID‐19 pandemic and methanol poisoning outbreak in Iranian children and adolescents: A data linkage study. Alcohol Res 2021. [DOI: https://doi.org/10.1111/acer.14680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Ali‐Asghar Kolahi
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Maryam Akhgari
- Legal Medicine Research Center Legal Medicine Organization Tehran Iran
| | - Farzad Gheshlaghi
- Department of Clinical Toxicology Isfahan Clinical Toxicology Research Center School of Medicine Isfahan University of Medical Sciences Isfahan Iran
| | - Narges Gholami
- Department of Pediatrics School of Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center Mashhad University of Medical Sciences Mashhad Iran
| | - Neda Mohtasham
- Department of Pediatric Clinical Toxicology Abuzar’s Children Medical Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Sara Ebrahimi
- School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Pardis Ziaeefar
- School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Rebecca McDonald
- National Addiction Centre Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Basak Tas
- National Addiction Centre Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | | | - Alireza Amirabadizadeh
- Cardiovascular Disease Research Center Birjand University of Medical Sciences South Khorasan Iran
| | | | - Farkhondeh Jamshidi
- Department of Forensic Medicine and Social Determinant of Health Research Center Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran
| | - Bita Dadpour
- Medical Toxicology Research Center Mashhad University of Medical Sciences Mashhad Iran
| | | | - Fariba Farnaghi
- Department of Pediatrics School of Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Nasim Zamani
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Clinical Toxicology Loghman Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hossein Hassanian‐Moghaddam
- Social Determinants of Health Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Clinical Toxicology Loghman Hakim Hospital School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
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Ahangar H, Karimdoost A, Salimi A, Akhgari M, Phillips S, Zamani N, Hassanpour N, Kolahi AA, Krieger GR, Hassanian-Moghaddam H. Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study. BMC Public Health 2021. [DOI: https://doi.org/10.1186/s12889-021-11494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities.
Methods
In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places.
Results
Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026).
Conclusion
Children’s playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.
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Ahangar H, Karimdoost A, Salimi A, Akhgari M, Phillips S, Zamani N, Hassanpour N, Kolahi AA, Krieger GR, Hassanian-Moghaddam H. Environmental assessment of pediatric Lead exposure in Tehran; a prospective cross-sectional study. BMC Public Health 2021; 21:1437. [PMID: 34289825 PMCID: PMC8296531 DOI: 10.1186/s12889-021-11494-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities. METHODS In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places. RESULTS Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p < 0.001) and interior windowsill dust lead level (median = 291, p = 0.011) were both significantly higher than the environmental protection agency (EPA) standards of 40 μg/ft2, 250 μg/ft2. Interior windowsill dust lead concentrations were significantly higher in industrial areas (p = 0.026). CONCLUSION Children's playing environment should be cleaned more often to reduce dust. Moreover, specific rules may need to be implemented for paint lead concentrations and air pollution, especially in industrial areas.
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Affiliation(s)
- Hedieh Ahangar
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Afsoon Karimdoost
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Amir Salimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
| | - Scott Phillips
- University of Colorado Anchutz Medical Campus, Rocky Mountain Poison & Drug Safety, Denver, CO and Washington Poison Center, Seattle, WA, USA
| | - Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Karegar Street, Tehran, Iran
| | - Nasibeh Hassanpour
- Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gary R Krieger
- Skaggs School of Pharmacy and Pharmaceutical Science, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Karegar Street, Tehran, Iran.
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Akhgari M. Determination of Methadone and Tramadol in Vitreous Humor Specimens Using Dispersive LiquidLiquidMicroextractionandUltraHighPerformance Liquid Chromatography. IJMTFM 2021. [DOI: 10.32598/ijmtfm.v11i1.31530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Drug abuse is spreading rapidly all over the world. Methadone and tramadol are among not only the most abused opioids but also important from the forensic point of view. Therefore, we need to devise a simple and sensitive method for the sample preparation and identification of abused drugs in postmortem specimens. Methods: A simple and rapid Dispersive Liquid-Liquid Microextraction (DLLME) technique coupled with Ultrahigh Performance Liquid Chromatography (UHPLC) was developed for the extraction and analysis of methadone and tramadol from postmortem vitreous humor samples. Different parameters affecting the extraction recovery, such as the type and volume of extraction and dispersion solvents, pH value, sensitivity, and specificity, were optimized and studied. Results: Under optimized conditions, the recovery ranges were 82.3%-89.6% and 85.4%-87.1% for methadone and tramadol, respectively. The linear range was 25-100 ng/mL for both methadone and tramadol with a correlation coefficient (R2) of more than 0.98. Limit of Detection (LoD) and Limit of Quantification (LoQ) were 3 and 8 ng/mL for methadone and 6 and 16 ng/mL for tramadol. The accuracy level of the methods for methadone and tramadol detection were 99.4%-100% and 99.7%-99.9%, respectively. The method was specific enough for the qualitative and quantitative determination of methadone and tramadol. Conclusion: The obtained results showed that DLLME combined with UHPLC is a fast and straightforward method for determining methadone and tramadol in postmortem vitreous humor specimens.
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Noroozi M, Akhgari M, Abdollahi A. Occupational Exposure to Paving Asphalt Fumes, Impact on Liver and Kidney Function Test Parameters. IJMTFM 2021. [DOI: 10.32598/ijmtfm.v11i1.29730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Asphalt is a mixture of aliphatic and aromatic hydrocarbons. It also contains different kinds of heavy metals. Hot mix asphalt emits hazardous volatile substances. Asphalt is used in many industries, causing serious adverse health effects for workers. Therefore, investigation of the health status of workers is of crucial importance. The present study aimed to assess the impact of asphalt vapor on hepatic and renal function tests parameters and the clinical parameters in road paving workers compared to healthy subjects. Methods: In a cross-sectional study, 41 road asphalt paving workers and 120 healthy non-exposed subjects were selected. The serum enzymes of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin, triglyceride, urea, and creatinine levels were assessed using diagnostic kits. A medical practitioner examined all subjects for any possible medical condition. Results: Liver and kidney function test parameters were significantly higher in road asphalt paving workers compared to their healthy counterparts (P<0.05 for all parameters). About 63% of workers exposed to asphalt fumes for more than 10 years showed cardiac, pulmonary, and metabolic complications. Conclusion: Significant elevations in liver and kidney function test parameters suggest that exposure to asphalt fumes is associated with hepatic and renal dysfunction in asphalt-exposed workers.
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Paknahad S, Akhgari M, Ghadipasha M. An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011-2018. Forensic Sci Med Pathol 2020; 17:208-215. [PMID: 33237521 DOI: 10.1007/s12024-020-00339-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
Methamphetamine is one of the most commonly abused illicit drugs in Iran. Despite this fact, there has been relatively little research on methamphetamine-associated deaths in Iran. The present study aimed to investigate the cause of death in methamphetamine positive cases based on forensic toxicology findings In this data base descriptive study, individuals with methamphetamine-associated deaths that were referred to the Legal Medicine Organization, Tehran, Iran (2011-2018) were assessed. Deaths including those from natural causes, toxicity, accident and suicides with positive forensic toxicology analyses for methamphetamine and its metabolite amphetamine in postmortem samples were investigated. All cases were examined to determine trends in methamphetamine-associated deaths, and in the manner and causes of deaths. During the eight year study there were 1389 methamphetamine-associated deaths. The mean age was 37.47±10.87 years, with a male/female ratio of 12.36:10. The methamphetamine-associated death rate increased significantly during the study period (2.05 vs. 21.93 per 106 Tehran province populations). The most common cause of death was cardiac arrest due to stimulant abuse with supportive histologic findings of acute myocardial infarction, myocardial fiber hypertrophy, aortic dissection and perivascular fibrosis (25%). Opioids (methadone, tramadol and morphine), tricyclic antidepressants and benzodiazepines were frequently present in postmortem samples of study cases. Methamphetamine-associated deaths significantly contribute to illicit drug-associated deaths in Tehran and represent a substantial clinical and public health problem.
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Affiliation(s)
- Somayeh Paknahad
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Masoud Ghadipasha
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Paknahad S, Akhgari M, Ghadipasha M. An alarming rise in the prevalence of deaths with methamphetamine involved in Tehran, Iran 2011-2018. Forensic Sci Med Pathol 2020. [DOI: https://doi.org/10.1007/s12024-020-00339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Akhgari M, Bahmanabadi L, Sardari Iravani FS, Jokar F. Forensic laboratory validation of immunochromatography and gas chromatography/mass spectrometry methods for the detection of methamphetamine and amphetamine in postmortem urine specimens. Toxicologie Analytique et Clinique 2020. [DOI: https://doi.org/10.1016/j.toxac.2020.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Akhgari M, Bahmanabadi L, Sardari Iravani FS, Jokar F. Forensic laboratory validation of immunochromatography and gas chromatography/mass spectrometry methods for the detection of methamphetamine and amphetamine in postmortem urine specimens. Toxicologie Analytique et Clinique 2020. [DOI: 10.1016/j.toxac.2020.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Jafarinejad M, Ezoddin M, Lamei N, Abdi K, Babhadi‐Ashar N, Pirooznia N, Akhgari M. Effervescent tablet‐assisted demulsified dispersive liquid–liquid microextraction based on solidification of floating organic droplet for determination of methadone in water and biological samples prior to GC‐flame ionization and GC‐MS. J Sep Sci 2020. [DOI: https://doi.org/10.1002/jssc.202000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Masoomeh Jafarinejad
- Department of Toxicology & PharmacologyFaculty of PharmacyPharmaceutical Sciences BranchIslamic Azad University (IAUPS) Tehran Iran
| | - Maryam Ezoddin
- Department of ChemistryPayame Noor University P.O. BOX 19395‐3697 Tehran Iran
| | - Navid Lamei
- Drug Design and Development Research CenterTehran University of Medical Sciences Tehran Iran
| | - Khosrou Abdi
- Department of RadiopharmacyFaculty of PharmacyTehran University of Medical Sciences Tehran Iran
- Iranian National Center for Addiction Studies (INCAS)Tehran University of Medical Sciences Tehran Iran
| | - Nima Babhadi‐Ashar
- Iranian National Center for Addiction Studies (INCAS)Tehran University of Medical Sciences Tehran Iran
| | - Nazanin Pirooznia
- Department of RadiopharmacyFaculty of PharmacyTehran University of Medical Sciences Tehran Iran
| | - Maryam Akhgari
- Forensic Toxicology DepartmentLegal Medicine Research CenterLegal Medicine Organization Tehran Iran
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Zamani N, Rafizadeh A, Hassanian-Moghaddam H, Akhavan-Tavakoli A, Ghorbani-Samin M, Akhgari M, Shariati S. Evaluation of methanol content of illegal beverages using GC and an easier modified Chromotropic acid method; a cross sectional study. Subst Abuse Treat Prev Policy 2019. [DOI: https://doi.org/10.1186/s13011-019-0244-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Methanol is highly toxic to human beings and naturally exists in some beverages. Having access to an easy and cheap method for its determination is of great importance to increase the safety of use of these beverages. Our main aim is to evaluate methanol concentration of some alcoholic beverages in Iran black market and compare it with the European and US standards. Also, we evaluated the efficacy of a newly designed and produced chemical kit in determining the risk of methanol toxicity by drinking of such samples compared to gas chromatography method.
Methods
Methanol content of suspected alcoholic beverages referred to forensic toxicology laboratory, Guilan province, Iran was measured using gas chromatography and a recently designed kit based on modified colorimetric chromotropic acid method.
Results
Of 1221 samples, 145 (11.9%) had no ethanol content, while in three samples (0.25%), methanol was high enough (700,000; 870,000; 920,000 mg/L) to cause severe methanol toxicity. Median [IQR] ethanol content of the suspected samples was 9% [3.7, 32.75]. Methanol was detected in 128 (10.48%) samples using gas chromatography method and 160 samples (13.1%) with designed kit with 100% sensitivity, 97.07% specificity, and 100% negative-predictive-value.
Conclusions
Alcoholic beverages produced in local black market in Iran are not safe at all. The application of the new method is practical, rapid, easy, and accurate to evaluate the risk of methanol toxicity in suspected alcoholic drinks.
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22
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Zamani N, Rafizadeh A, Hassanian-Moghaddam H, Akhavan-Tavakoli A, Ghorbani-Samin M, Akhgari M, Shariati S. Evaluation of methanol content of illegal beverages using GC and an easier modified Chromotropic acid method; a cross sectional study. Subst Abuse Treat Prev Policy 2019; 14:56. [PMID: 31842979 PMCID: PMC6916049 DOI: 10.1186/s13011-019-0244-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022]
Abstract
Background Methanol is highly toxic to human beings and naturally exists in some beverages. Having access to an easy and cheap method for its determination is of great importance to increase the safety of use of these beverages. Our main aim is to evaluate methanol concentration of some alcoholic beverages in Iran black market and compare it with the European and US standards. Also, we evaluated the efficacy of a newly designed and produced chemical kit in determining the risk of methanol toxicity by drinking of such samples compared to gas chromatography method. Methods Methanol content of suspected alcoholic beverages referred to forensic toxicology laboratory, Guilan province, Iran was measured using gas chromatography and a recently designed kit based on modified colorimetric chromotropic acid method. Results Of 1221 samples, 145 (11.9%) had no ethanol content, while in three samples (0.25%), methanol was high enough (700,000; 870,000; 920,000 mg/L) to cause severe methanol toxicity. Median [IQR] ethanol content of the suspected samples was 9% [3.7, 32.75]. Methanol was detected in 128 (10.48%) samples using gas chromatography method and 160 samples (13.1%) with designed kit with 100% sensitivity, 97.07% specificity, and 100% negative-predictive-value. Conclusions Alcoholic beverages produced in local black market in Iran are not safe at all. The application of the new method is practical, rapid, easy, and accurate to evaluate the risk of methanol toxicity in suspected alcoholic drinks.
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Affiliation(s)
- Nasim Zamani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Street, Tehran, Iran
| | - Ali Rafizadeh
- Departments of Nursing & Midwifery, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Street, Tehran, Iran.
| | | | | | - Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Shahab Shariati
- Department of Chemistry, Rasht Branch, Islamic Azad University, Rasht, Iran
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Zarghi A, Kebriaeezadeh A, Ahmadkhaniha R, Akhgari M, Rastkari N. Selective Liquid Chromatographic Method for Determination of Fluoxetine in Plasma. J AOAC Int 2019. [DOI: doi.org/10.1093/jaoac/84.6.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
A selective and sensitive liquid chromatographic method was developed for the determination of fluoxetine (FLU) in plasma. FLU was isolated from plasma by liquid–liquid extraction. The chromatographic separation was performed on an analytical 250 × 3.9 mm id Novapak C18 column (4 μm particle size) with an isocratic mobile phase consisting of phosphate buffer–acetonitrile–methanol–triethylamine (58 + 30 + 10 + 2, v/v) adjusted to pH 7. Using UV detection at 226 nm, the detection limit for FLU in plasma was 3 ng/mL. No interferences were found with tricyclic antidepressant drugs, which allows this method to be used in clinical studies. The calibration curve was linear over the concentration range of 10–200 ng/mL. The average recovery was about 80% for plasma. The inter- and intraday assay coefficients of variation were <8%.
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Affiliation(s)
- Afshin Zarghi
- Shaheed Beheshti University of Medical Sciences, Department of Pharmacy, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Reza Ahmadkhaniha
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Maryam Akhgari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Nooshin Rastkari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
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Zarghi A, Kebriaeezadeh A, Ahmadkhaniha R, Akhgari M, Rastkari N. Selective Liquid Chromatographic Method for Determination of Fluoxetine in Plasma. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.6.1735] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A selective and sensitive liquid chromatographic method was developed for the determination of fluoxetine (FLU) in plasma. FLU was isolated from plasma by liquid–liquid extraction. The chromatographic separation was performed on an analytical 250 × 3.9 mm id Novapak C18 column (4 μm particle size) with an isocratic mobile phase consisting of phosphate buffer–acetonitrile–methanol–triethylamine (58 + 30 + 10 + 2, v/v) adjusted to pH 7. Using UV detection at 226 nm, the detection limit for FLU in plasma was 3 ng/mL. No interferences were found with tricyclic antidepressant drugs, which allows this method to be used in clinical studies. The calibration curve was linear over the concentration range of 10–200 ng/mL. The average recovery was about 80% for plasma. The inter- and intraday assay coefficients of variation were <8%.
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Affiliation(s)
- Afshin Zarghi
- Shaheed Beheshti University of Medical Sciences, Department of Pharmacy, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Reza Ahmadkhaniha
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Maryam Akhgari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Nooshin Rastkari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
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Zarghi A, Kebriaeezadeh A, Ahmadkhaniha R, Akhgari M, Rastkari N. Selective Liquid Chromatographic Method for Determination of Fluoxetine in Plasma. J AOAC Int 2019. [DOI: https://doi.org/10.1093/jaoac/84.6.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
A selective and sensitive liquid chromatographic method was developed for the determination of fluoxetine (FLU) in plasma. FLU was isolated from plasma by liquid–liquid extraction. The chromatographic separation was performed on an analytical 250 × 3.9 mm id Novapak C18 column (4 μm particle size) with an isocratic mobile phase consisting of phosphate buffer–acetonitrile–methanol–triethylamine (58 + 30 + 10 + 2, v/v) adjusted to pH 7. Using UV detection at 226 nm, the detection limit for FLU in plasma was 3 ng/mL. No interferences were found with tricyclic antidepressant drugs, which allows this method to be used in clinical studies. The calibration curve was linear over the concentration range of 10–200 ng/mL. The average recovery was about 80% for plasma. The inter- and intraday assay coefficients of variation were <8%.
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Affiliation(s)
- Afshin Zarghi
- Shaheed Beheshti University of Medical Sciences, Department of Pharmacy, Tehran, Iran
| | - Abbas Kebriaeezadeh
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Reza Ahmadkhaniha
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Maryam Akhgari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
| | - Nooshin Rastkari
- Tehran University of Medical Sciences, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran, Iran
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Fakoor M, Akhgari M, Shafaroodi H. Lead Poisoning in Opium-Addicted Subjects, Its Correlation with Pyrimidine 5'-Nucleotidase Activity and Liver Function Tests. Int J Prev Med 2019; 10:36. [PMID: 30967922 PMCID: PMC6425880 DOI: 10.4103/ijpvm.ijpvm_490_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/31/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Lead may be added to the opium by drug smugglers. It can cause elevated blood lead level (BLL) in opium-addicted patients. Erythrocyte pyrimidine 5′-nucleotidase (P5N) activity is susceptible to high BLL. The aim of this study was to find out whether opium-addicted patients show erythropathy and elevated liver enzymes explainable by high BLL and decreased P5N activity. Methods: Forty orally opium-addicted subjects and 40 normal healthy volunteers were enrolled in this study. BLL was measured in whole blood specimens using atomic absorption spectrometry instrumentation. Enzymatic activity, protein amount of P5N, and erythrocyte purine/pyrimidine ratio were determined. Blood films were analyzed for the presence of basophilic stippling of red cells and hemolytic anemia. The level of liver function enzymes was measured. Results: The mean BLL for opium-addicted patients was significantly higher than control group (P < 0.001). On the contrary, P5N activity showed a valid decrease in opium-addicted patients when compared with control group (P < 0.001). In line with repressed P5N activity, erythrocyte purine/pyrimidine ratio in patients was lower than control group (P < 0.001). A statistically significant reverse correlation was found between BLL and P5N activity (P < 0.05, r = −0.85). The prevalence of both basophilic stippling (P < 0.001, z = 6.62) and hemolytic anemia (P < 0.001, z = 6.52) in study population was significantly associated with elevated BLL. We could not find any significant correlation between serum level of liver enzymes and BLL. Conclusions: Opium-addicted patients in Tehran, Iran, are at high risk of lead poisoning which may result in hematologic problems and possibly hepatic damage.
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Affiliation(s)
- Mandana Fakoor
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Gharedaghi F, Hassanian-Moghaddam H, Akhgari M, Zamani N, Taghadosinejad F. Drug-facilitated crime caused by drinks or foods. Egypt J Forensic Sci 2018. [DOI: https://doi.org/10.1186/s41935-018-0100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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29
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Gharedaghi F, Hassanian-Moghaddam H, Akhgari M, Zamani N, Taghadosinejad F. Drug-facilitated crime caused by drinks or foods. Egypt J Forensic Sci 2018. [DOI: 10.1186/s41935-018-0100-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Saberi N, Akhgari M, Bahmanabadi L, Bazmi E, Mousavi Z. Determination of synthetic pharmaceutical adulterants in herbal weight gain supplements sold in herb shops, Tehran, Iran. Daru 2018; 26:117-127. [PMID: 30242673 PMCID: PMC6279663 DOI: 10.1007/s40199-018-0216-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/04/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Nowadays with the growing popularity of herbal remedies across the world, large sections of population rely on herbal drug practitioners for their primary care. Therefore there is a need to ensure about the safety of herbal drugs and to detect adulteration with undeclared active pharmaceutical ingredients. Herbal drugs are used as first-line drug therapy in some instances. Unfortunately even if there are claims as to be natural, undeclared active pharmaceutical ingredients have been detected in these supplements. OBJECTIVES The purpose of the present study was to analyse herbal weight gain drugs collected from herb shops located in Tehran, Iran to detect hidden pharmaceutical ingredients using UHPLC and GC/MS instrumentations. METHODS Sixty herbal drugs advertised as weight gain supplements were gathered from herb shops Tehran province, Iran. All samples were analysed from analytical toxicology point of view to detect undeclared active pharmaceutical ingredients. Method was validated for quantitative analysis of cyproheptadine and dexamethasone. RESULTS Method validity parameters showed good results for quantitative analysis of pharmaceutical ingredients. Cyproheptadine, dexamethasone, sildenafil, tramadol, caffeine and acetaminophen were detected in herbal weight gain drugs. Analysed dosage forms contained cyproheptadine and dexamethasone in concentrations higher than therapeutic doses. Quantitative analysis of contaminated drugs showed that the content of pharmacologic ingredients were 0.2-67 and 5.5-10.1 mg/tablet or capsule for cyproheptadine and dexamethasone respectively. CONCLUSIONS Despite natural supplements producers' claim, herbal weight gain drugs were not natural at all. Undeclared active pharmaceutical ingredients can predispose patients to health problems and even life-threatening situations. Graphical Abstract ᅟ.
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Affiliation(s)
- Niosha Saberi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Leila Bahmanabadi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Elham Bazmi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Zahra Mousavi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
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Abstract
This study aimed at describing demographic information of the deceased resulting from hanging by means of different methods of suicide. In this cross-sectional study, the file of suicide cases referred to the Central Legal Medicine Organization was investigated retrospectively. Of 1681 suicide cases, the highest suicide mode was hanging by 993 cases (57.4%) and intoxication by 674 cases (39%). The mean age of hanging was 36.22±15.76 and for other suicide methods it was 32.61±13.70 (P=0.000). Hanging was higher in males. Female victims used other methods like intoxication (P=0.000). The most common seasons for hanging were spring and winter. Toxicological analysis in cases of hanging was positive with opioid alkaloids in 95 cases (9/9%) and methamphetamine in 68 cases (7%). Intoxication with aluminum phosphide was in 35.8% of cases. Most of the cases (68.3%) were self-employed victims. A total of 534 (63%) cases were married. There was a statistically significant difference between hanging and other suicide modes concerning age, gender, occupation, marital status, and drug abuse history (P<0.001). The frequency of hanging was higher in males, marrieds, self-employed, unemployed and drug abusers. Students were victims of intoxication. Self-employed victims, unemployed victims and drug abusers were exposed to successful attempts more than others. Screening plans can be helpful in preventing suicide by prioritizing the people at risk.
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Affiliation(s)
- Maryam Ameri
- Department of Forensic Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Roya Kordrostami
- Department of Forensic Medicine, Iran University of Medical Sciences, Tehran, Iran
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Ameri M, Akhgari M, Kordrostami R. Demographic findings in suicidal hangings among Iranian population. J Emerg Pract Trauma 2018. [DOI: doi 10.15171/jept.2018.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study aimed at describing demographic information of the deceased resulting from hanging by means of different methods of suicide. In this cross-sectional study, the file of suicide cases referred to the Central Legal Medicine Organization was investigated retrospectively. Of 1681 suicide cases, the highest suicide mode was hanging by 993 cases (57.4%) and intoxication by 674 cases (39%). The mean age of hanging was 36.22±15.76 and for other suicide methods it was 32.61±13.70 (P=0.000). Hanging was higher in males. Female victims used other methods like intoxication (P=0.000). The most common seasons for hanging were spring and winter. Toxicological analysis in cases of hanging was positive with opioid alkaloids in 95 cases (9/9%) and methamphetamine in 68 cases (7%). Intoxication with aluminum phosphide was in 35.8% of cases. Most of the cases (68.3%) were self-employed victims. A total of 534 (63%) cases were married. There was a statistically significant difference between hanging and other suicide modes concerning age, gender, occupation, marital status, and drug abuse history (P<0.001). The frequency of hanging was higher in males, marrieds, self-employed, unemployed and drug abusers. Students were victims of intoxication. Self-employed victims, unemployed victims and drug abusers were exposed to successful attempts more than others. Screening plans can be helpful in preventing suicide by prioritizing the people at risk.
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Affiliation(s)
- Maryam Ameri
- Department of Forensic Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Roya Kordrostami
- Department of Forensic Medicine, Iran University of Medical Sciences, Tehran, Iran
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Saberi N, Akhgari M, Bahmanabadi L, Bazmi E, Mousavi Z. Determination of synthetic pharmaceutical adulterants in herbal weight gain supplements sold in herb shops, Tehran, Iran. Daru 2018. [DOI: doi.org/10.1007/s40199-018-0216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Akhgari M, Moradi F, Ziarati P. The Texture of Psychoactive Illicit Drugs in Iran: Adulteration with Lead and other Active Pharmaceutical Ingredients. J Psychoactive Drugs 2018; 50:451-459. [DOI: 10.1080/02791072.2018.1508791] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Fatemeh Moradi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Ziarati
- Department of Medicinal Chemistry, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
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Akhgari M, Moradi F, Ziarati P. The Texture of Psychoactive Illicit Drugs in Iran: Adulteration with Lead and other Active Pharmaceutical Ingredients. J Psychoactive Drugs 2018. [DOI: https://doi.org/10.1080/02791072.2018.1508791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Fatemeh Moradi
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Ziarati
- Department of Medicinal Chemistry, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
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Dastjerdi AG, Akhgari M, Kamali A, Mousavi Z. Principal component analysis of synthetic adulterants in herbal supplements advertised as weight loss drugs. Complement Ther Clin Pract 2018. [DOI: https://doi.org/10.1016/j.ctcp.2018.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Akhgari M, Amini-Shirazi N, Iravani FS. Forensic Toxicology Perspectives of Methadone-associated Deaths in Tehran, Iran, a 7-year Overview. Basic Clin Pharmacol Toxicol 2017; 122:436-441. [PMID: 29076627 DOI: 10.1111/bcpt.12930] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/20/2017] [Indexed: 02/02/2023]
Abstract
Methadone has a long history of pain relief and successful substitute for maintenance treatment in heroin and narcotic addiction. The aim of the study was to assess the trends of methadone-associated deaths in Tehran, Iran, in 2009-2015, from a forensic toxicology point of view. All methadone-associated deaths during this 7-year study period were evaluated according to demographic parameters and forensic toxicology analysis results. Results showed that 1274 cases of methadone-associated deaths were investigated during the study period. The incidence rate of methadone-associated deaths had risen 7.7 times in 2015 in comparison with 2009 (p < 0.05). The majority of cases were men (90.35%), aged from 20 to 40 years. About 80% of cases had shown positive results for other drugs and poisons in combination with methadone. Methamphetamine and tramadol were the most drugs detected in post-mortem samples. Death rates among methadone users in Tehran, Iran, increased year by year during 2009-2015. These findings raise the attention to the concomitant use of drugs with the need for changes in regulation and regulatory policy to restrict access and use of controlled drugs.
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Affiliation(s)
- Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Akhgari M, Amini-Shirazi N, Iravani FS. Forensic Toxicology Perspectives of Methadone-associated Deaths in Tehran, Iran, a 7-year Overview. Basic Clin Pharmacol Toxicol 2017. [DOI: https://doi.org/10.1111/bcpt.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maryam Akhgari
- Legal Medicine Research Center; Legal Medicine Organization; Tehran Iran
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Akhgari M, Jokar F, Etemadi-Aleagha A, Ghasemi A. Discrimination Between Drug Abuse and Medical Therapy: Case report of a tranylcypromine overdose-related fatality. Sultan Qaboos Univ Med J 2017. [PMID: 28690895 DOI: 10.18295/squmj.2016.17.02.013 case report] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Farzaneh Jokar
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Afshar Etemadi-Aleagha
- Department of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghasemi
- Department of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, Iran
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Akhgari M, Jokar F, Etemadi-Aleagha A, Ghasemi A. Discrimination Between Drug Abuse and Medical Therapy: Case report of a tranylcypromine overdose-related fatality. Sultan Qaboos Univ Med J 2017. [DOI: doi.org/10.18295%2fsqumj.2016.17.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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41
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Akhgari M, Jokar F, Etemadi-Aleagha A, Ghasemi A. Discrimination Between Drug Abuse and Medical Therapy: Case report of a tranylcypromine overdose-related fatality. Sultan Qaboos Univ Med J 2017; 17:e213-e217. [PMID: 28690895 DOI: 10.18295/squmj.2016.17.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/23/2017] [Accepted: 03/09/2017] [Indexed: 12/29/2022] Open
Abstract
Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Farzaneh Jokar
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Afshar Etemadi-Aleagha
- Department of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghasemi
- Department of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, Iran
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Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. ACTA ACUST UNITED AC 2017; 25:15. [PMID: 28610598 PMCID: PMC5470324 DOI: 10.1186/s40199-017-0181-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/06/2017] [Indexed: 11/13/2022]
Abstract
Background Suicide ranks among the top ten causes of death in all age groups all over the world. There are many methods for committing suicide including self-poisoning, firearm and hanging. The aim of the present study was to provide an overview of self-poisoning related suicidal deaths with special focus on forensic toxicology analysis results in Tehran, Iran from 2011 to 2015. Methods All suspicious cases with the the history of self-poisoning were investigated to define the cause and manner of death under the supervision of forensic medicine practitioners. Postmortem samples were analysed in forensic toxicology laboratory to confirm the presence of drugs in cadaver of suicidal cases. Drugs and poisons were analysed using thin layer chromatography, high performance liquid chromatography, gas chromatography/mass spectrometry, headspace gas chromatography and gas chromatography equipped with nitrogen phosphorus detector. Demographic data were collected from autopsy reports of all cases with confirmed self-poisoning suicidal cause of death. Results Results showed that 674 cases of self-poisoning deaths were investigated during a five-year study period, of which 68.55% were male. The most often used suicide method was self-poisoning in young population. Phosphine gas liberated from aluminum phosphide tablets was the most toxic substance detected in postmortem samples (619 cases) followed by opioids, methamphetamine, organophosphates, cyanide and strychnine. Conclusion In conclusion self-poisoning suicidal death was predominant in young male population in Tehran, Iran. It seems that free access to suicide means such as drugs and poisons should be restricted by national and health authorities. Trial registration Not applicable.
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Affiliation(s)
- Roya Kordrostami
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
| | - Maryam Ameri
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ghadipasha
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Kamran Aghakhani
- Forensic & Legal Medicine Department, Iran University of Medical Sciences, Tehran, Iran
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Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. Daru 2017. [DOI: https://doi.org/10.1186/s40199-017-0181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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44
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Akhgari M, Mobaraki H, Etemadi-Aleagha A. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths. Daru 2017. [DOI: https://doi.org/10.1186/s40199-017-0170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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45
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Akhgari M, Mobaraki H, Etemadi-Aleagha A. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths. ACTA ACUST UNITED AC 2017; 25:5. [PMID: 28212679 PMCID: PMC5316196 DOI: 10.1186/s40199-017-0170-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Methamphetamine abuse is a worldwide health concern. Methamphetamine causes health hazards in many vital organs. It can cause damage to cardiac tissue via catecholamines release. Methamphetamine related deaths are becoming one of the most important problems in Iran. The purpose of the present study was to determine cardiac pathology in methamphetamine poisoning-related deaths. METHODS The study included 100 cases of methamphetamine poisoning-related deaths and 100 cases as control group. Toxicology analysis of liver, gastric content, bile, urine, blood and vitreous humor were conducted to detect drugs, poisons and alcohols using thin layer chromatography, gas chromatography/mass spectrometry, and high performance liquid chromatography. Positive toxicology analysis results except for amphetamine and methamphetamine were excluded from the study in order to omit interfering factors. The most striking features of cardiac damage were observed by light microscopy. RESULTS Methamphetamine and amphetamine were detected in either urine or gastric content samples. In all of the cases methamphetamine toxicity was determined to be a direct cause of death by forensic medicine practitioner. Cardiovascular pathology was noted in 68% of studied cases. The most common histopathologic features were myocardial fiber hypertrophy, mild, moderate to severe atherosclerosis and focal degeneration/necrosis. CONCLUSION The results of the present study indicate that cardiotoxicity is one of the major contributing factors in methamphetamine poisoning related deaths. Overall, the current study highlights the fact that cardiotoxic effects of methamphetamine can explain increasing reports of heart failure and consequently death in young abusers. TRIAL REGISTRATION Not applicable. Histopathological study of cardiac lesions in methamphetamine poisoning-related deaths.
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Affiliation(s)
- Maryam Akhgari
- Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Old Ghom Road, 500 meters after Beheste Zahra, 1816153141, Tehran, Iran.
| | - Homeira Mobaraki
- Department of Forensic Pathology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Abdali E, Javadi S, Akhgari M, Hosseini S, Dastan D. Chemical composition and biological properties of Satureja avromanica Maroofi. J Food Sci Technol 2017; 54:727-734. [PMID: 28298686 DOI: 10.1007/s13197-017-2512-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 12/29/2016] [Accepted: 01/25/2017] [Indexed: 10/20/2022]
Abstract
Satureja avromanica is an indigenous plant which is frequently used as a spice in Avraman-Kurdistan region of Iran. The present study aimed to investigate the chemical composition, antimicrobial and antioxidant properties of the S. avromanica. In addition, rosmarinic acid and total phenolic content of S. avromanica was assessed by spectrophotometric method and HPTLC. The essential oil and methanolic extract were isolated by hydrodistillation and maceration methods, respectively. A total of 32 compounds representing 98.6% of the essential oil were identified by GC-MS and GC-FID. The main constituents were n-pentacosane (23.8%), spathulenol (11.5%), β-bourbonen (11.3%) and n-docosane (11.0%). The antibacterial activity of samples were carried out by disc diffusion method and evaluate the minimal inhibitory concentration (MIC) essential oil and methanolic extract were found to be effective against Staphylococcus aureus, Bacillus cereus and Bacillus pumilus. The highest scavenging activity was found for methanolic extract of S. avromanica (21.58 µg/mL) and the total phenolics of methanolic extract of S. avromanica was 95.3 mg GAE/g. The rosmarinic acid content of S. avromanica methanolic extract was 0.83 mg/g plant. Antioxidant activity and rosmarininc acid content of S. avromanica suggests that the essential oil and methanolic extract of S. avromanica has great potential for application as a natural antimicrobial and antioxidant agent to preserve food.
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Affiliation(s)
- Elham Abdali
- Department of Toxicology and Pharmacology, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Shima Javadi
- Department of Toxicology and Pharmacology, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Seyran Hosseini
- Department of Nutrition, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dara Dastan
- Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Pharmacognosy and Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
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Abdali E, Javadi S, Akhgari M, Hosseini S, Dastan D. Chemical composition and biological properties of Satureja avromanica Maroofi. J Food Sci Technol 2017. [DOI: doi 10.1007/s13197-017-2512-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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48
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Foroughi MH, Akhgari M, Jokar F, Mousavi Z. Identification of undeclared active pharmaceutical ingredients in counterfeit herbal medicines used as opioid substitution therapy. AUST J FORENSIC SCI 2017. [DOI: https://doi.org/10.1080/00450618.2016.1273387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mohammad Hadi Foroughi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Farzaneh Jokar
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Zahra Mousavi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
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Foroughi MH, Akhgari M, Jokar F, Mousavi Z. Identification of undeclared active pharmaceutical ingredients in counterfeit herbal medicines used as opioid substitution therapy. AUST J FORENSIC SCI 2017. [DOI: 10.1080/00450618.2016.1273387] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mohammad Hadi Foroughi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
| | - Maryam Akhgari
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Farzaneh Jokar
- Forensic Toxicology Department, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Zahra Mousavi
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University (IAUPS), Tehran, Iran
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Bazmi E, Behnoush B, Akhgari M, Bahmanabadi L. Quantitative analysis of benzodiazepines in vitreous humor by high-performance liquid chromatography. SAGE Open Med 2016; 4:2050312116666243. [PMID: 27635251 PMCID: PMC5011391 DOI: 10.1177/2050312116666243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/02/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Benzodiazepines are frequently screened drugs in emergency toxicology, drugs of abuse testing, and in forensic cases. As the variations of benzodiazepines concentrations in biological samples during bleeding, postmortem changes, and redistribution could be biasing forensic medicine examinations, hence selecting a suitable sample and a validated accurate method is essential for the quantitative analysis of these main drug categories. The aim of this study was to develop a valid method for the determination of four benzodiazepines (flurazepam, lorazepam, alprazolam, and diazepam) in vitreous humor using liquid-liquid extraction and high-performance liquid chromatography. METHODS Sample preparation was carried out using liquid-liquid extraction with n-hexane: ethyl acetate and subsequent detection by high-performance liquid chromatography method coupled to diode array detector. This method was applied to quantify benzodiazepines in 21 authentic vitreous humor samples. Linear curve for each drug was obtained within the range of 30-3000 ng/mL with coefficient of correlation higher than 0.99. RESULTS The limit of detection and quantitation were 30 and 100 ng/mL respectively for four drugs. The method showed an appropriate intra- and inter-day precision (coefficient of variation < 10%). Benzodiazepines recoveries were estimated to be over 80%. The method showed high selectivity; no additional peak due to interfering substances in samples was observed. CONCLUSION The present method was selective, sensitive, accurate, and precise for the quantitative analysis of benzodiazepines in vitreous humor samples in forensic toxicology laboratory.
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Affiliation(s)
- Elham Bazmi
- Legal Medicine Research Center, Legal Medicine Organization, Forensic Toxicology Department, Tehran, Iran
| | - Behnam Behnoush
- Department of Forensic Medicine, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Akhgari
- Legal Medicine Research Center, Legal Medicine Organization, Forensic Toxicology Department, Tehran, Iran
| | - Leila Bahmanabadi
- Legal Medicine Research Center, Legal Medicine Organization, Forensic Toxicology Department, Tehran, Iran
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