determination of 25-OH vitamin [D2/D3] in human serum by liquid chromatography tandem mass spectrometry with comparison to IDS enzyme immunoassay

The proper assessment of the status of vitamin D requires the accurate measurement of both 25-OH vitamin D2 and 25- OH vitamin D3, which collectively constitute 25-OH vitamin D, the best indicator of vitamin D status. Currently, numerous assay methods are available for 25-OH vitamin D measurement but their comparability is uncertain. We employed isotope dilution liquid chromatography coupled with tandem mass spectrometry [ID-LC-MS/MS] to quantify 25-OH vitamin D2 and 25-OH vitamin D3 in human serum. Hexadeuterium labeled 25-OH vitamin D3 internal standard was added to calibrators, controls prepared in 6% bovine serum albumin in phosphate buffered saline, and patients' sera. Zinc sulphate was added to release 25-OH vitamin D metabolites for vitamin D binding protein, followed by a precipitation step with the addition of acetonitrile. Subsequent online phase extraction by trap column followed by chromatographic separation on a C-8 column using a water/acetonitrile gradient was employed. Detection was performed using Atmospheric Pressure Chemical Ionization [AP-CI] in a Multiple Reaction Monitoring [MRM] mode. The method was linear from 4 to 70 ng/mL. The intra and inter-day CV% were

Alcohol and psychoactive drugs in road traffic fatalities within northern district of Amman

Several studies have demonstrated that alcohol and psychoactive drugs consumption are important risk factors underlying fatal accidents. This paper presents a prospective and a pilot study for toxicological findings in road traffic accident fatality victims within the northern district of Amman in order to have an overall picture of the occurrence of these substances in the victims in Jordan. Over a two-year period [2004-2005], 400 autopsies were conducted at Jordan University Hospital in which 94 [23.5%] were road traffic accident fatality victims. Biological specimens from these victims were collected. Toxicology screens for psychoactive drugs and alcohol were conducted on these specimens and the results were analyzed according to age, sex, and victim's status. The data showed that ethanol and psychoactive drugs were positive in 72.3%, n = 68 and for ethanol alone 23.4%, n = 22. The majority of victims were the driver [n = 29] and the highest percentage of positive findings occurred among them [20.2%, n=19] Males in the age group 19-29 were mostly involved [35.7%]. Detected psychoactive drugs were benzodiazepines, opioids, barbiturates and anti-depressants. None of the collected specimens were positive for illicit cocaine, amphetamines, or cannabis. The results of this study documented the presence of alcohol and psychoactive drugs in road traffic accident victims which could have some association between the uses of these substances and the accident involvement. However, due to some limitations, conclusions require further data collections, cooperation with related parties in Jordan, and utilizing simple and extended toxicological screens

Development of systematic toxicological analysis using GC-MS in the identification of drugs in blood for clinical and forensic purposes

A rapid auto-identification method was developed to reduce the time required for unknown detection in defined groups of compounds in postmortem biological materials. This was achieved by the creation of an excel sheet containing retention time and retention index of n-alkane mixture [C15 - C36]. Then, a calculated retention index and the retention time for a list of compounds with their target ion, two references ions and their ion ratios were saved in a new method table. The new system will automatically search for and identify any compound in the post-run Gas Chromatography - Mass spectrometry data. The developed method showed a high sensitivity and specificity

Poisoning in Jordan: analysis of three year data from Jordan national drug and poison information center

This study aims at analyzing the patterns of poisoning cases reported to the Jordan National Drug and Poison Information Center and emphasizes the roles and challenges faced by the center from a practical perspective. A retrospective analysis of a three year period 2006- 2008 was conducted depending on the data collected by the center. Analysis of data shows that a total of 914 inquiries were received by the center during the study period. More than 90% of the enquiries were from health care providers and 3.6% from the public that included victims and victims' relatives. The exposed population age ranged from less than 1 year to 80 years, with the highest incidence in children less or equal to 5 years [34.9%]. The most common reason of poisoning was unintentional [49.39%], followed by suicidal attempts [23.94%]. The highest incidence of poisoning was due to drugs which accounted for more than 42% of all exposures, where acetaminophen products were responsible for most of the cases within this category [13.4%]. The poisoning features in Jordan reflect mostly the incidences of poisoning within Amman- the capital of Jordan- in addition to other major cities in the country. Yet the center seeks more perception from the public, support from healthcare providers and verification from related governmental parties, which will enable the center to fulfill its duties according to international standards

Outbreak of methanol fatalities in Jordan

To investigate methanol poisoning from a national forensic perspective in Jordan. From 1st January 2006 to 31st December 2006 a total number of 1388 autopsies were carried out at the National Institute of Forensic Medicine; the medico legal and toxicology reports were probed for methanol related deaths. Variables abstracted included age, sex, circumstances of death, admission to hospital, principle cause of death, and blood methanol concentration. Seventeen cases of fatal methanol intoxication were reported, representing a mortality rate of 0.3 per 100,000. All deaths occurred in the last quarter of the year 2006, and all victims were males. The major outbreak of 11 cases [64.7%] occurred in October. The victims mean age was 36 years [24-56 years], the age group 21 -30 years accounted for 35.3% of the total cases. Eleven cases were found dead, 4 were admitted to hospital before death and 2 cases were brought to the forensic medicine institution due to fatal road traffic accident. Methanol concentration ranged from 46 to 645 mg/dl [mean 306 mg/100ml], no ethanol or drugs of abuse were detected. As alcohol intake propagates within Jordanian community, a significant increase in the number of fatal alcohol poisoning is expected. Jordanian society lacks the public awareness regarding the grave consequences of methanol intoxication. A prompt medical, legal and education plan should be implemented as soon as possible to save lives, and eradicate poisoning outbreaks

Nicotine content in tobacco used in hubble-bubble smoking

To determine the nicotine content of commonly used tobacco in hubble-bubble [HB] and compare it with that found in cigarettes. Analysis of nicotine content of 13 commercial brands of HB tobacco was carried out using gas chromatography over an 8 month period; November 2002 through to June 2003 at the Toxicology Laboratory, University of Jordan. A wide variation in nicotine content in all brands was noticed with an average of 8.32 mg/g tobacco, range [1.8-41.3 mg/g]. The average nicotine content in each HB head [20 gm] of unflavored tobacco was [713mg/head] and flavored tobacco has [67mg/head]. One head of unflavored tobacco has nicotine equivalent to 70 regular cigarettes. The addition of adulterations; honey, glycerin and other flavors in the process of preparing the flavored [Muasel] tobacco contributes to lowering the nicotine content in each gram of flavored tobacco. Smoking one head of flavored [Mua'sel] tobacco which contains on average one third of nicotine presented in 20 cigarettes [204mg/pack] usually resulted in a higher plasma nicotine level by 20%. Hubble-bubble smokers are not at a lesser risk from smoking than cigarette smokers in relation to nicotine dependence. The inability of water to trap significant amounts of chemical substances present in tobacco [especially nicotine] and the danger which might result from the combustion of additives like; glycerin, honey and other flavors could be a very important factor to extrapolate the damage resulting from HB smoking

Body fluid levels of fentanyl, pethidine and midazolam following their intravenous intake in a suicidal case

Level of fentanyl, pethidine and midazolam in body fluids were estimated after suspected drug overdose. The samples were obtained from different locations of a young female body during autopsy, which was performed on the following morning [about l8hrs after death]. Pathological examination disclosed recent venipuncture marks, congestion and edema in the lungs, kidneys, liver and brain. Toxicological analysis was conducted on blood, urine, stomach contents and the used syringes present beside the body. Levels of fentanyl, pethidine and midazolam in these fluids ranged 0-1.3, 2300-5600 and 280-490 ng/ml respectively. The cause of death Was attributed to drug intoxication. Pethidine was Present at toxic levels while fentanyl and midazolam were within their therapeutic levels. The combination of these drugs can produce additive central nervous system depression. The highest levels of these drugs were found in the stomach contents. This was explained by the weak basic properties of such drugs, where their converted ions [which occurred upon contact with the acidic medium of the stomach] were trapped there during the distribution phase and consequent increase of their concentrations