Analysis of tobacco-specific nitrosamines in the common smokeless tobacco Afzal in Oman

Objectives: There is a lack of awareness regarding the carcinogenicity of Afzal, an illegal smokeless tobacco product [STP] widely used among the Omani youth. Previous research has shown that certain types of tobacco-specific nitrosamines [TSNAs] are associated with oral and lung cancers. This study therefore aimed to assess levels of four common TSNAs in a randomly selected sample of Afzal

Methods: This study was carried out at Sultan Qaboos University in Muscat, Oman, between April and September 2013. A random sample of Afzal was analysed for four types of TSNAs using high-performance liquid chromatography-tandem mass spectrometry. The four types of TSNAs analysed were 4-[N-nitrosomethylamino]-1-[3-pyridyl]-1-butanone [NNK], N-nitrosonornicotine [NNN], N-nitrosoanatabine [NAT] and N-nitrosoanabasine [NAB]. As a reference product, a sample of laboratory-manufactured American moist snuff [Centers for Disease Control and Prevention, Atlanta, Georgia, USA] was also used to confirm the accuracy and precision of the analysis

Results: The analysis revealed total TSNA levels of 3.573 micro g/g in the Afzal sample. Mean levels of NNN, NNK, NAT and NAB were 1.205, 1.015, 0.809 and 0.545 micro g/g, respectively

Conclusion: Levels of the two most abundant TSNAs [NNN and NNK] found in the Afzal sample exceeded international regulatory limits. Afzal users therefore need to be educated regarding the potential health risks associated with their STP use. Stricter implementation of current legislation is recommended to reduce the availability and usage of Afzal in Oman

Determination of heavy metals in the common smokeless Tobacco Afzal in Oman

Afzal is an illegally sold smokeless tobacco product [STP] commonly used by youths and teenagers in Oman. The aim of this study was to analyse the composition of Afzal, also commonly known as sweekah, as it is believed to contain many carcinogens and toxic components. In particular, Afzal's heavy metal content includes cadmium [Cd], chromium [Cr], lead [Pb] and nickel [Ni]. This study was conducted between March and June 2013. Three samples of Afzal were first dried and then ground to form a homogenous powder. The powder was digested prior to the heavy metal analysis by inductively coupled plasma-mass spectrometry [ICPMS]. Afzal was shown to have high levels of all heavy metals except for Ni and Pb, which were detected in quantities below acceptable international limits. The concentrations of the tested metals were 15.75 micro g/g, 1.85 micro g/g, 1.62 micro g/g and 1.57 micro g/g for Cr, Cd, Pb and Ni, respectively. The estimated daily intake of heavy metals from Afzal was below the maximum permissible limit accepted by the Food and Agriculture Organization and World Health Organization, except for Cr and Ni which were found to be dangerously elevated when compared with international standards. The results of this study showed that Afzal contains a number of heavy metals that may cause health problems. Therefore, urgent regulation of the illegal sale of Afzal is needed at the national level in Oman along with a campaign to address public health education and awareness of Afzal and its health risks

[The] identification of Pompe disease mutations in archival tissues and development of a rapid molecular-based test

Pompe disease [glycogen storage disease type II] is a rare autosomal recessive lysosomal storage disease that is caused by acid alpha-glucosidase deficiency. Early enzyme replacement therapy can benefit infants with the disease but the diagnosis is complicated by the rarity of the disease and the heterogeneity of the clinical manifestations. In this study, DNA extracted from archival postmortem formalin-fixed paraffin-embedded tissues was used to identify Pompe disease mutations in Oman and develop a rapid molecular-based test. Intronic primers were designed to amplify short fragments [193-454 base pairs [bp]] from coding exons [2-20] and screen for mutations using direct sequencing [DS]. Two mutations known to cause severe disease were identified in two samples. One was a coding mutation, c.2560C>T [p.Arg854X], and the second was found at a splice acceptor site, c.1327-2A>G. Polymerase chain reaction- and restriction fragment length polymorphism-based tests were designed for the rapid genotyping of the identified mutations. These tests can facilitate prenatal diagnosis and help in identifying carriers in families with the identified mutations