RESUMO
Interpreting fatalities involving khat is challenging due to a lack of data on cathinone and cathine reference concentrations in postmortem tissues. This study investigated the autopsy findings and toxicological results of fatalities involving khat in Saudi Arabia's Jazan region from 1 January 2018 to 31 December 2021. All confirmed cathine and cathinone results in postmortem blood, urine, brain, liver, kidney, and stomach samples were recorded and analyzed. Autopsy findings and the manner and cause of death of the deceased were assessed. Saudi Arabia's Forensic Medicine Center investigated 651 fatality cases over four years. Thirty postmortem samples were positive for khat's active constituents, cathinone and cathine. The percentage of fatalities involving khat was 3% in 2018 and 2019 and increased from 4% in 2020 to 9% in 2021, when compared with all fatal cases. They were all males ranging in age from 23 to 45. Firearm injuries (10 cases), hanging (7 cases), road traffic accident (2 cases), head injury (2 cases), stab wounds (2 cases), poisoning (2 cases), unknown (2 cases), ischemic heart disease (1 case), brain tumor (1 case), and choking (1 case) were responsible for the deaths. In total, 57% of the postmortem samples tested positive for khat only, while 43% tested positive for khat with other drugs. Amphetamine is the drug most frequently involved. The average cathinone and cathine concentrations were 85 and 486 ng/mL in the blood, 69 and 682 ng/mL in the brain, 64 and 635 ng/mL in the liver, and 43 and 758 ng/mL in the kidneys, respectively. The 10th-90th percentiles of blood concentrations of cathinone and cathine were 18-218 ng/mL and 222-843 ng/mL, respectively. These findings show that 90% of fatalities involving khat had cathinone concentrations greater than 18 ng/mL and cathine concentrations greater than 222 ng/mL. According to the cause of death, homicide was the most common fatality involving khat alone (77%). More research is required, especially toxicological and autopsy findings, to determine the involvement of khat in crimes and fatalities. This study may help forensic scientists and toxicologists investigate fatalities involving khat.
RESUMO
Medico-legal tasks are not exclusive to forensic medical experts -any physician may face medico-legal issues in his career. Hence, the practice of medicine requires education in legal issues. In Saudi Arabia, there are 30 universities with medical colleges, but we do not know how they teach undergraduate forensic medicine and medico-legal issues. The aim of this study was to discover undergraduate training courses in forensic medicine in Saudi universities. We conducted a cross-sectional study involving all colleges of medicine in Saudi Arabia. A structured, self-administered questionnaire containing 13 items relating to the undergraduate forensic medicine course was distributed. Out of a total of 30 universities, 27 universities responded. Of these 27 universities, 16 (59.26%) teach forensic medicine to undergraduate medical students, and 11 (40.74%) do not teach forensic medicine in their undergraduate curriculum. Of the 27 universities that responded, none has a department of forensic medicine. Eleven universities that do not teach forensic medicine have no forensic medicine unit/division or faculty at all. Forensic medicine belongs to the pathology department in 11 universities, while it belongs to different departments in five universities. There is variation in teaching methods, years where the course is taught and length of the course. Practical and morgue visits take place in 7/16 (43.8%) universities, while 9/16 (56.3%) universities only teach the theoretical aspects of forensic medicine. All 16 universities teach forensic medicine only to medical students and do not teach it to students in other colleges such as dentistry and nursing.
