The detection of drugs of abuse and pharmaceuticals in drinking water using solid-phase extraction and liquid chromatography-mass spectrometry

Pharmaceuticals and drugs of abuse including novel psychoactive substances (NPS) are emerging as newer contaminants in the aquatic environment. The presence of such pollutants has implications on the environment as well as public health and therefore their identification is important when monitoring water quality. This research presents a new method for the simultaneous detection of 20 drugs of abuse and pharmaceuticals in drinking water, including 15 NPS, three traditional illicit drugs and two antidepressants. The developed method is based on the use of solid-phase extraction (SPE) followed by liquid chromatography-mass spectrometry (LC-MS). The SPE recoveries for the majority of target analytes ranged between 62 and 107%. The method detection and quantification limits ranged between 0.01 and 1.09 ng/L and 0.02–3.64 ng/L respectively. Both instrumental and method precisions resulted in relative standard deviations <15.04%, with an accuracy of < ±8.66%. The results show that LC-MS can be an alternative to the more popular technique of liquid chromatography-tandem mass spectrometry for the analysis of drugs of abuse and pharmaceuticals in drinking water. This newly developed simultaneous detection method has been applied to drinking water collected from the East Anglia region of the UK. Citalopram, cocaine, fluoxetine, ketamine, mephedrone, methamphetamine and methylone were detected at the range of 0.14 and 2.81 ng/L. This is the first time that the two NPS mephedrone and methylone, have been detected in UK drinking water

Hemoglobin status in pregnant women for diagnosis of anemia, assessment of severity and its socio-demographic determinants in rural area of Kanpur district, Uttar Pradesh, India

Background: Anaemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. In India anaemia in pregnancy is a major health issue with adverse maternal and foetal outcome. Nutritional anaemia in pregnant women continues to be a cause of concern despite the fact that this problem is largely preventable and easily treatable. Objectives was to determine the prevalence and severity of anaemia in the pregnant women.Methods: Around 350 pregnant women in different trimesters of pregnancy were enrolled coming for the 1st time in outpatient department of Obstetrics and Gynaecology, in Rama Medical College Hospital and Research Centre, Kanpur from Janurary 2016 to December 2016. Information regarding age, age at marriage, age at 1st pregnancy, parity, Interval between previous and index pregnancy, no of abortions, educational status, dietary habits, Type of family, Socioeconomic status was collected in pre-designed structured schedule after taking written consent from pregnant women attending out-patient department. Haemoglobin estimation was done by auto analyser and anaemia was graded according to WHO criterion. Statistical analysis was done by percentages and proportions.Results: A high prevalence of anaemia, (87.71%) was observed in pregnant women. The current study shows (24.7%) cases of mild anaemia, (54.5%) cases of moderate anaemia, and (7.9%) of severe anaemia.Conclusions: A very high prevalence of anaemia in pregnancy needs awareness about late marriage, birth spacing, one or two child norm, antenatal care, green leafy vegetable in diet, mandatory regular supply of iron folic acid (IFA) tablets to adolescent and pregnant women along with correction of other nutritional deficiencies

A multifactorial critical appraisal of substances found in Drug Facilitated Sexual Assault cases

Drug-facilitated sexual assault (DFSA) is a sexual act in which the victim is unable to give or rescind consent due to intoxication with alcohol and/or drugs that have been self-administered (opportunistic DFSA) or covertly administered by the perpetrator (predatory DFSA). The drugs that are most commonly associated with DFSA are flunitrazepam and gamma-hydroxybutyric acid (GHB). They cause sedation and amnesia, are readily dissolved in beverages and are rapidly eliminated from the system. However, drugs such as amphetamine and cocaine, which are central nervous system (CNS) stimulants, have also been encountered in DFSA cases. This paper critically evaluates trend data from cohort studies, identifying drugs that have been detected in DFSA cases and reports on the differences in drugs used between opportunistic and predatory DFSA. This is the first time that a critical multifactorial review of drugs used in DFSA has been conducted. The pharmacology of each identified group of drugs is presented, showing why these compounds are of interest and used in the perpetration of DFSA. Furthermore, the pharmacology and mechanisms of action are described to explain how the drugs cause their effects. It is also apparent from this study that if meaningful data is to be exchanged between law enforcement agencies then it is necessary to agree on protocols for the collection of evidence and the drugs for which analysis should be performed and indeed on the analytical methods used

Simultaneous detection of controlled substances in waste water

This study presents a method of simultaneous detection of both traditional and newly emerged drugs of abuse in wastewater. The method is based on solid phase extraction and gas chromatography-mass spectrometry analysis. This analytical method separates 25 drugs from different classes including amphetamines, cathinones, tropane alkaloids, piperazines plus ketamine, amitriptyline, diazepam and morphine. In addition, newer compounds (methcathinone, mephedrone, butylone), and isomers (1-(2-methoxyphenyl) piperazine, 1-(4-methoxyphenyl) piperazine; 1-(2-flurophenyl) piperazine, 1-(4-flurophenyl) piperazine; 1-(3-trifluoromethylphenyl) piperazine, 1-(4-trifluoromethylphenyl) piperazine) have been separated, with greater sensitivity (×100 order of magnitude). This work reports the detection of butylone, mephedrone, 1-(4-methoxyphenyl) piperazine, 1-(2-flurophenyl) piperazine and 1-methyl-4-benzylpiperazine for the first time in waste water. This suggests that with changes in drug use patterns, constant monitoring of waste water entering treatment plants should be carried out and treatment processes need to be put in place for their removal

Use, abuse, and associated impacts of alcohol on health and crimes in Nepal

Alcohol is a socially acceptable and widely available drink in most countries. Its excessive consumption is linked to various health issues, increase in crime rate and even loss of life. This puts heavy strain in low-income countries like Nepal where full medical facilities are still out of reach for most of the population. Therefore, in this article, we have provided an overview of (i) the effect of alcohol on public health; (ii) trend data on alcohol seizures; (iii) alcohol (including methanol) positive forensic cases; and (iv) other alcohol associated crimes. Our analysis is drawn from a range of data types and sources, triangulating the collected data with alcohol specific academic and grey literature, a survey with students and insights from stakeholder engagements in Nepal. We have shown that alcohol has been associated with a range of health-related issues and crime types in Nepal. For example, alcohol was the most mentioned compound in the student survey (50.7%; n=418) followed by other drugs in Drugs Facilitated Sexual Assault cases. We have also discussed issues with adulteration, surrogates and sub-standard alcohol, highlighting the need for strict monitoring, regulations and extra vigilance about quality control of alcohol in circulation. This should be supported by public awareness campaigns on the use, abuse and impacts of alcohol

Saccharin and Sucralose Protect the Glomerular Microvasculature In Vitro against VEGF-Induced Permeability

Diabetic kidney disease (DKD) has become a global health concern, with about 40% of people living with type 1 and type 2 diabetes mellitus developing DKD. Upregulation of vascular endothelial growth factor (VEGF) in the kidney is a significant pathology of DKD associated with increased glomerular vascular permeability. To date, however, current anti-VEGF therapies have demonstrated limited success in treating DKD. Recent studies have shown that artificial sweeteners exhibit anti-VEGF potential. The aim of this study was therefore to assess the effects of aspartame, saccharin, and sucralose on VEGF-induced leak using an in vitro model of the glomerular endothelium. Saccharin and sucralose but not aspartame protected against VEGF-induced permeability. Whilst the sweeteners had no effect on traditional VEGF signalling, GC-MS analysis demonstrated that the sweetener sucralose was not able to enter the glomerular endothelial cell to exert the protective effect. Chemical and molecular inhibition studies demonstrated that sweetener-mediated protection of the glomerular endothelium against VEGF is dependent on the sweet taste receptor, T1R3. These studies demonstrate the potential for sweeteners to exert a protective effect against VEGF-induced increased permeability to maintain a healthy endothelium and protect against vascular leak in the glomerulus in settings of DKD

Merging Wildlife and Environmental Monitoring Approaches with Forensic Principles: Application of Unconventional and Non-Invasive Sampling in Eco-Pharmacovigilance

Pharmaceutical residues in the environment have the potential to harm wildlife. A population’s fragility or an animal’s secretive nature may preclude capture and the use of invasive/destructive sampling techniques that are typically used in a risk assessment. Conventionally favoured matrices gathered opportunistically from carcasses have a finite lifespan, thereby limiting the detection window. This multidisciplinary paper aims to promote the use of non-invasive approaches and optimize use of even the most degraded carcasses. We highlight a selection of promising alternative, unconventional and underutilized sample types that could be applied in environmental monitoring efforts and wildlife forensic investigations. With a focus on non-steroidal anti-inflammatory drugs (NSAIDs), now under increasing scrutiny in the freshwater and terrestrial environment, we first illustrate current sampling practices and gaps in knowledge by summarizing exposure of: 1) aquatic organisms to urban effluent discharged into waterways, and, 2) scavenging species to veterinary residues in livestock and other carrion. We then consider the merits and limitations of a range of alternative environmentally robust sample options that offer a broader detection interval for NSAIDs, with emphasis on hair, wool and feathers. The viability of eyes/ocular material, bone matter, fecal matter, injection sites, ingesta/pellets and scavenging/coprophagous insects are also discussed

The Impact of Decaffeinated Green Tea Extract on Fat Oxidation, Body Composition and Cardio-Metabolic Health in Overweight, Recreationally Active Individuals

This study investigated the effect of decaffeinated green tea extract (dGTE), with or without antioxidant nutrients, on fat oxidation, body composition and cardio-metabolic health measures in overweight individuals engaged in regular exercise. Twenty-seven participants (20 females, 7 males; body mass: 77.5 ± 10.5 kg; body mass index: 27.4 ± 3.0 kg·m2; peak oxygen uptake (O2peak): 30.2 ± 5.8 mL·kg−1·min−1) were randomly assigned, in a double-blinded manner, either: dGTE (400 mg·d−1 (−)-epigallocatechin−3-gallate (EGCG), n = 9); a novel dGTE+ (400 mg·d−1 EGCG, quercetin (50 mg·d−1) and α-lipoic acid (LA, 150 mg·d−1), n = 9); or placebo (PL, n = 9) for 8 weeks, whilst maintaining standardised, aerobic exercise. Fat oxidation (‘FATMAX’ and steady state exercise protocols), body composition, cardio-metabolic and blood measures (serum glucose, insulin, leptin, adiponectin, glycerol, free fatty acids, total cholesterol, high [HDL-c] and low-density lipoprotein cholesterol [LDL-c], triglycerides, liver enzymes and bilirubin) were assessed at baseline, week 4 and 8. Following 8 weeks of dGTE+, maximal fat oxidation (MFO) significantly improved from 154.4 ± 20.6 to 224.6 ± 23.2 mg·min−1 (p = 0.009), along with a 22.5% increase in the exercise intensity at which fat oxidation was deemed negligible (FATMIN; 67.6 ± 3.6%O2peak, p = 0.003). Steady state exercise substrate utilisation also improved for dGTE+ only, with respiratory exchange ratio reducing from 0.94 ± 0.01 at week 4, to 0.89 ± 0.01 at week 8 (p = 0.004). This corresponded with a significant increase in the contribution of fat to energy expenditure for dGTE+ from 21.0 ± 4.1% at week 4, to 34.6 ± 4.7% at week 8 (p = 0.006). LDL-c was also lower (normalised fold change of −0.09 ± 0.06) for dGTE+ by week 8 (p = 0.038). No other significant effects were found in any group. Eight weeks of dGTE+ improved MFO and substrate utilisation during exercise, and lowered LDL-c. However, body composition and cardio-metabolic markers in healthy, overweight individuals who maintained regular physical activity were largely unaffected by dGTE