The interpretation of postmortem drug levels is complicated by changes in drug blood levels in the postmortem period, a phenomena known as postmortem drug redistribution. We investigated the postmortem redistribution of the heroin metabolites morphine and morphine-3-glucuronide in a rabbit model. Heroin (1mg/kg) was injected into anesthetised rabbit, after 1 hour an auricular vein blood sample was taken and the rabbit was euthanised. Following death rabbits were placed in a supine position at room temperature and divided into 3 groups namely 1) immediate autopsy, 2) autopsy after 30 minutes and 3) autopsy 24 h after death. Various samples which included femoral
Chewing khat leaves has been associated with several adverse health effects, and there are very few case reports of cardiotoxicity, stroke and death resulting from this. In addition, postmortem distribution of cathine and cathinone, active components of khat, are not yet fully clear. This postmortem case report aimed to identify and determine the concentration of cathine and cathinone in different body organs and green chewed plants found in the mouth of the deceased. Immunoassay and non-targeted GC-MS analysis showed that samples were only positive for amphetamine type stimulants. LC-MS/MS quantitative analysis confirmed that samples were positive for cathinone and cathine. The results showed that cathinone concentration was 0.03, 0.03, 0.06, 0.07, 1.85 and 31 μg/ml in brain, liver, blood, vitreous humor, stomach and chewed green plant, respectively. Whereas, the concentration of cathine was 0.31, 3.28, and 141 μg/ml in kidney, stomach and chewed green plant, respectively. Cathine and cathinone concentrations were found to be changed with respect to site of sampling. The results suggest that stomach and chewed green plants are considered as good samples to show the concentration for both cathine and cathinone at the time of death of the khat chewer. This paper reports a postmortem case whose death was suspected to be khat overdose. The deceased, a young
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.
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