Fatal Intoxications Due to Administration of Isosorbide Tablets Contaminated with Pyrimethamine

In January 2012, 664 cases of pyrimethamine toxicity and 151 deaths were reported among cardiac patients that had recently received free medicines from pharmacy of Punjab Institute of Cardiology, Lahore, Pakistan. These patients, ages ranged from 58 to 75 years, were prescribed simvastatin, clopidogrel, aspirin soluble, isosorbide mononitrate, and amlodipine. On examination of medications being given to them, it was found that a particular batch of isosorbide mononitrate tablets was contaminated with 50 mg pyrimethamine. Cardiac patients were taking isosorbide contaminated with pyrimethamine twice daily (100 mg pyrimethamine/day), whereas therapeutic dose of pyrimethamine for malaria is 25 mg/week. Postmortem urine, cardiac blood, and femoral blood specimens of three deceased males were submitted to author's laboratory for analysis. Postmortem toxicological analysis revealed that pyrimethamine concentration fell within the range of 1–10 μg/mL by liquid chromatography. Clinical, autopsy, histopathological, and toxicological findings strongly suggested toxicity due to pyrimethamine accumulation that resulted in deaths of these cardiac patients.     

Validation of the InnoXtract™ DNA extraction method for bone,teeth, and rootless hair

Forensic casework samples often include human hairs, teeth, and bones. Hairs with roots are routinely processed for DNA analysis, while rootless hairs are either not tested or processed using mitochondrial DNA. Bones and teeth are submitted for human remains identifications for missing persons and mass disaster cases. DNA extraction from these low templates and degraded samples is challenging. The new InnoXtract DNA extraction method utilizes magnetic beads that are optimized to bind small DNA fragments, as small as 100 base pairs, to purify high-yield DNA from compromised samples. This validation study evaluates InnoXtract's ability to obtain amplifiable DNA from samples such as rootless hairs and skeletal remains. Studies performed include sensitivity, stability, repeatability, reproducibility, non-probative samples, and comparison to standard organic extractions. Sensitivity studies demonstrate average yield recoveries ranging from 53% to 100% and 73% to 85% for the InnoXtract hair and bone methods, respectively. Studies demonstrate consistent results across a range of sample types, such as insulted and un-insulted bone and teeth, as well as hair shafts from donors of various ages, gender, race, and hair characteristics. The InnoXtract bone method outperformed organic extraction. The method was successfully automated on a MagMAX™ Express-96, with recoveries over 70% relative to the manual version. InnoXtract has the potential as an automated high-throughput, high-yield bone extraction method with 6 h of total extraction time for up to 96 samples. The validation study results demonstrate that the InnoXtract kits produce high-yield and high-quality DNA from compromised bone, teeth, and hair shaft samples.     

Adaptation vs. development: basic services for building resilience

In a transect along Indus River after the 2010 floods in Pakistan, this article explores the relationship between the use and duration of use of basic services, among those who recovered well and those who did not, using non-parametric statistical testing in a quasi-experimental design. The research shows a clear and strong correlation between access and duration of usage of certain services before the disaster, and the rate of recovery in each location. This analysis demonstrates a relatively robust and cost-effective methodology to identify and prioritise development interventions that build resilience against climatic shocks that are not undertaken at the cost of poverty reduction.     

Corruption and the Decline of the State in Pakistan

Pakistan is generally included in most discussions of ‘failing states’ that pose the maximum danger to global security, with the rise of Islamic militancy being the most commonly cited reason for the ‘failure’. However, Islamic militancy is a result of impending state failure, not a cause of it. This article argues that the state's inability, caused by decades of systemic corruption, to provide any appreciable level of public goods or services, broadly defined, is responsible for the delegitimization of the state and its inability to maintain law and order in the cities or suppress Islamist insurgents in the rest of the country.     

Development of Rapid and Economical Colorimetric Screening Method for p‐Phenylenediamine in Variety of Biological Matrices and its Application to Eleven Fatal Cases of p‐Phenylenediamine Poisoning

A rapid colorimetric method for detection of p‐phenylenediamine (PPD) in various biological samples is developed. The o‐cresol test for acetaminophen detection has been modified to detect PPD in blood, urine, gastric contents, and liver. After precipitating protein with trichloroacetic acid solution (2 mL, 10% w/v), biological specimens were required to convert PPD metabolites to PPD by acid hydrolysis. Finally, o‐cresol solution (1 mL, 1% w/v), hydrogen peroxide (200 μL, 3%v/v), and concentrated ammonium hydroxide (0.5 mL) were added in the biological samples. The presence of PPD was indicated by formation of violet color which was turned to bluish green color within 10–15 min. The limit of detection was found to be 2 mg/L in blood, urine, and gastric contents and 2 mg/Kg in liver. This method is also free from any potential interference by p‐aminophenol, acetaminophen, and other amine drugs under test conditions. This method was successfully employed to thirteen fatal cases of PPD poisoning.     

The Organisation of Drug Supply: South Asian Criminal Enterprise in the UK

This paper examines the structure and modus operandi of South Asian criminal organisations operating in the UK. It is based on empirical research conducted between 2005 and 2006 among prisoners sentenced for drug offences, a number of drug distributors operating in the market, and observers with a knowledge of the drugs business working for the police force or for rehabilitation services. First, the paper offers an overview of the debate on organised crime, and after a methodological note, the research findings are utilised to propose a typology. Hypotheses are formulated around the illicit drug enterprises involved in British markets. Finally, the implications for law enforcement with respect to these enterprises are discussed.

Female student athletes’ perceptions of acceptability and the occurrence of sexual-related behaviour by their coaches in India

The current study assessed the perceptions of acceptable sexual behaviour of coaches and the occurrence of sexual harassment among female student in India. A sample of 180 Indian female student-athletes at intercollegiate and inter-university levels with male coaches participated in this study. A questionnaire on sport-specific Touch and Behaviour versus Unwanted Intimacy from coaches (Vanden Auweele et al., 2008), consisting of 41 items on a 5-point rating scale was used. The participants were asked to indicate the acceptability of specific coaching behaviour as well as the occurrence of the behaviour represented in each item. The acceptability of the behaviour was determined by means and standard deviations, while the occurrence was determined by frequencies. Factor analysis was performed to determine the structure of the coaches’ behaviour and athletes’ acceptability thereof, which yielded four factors. Cronbach’s alpha was used to determine the internal consistency of the extracted items on each factor. Two factors, namely, unwanted sexual behaviour and inappropriate verbal and physical sexual behaviour, were regarded by athletes as very serious and unacceptable coach behaviour, while a third factor represented context-dependent suspicious behaviour (a grey area in which athletes differ in their opinion) and was perceived to be serious and unacceptable. A fourth factor represented acceptable behaviour. The occurrence of very serious and unacceptable behaviour was reported by 31% of the female athletes.