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Neumann J, Dhein S, Kirchhefer U, Hofmann B, Gergs U. Effects of congeners of amphetamine on the human heart. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:4615-4642. [PMID: 38340182 PMCID: PMC11166837 DOI: 10.1007/s00210-024-02983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Central stimulatory and hallucinogenic drugs of abuse like amphetamine and most congeners of amphetamine can have cardiac harmful effects. These cardiac side effects can lead to morbidities and death. In this paper, we review current knowledge on the direct and indirect effects of these amphetamine congeners on the mammalian heart-more specifically, the isolated human heart muscle preparation. In detail, we address the question of whether and how these drugs affect cardiac contractility and their mechanisms of action. Based on this information, further research areas are defined, and further research efforts are proposed.
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Affiliation(s)
- Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 4, 06112, D-06097, Halle, Germany.
| | - Stefan Dhein
- Rudolf-Boehm Institut für Pharmakologie und Toxikologie, Universität Leipzig, Härtelstraße 16-18, D-04107, Leipzig, Germany
| | | | - Britt Hofmann
- Cardiac Surgery, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, D-06097, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 4, 06112, D-06097, Halle, Germany
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Oumer A. Khat consumption and undernutrition among adult population in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0299538. [PMID: 38652725 PMCID: PMC11037525 DOI: 10.1371/journal.pone.0299538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/12/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND In Ethiopia, malnutrition is a public health threat causing a significant burden of morbidity, mortality, and economic crisis. Simultaneously, khat consumption is alarmingly increasing among adults, yet it might contribute to the existing burden of malnutrition, where the current evidence is inconclusive. Hence, this review was to estimate the association between khat consumption and undernutrition among adults in Ethiopia. METHODS A comprehensive search for Google, Google Scholar, and PubMed, coupled with a thorough manual search of the literature, was done up to date, October 18, 2023, using relevant search terms: "impact," "effects," "khat chewing," "khat consumption," "Ethiopia," "nutritional status," and "undernutrition." An updated PRISMA guideline was used to select relevant literature. The extracted data was summarized in narrative summaries, descriptions, and meta-analyses. The risk of bias was assessed. The results are presented in forest plots and funnel plots to assess publication bias. A pooled effect size (odds ratio) with a 95% certainty level was reported. RESULTS While a total of 17 articles (n = 45,679) were included in the narrative review, only 15 articles were included in the quantitative meta-analysis. The majority of studies had a low and moderate risk of bias (based on risk of bias assessment tool), mainly due to unclear exposure assessment and high study heterogeneity. A total of 11 studies were cross-sectional studies (71%), three were comparative studies (17.4%), and three were case control studies (17.4%). There is a higher risk of publication bias as evidenced by the funnel plot. Overall, five studies were from the Oromia region, and three studies were conducted at the national level. Overall, chewing had been shown to significantly increase the risk of undernutrition by 53% (pooled OR = 1.53; 95% CI: 1.09-2.16) under a random effect model. Under the fixed effect model, higher weight was given to national-level studies with higher samples, where chewing contributed to a 12% increased risk of undernutrition (AOR = 1.12; 95% CI: 1.01-2.23). Hence, khat chewing could raise the odds of undernutrition by 12-53%. CONCLUSION There is evidence of an association between khat chewing and an increased risk of undernutrition among adults in Ethiopia, which highlights the need for public health interventions to address the potential adverse effects of khat chewing on nutritional status.
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Affiliation(s)
- Abdu Oumer
- School of Public Health, College of Medicine and Health Sciences, Haramaya University, Harar, Ethiopia
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Hailesellasie G, Oumer A, Asfaw A. Determinants of undernutrition among khat chewing and non-khat chewing male adults in Addis Ababa, Ethiopia: a comparative cross-sectional study. Sci Rep 2024; 14:4679. [PMID: 38409396 PMCID: PMC10897126 DOI: 10.1038/s41598-024-54471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
Khat chewing is a deep-rooted socio-cultural tradition that affects appetite, gastric emptying, and food intake, ultimately influencing nutritional status. Moreover, there is significant variation in lifestyles and ways of living among khat chewing and non-chewing people. However, there is limited evidence on the disaggregated determinants of undernutrition among khat chewers and non-chewers in Ethiopia. A community-based comparative cross-sectional study was conducted with 253 Khat-chewing and 249 non-chewing male adults in Addis Ababa, Ethiopia. Weight and height were measured under standard procedure and used to calculate the body mass index (BMI < 18.5 kg/m2 indicates undernutrition). Variables with p-values below 0.25 in the bi-variable analysis were entered into a multivariable logistic regression model to identify factors associated with undernutrition and to control confounding respectively. An adjusted odds ratio with 95% confidence interval was used to declare the presence and the strength of association between the independent and outcome variable. Statistical significance was declared at a p value of 0.05. In this study, a total of 138 (27.5%: 23.6-31.6%) adult males were undernourished; among them, 78 (32.0%) were khat chewers and 60 (23.9%) were non chewers. Christian religion (AOR = 1.49; 1.02-2.30), vegetable consumption (AOR = 1.69; 95% CI 1.12-2.55) and khat chewing (AOR = 1.60; 1.04-2.45) were independent risk factors for undernutrition. However, none of the above factors showed a statistically significant association among non-khat chewer male adults. In conclusion, undernutrition was a public health concern in male adults in the study area. Frequent consumption of fruits, vegetables and family size of the households were the independent predictors of undernutrition. The practical implication of identifying risk factors of undernutrition among chewers and non-chewers could be helpful in depicting the relevant risk factors by exposure category and helping to further refine intervention packages. In addition, focusing on interventions which can increase the availability and accessibility of fruits and vegetables are important to improve the nutritional status of adult male populations.
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Affiliation(s)
- Genene Hailesellasie
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, P.O. Box: 07, Gubre, Ethiopia
| | - Abdu Oumer
- School of Public Health, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | - Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, P.O. Box: 07, Gubre, Ethiopia.
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Arab AO, Alasmari F, Albaker AB, Alhazmi HA, Alameen AA, Alagail NM, Alwaeli SA, Rizwan Ahamad S, AlAsmari AF, AlSharari SD. Clavulanic Acid Improves Memory Dysfunction and Anxiety Behaviors through Upregulating Glutamatergic Transporters in the Nucleus Accumbens of Mice Repeatedly Exposed to Khat Extract. Int J Mol Sci 2023; 24:15657. [PMID: 37958641 PMCID: PMC10648086 DOI: 10.3390/ijms242115657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
Khat (Catha edulis) is an evergreen shrub whose buds and leaves give a state of delight and euphoria when chewed. Cathinone, an amphetamine-like stimulant that is among the active ingredients in khat, is able to downregulate glutamate transporter subtype I (GLT-1). Neurobehavioral dysfunctions such as altered locomotor activity, anorexia, and nociception have been observed in animals exposed to cathinone. Interestingly, treatment with a β-lactam antibiotic such as ceftriaxone, which upregulates GLT-1, normalizes cathinone-induced conditioned place preference, and alters repetitive movements in rats. However, little is known about the role of the glutamatergic system in memory dysfunction and anxiety-like behaviors in mice exposed to khat. We found here that clavulanic acid, a β-lactam-containing compound and GLT-1 upregulator, would modulate the neurobehavioral changes, including memory impairment and anxiety-like behaviors, associated with repeated exposure of mice to khat. Our data supported that clavulanic acid could improve memory impairment and anxiety-like behaviors through upregulating GLT-1 in the nucleus accumbens (NAc), an effect abolished with a selective GLT-1 blocker. This upregulation was associated with restored glutamate/cystine antiporter expression in the NAc using a Western blotting assay. Cathine and cathinone were identified in khat extract using the gas chromatography technique. Our work provides preclinical insight into the efficacy of β-lactam-containing compounds for the attenuation of neurobehavioral changes induced by khat exposure.
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Affiliation(s)
- Amal O. Arab
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Awatif B. Albaker
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Hassan A. Alhazmi
- Department of Pharmaceutical Chemistry and Pharmacognosy, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Alaa Alnoor Alameen
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Naser M. Alagail
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saleh A. Alwaeli
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Syed Rizwan Ahamad
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdullah F. AlAsmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Shakir D. AlSharari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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Olani AB, Decorte T. Perceived harms and protective behavioural strategies among khat chewers: a qualitative study in Jimma, Ethiopia. Harm Reduct J 2023; 20:155. [PMID: 37875920 PMCID: PMC10594897 DOI: 10.1186/s12954-023-00890-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND While there have been many previous studies focusing on the adverse effects of khat chewing, attempts to investigate the protective behavioural strategies (PBS) employed by the khat using population are rare. PBS are strategies that substance users employ to minimize or alleviate the possible negative consequences related to the behaviour. This study focuses on the harms that chewers associate with khat use, and the behavioural strategies they practise to prevent or minimize these harms. METHODS A community-based qualitative study was conducted using a snowball sampling technique to recruit a diverse sample of khat chewing participants (N = 102) in Jimma city, Ethiopia. Face-to-face in-depth interviews were carried out with the participants. RESULTS Participants identified a variety of harms likely to result from chewing khat. These include impacts on their finances, work, social life and health. The PBS that participants employed to avoid or minimize the risks were classified into four themes based on their temporal sequence with khat chewing sessions: prior to chewing, during chewing, after chewing and general PBS covering the whole of their khat chewing career. The PBS enable khat chewers to prevent or minimize the adverse health consequences of chewing, socialize and work without or with fewer difficulties and manage their economy successfully. CONCLUSION The study participants believe that khat-related harms are avoidable if khat users implement appropriate strategies prior to, during and after chewing, and if they apply PBS to khat-related factors (e.g. type, amount and frequency), set factors (e.g. reason for using and health behaviour) and setting factors (e.g. place of use, when used, with whom used and social norms) covering the whole of their khat chewing career.
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Affiliation(s)
- Amanti Baru Olani
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, 9000, Ghent, Belgium.
- Department of Sociology, Jimma University, Jimma, Ethiopia.
| | - Tom Decorte
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, 9000, Ghent, Belgium
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Wadia PM, Mathur V, Kukkle PL, Khanna JN. Task-specific oromandibular dystonia secondary to chewing Khat (Catha edulis)- A series of 35 cases. Parkinsonism Relat Disord 2023; 114:105806. [PMID: 37619301 DOI: 10.1016/j.parkreldis.2023.105806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The leaves of "Khat" (Catha edulis), an indigenous shrub of Yemen and Arabian Peninsula are habitually chewed by the inhabitants for psychostimulant properties. OBJECTIVE To describe a unique task specific Oro-mandibular dystonia (OMD) in Yemenese men, with a temporal association with chewing "Khat". METHODS Multicentric, retrospective analysis (2009-2020) of patients with OMD associated with "Khat" chewing, evaluating clinical features and response to Onabotulinum toxin A. RESULTS 35 Yemenese men with a negative family history, normal neuroimaging mean age of 44.31(±3.21) years and prolonged (20.31 ± 3.27 years) history of chewing Khat, around 5.16(±0.80) hours/day presented with OMD-20 jaw opening, 13 jaw closing and 2 mixed affecting chewing (n = 6), speech (n = 3), or both (n = 26). Additional lingual dystonia was seen in five. CONCLUSIONS Chewing of khat is a repetitive task involving the jaw musculature and may be one of the causative factors of this task specific OMD. Recognition can prevent disability in these regions.
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Affiliation(s)
- Pettarusp Murzban Wadia
- Movement Disorder Clinic, Department of Neurology, Jaslok Hospital and Research Centre, Mumbai, India.
| | - Vaibhav Mathur
- Movement Disorder Clinic, Department of Neurology, Jaslok Hospital and Research Centre, Mumbai, India
| | - Prashanth Lingappa Kukkle
- Center for Parkinson's Disease and Movement Disorders Clinic, Manipal Hospital, Miller's Road, Bangalore, India; Parkinson's Disease and Movement Disorders Clinic, Bangalore, India
| | - Jitendra N Khanna
- Department of Dentistry, Jaslok Hospital and Research Centre, Mumbai, India
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Nigussie K, Negash A, Sertsu A, Mulugeta A, Tamire A, Kassa O, Abdeta T, Dereje J. Khat chewing and associated factors among public secondary school students in Harar town, Eastern Ethiopia: a multicenter cross-sectional study. Front Psychiatry 2023; 14:1198851. [PMID: 37720900 PMCID: PMC10499630 DOI: 10.3389/fpsyt.2023.1198851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Background Khat is a huge, evergreen tree that grows at high altitudes throughout the Arabian Peninsula and in the region stretching from eastern to southern Africa. Cathinone, cathine, and norephedrine are psychoactive ingredients contained in khat. Ethiopian teenagers, especially those in secondary school, frequently use khat. This use of khat may lead to students frequently missing class and experiencing subpar academic performance. However, the study area lacks information regarding the prevalence of khat use and the factors associated with it. Objective This study's primary goal is to determine the prevalence of khat chewing and related factors among secondary school students in public schools in Harar, Eastern Ethiopia, in 2022. Methods A multicenter cross-sectional study design was employed from June 01-June 30, 2022, in three public secondary schools in Harar town in a sample of 485 students. Systematic random sampling was used to choose the study sample. Data were gathered using self-administered questionnaires, and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess khat chewing. Epidata version 4.6 was used to enter the data, while STATA version 14 was used to analyze them. To determine the factors related to khat chewing, bivariate and multivariate logistic regression analysis was conducted, and statistical significance was determined at a 95% confidence level with a P-value under 0.05. Results Out of 485 eligible participants, 455 responded to this survey, giving a response rate of 93.8%. Overall, 33.2% (95% CI: 29.2%-37.6%) of the sample's participants reported currently chewing khat. Age ranged from 20 to 25 years (AOR = 2.04; 95% CI: 1.19-3.48), male students (AOR = 7.03; 95% CI: 4.35-12.57), current alcohol user (AOR 6.48; 95% CI: 2.30-18.28), presence of chewer friends (AOR 3.86; 95% CI: 2.38-6.24), and depression (AOR 1.84, 95%CI: 1.02-3.30), were strongly associated with khat chewing at a p-value of < 0.05. Conclusion Khat chewing was very common among students in Eastern Ethiopia's public secondary schools. Ages between 20 and 25 years, being a male, being current alcohol users, having chewer buddies, and depression are all significantly linked to khat use. Thus, schools should create and implement audience-specific behavioral change communication to deter and stop students from chewing khat. Additionally, it is important to ban the sale of khat to young adults and adolescents, promote medical care for khat users, and foster peer advocacy for support services.
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Affiliation(s)
- Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Abiy Mulugeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Aklilu Tamire
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Obsan Kassa
- School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Jerman Dereje
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Ferdjallah A, Hassan M. Traditional Somali Diaspora Medical Practices in the USA: A Scoping Review. JOURNAL OF RELIGION AND HEALTH 2023; 62:2412-2435. [PMID: 34812997 DOI: 10.1007/s10943-021-01456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
Minnesota has the largest Somali diaspora in the world. Uniquely, the Minnesotan Somali diaspora utilizes traditional healing practices along with Western medicine. Therefore, medical providers who regularly interact with Somali patients must be aware of traditional healing practices. A scoping review inclusive of three databases (Embase Classic + Embase, Ovid MEDLINE, PsychINFO) was conducted. Fifty-eight studies met established criteria. Traditional medicine is performed with conventional medicine. Illnesses are acknowledged to be caused by a malfunctioning body, evil eye, and/or zar (possession). Examples of the utilization of dawo dhaqmeed (traditional practices) included ilko dacowo (dental enucleation), khat (catha edulis), guboow (use of a fire-heated object), cupping, xoq (scraping), xidhayn (female genital mutilation), duugto (massage), baan (nutrition), herbs, caano geel (camel milk), Qur'anic healing, prayer, zam zam (holy water), tahliil liquid (blessed water), and amulets. Practices ranged from benign to harmful. Identifying Somali traditional healing practices is the first step in understanding the health of the Somali community in Minnesota.
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Affiliation(s)
- Asmaa Ferdjallah
- Department of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, USA.
| | - Mohamed Hassan
- Division of Gastroenterology Hepatology and Nutrition, University of Minnesota, Minneapolis, USA
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Olani AB, Gerbaba M, Getnet M, Soboka M, Decorte T. Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base. Subst Abuse Treat Prev Policy 2023; 18:39. [PMID: 37370160 DOI: 10.1186/s13011-023-00545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Khat (Catha edulis) is a plant commonly found in the horn of Africa whose leaves are chewed for their psycho-stimulant effects. Several studies have demonstrated the association between khat use and mental health problems. Nevertheless, evidence is mixed and inconsistent, warranting further review of available studies. This scoping review is aimed at investigating the content and quality of evidence base on the associations between khat use and mental health disorders and suggesting avenues for further research. METHODS We used a scoping review methodology to map the existing evidence using PubMed, SCOPUS, Embase, and CINAHL databases. Primary studies focusing on the association between any pattern of khat use and any form of mental health disorders are included. The review focused on all age groups, any study design, all geographical locations, and any publication year. The terms used for searching eligible studies include khat, mental disorders, and various alternative terminologies. Narrative review is employed to present findings. RESULTS 7,121 articles were found, of which 108 were eligible, conducted across 12 different countries. The majority of the studies was done during the last ten years and the studies mostly employed cross-sectional design. About 10 different categories of mental health disorders have been identified as showing associations with khat use. Despite many contradictory findings between the studies, most of the evidence base suggests that khat use is associated with mental health disorders. Non-specific psychological distress is the most frequently mentioned mental health problem (reported in 26.9% of the studies). Khat use as a predictor variable is mostly assessed using a 'yes/no' category, and as a result, dose-dependent effects of khat use on mental health are not given much consideration. CONCLUSION Although most of the studies associate khat use with mental health disorders, the causal relationships are inconclusive given the cross-sectional design of the studies, and the presence of potential confounders and several forms of biases. Available studies also report contradictory findings. Further studies are recommended using prospective designs, standardized and valid measures of khat use, and focusing on specific types of mental health disorders.
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Affiliation(s)
- Amanti Baru Olani
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium.
- Department of Sociology, Jimma University, Jimma, P.O.Box 378, Ethiopia.
| | - Mulusew Gerbaba
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Masrie Getnet
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Tom Decorte
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium
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Shaikhain G, Gaballah M, Alhazmi A, Khardali I, Hakami A, Oraiby M, Alharbi S, Tobaigi M, Ghalibi M, Fageeh M, Albeishy M, Attafi I. Fatalities Involving Khat in Jazan, Saudi Arabia, 2018 to 2021. TOXICS 2023; 11:506. [PMID: 37368606 DOI: 10.3390/toxics11060506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
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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Affiliation(s)
- Ghassan Shaikhain
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohammed Gaballah
- Forensic Medicine Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Ahmad Alhazmi
- Forensic Medicine Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Ibrahim Khardali
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Ahmad Hakami
- Forensic Medicine Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Magbool Oraiby
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Sultan Alharbi
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohammad Tobaigi
- Forensic Medicine Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohammed Ghalibi
- Forensic Medicine Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohsen Fageeh
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohammed Albeishy
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Ibraheem Attafi
- Forensic Toxicology Services, Forensic Medical Center, Ministry of Health, Jazan 45142, Saudi Arabia
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11
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Dobšíková K, Javorská Ž, Paškan M, Spálovská D, Trembulaková P, Herciková J, Kuchař M, Kozmík V, Kohout M, Setnička V. Enantioseparation and a comprehensive spectroscopic analysis of novel synthetic cathinones laterally substituted with a trifluoromethyl group. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 291:122320. [PMID: 36634495 DOI: 10.1016/j.saa.2023.122320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
Recently, the number of structural modifications of synthetic cathinones has been growing making them the second largest group of new psychoactive substances in Europe. Although they are abused because of their various psychoactive effects, some compounds from this group also serve as pharmaceuticals. Since synthetic cathinones are chiral molecules with one chiral center, their biological, toxicological, and pharmacological properties may significantly differ according to their absolute configuration and enantiomeric excess. In this study, we have synthesized two substances bearing a pharmacologically interesting trifluoromethyl group and developed a chiral liquid chromatography method using a polysaccharide chiral stationary phase to separate the corresponding enantiomers of both these drugs. Subsequently, we utilized molecular spectroscopic methods including chiroptical (electronic circular dichroism and vibrational circular dichroism) and non-polarizable (infrared and ultraviolet absorption) spectroscopies. In combination with density functional theory calculations, we have obtained stable conformers of selected enantiomers in solution and their relative abundances, which we used to simulate their spectra. The experimental and calculated data have been used to elucidate the 3D structure of the enantiomerically pure compounds and assign the absolute configuration of all prepared compounds.
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Affiliation(s)
- K Dobšíková
- Department of Analytical Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - Ž Javorská
- Department of Organic Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - M Paškan
- Department of Organic Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - D Spálovská
- Department of Analytical Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - P Trembulaková
- Department of Analytical Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - J Herciková
- Department of Organic Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - M Kuchař
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic; Psychedelic Research Centre, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic
| | - V Kozmík
- Department of Organic Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - M Kohout
- Department of Organic Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic
| | - V Setnička
- Department of Analytical Chemistry, University of Chemistry and Technology, Technická 5, Prague 6 166 28, Czech Republic.
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12
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The impact of khat chewing on heart activity and rehabilitation therapy from khat addiction in healthy khat chewers. Sci Rep 2022; 12:22083. [PMID: 36543861 PMCID: PMC9772382 DOI: 10.1038/s41598-022-26714-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Khat is a flowering plant whose leaves and stems are chewed for excitement purposes in most of east African and Arabian countries. Khat can cause mood changes, increased alertness, hyperactivity, anxiety, elevated blood pressure, and heart diseases. However, the effect of khat on the heart has not been studied exclusively. The purpose of this study was to investigate the impact of khat chewing on heart activity and rehabilitation therapy from khat addiction in healthy khat chewers. ECG signals were recorded from 50 subjects (25 chewers and 25 controls) before and after chewing session to investigate the effect of khat on heart activity. In addition, ECG signals from 5 subjects were recorded on the first and eightieth day of rehabilitation therapy for investigating the effect of rehabilitation from khat addiction. All the collected signals were annotated, denoised and features were extracted and analysed. After chewing khat, the average heart rate of the chewers was increased by 5.85%, with 3 subjects out of 25 were prone to tachycardia. 1.66% QRS duration and 23.56% R-peak amplitude reduction were observed after chewing session. Moreover, heart rate variability was reduced by 19.74% indicating the effect of khat on suppressing sympathetic and parasympathetic nerve actions. After rehabilitation therapy, the average heart rate was reduced by 11.66%, while heart rate variability (HRV), QRS duration, and RR interval were increased by 25%, 3.49%, and 12.53%, respectively. Statistical analysis results also confirmed that there is a significance change (p < 0.05) in ECG feature among pre- and post-chewing session. Our findings demonstrate that, khat chewing raises heart rate, lowers heart rate variability, or puts the heart under stress by lowering R-peak amplitude and QRS duration, which in turn increases the risk of premature ventricular contraction and arrhythmia. The results also show that rehabilitation therapy from khat addiction has a major impact on restoring cardiac activity to normal levels.
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Impaired delay discounting and time sensitivity in methcathinone use disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:1595-1602. [PMID: 35091796 DOI: 10.1007/s00406-021-01372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022]
Abstract
Substance use disorder (SUD) is characterized by continued drug use despite adverse consequences. Methcathinone is a new type of psychoactive substance that is associated with high excitement and impulsive behaviors. However, it is unclear if individuals with methcathinone use disorders (MCUD) are with impaired decision-making ability. We analyzed the task performance in 45 male MCUD subjects and 35 male matched healthy controls (HC) with intertemporal decision-making task. Constant sensitivity discounting model was used to estimate potential changes in both discounting rate and time sensitivity. The results showed that MCUD individuals exhibited a higher delay discounting rate (p = 0.003, Cohen's d = 0.683) and reduced sensitivity to time (p < 0.001, Cohen's d = 1.662). The delay discounting rate was correlated to the first age for drug use (r = - 0.41, p = 0.004), and the time sensitivity was negatively correlated with the duration of abstinence (r = - 0.31, p = 0.036). We conclude that MCUD individuals are with impaired decision-making ability and time perception disturbances.
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Pinazo-Bandera JM, García-Cortés M, Segovia-Zafra A, Lucena MI, Andrade RJ. Recreational Drugs and the Risk of Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:5395. [PMID: 36358813 PMCID: PMC9657889 DOI: 10.3390/cancers14215395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/03/2023] Open
Abstract
Recreational or aesthetic drug use is a distinctive behavior of humans, principally attested in the last century. It is known that recreational and illegal drugs are major contributors to the universal morbidity rate worldwide. Many of these substances have a well-established hepatotoxic potential, causing acute or chronic liver injury, liver fibrosis and cirrhosis, but their implications for hepatocellular carcinoma or other varieties of liver tumors are little known. In this article, we perform an extensive literature review, aiming to provide updated information about recreational drug use and the risk of developing liver tumors. Khat use and pyrrolizidine alkaloid consumption (present in some natural plants) have been linked to liver cirrhosis. Kava intake is associated with different liver tumors in animal models but not in humans. Cannabis' potential to accelerate liver fibrosis in chronic hepatitis is controversial according to the existing data. Cigarette smoking is an important contributor to hepatocellular carcinoma, and anabolic androgen steroids are well-defined causes of a variety of liver cancers and other hepatic tumors. Long-term follow-up studies of subjects who have developed injuries in association with the use of recreational drugs are warranted so as to better define the risk of developing hepatocellular carcinoma in association with these substances and, thus, to implement health care policies to combat this preventable cause of cancer.
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Affiliation(s)
- José M. Pinazo-Bandera
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
| | - Miren García-Cortés
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
| | - Antonio Segovia-Zafra
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
- Service of Clinical Pharmacology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
| | - María Isabel Lucena
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
- Service of Clinical Pharmacology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
| | - Raúl J. Andrade
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
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Khat Abuse and Life-threatening Intestinal Ischemia. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Khat, a Cultural Chewing Drug: A Toxicokinetic and Toxicodynamic Summary. Toxins (Basel) 2022; 14:toxins14020071. [PMID: 35202099 PMCID: PMC8875844 DOI: 10.3390/toxins14020071] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 12/10/2022] Open
Abstract
Khat (Catha edulis) is a recreational, chewed herbal drug that has been used as a psychostimulant for centuries in East Africa and the Arabian Peninsula, namely in Somalia, Ethiopia, and Yemen. However, the growing worldwide availability of khat has produced widespread concern. The plant comprises a large number of active substances, among which cathinone, cathine, and norephedrine are the main constituents, which can be included in the group of sympathomimetics of natural origin. In fact, these compounds are amphetamine analogues, and, as such, they have amphetamine-like nervous system stimulant effects. Chewing the leaves gives people a sensation of well-being and increases energy, alertness, and self-confidence. The chronic use of khat is, however, associated with severe cardiac, neurological, psychological, and gastrointestinal complications. The psychological dependence and withdrawal symptoms of khat are the reasons for its prolonged use. The aim of this paper is to review current knowledge on the khat plant with toxicokinetic and toxicodynamic perspectives. Namely, this review paper addresses in vitro, in vivo, and human studies. The models used, as well as the concentrations and doses with the respective biological effects, are discussed. Additionally, the main drug interactions involved with khat are described.
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Alshahrani SA, Al-Qahtani WS, Almufareh NA, Domiaty DM, Albasher GI, Safhi FA, AlQassim FA, Alotaibi MA, Al-Hazani TM, Almutlaq BA. Oral cancer among Khat users: finding evidence from DNA analysis of nine cancer-related gene mutations. BMC Oral Health 2021; 21:626. [PMID: 34876124 PMCID: PMC8650367 DOI: 10.1186/s12903-021-01981-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/22/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Khat leaves contain the alkaloid cathinone. Research shows that khat might provoke toxicity, mutagenicity, as well as carcinogenicity. METHODS Two groups were identified as khat abusers and were categorized by abuse time and diagnosis of oral squamous cell carcinoma (OSCC). Here, 41 participants from Group 2 were short-term khat users, and 42 participants were long-term khat users. The control group included 30 healthy individuals. The coding exons included nine cancer-related genes and were analysed. The histopathological research was conducted with H&E staining along with the TP53 protein expression by implementing immunohistochemical analyses. RESULTS Here, 41 short-term khat users carried seven somatic mutations in four out of nine cancer-related genes: 29/41(70.73%) ARID1A, 24/41(58.53%) MLH1, 34/41(82.92%) PIK3CA and 36/41(87.80%) TP53. The 42 long-term khat users incorporated nine somatic mutations in five out of nin ecancer-related genes: 40/42(95.23%) ARID1A, 36/42(85.71%) ARID2, 29/42(69.04%) PIK3CA, 27/42(64.28%) MLH1, and 35/42(83.33%) TP53. Every khat user had somatic mutations related to OSCC affecting the gingiva and the lower lip. TP53 protein expression was confirmed in all immunohistochemical oral tests. Carcinoma was also positive in the histopathological analysis. CONCLUSIONS Khat is a mutagenic and carcinogenic plant that provoked OSCC among short-term khat users (<15 years of use) and long-term users (>15 years of use).
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Affiliation(s)
| | - Wedad Saeed Al-Qahtani
- Department of Forensic Sciences, College of Criminal Justice, Naif Arab University for Security Sciences, P.O. Box 6830, 11452, Riyadh, Saudi Arabia.
| | - Nawaf Abdulrahman Almufareh
- Department of Paediatric Dentistry and Preventive Dental Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Dalia Mostafa Domiaty
- College of Science, Department of Biology, University of Jeddah, P.O. Box 13151, 21493, Jeddah, Saudi Arabia
| | | | - Fatmah Ahmed Safhi
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | | - Tahani Mohamed Al-Hazani
- Department of Biology, College of Sciences and Humanities, Prince Sattam Bin Abdulaziz University, P.O. Box 83, 11940, Al-Kharj, Saudi Arabia
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18
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Tamene A. Occupational Contact Dermatitis in Employees of Large-Scale Narcotic Crop Farms of Ethiopia: Prevalence and Risk Factors. A Self-Reported Study Using the Nordic Occupational Skin Questionnaire. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211048378. [PMID: 34658622 PMCID: PMC8511918 DOI: 10.1177/11786302211048378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Occupational skin diseases are the second leading occupational disease, accounting for almost 25% of all missed workdays. Occupational contact dermatitis (OCD) accounts for 70% to 90% of all skin disorders in the workplace. Only a few occupational epidemiology studies have looked into the prevalence and risk factors of occupation-induced dermatitis among narcotic crop farm workers around the world. Related studies in Ethiopia are even fewer. METHODS A cross-sectional survey was conducted in the Dirashe district of Southern Ethiopia from March 23 to April 12, 2021. Data was collected using a standardized interviewer-administered questionnaire. The history of contact dermatitis was determined using the standardized Nordic Occupational Skin Questionnaire version 2002 (NOSQ-2002). A total of 578 farm laborers took part in the study, which was conducted using a systematic random sampling. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with occupational contact dermatitis. RESULT The prevalence of self-reported occupational contact dermatitis in the past 12 months among workers of large-scale Khat farms was (AOR: 67.80%, 95% CI [61.00, 76.23]). In the multivariable regression, being older (AOR: 5.51, 95% CI [1.79, 7.24]), working as a bundle binder (AOR: 5.74, 95% CI [2.12, 15.55]), not wearing personal protective equipment (PPE) (AOR: 2.50, 95% CI [1.64, 3.81]), and having poor knowledge of pesticides use, storage, and disposal methods (AOR: 2.50, 95% CI [1.64, 3.81]) were associated with occupational contact dermatitis. CONCLUSION Contact dermatitis caused by work is very common among Khat farm laborers. Measures to promote safe practices and reduce exposure to hazards, such as removing expired and/or banned chemicals, purchasing alternative pesticides that meet legislative requirements, job rotation and routine training of staff on safe practices, increasing safety signage, and performing risk assessments, as well as improving the quantity and quality of institutional protective equipment supplies may thus contribute to the enhancement of safe work practices.
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Affiliation(s)
- Aiggan Tamene
- Aiggan Tamene, Environmental Health Unit,
School of Public Health, College of Medicine and Health Sciences, Wachemo
University, P.O. Box 667, Hosaena, B51, Ethiopia.
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19
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Thomas AM, Cargile KJ, Lunn JA, Baker LE. Characterization of 3,4-methylenedioxypyrovalerone discrimination in female Sprague-Dawley rats. Behav Pharmacol 2021; 32:524-532. [PMID: 34397448 PMCID: PMC8371744 DOI: 10.1097/fbp.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
3,4-Methylenedioxypyrovalerone (MDPV), one of several synthetic cathinones, is a popular constituent of illicit 'bath salts'. In preclinical studies utilizing drug discrimination methods with male rodents, MDPV has been characterized as similar to both cocaine and 3,4-methylenedioxymethamphetamine-hydrochloride (MDMA). Whereas few drug discrimination studies have utilized female rats, the current study evaluated the discriminative stimulus effects of MDPV in 12 adult female Sprague-Dawley rats trained to discriminate 0.5 mg/kg MDPV from saline under a fixed ratio 20 schedule of food reinforcement. Stimulus substitution was assessed with MDPV and its enantiomers, other synthetic cathinones [alpha pyrrolidinopentiophenone-hydrochloride(α-PVP), 4-methylmethcathinone (4-MMC)], other dopamine agonists (cocaine, [+)-methamphetamine] and serotonin agonists [MDMA, lysergic acid diethylamide (LSD)] Stimulus antagonism was assessed with the dopamine D1 receptor antagonist, Sch 23390 and the D2 receptor antagonist, haloperidol. Cocaine and (+)-methamphetamine engendered full stimulus generalization to MDPV with minimal effects on response rate. LSD produced partial substitution, whereas MDMA and 4-MMC produced complete substitution, and all these serotonergic compounds produced dose-dependent response suppression. (S)-MDPV and α-PVP engendered full substitution with similar potency to the racemate, while (R)-MDPV failed to substitute up to 5 mg/kg. Both Sch 23390 and haloperidol attenuated the discrimination of low MDPV doses and essentially shifted the dose-response curve to the right but failed to block discrimination of the training dose. These findings are generally consistent with previous reports based exclusively on male rodents. Moreover, they confirm the contribution of dopaminergic mechanisms but do not rule out the possible contribution of other neurotransmitter actions to the interoceptive stimulus effects of MDPV.
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Affiliation(s)
- Angela M Thomas
- Department of Psychology, Western Michigan University, Kalamazoo, Michigan, USA
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20
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Yang CS, Chen XL. Research on esophageal cancer: With personal perspectives from studies in China and Kenya. Int J Cancer 2021; 149:264-276. [PMID: 33270917 PMCID: PMC8141013 DOI: 10.1002/ijc.33421] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/11/2022]
Abstract
The most common form of esophageal cancer (EC), esophageal squamous cell carcinoma (ESCC), is prevalent in many unindustrialized societies, among people with lower socioeconomic status and those who frequently use tobacco and alcohol. In some areas, ESCC mortality ranked top among all cancer. In this review, we begin with discussions of the extensive research on EC in Linxian in northern China that started 60 years ago and the recent studies in Kenya from our personal perspectives. Based on the results obtained from these studies and information from the literature, we summarize our current understanding about the risk factors for ESCC including lifestyle factors (smoking, alcohol, consumption of food and beverages at high temperature and other unhealthy habits), poor diet and nutritional insufficiencies and genetic susceptibility. Elimination or minimization of these environmental risk factors, as well as early detection and treatment of precancerous lesions, would be effective means for the prevention of ESCC. Current knowledge of molecular alterations in ESCC (gene mutations, hypermethylation and amplification or overexpression), as well as treatment of ESCC and the potential of targeted therapy, are also discussed. Finally, we propose effective approaches for the prevention of ESCC by adapting a healthy lifestyle, including a healthy diet that would also prevent other diseases. Community outreach, public education and international collaboration are important for achieving this public health goal.
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Affiliation(s)
- Chung S. Yang
- Department of Chemical BiologyErnest Mario School of Pharmacy, Rutgers, The State University of New JerseyPiscatawayNew JerseyUSA
| | - Xiaoxin Luke Chen
- Cancer Research Program, Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central UniversityDurhamNorth CarolinaUSA
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21
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Bulto LN, Magarey J, Rasmussen P, Hendriks JML. Awareness of heart disease and associated health behaviours in a developing country: a qualitative study. Nurs Open 2021; 9:2627-2636. [PMID: 34117843 PMCID: PMC9584483 DOI: 10.1002/nop2.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/07/2021] [Accepted: 05/27/2021] [Indexed: 11/08/2022] Open
Abstract
AIM The aim of this study was to explore awareness of heart disease and associated health behaviours. DESIGN A qualitative study was conducted using in-depth interviews. METHODS The study participants were patients with hypertension. Data analysis was guided by Braun and Clarke's steps of thematic analysis and using NVivo12 software. RESULTS A total of 18 patients with hypertension were interviewed. The patients had poor understanding of heart disease and were not concerned about developing heart disease in the future. Barriers to fruit and vegetable consumption were poor access, cost and sociocultural factors, whereas being busy, poor physical health and lack of access to an exercise facility were barriers to physical activity.
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Affiliation(s)
- Lemma N Bulto
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Adelaide Nursing School, University of Adelaide, Adelaide, SA, Australia
| | - Judy Magarey
- Adelaide Nursing School, University of Adelaide, Adelaide, SA, Australia
| | - Philippa Rasmussen
- Adelaide Nursing School, University of Adelaide, Adelaide, SA, Australia
| | - Jeroen M L Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.,Centre for Heart Rhythm Disorders, University of Adelaide, and Department of Cardiology Royal Adelaide Hospital, Adelaide, SA, Australia
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22
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Ahmed A, Ruiz MJ, Cohen Kadosh K, Patton R, Resurrección DM. Khat and neurobehavioral functions: A systematic review. PLoS One 2021; 16:e0252900. [PMID: 34111184 PMCID: PMC8192015 DOI: 10.1371/journal.pone.0252900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/24/2021] [Indexed: 12/09/2022] Open
Abstract
Background Khat is a plant that is used for its amphetamine-like stimulant properties. However, although khat is very popular in Eastern Africa, Arabian Peninsula, and the Middle East, there is still a lack of studies researching the possible neurobehavioral impairment derived from khat use. Methods A systematic review was conducted to identify studies that assessed the effects of khat use on neurobehavioral functions. MedLine, Scopus, Cochrane, Web of Science and Open Grey literature were searched for relevant publications from inception to December 2020. Search terms included (a) khat and (b) several cognitive domains. References from relevant publications and grey literature were also reviewed to identify additional citations for inclusion. Results A total of 142 articles were reviewed, 14 of which met the inclusion criteria (nine human and five rodent studies). Available human studies suggest that long term khat use is associated with significant deficits in several cognitive domains, including learning, motor speed/coordination, set-shifting/response inhibition functions, cognitive flexibility, short term/working memory, and conflict resolution. In addition, rodent studies indicated daily administration of khat extract resulted in dose-related impairments in behavior such as motor hyperactivity and decreased cognition, mainly learning and memory. Conclusions The findings presented in this review indicates that long-term khat use may be contributing to an impairment of neurobehavioral functions. However, gaps in literature were detected that future studies could potentially address to better understand the health consequences of khat use.
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Affiliation(s)
- Ayan Ahmed
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
- * E-mail:
| | - Manuel J. Ruiz
- Department of Psychology, University of Extremadura, Badajoz, Badajoz, Spain
| | - Kathrin Cohen Kadosh
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Robert Patton
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
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23
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Jiang G, Tang S, Jiang Q. Drugs behind the veil of Islam: a view of Saudi youth. CRIME, LAW, AND SOCIAL CHANGE 2021; 76:299-319. [PMID: 33994666 PMCID: PMC8110685 DOI: 10.1007/s10611-021-09943-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
Insufficient research exists on drug trafficking and abuse in Saudi Arabia. This paper aims to uncover how drugs are trafficked to Saudi Arabia, what factors contribute to an ever-growing drug use in the Kingdom, and what the life of illegal drug use looks like in such an Islamic environment. Documentary methods and in-depth interviews were adopted to associate drug problems with social environments. It is discovered that drug trafficking is correlated to economic disparity among regions and social strata in the Kingdom, methods of drug purchase differ regionally, and drug use is an unintended consequence of social changes. The study concludes that drug offenses, countering traditional associations of Saudi society, creates a double life in the Kingdom.
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Affiliation(s)
- Guoping Jiang
- School of Public Administration, Nanchang University, Nanchang City, Jiangxi Province People’s Republic of China
| | - Siqi Tang
- School of Public Administration, Nanchang University, Nanchang City, Jiangxi Province People’s Republic of China
| | - Qizhen Jiang
- School of Public Administration, Nanchang University, Nanchang City, Jiangxi Province People’s Republic of China
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Tiruneh SA, Bukayaw YA, Yigizaw ST, Angaw DA. Prevalence of hypertension and its determinants in Ethiopia: A systematic review and meta-analysis. PLoS One 2020; 15:e0244642. [PMID: 33382819 PMCID: PMC7774863 DOI: 10.1371/journal.pone.0244642] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 12/14/2020] [Indexed: 02/08/2023] Open
Abstract
Introduction Hypertension is a major public health problem globally and it is a leading cause of death and disability in developing countries. This review aims to estimate the pooled prevalence of hypertension and its determinants in Ethiopia. Methods A systematic literature search was conducted at the electronic databases (PubMed, Hinari, and Google Scholar) to locate potential studies. Heterogeneity between studies checked using Cochrane Q test statistics and I2 test statistics and small study effect were checked using Egger’s statistical test at 5% significance level. Sensitivity analysis was checked. A random-effects model was employed to estimate the pooled prevalence of hypertension and its determinants in Ethiopia. Results In this review, 38 studies that are conducted in Ethiopia and fulfilled the inclusion criteria with a total number of 51,427 study participants were reviewed. The overall pooled prevalence of hypertension in the country was 21.81% (95% CI: 19.20–24.42, I2 = 98.35%). The result of the review also showed that the point of prevalence was higher among males (23.21%) than females (19.62%). When we see the pervasiveness of hypertension from provincial perspective; the highest prevalence of hypertension was observed in Addis Ababa (25.35%) and the lowest was in Tigray region (15.36%). In meta-regression analysis as the mean age increases by one year, the likelihood of developing hypertension increases by a factor of 0.58 times (β = 0.58, 95% CI: 0.31–0.86, R2 = 36.67). Male sex (OR = 1.29, 95% CI: 1.03–1.61, I2 = 81.35%), age > 35 years (OR = 3.59, 95% CI: 2.57–5.02, I2 = 93.48%), overweight and/or obese (OR = 3.34, 95% CI: 2.12–5.26, I2 = 95.41%), khat chewing (OR = 1.42, 95% CI: I2 = 62%), alcohol consumption (OR = 1.50, 95% CI: 1.21–1.85, I2 = 64%), family history of hypertension (OR = 2.56, 95% CI: 1.64–3.99, I2 = 83.28%), and family history of diabetes mellitus (OR = 3.69, 95% CI: 1.85–7.59, I2 = 89.9%) are significantly associated with hypertension. Conclusion Hypertension is becoming a major public health problem in Ethiopia. Nearly two out of ten individuals who are older than 18 years living with hypertension. Sex, age, overweight and/or obese, khat chewing, alcohol consumption, and family history of hypertension and diabetes mellitus are statistically significant determinant factors for hypertension in Ethiopia. Primary attention should be given for behavioral risk factors to tackle the alarming increase of hypertension in Ethiopia.
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Affiliation(s)
- Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- * E-mail:
| | - Yeaynmarnesh Asmare Bukayaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Seblewongel Tigabu Yigizaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Lisecki SR, Solomon S, Kassa G, King EJ. Factors associated with recent HIV testing uptake and HIV-positive serostatus among female sex workers in Addis Ababa, Ethiopia. Glob Public Health 2020; 17:431-443. [PMID: 33378626 DOI: 10.1080/17441692.2020.1868015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The HIV burden is high among female sex workers (FSW) in Ethiopia, yet HIV testing coverage is suboptimal. We conducted a cross-sectional survey among 137 FSW in Addis Ababa. We examined factors related to recent HIV testing and self-reported HIV serostatus using logistic regression. HIV prevalence was 10%; and among HIV-negative participants, 63% reported recent HIV testing. Involvement in sex work for ≥5 years (aOR 3.25; 95% CI 1.22, 8.69; p-value 0.02) and hormonal contraceptive use (aOR 3.37; 95% CI 1.09, 10.41; p-value 0.03) were significantly associated with recent HIV testing. Involvement in sex work for ≥5 years (aOR 13.13, 95% CI 1.31 132.01, p-value 0.03), drug use (aOR 8.02; 95% CI 1.36, 47.31; p-value 0.02), and having a job other than sex work (aOR 122.05, 95% CI 2.97 > 999.99, p-value 0.01) were significantly associated with self-reported HIV-positive serostatus. These results identify areas to target future HIV risk-reduction interventions for FSW in Ethiopia.
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Affiliation(s)
- Shelbi R Lisecki
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Samrawit Solomon
- Department of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Elizabeth J King
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Kalyanasundar B, Perez CI, Arroyo B, Moreno MG, Gutierrez R. The Appetite Suppressant D-norpseudoephedrine (Cathine) Acts via D1/D2-Like Dopamine Receptors in the Nucleus Accumbens Shell. Front Neurosci 2020; 14:572328. [PMID: 33177980 PMCID: PMC7596745 DOI: 10.3389/fnins.2020.572328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023] Open
Abstract
D-norpseudoephedrine (NPE), also known as cathine, is found naturally in the shrub Catha edulis “Khat.” NPE has been widely used as an appetite suppressant for the treatment of obesity. Although it is known that NPE acts on α1-adrenergic receptors, there is little information about the role of dopamine receptors on NPE’s induced anorectic and weight loss effects. Equally untouched is the question of how NPE modulates neuronal activity in the nucleus accumbens shell (NAcSh), a brain reward center, and a pharmacological target for many appetite suppressants. To do this, in rats, we characterized the pharmacological effects induced by NPE on weight loss, food intake, and locomotion. We also determined the involvement of dopamine D1- and D2-like receptors using systemic and intra-NAcSh antagonists, and finally, we recorded single-unit activity in the NAcSh in freely moving rats. We found that NPE decreased 24-h food intake, induced weight loss, and as side effects increased locomotor activity and wakefulness. Also, intraperitoneal and intra-NAcSh administration of D1 and D2 dopamine antagonists partially reversed NPE’s induced weight loss and food intake suppression. Furthermore, the D1 antagonist, SCH-23390, eliminated NPE-induced locomotion, whereas the D2 antagonist, raclopride, only delayed its onset. We also found that NPE evoked a net activation imbalance in NAcSh that propelled the population activity trajectories into a dynamic pharmacological brain state, which correlated with the onset of NPE-induced wakefulness. Together, our data demonstrate that NPE modulates NAcSh spiking activity and that both dopamine D1 and D2 receptors are necessary for NPE’s induced food intake suppression and weight loss.
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Affiliation(s)
- B Kalyanasundar
- Laboratory of Neurobiology of Appetite, Department of Pharmacology, Center for Research and Advanced Studies (CINVESTAV), Mexico City, Mexico
| | - Claudia I Perez
- Laboratory of Neurobiology of Appetite, Department of Pharmacology, Center for Research and Advanced Studies (CINVESTAV), Mexico City, Mexico
| | - Benjamin Arroyo
- Laboratory of Neurobiology of Appetite, Department of Pharmacology, Center for Research and Advanced Studies (CINVESTAV), Mexico City, Mexico
| | - Mario Gil Moreno
- Laboratory of Neurobiology of Appetite, Department of Pharmacology, Center for Research and Advanced Studies (CINVESTAV), Mexico City, Mexico
| | - Ranier Gutierrez
- Laboratory of Neurobiology of Appetite, Department of Pharmacology, Center for Research and Advanced Studies (CINVESTAV), Mexico City, Mexico
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Elkady EF, Fouad MA, Alshoba N, Tarek Mahmoud S. Validated LC–MS/MS method for the determination of some prescribed CNS drugs: Application to an in vivo pharmacokinetic study of drug-herb metabolic interaction potential of khat. Microchem J 2020. [DOI: 10.1016/j.microc.2020.105261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Risca HI, Zuarth-Gonzalez JD, Baker LE. Conditioned place preference following concurrent treatment with 3, 4-methylenedioxypyrovalerone (MDPV) and methamphetamine in male and female Sprague-Dawley rats. Pharmacol Biochem Behav 2020; 198:173032. [PMID: 32888971 PMCID: PMC8667570 DOI: 10.1016/j.pbb.2020.173032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/31/2020] [Accepted: 08/31/2020] [Indexed: 01/31/2023]
Abstract
Synthetic cathinones gained initial popularity on the illicit drug market as a result of attempts to evade legal restrictions on other commonly abused psychostimulants. A body of published research has determined that the psychopharmacology of the synthetic cathinone 3, 4-methylenedioxypyrovalerone (MDPV) is comparable to cocaine and methamphetamine (METH). Few preclinical studies have systematically investigated concurrent use of synthetic cathinones with other psychostimulant drugs. The present study utilized conditioned place preference (CPP), a rodent model of conditioned drug reward, to evaluate the effects of concurrent treatment with MDPV and METH. Male (N = 72) and female (N = 105) Sprague-Dawley rats underwent a two-compartment biased CPP procedure, with one trial per day for eight consecutive days. Subjects were randomly assigned to the following treatment groups: saline, METH (1 mg/kg), MDPV (1, 3.2, 5.6 mg/kg) or a mixture consisting of METH (1 mg/kg) and MDPV (1, 3.2, 5.6 mg/kg). All treatments increased locomotor activity during drug conditioning trials, and most treatments produced higher activity increases in females compared to males. Although the level of CPP established by MDPV and MDPV + METH mixtures varied between males and females, sex differences were not statistically significant. Although none of the MDPV+METH mixtures produced stronger CPP than either substance alone, some mixtures of MDPV and METH produced higher increases in locomotor activity compared to either drug alone. Further studies with higher doses may be warranted to determine if concurrent use of MDPV and METH pose an enhanced risk for abuse.
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Affiliation(s)
- Harmony I Risca
- Department of Psychology, Western Michigan University, Kalamazoo, MI 49008, USA
| | | | - Lisa E Baker
- Department of Psychology, Western Michigan University, Kalamazoo, MI 49008, USA.
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Murithi CK, Kabaru JM, Patel NB. Catha edulis Forsk (khat) reduces spontaneous and rewarded alternation in female mice. IBRO Rep 2020; 9:270-275. [PMID: 33117909 PMCID: PMC7581920 DOI: 10.1016/j.ibror.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/07/2020] [Indexed: 11/17/2022] Open
Abstract
Khat is a widely used plant-based psychostimulant. Administration of khat leads to disruption of spatial working memory in mice. It promotes in mice perseverative behavior rather than alternation behavior. Khat treated mice also show right side position preference.
Around 10 million people chew the fresh leaves and twigs of Catha edulis Forsk (khat), which synthesize cathinone, for its psychostimulatory effect. Several studies have reported that regular khat users show executive and cognitive dysfunction, such as impaired inhibitory control and poor performance on memory tests. In this study, the effect of fresh khat extract (100 and 250 mg/kg) on spatial working memory and short-term memory in mice was assessed using spontaneous and rewarded alternation T-maze tests. In the spontaneous alternation test, mice treated with fresh khat extract decreased their spontaneous alternation level to around chance level, and it remained at this level over the 7 days of khat administration and testing. On testing after a 7-day khat free period, the previously khat treated mice showed alternation level above chance but below their pre-khat alternation level. In the rewarded alternation test, acute treatment with khat caused the mice to alternate well below chance level, and then over the next 3 days of khat treatment, the alternation level increased. After a 2 and 9-day khat-free period, the previously khat treated mice alternated above chance level but below their pre-khat level. In both these tests, the mice did not show any position preference before khat treatment; however, during the khat treatment, the mice showed a right side tendency. The results show that khat treatment causes persistent changes in alternation behavior and promotes perseverative behavior, presumably due to its effect on the neural circuits activity and the neurotransmitters and promotion of position preference.
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Affiliation(s)
- Caroline K Murithi
- School of Biological Sciences, College of Biological and Physical Sciences, University of Nairobi, Kenya
| | - Jacques M Kabaru
- School of Biological Sciences, College of Biological and Physical Sciences, University of Nairobi, Kenya
| | - Nilesh B Patel
- Department of Medical Physiology, School of Medicine, College of Health Sciences, University of Nairobi, Kenya
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Kennedy C, Okanya P, Nyariki JN, Amwayi P, Jillani N, Isaac AO. Coenzyme Q 10 nullified khat-induced hepatotoxicity, nephrotoxicity and inflammation in a mouse model. Heliyon 2020; 6:e04917. [PMID: 32984611 PMCID: PMC7498867 DOI: 10.1016/j.heliyon.2020.e04917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/29/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023] Open
Abstract
Ethnopharmacological relevance The consumption of khat (Catha Edulis, Forsk) is on the rise despite the much publicized associated deleterious health effects. How chemicals present in khat, affect various physiological and biochemical processes requires further scrutiny. A clear understanding of these processes will provide an avenue for countering khat-driven negative effects using appropriate pharmacological and/or nutritional interventions. Aim of the study The current study investigated the effect of khat on vital physiological and biochemical processes such as oxidative stress, inflammation and immune responses and the role of Coenzyme-Q10 (CoQ10), a potent antioxidant and anti-inflammatory, in modulating any negative effects due to khat exposure. Methodology Three (3) weeks old forty (40) Swiss albino mice were randomly assigned into four treatment groups (n = 10). The first group was the control that was not administered with khat or CoQ10. The second group received 200 mg/kg body weight (b/w) of CoQ10, while the third group received 1500 mg/kg b/w of khat extract and finally the forth group was co-treated with 200 mg/kg b/w of CoQ10 and 1500 mg/kg b/w of khat extract. The experiment was conducted for 90 days after which samples were collected for physiological and biochemical analyses. Results The effects of khat and CoQ10 on the weights of brain, liver, kidney and spleen was determined. Administration of khat decreased the levels of RBCs and its subtypes (MCV, MCH, RDW-SD and RDW-CV), a clear indicator of khat-induced normochromic microcytic anemia. White blood cells (lymphocytes, monocytes, neutrophils and eosinophil) which are vital in responding to infections were markedly elevated by khat. Moreover, these results provide evidence for khat-induced liver and kidney injury as shown by increased biomarkers; AST, ALT, GGT and creatinine respectively. Standard histopathological analysis confirmed this finding for khat-driven liver and kidney injury. Further studies showed evidence for khat-induced inflammation and oxidative stress as depicted by increased levels of the pro-inflammatory cytokine TNF-alpha and elevation of GSH in the brain, liver and spleen. Remarkably, this is the first study to demonstrate the potential of CoQ10 in ameliorating khat-induced negative effects as outlined. CoQ10 supplementation restored the khat-induced reduction in RBC subtypes, and was protective against liver and kidney injury as shown by the appropriate biomarkers and standard histopathology analysis. The other significant finding was the CoQ10-driven normalization of GSH and TNF-α levels, indicating a protective effect from khat-driven oxidative stress and inflammation respectively. Conclusion From this study, we conclude that CoQ10 may be useful in nullifying khat-driven deleterious events among chronic khat users.
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Affiliation(s)
- Chepukosi Kennedy
- Department of Biochemistry and Biotechnology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya.,School of Biological and Life Sciences, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya
| | - Patrick Okanya
- Department of Biochemistry and Biotechnology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya.,School of Biological and Life Sciences, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya
| | - James Nyabuga Nyariki
- Department of Biochemistry and Biotechnology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya.,School of Biological and Life Sciences, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya
| | - Peris Amwayi
- Department of Biochemistry and Biotechnology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya.,School of Biological and Life Sciences, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya
| | - Ngalla Jillani
- Institute of Primates Research, P.O. Box 24481, Karen, 00502, Nairobi, Kenya
| | - Alfred Orina Isaac
- Department of Pharmaceutical Sciences and Technology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya.,School of Health Sciences and Technology, Technical University of Kenya, P. O. Box 52428, 00200 Nairobi, Kenya
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Tyler Davidson J, Piacentino EL, Sasiene ZJ, Abiedalla Y, DeRuiter J, Clark CR, Berden G, Oomens J, Ryzhov V, Jackson GP. Identification of novel fragmentation pathways and fragment ion structures in the tandem mass spectra of protonated synthetic cathinones. Forensic Chem 2020. [DOI: 10.1016/j.forc.2020.100245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alemu WG, Zeleke TA, Takele WW, Mekonnen SS. Prevalence and risk factors for khat use among youth students in Ethiopia: systematic review and meta-analysis, 2018. Ann Gen Psychiatry 2020; 19:16. [PMID: 32165908 PMCID: PMC7061479 DOI: 10.1186/s12991-020-00265-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/21/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Khat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia. Khat use among students has been linked with mental, physical, social, and psychological problems. Reliable prevalence has not been recognized because of varying published rates. The objective of this systematic review and meta-analysis is to synthesize evidence on the prevalence and potential risk factors of khat use in Ethiopia. METHODS We found 284 studies of which 266 were removed due to duplication, irrelevant topics, and other reasons, respectively. All studies conducted in Ethiopia on khat chewing among students irrespective of time frame were included. Subsequently, 18 studies were used for synthesis of prevalence. Figures were extracted from published reports, and any lost information was requested from investigators. The quality of the included literature was evaluated by using the Newcastle-Ottawa Scale (NOS). Prevalence was pooled using random-effects meta-analyses. The presence of association was declared using P-values and an odds ratio with a corresponding 95% CI. RESULTS The pooled prevalence of khat use among students was 16.7% (13.7-19.7%). In the subgroup analysis, the highest prevalence was observed in the Oromia region, at 21.1% (15.5%, 26.7%), and an almost equal prevalence of 14.8% (10.6, 18.9) and 14.3% (10.3, 18.3) was observed in Amhara and the Southern Nation, Nationalities, and People's Region of Ethiopia, respectively. Being male (OR: 2.43 (1.73, 3.13)), being a Muslim religion follower (OR: 2.22 (1.6, 2.8)), being an alcohol user (OR: 2.3 (1.5, 3.0)), khat use by a family member (OR: 1.8 (1.4, 2.2)), peer pressure (OR: 4.4 (3.1, 5.6)), and being a cigarette smoker (OR: 8.5 (5.3, 11.7)) were found to be risk factors for khat chewing. CONCLUSIONS Khat use is a common problem among students. Health promotion, awareness on effect of khat, set policy on khat and substance use on the male sex, Muslim religion, alcohol user, having a family-member khat user, peer pressure, and being a cigarette smoker as possible risk factors for khat use among students. LIMITATIONS Irrespective of time restriction, all studies conducted in Ethiopia are included and cross-sectional in nature. Protocol no. CRD-42017081886.
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Affiliation(s)
- Wondale Getinet Alemu
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet Mekonnen
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Akalu TY, Baraki AG, Wolde HF, Lakew AM, Gonete KA. Factors affecting current khat chewing among male adults 15-59 years in Ethiopia, 2016: a multi-level analysis from Ethiopian Demographic Health Survey. BMC Psychiatry 2020; 20:21. [PMID: 31937273 PMCID: PMC6961402 DOI: 10.1186/s12888-020-2434-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/08/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Regular khat chewing causes gingivitis, tooth loss, gastric disorders, cardiac complications, male impotence, sleeplessness, and several mental health problems. Based on the Ethiopian Demographic and Health Survey (EDHS) 2016, 12% of women and 27% of men have reported having ever chewed khat. Even though khat addiction is a major public health problem, studies that consider both individual level and community level factors are limited. Therefore, this study aimed to determine the prevalence and factors affecting current khat chewing among male adults in Ethiopia. METHODS Data from EDHS, a community-based cross-sectional study conducted from January 18, 2016, to June 27, 2016, was used. A multistage stratified cluster sampling technique was used to select participants. Both descriptive and analytical statistics were done. Bi-variable and multivariable multilevel logistic regression analyses were performed to determine factors affecting current khat chewing. Adjusted Odds ratio (AOR) with 95% Confidence Interval (CI) for variables with P-value < 0.05 was used as a measure of association. RESULT A total of 12,595 male adults were included. The prevalence of current khat chewing was 23.61% (95% CI: 22.87, 24.36). Age 20-24 years; (AOR = 2.68, 95% CI: 2.02, 3.56), being uneducated (AOR = 1.62, 95% CI: 1.10, 2.39), professional/technical/managerial job (AOR = 3.59, 95% CI: 2.18, 5.91), Muslim religion (AOR = 18.30, 95% CI: 13.54, 24.74), poorest wealth index (AOR = 0.67, 95% CI: 0.51, 0.89), being divorced (AOR = 0.38, 95% CI: 0.21, 0.69), history of alcohol drinking in the last 30 days (AOR = 2.15, 95% CI: 1.69, 2.73), and history of cigarette smoking in the last 30 days (AOR = 14.92, 95% CI: 10.88, 20.47), and Amhara region (AOR = 0.07, 95% CI: 0.04, 0.14) were significantly associated with khat chewing. CONCLUSION Khat chewing remains high in Ethiopia with certain regional variations. The uneducated, older age, Alcohol and cigarette users, Muslims, and professional workers were at higher risk of khat chewing whereas the poorest wealth index and being divorced reduced its risk. Policymakers should consider a multi-faceted policy approach that accounts for regional variation and the identified risk factors to alleviate the problem.
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Affiliation(s)
- Temesgen Yihunie Akalu
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Haileab Fekadu Wolde
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- 0000 0000 8539 4635grid.59547.3aDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kedir Abdela Gonete
- 0000 0000 8539 4635grid.59547.3aDepartment of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Prevalence of Common Mental Disorder and Its Association with Khat Chewing among Ethiopian College Students: A Systematic Review and Meta-Analysis. PSYCHIATRY JOURNAL 2020; 2020:1462141. [PMID: 31970194 PMCID: PMC6969648 DOI: 10.1155/2020/1462141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/06/2019] [Indexed: 12/11/2022]
Abstract
Background Mental disorder is a global burden that affects all groups of people. Young people, particularly college/university students, are more vulnerable to common mental disorders than the general population. Thus, students may use khat to gain immediate relief from their psychological distress which may worsen again after longer time of chewing. In Ethiopia, there are studies showing discrepant and inconsistent results of common mental disorder among college/university students. Therefore, this review sought to determine the prevalence of common mental disorder and its association with khat chewing among Ethiopian college/university students. Methods Different kinds of literature were searched from the databases of Google Scholar, PubMed/Medline, ScienceDirect, and PsycINFO. A total of 10 primary studies which report the prevalence of common mental disorder among Ethiopian college/university students were included in the review. The data were extracted using a standardized data extraction format prepared in Microsoft Excel. STATA version 14 statistical software was used for analysis. Cochran's Q test statistics and I 2 test were used to assess heterogeneity. A random effects meta-analysis model was used to estimate the pooled prevalence of common mental disorder due to the variability of the studies. Lastly, the association between common mental disorder and khat chewing was conducted. Results The pooled prevalence of common mental disorder among Ethiopian college/university students was 37.73% (95% CI: 30.43, 45.03). The subgroup analysis showed the highest [51.9% (95% CI: 30.19, 73.70)] and lowest [33.28% (95% CI: 19.95, 46.60)] prevalences of common mental disorder among Ethiopian college/university students found in Amhara and South Nation Nationality and People regions, respectively. The pooled effect (odds ratio) of khat chewing on common mental disorder was 2.01 (95% CI: 1.38, 2.95). Conclusions In our review, it is found that more than one-third of college/university students suffered from common mental disorder. Khat chewers were found to be twofolds more vulnerable to develop common mental disorder than nonchewers.
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Prevalence of lifetime substances use among students in Ethiopia: a systematic review and meta-analysis. Syst Rev 2019; 8:326. [PMID: 31837700 PMCID: PMC6911280 DOI: 10.1186/s13643-019-1217-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of substances is a growing concern in Ethiopia, and their impacts on younger generation have been a concern of different professionals. Even though students are at high-risk of substance abuse, there is lack of comprehensive evidence for policy decision on substance use among students. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence of common substances among students in Ethiopia. METHOD A comprehensive literature searches were done from biomedical databases: PubMed/Medline, African Journal Online, HINARI, Science Direct, and Google Scholar for article published until Dcember 31, 2017, and Addis Ababa Uiversity's electronic library search of unpublished thesis and dissertations. Two authors autonomously selected studies, extracted data, and evaluated quality of studies. The prevalence of lifetime substances use was estimated using the random effects model. Q and I2 statistics were computed to measure the extents of heterogeneity. RESULTS A total 676 study articles were identified from electronic databases, and 28 of them were included in meta-analysis. The analysis revealed that the lifetime prevalence of any substance use was 52.5% (95% CI 42.4-62.4%), khat 24.7% (95% CI 21.8-27.7%), alcohol 46.2% (95% CI 40.3-52.2%), and smoking cigarette 14.7% (95% CI 11.3-18.5%). Significant heterogeneity was observed but there was no significant publication bias. The lifetime prevalence of khat, alcohol, and cigarette smoking among high school vs university students was 22.5% (95% CI 15.2-30.7%) vs 25.1% (95% CI 21.9-28.5%), 41.4% (95% CI 22.1-62.1%) vs 47.8% (95% CI 39.9-55.7%), and 21.5% (95% CI 12.6-32.1%) vs 12.9% (95% CI 10.1-16.0%), respectively. CONCLUSION This meta-analysis highlighted the extent of lifetime prevalence of any substance, khat, alcohol, and cigarettes smoking among students in Ethiopia. Significant percent of high school students have exposed to substances. Policy makers should devise and implement strictly binding regulation to curb widespread of substances around educational institution premises at national level. Priority should be given to intervention strategies that help delay first use of substance to prevent problems later in life. Besides, the problem warrants regular national-level educational institutions based studies focusing on the magnitude, trajectory, and consequences of substance use among students. Systematic review registration: PROSPERO CRD42018082635.
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Berihu BA, Asfeha GG, Welderufael AL, Debeb YG, Zelelow YB, Beyene HA. Toxic effect of khat ( Catha edulis) on memory: Systematic review and meta-analysis. J Neurosci Rural Pract 2019; 8:30-37. [PMID: 28149078 PMCID: PMC5225718 DOI: 10.4103/0976-3147.193524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND People use khat (Catha edulis) for its pleasant stimulant effect of physical activity, consciousness, motor, and mental functions. Although there are reports assessing the effect of khat on memory, there was no study based on formal systematic review and meta-analysis. OBJECTIVE We have therefore conducted this meta-analysis to determine the level of evidence for the effect of khat (C. edulis Forsk) on memory discrepancy. METHODS MEDLINE, Cochrane Library, PubMed, Academic Search Complete, SPORTDiscus, ScienceDirect, Scopus, Web of Science, and Google Scholar were searched to retrieve the papers for this review. Keywords utilized across database search were khat, cat, chat, long-term memory, short-term memory, memory deficit, randomized control trial, and cross-sectional survey. The search was limited to studies in humans and rodents; published in English language. RESULT Finding of various studies included in our meta-analysis showed that the effect of acute, and subchronic exposure to khat showed that short-term memory appears to be affected depending on the duration of exposure. However, does not have any effect on long-term memory. CONCLUSION Although a number of studies regarding the current topic are limited, the evidenced showed that khat (C. edulis) induced memory discrepancy.
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Affiliation(s)
- Birhane Alem Berihu
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebrekidan Gebregzabher Asfeha
- Department of Biochemistry and Molecular Biology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abadi Leul Welderufael
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yared Godefa Debeb
- Department of Physiology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yibrah Berhe Zelelow
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hafte Assefa Beyene
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Khat use and psychotic symptoms in a rural Khat growing population in Kenya: a household survey. BMC Psychiatry 2019; 19:137. [PMID: 31064338 PMCID: PMC6505064 DOI: 10.1186/s12888-019-2118-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Khat is an amphetamine like psychostimulant chewed by over 10 million people globally. Khat use is thought to increase the risk of psychosis among its chewers. The evidence around this however remains inconclusive stemming from the scanty number of studies in this area and small study sample sizes. We undertook a large household survey to determine the association between psychotic symptoms and khat chewing in a rural khat growing and chewing population in Kenya. METHODS For this cross-sectional household survey, we randomly selected 831 participants aged 10 years and above residing in the Eastern region of Kenya. We used the psychosis screening questionnaire (PSQ) to collect information on psychotic symptoms and a researcher designed sociodemographic and clinical questionnaire to collect information on its risk factors. We used descriptive analysis to describe the burden of khat chewing and other substance use as well as rates and types of psychotic symptoms. Using a univariate and multivariate analyses with 95% confidence interval, we estimated the association between khat chewing and specific psychotic symptoms. RESULTS The prevalence of current khat chewing in the region was at 36.8% (n = 306) with a male gender predominance (54.8%). At least one psychotic symptom was reported by 16.8% (n = 168) of the study population. Interestingly, psychotic symptoms in general were significantly prevalent in women (19.5%) compared to men (13.6%) (p = 0.023). Khat chewing was significantly associated with reported strange experiences (p = 0.024) and hallucinations (p = 0.0017), the two predominantly reported psychotic symptoms. In multivariate analysis controlling for age, gender, alcohol use and cigarette smoking, there was a positive association of strange experiences (OR, 2.45; 95%CI, 1.13-5.34) and hallucination (OR, 2.08; 95% C.I, 1.06-4.08) with khat chewing. Of note was the high concurrent polysubstance use among khat chewers specifically alcohol use (78.4%) and cigarette smoking (64.5%). CONCLUSIONS Psychotic symptoms were significantly elevated in khat users in this population. Future prospective studies examining dose effect and age of first use may establish causality.
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Woldeamanuel GG, Geta TG. Impact of chronic khat ( Catha edulis Forsk) chewing on pulmonary function test and oxygen saturation in humans: A comparative study. SAGE Open Med 2019; 7:2050312118824616. [PMID: 30719292 PMCID: PMC6348536 DOI: 10.1177/2050312118824616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/20/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Chronic consumption of khat affects many organ systems and leads to various health disturbances in the chewers. Few studies examined the acute effects of khat ingestion on lung function parameters. However, studies which assessed the long-term effects of khat chewing on pulmonary function parameters and oxygen saturation are lacking. Objective: The aim of this study was to assess the impact of chronic Khat chewing on pulmonary function parameters and oxygen saturation among chronic Khat chewers in Wolkite, Ethiopia. Methods: A community-based comparative cross-sectional study was conducted in Wolkite, Ethiopia from 1 June 2018 to 15 August 2018. A total of 324 participants, 162 khat chewers and 162 non-chewers were included in the study. The data were collected through face-to-face interview by trained data collectors. British Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A spirometer was used to assess various lung function parameters. Moreover, oxygen saturation of hemoglobin was measured using pulse oximeter. Data were entered into CSPro version 6.2 and analyzed using SPSS version 23. Results: This study showed statistically significant (p < 0.05) reduction in the mean values of forced vital capacity, forced expiratory volume in first second and maximum ventilation volume among khat chewers as compared to non-chewers. There was no significant difference in the mean values of other lung function parameters between the two groups. Similarly, there was no significant difference (p = 0.642) in mean oxygen saturation of hemoglobin (SaO2) across the two groups. Conclusion: It is evident from this study that long-term khat consumption is associated with decreased mean forced vital capacity, forced expiratory volume in first second and maximum ventilation volume. Hence, there is a need for further study to strengthen the current findings and to explore the mechanisms of khat chewing effect on lung function parameters.
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Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Teshome Gensa Geta
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Gholami M, Esmaeilzadeh Bahabadi S. Kaurene as the major constituent of the essential oils of the narcotic plant, Khat ( Catha edulis Forsk). Nat Prod Res 2019; 33:126-129. [DOI: 10.1080/14786419.2018.1437424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Morteza Gholami
- Faculty of Sciences, Department of Chemistry, Golestan University, Gorgan, Iran
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Mohan S, Shaheen E, El-Amir Y, Khadashi H, Ncibi S, Farasani A, Abdelwahab S. Catha edulis-induced skeletal muscle toxicity in experimental rats via regulation of rhabdomyolysis biomarkers. Pharmacogn Mag 2019. [DOI: 10.4103/pm.pm_142_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alemu WG, Amare Zeleke T, Takele WW. Prevalence and associated factors of khat chewing among students in Ethiopia: a protocol for systematic review and meta-analysis. BMJ Open 2018; 8:e021157. [PMID: 30478104 PMCID: PMC6254418 DOI: 10.1136/bmjopen-2017-021157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION These days, in Ethiopia, khat chewing is one of the widely spreading public health problems affecting the most productive segment of the population. The health implications of khat chewing among students are strongly linked with poor mental, physical and social performances. However, the national magnitude of khat chewing and the associated factors among Ethiopian students are unknown. Therefore, this systematic review and meta-analysis will answer the national prevalence of khat chewing and the associated factors among students in Ethiopia. METHODS Published primary relevant articles will be accessed using various databases, such as Medline, PubMed, EMBASE and Scopus. Other electronic search engines, for instance, Google Scholar and Google, will be used. Furthermore, additional studies will be collected by communicating with the author(s) and following the references of relevant articles. To select eligible studies, the Joanna Briggs Institute quality appraisal checklist will be used. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed to keep the scientific rigour of the study. Heterogeneity between studies will be examined through forest plot and I2 heterogeneity tests. To identify influential studies, sensitivity analysis will be done. For substantial heterogeneity (I2>50%), the DerSimonian and Laird random-effects model will be employed. Subgroup analyses will be conducted using the random-effect model. Moreover, small studies' publication bias will be checked by funnel plots and objectively by Egger's regression test. If in case Egger's test was found to be statistically significant (p<0.05), trim and fill (Duval and Tweedie) analysis will be performed. The presence of association will be declared using p≤0.05 and OR with corresponding 95% CI. ETHICS AND DISSEMINATION Since the intention of the study is to describe earlier primary studies qualitatively and pool the results of those articles, ethical clearance will not be a concern. The results of the study will be published in a reputable peer-reviewed journal and presented at different scientific research conferences. It will also be disseminated to academic as well as other concerned institutions. PROSPERO REGISTRATION NUMBER CRD-42,017,081,886.
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Affiliation(s)
- Wondale Getinet Alemu
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Nakajima M, Hoffman R, Alsameai A, Khalil NS, al'Absi M. Development of the Khat Knowledge, Attitudes and Perception Scale. Drug Alcohol Rev 2018; 37:802-809. [PMID: 29931779 DOI: 10.1111/dar.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/09/2018] [Accepted: 05/22/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION AND AIMS Khat (Catha edulis) is a stimulant plant widely used in East Africa and the Arabian Peninsula. Tobacco is often co-used with khat and its use has expanded to other parts of the world. Chronic khat use is associated with negative health consequences. There is a lack of research to develop a tool to assess attitudes toward khat use. This study aimed to develop a brief tool to assess attitude and perception related to khat (i.e. the Khat Knowledge, Attitudes and Perception Scale). DESIGN AND METHODS Four-hundred and three participants in Yemen (151 concurrent users of khat and tobacco, 141 khat-only users and 92 non-users of khat and tobacco) were asked about knowledge and attitudes related to khat. A principle component analysis with Promax rotation, Scree-plot and Cronbach's α coefficients was performed to examine psychometric properties of the Khat Knowledge, Attitudes and Perception Scale. RESULTS Principle component analysis revealed five factors: negative beliefs, positive beliefs, idleness, weight control and family issues. Internal consistency of items in negative beliefs, positive beliefs, idleness, weight control and family issues were 0.88, 0.62, 0.62, 0.72 and 0.53, respectively. Greater negative beliefs was inversely correlated with positive beliefs but positively associated with idleness, weight control and family issues. Concurrent users and khat-only users had lower scores on negative beliefs than non-users. Concurrent users had higher scores on positive beliefs than khat-only and non-users. DISCUSSION AND CONCLUSIONS These results provide initial support of the usefulness of the Khat Knowledge, Attitudes and Perception Scale.
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Affiliation(s)
- Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
| | - Richard Hoffman
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
| | - Abed Alsameai
- Department of Linguistics, Taiz University, Taiz, Yemen
| | | | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
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The Designer Drug 3-Fluoromethcathinone Induces Oxidative Stress and Activates Autophagy in HT22 Neuronal Cells. Neurotox Res 2018; 34:388-400. [PMID: 29656349 PMCID: PMC6154176 DOI: 10.1007/s12640-018-9898-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 12/24/2022]
Abstract
Synthetic cathinones are psychoactive substances, derivatives of a natural psychostimulant cathinone. Although many synthetic cathinones have lost their legal status in many countries, their abuse still continues worldwide. Recently, they have been reported to exert neurotoxic effects in vitro and in vivo. The molecular mechanisms of their action have not been fully elucidated. Recently, they have been linked to the induction of oxidative stress, autophagy, and apoptosis. The aim of this study was to investigate whether 3-fluoromethcathinone (3-FMC), a synthetic cathinone, is able to induce oxidative stress, autophagy, and apoptosis in HT22 immortalized mouse hippocampal cells. We found that treatment of HT22 cells with this compound results in a concentration-dependent increase in the intracellular production of reactive oxygen species. Moreover, 3-FMC induced concentration-dependent conversion of cytosolic LC3-I to membrane-bound LC3-II and formation of autophagic vacuoles. Additionally, the level of p62/SQSTM1 protein decreased after 3-FMC treatment, suggesting that accumulation of autophagic vacuoles resulted from activation rather than inhibition of autophagy. Our results also showed that 3-FMC at millimolar concentration is able to induce caspase-dependent apoptotic cell death in HT22 cells. Our findings suggest that abuse of 3-FMC may disturb neuronal homeostasis and impair functioning of the central nervous system.
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Gebrie A, Alebel A, Zegeye A, Tesfaye B. Prevalence and predictors of khat chewing among Ethiopian university students: A systematic review and meta-analysis. PLoS One 2018; 13:e0195718. [PMID: 29649253 PMCID: PMC5896981 DOI: 10.1371/journal.pone.0195718] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background Khat chewing has become a common practice among university students in developing countries like Ethiopia. It has a potential effect on physical, mental, social and cognitive aspects of student functioning. In Ethiopia, study findings regarding the prevalence of khat chewing were highly dispersed and inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of khat chewing and its predictors among Ethiopian university students. Method A systematic review and meta-analysis was conducted to assess the prevalence and predictors of khat chewing among university students in Ethiopia. We searched literature from the databases of PubMed, Google Scholar, Science Direct, and the Cochrane Library. A total of 24 Ethiopian studies reporting the prevalence of khat chewing among university students were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies exhibit high heterogeneity, a random effect meta-analysis model was computed to estimate the pooled prevalence of khat chewing. Moreover, the association between predictor variables, and khat chewing practice were examined. Results The meta-analysis of 24 studies revealed that the pooled prevalence of khat chewing among university students in Ethiopia was 23.22% (95% CI: 19.5, 27.0). In the subgroup analysis, the highest prevalence was observed in Oromia region (31.6%; 95CI: 21.2, 41.9) whereas the lowest prevalence was observed in Amhara region (18.1%; 95%CI: 12.4, 23.8). Being male OR: 2.76 (95% CI 1.64, 4.63), family khat chewing practice OR: 2.91 (95% CI 1.06, 7.98), friend khat chewing habit OR: 4.74 (95% CI 3.48, 13.06), alcohol drinking OR: 7.06 (95% CI 5.65, 8.82) and cigarette smoking habit OR: 15.11 (95% CI 8.96, 25.51) were found to be predictors of khat chewing. Conclusion The study found that the prevalence of khat chewing among university students was quite common, with slightly more than 1 in 5 students engaging in the use of this substance. Being male, family khat chewing practice, friend’s khat chewing habit, alcohol drinking, and cigarette smoking were found to be predictors of khat chewing practice among university students.
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Affiliation(s)
- Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Animut Alebel
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abriham Zegeye
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Bekele Tesfaye
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Mega TA, Dabe NE. Khat ( Catha Edulis) as a Risk Factor for Cardiovascular Disorders: Systematic Review and Meta-Analysis. Open Cardiovasc Med J 2017; 11:146-155. [PMID: 29387278 PMCID: PMC5748832 DOI: 10.2174/1874192401711010146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/11/2017] [Accepted: 11/28/2017] [Indexed: 11/22/2022] Open
Abstract
Background About 20 million people worldwide are believed to be using khat. Although some studies reported that khat chewing might result in cardiovascular disorders, conclusive evidence is limited. Method The objective of this review was to synthesize the best available evidence for the effect of khat on the cardiovascular system. Databases searched were PubMed, Cochrane database of systematic reviews, CINAHL, poplin, LILACS, MedNar and Scopus. All papers included in the review were subjected to rigorous appraisal using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. Review Manager Software (Revman 5.3) was used for meta-analysis and effect size and the 95% confidence interval (CI) was calculated. Result Data was extracted from 10 articles. Our meta-analysis included 9,207 subjects, (2123 chewers and 7084 non-chewers, respectively) to elucidate the effect of khat on heart rate, diastolic and systolic blood pressure. The mean diastolic and systolic blood pressure of khat chewers was higher than the non-chewers with a mean difference of 5.1 mmHg, 95%CI [2.7,7.5] and 7.9 mmHg, 95%CI [2.65, 13.18], respectively. Similarly, the heart rate of the chewers remained consistently higher, making the mean difference of 6.9 beats/min, 95%CI [0.5, 13.3]. In addition, khat was found to have either a causative or worsening effect on stroke, myocardial infarction and heart failure. Conclusion We showed that khat chewing could significantly affect the cardiovascular system through its effect on heart rate and blood pressure. Therefore, health promotion should be aimed to encourage quitting khat chewing.
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Affiliation(s)
- Teshale Ayele Mega
- School of Pharmacy, Institute of Health Science, Jimma University, Jimma, Ethiopia
| | - Nikodimos Eshetu Dabe
- Department of Biomedical Science, College of Health Science, Mizan Tepi University, Mizan Teferi, Ethiopia
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Baş Y, Hassan HA, Adıgüzel C, Bulur O, Ibrahim İA, Soydan S. The distribution of cancer cases in Somalia. Semin Oncol 2017; 44:178-186. [PMID: 29248129 DOI: 10.1053/j.seminoncol.2017.10.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/18/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the frequency and distribution of cancer cases in a defined time period in Somalia. MATERIALS AND METHODS A total of 403 cancer cases were diagnosed between January 01, 2016 and March 01, 2017 in the Department of Pathology at the Somalia Mogadishu-Turkey Education and Research Hospital or the Department of Oncology at Uniso Hospital, Somalia University. Data on cancer type, patient age, and gender were obtained from pathology reports and hospital records. RESULTS Female patients totaled 49.6% (n = 200) and 50.4% of patients were male (n = 203). The youngest patient was 18 years of age, the oldest was 97, and the average age was 53.4 years. The 10 most common types of cancer were esophageal (n = 130, 32.3%), non-Hodgkin lymphoma (n = 35, 8.7%), liver (n = 26, 6.5%), breast (n = 24, 6.0%), skin (n = 17, 4.2%), thyroid (n = 13, 3.2%), brain (n = 12, 3.0%), bone (n = 11, 2.7%), colorectal (n = 11, 2.7%), and soft tissue (n = 11, 2.7%). The most common site of cancer in both males and females was the esophagus. CONCLUSION These results show a high incidence of esophageal cancer in Somalia, and strongly suggest that environmental risk factors and nutritional habits have a strong impact in this population. Serious and extensive research on the etiology of esophageal cancer is required.
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Affiliation(s)
- Yılmaz Baş
- Department of Pathology, Somalia-Turkey Education and Research Hospital, Mogadishu, Somalia; Hitit University Medical School, Çorum, Turkey.
| | | | - Cevdet Adıgüzel
- Department of Obstetrics and Gynecology, Somalia-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Oktay Bulur
- Department of Internal Medicine, Somalia-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - İkram Abdikarim Ibrahim
- Department of General Surgery, Somalia-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Seçil Soydan
- Department of General Surgery, Somalia-Turkey Education and Research Hospital, Mogadishu, Somalia
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Atlabachew M, Chandravanshi BS, Redi-Abshiro M. Preparative HPLC for large scale isolation, and salting-out assisted liquid-liquid extraction based method for HPLC-DAD determination of khat (Catha edulis Forsk) alkaloids. Chem Cent J 2017; 11:107. [PMID: 29086876 PMCID: PMC5645267 DOI: 10.1186/s13065-017-0337-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 10/12/2017] [Indexed: 12/15/2022] Open
Abstract
Background Khat (Catha edulis Forsk) is an evergreen shrub of the Celastraceae family. It is widely cultivated in Yemen and East Africa, where its fresh leaves are habitually chewed for their momentary pleasures and stimulation as amphetamine-like effects. The main psychostimulant constituents of khat are the phenylpropylamino alkaloids: cathinone, cathine and norephedrine. Results In this study, simple procedures based on preparative HPLC and salting-out assisted liquid–liquid extraction (SALLE) based methods were developed respectively for large scale isolation and the extraction of psychoactive phenylpropylamino alkaloids; cathinone, cathine and norephedrine, from khat (Catha edulis Forsk) chewing leaves, a stimulant and drug of abuse plant. The three khat alkaloids were directly isolated from the crude oxalate salt by preparative HPLC–DAD method with purity > 98%. In addition, a modified (SALLE) method has been developed and evaluated for the extraction efficiency of psychoactive phenylpropylamino alkaloids from khat (Catha edulis Forsk) chewing leaves. An in situ two steps extraction protocol was followed without dispersive SPE clean up. The method involves extraction of the samples with 1% HAc and QuEChERS salt (1.0 g of CH3COONa and 6.0 g of MgSO4) followed by subsequent in situ liquid–liquid partitioning by adding ethyl acetate and NaOH solution. The optimized method allowed recoveries of 80–86% for the three alkaloids from khat sample with relative standard deviation (RSD) values less than 15% and limits of detection (0.85–1.9 μg/mL). Conclusion The method was found to be simple, cost-effective and provides cleaner chromatogram with good selectivity and reproducibility. The SALLE based protocol provided as good results as the conventional extraction method (ultrasonic assisted extraction followed by solid phase extraction, UAE–SPE) and hence the method can be applicable in forensic and biomedical sectors. Electronic supplementary material The online version of this article (doi:10.1186/s13065-017-0337-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Minaleshewa Atlabachew
- Department of Chemistry, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia.,Blue Nile Water Institute, Bahir Dar University, P. O. Box 79, Bahir Dar, Ethiopia
| | | | - Mesfin Redi-Abshiro
- Department of Chemistry, Addis Ababa University, P. O. Box 1176, Addis Ababa, Ethiopia
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Nakajima M, Jebena MG, Taha M, Tesfaye M, Gudina E, Lemieux A, Hoffman R, al'Absi M. Correlates of khat use during pregnancy: A cross-sectional study. Addict Behav 2017; 73:178-184. [PMID: 28531823 DOI: 10.1016/j.addbeh.2017.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Khat is widely used in East African countries including Ethiopia. A growing body of evidence indicates that long-term khat use is associated with various health consequences. The aim of this study was to examine the magnitude and correlates of khat use in pregnant women. METHODS This study used a cross-sectional, face-to-face interview design that included 642 pregnant women receiving antenatal care services at primary care centers in Ethiopia. A series of chi-square tests and regression models were conducted to examine whether khat use status (i.e., 123 current khat users, 41 former khat users, and 478 non-users) was associated with socio-demographic, mental distress, and substance use measures. RESULTS As compared with non-users, current and former khat users had higher levels of depressive symptoms and distress. Khat users minimized potential health risks associated with khat use. Social and motivational factors related to khat use were different between current and former khat users. CONCLUSIONS Findings of this study suggest a substantial prevalence of khat use among pregnant women in Ethiopia and highlight the role of socio-demographic and cultural influences on khat use during pregnancy. Health care professionals in the region where khat is available are encouraged to ask their female patients about khat use and encourage them to refrain from use while they are pregnant. The positive link between khat and mental distress warrants further research focusing on biological, psychological, and social mechanisms of this relationship.
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Affiliation(s)
- Motohiro Nakajima
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | | | | | | | | | - Andrine Lemieux
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | - Richard Hoffman
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
| | - Mustafa al'Absi
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA.
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Lifson AR, Workneh S, Shenie T, Ayana DA, Melaku Z, Bezabih L, Waktola HT, Dagne B, Hilk R, Winters KC, Slater L. Frequent Use of Khat, an Amphetamine-Like Substance, as a Risk Factor for Poor Adherence and Lost to Follow-Up Among Patients New to HIV Care in Ethiopia. AIDS Res Hum Retroviruses 2017; 33:995-998. [PMID: 28462628 DOI: 10.1089/aid.2016.0274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Khat, a plant native to East Africa, has amphetamine-like psychoactive constituents, and is a potential risk factor for HIV infection. Chronic use can cause cognitive impairment and other mental disorders, raising concerns about effects on retention and adherence with HIV care. During 2013-2014, 322 Ethiopian patients newly enrolled at HIV clinics in Dire Dawa and Harar were surveyed about khat use and prospectively followed for 1 year; 9% died, 18% transferred care to other clinics, and 22% were lost to follow-up (LTFU) (no clinic visit for >3 months). Of 248 patients who received a 12-month follow-up survey, 37% used khat in the year after enrollment, with a median use of 60 h in a typical month. Those using khat ≥60 h/month (median among users) were more likely than others to be LTFU (31% vs. 16%, p = .014); those using khat ≥150 h/month (upper quartile) had 44% LTFU rates versus 16% for others (p = .002). Complete 3-day adherence (taking all doses) of antiretroviral therapy was reported by 77% of those using khat ≥60 h/month versus 95% of all others (p < .001), and 67% of those using khat ≥150 h/month versus 94% of others (p < .001). In two East African cities, where khat use is common, frequent use was a significant risk factor for higher 1-year LTFU and lower self-reported antiretroviral therapy adherence among people living with HIV entering HIV care. Where khat is widely utilized, interventions to promote either nonuse or reduced use are important as part of a comprehensive HIV care package and national HIV strategies.
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Affiliation(s)
- Alan R. Lifson
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Sale Workneh
- Ethiopian Office, National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia
| | - Tibebe Shenie
- Ethiopian Office, National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia
| | | | - Zenebe Melaku
- International Center for AIDS Care and Treatment Program, Addis Ababa, Ethiopia
| | - Lemlem Bezabih
- Ethiopian Office, National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia
| | - Hiwot Tekle Waktola
- Ethiopian Office, National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia
| | - Behailu Dagne
- Ethiopian Office, National Alliance of State and Territorial AIDS Directors, Addis Ababa, Ethiopia
| | - Rose Hilk
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Lucy Slater
- Global Program, National Alliance of State and Territorial AIDS Directors, Washington, District of Columbia
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50
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Hille J, Johnson NW. The burden of oral cancer in sub-Saharan Africa. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17721094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jos Hille
- Department of Oral and Maxillofacial Pathology, University of the Western Cape, and National Health Laboratories, Tygerberg Laboratories, Cape Town, South Africa
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
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