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Sabei FY, Khardali I, Al-Kasim MA, Shaheen ES, Oraiby M, Alamir A, David B, Alshahrani S, Jali AM, Attafi M, Albeishy MY, Attafi I. Disposition Kinetics of Cathinone and its Metabolites after Oral Administration in Rats. Curr Drug Metab 2024; 25:220-226. [PMID: 38752643 DOI: 10.2174/0113892002300638240513065512] [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: 02/04/2024] [Revised: 04/05/2024] [Accepted: 04/17/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Cathinone is a natural stimulant found in the Catha edulis plant. Its derivatives make up the largest group of new psychoactive substances. In order to better understand its effects, it is imperative to investigate its distribution, pharmacokinetics, and metabolic profile. However, the existing literature on cathinone remains limited. OBJECTIVE This study aimed to investigate the disposition kinetics and metabolic profile of cathinone and its metabolite cathine through a single oral dose of cathinone administration in rats. METHODS Cathinone and cathine concentrations were identified and quantified using ion trap liquid chromatography- mass spectrometry (LC-IT/MS). The metabolic profile in the serum, brain, lung, liver, kidney, and heart was analyzed at specific time points (0, 0.5, 2.5, 6, 12, 24, 48, and 72 hours) using the ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) method. RESULTS The highest concentration of cathinone was found in the kidney (1438.6 μg/L, which gradually decreased to 1.97 within 48 h and disappeared after 72 h. Cathinone levels in the lungs, liver, and heart were 859, 798.9, and 385.8 μg/L, respectively, within half an hour. However, within 2.5 hours, these levels decreased to 608.1, 429.3, and 309.1 μg/L and became undetectable after 24 h. In the rat brain, cathinone levels dropped quickly and were undetectable within six hours, decreasing from 712.7 μg/L after 30 min. In the brain and serum, cathine reached its highest levels at 2.5 hours, while in other organs, it peaked at 0.5 hours, indicating slower conversion of cathinone to cathine in the brain and serum. CONCLUSION This study revealed a dynamic interplay between cathinone disposition kinetics and its impact on organ-specific metabolic profiles in rats. These results have significant implications for drug development, pharmacovigilance, and clinical practices involving cathinone. Investigating the correlation between the changes in biomarkers found in the brain and the levels of cathinone and cathine is essential for informed decision- making in medical practices and further research into the pharmacological properties of cathinone.
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Affiliation(s)
- Fahad Y Sabei
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Ibrahim Khardali
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Mohamed A Al-Kasim
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | | | - Magbool Oraiby
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Ahmad Alamir
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Banji David
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Saeed Alshahrani
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Abdulmajeed M Jali
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Mohammed Attafi
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Mohammed Y Albeishy
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
| | - Ibraheem Attafi
- Forensic Toxicology Services, Forensic and Janoub Al-Qunfudah Hospital, Ministry of Health, Jazan, 45142, Saudi Arabia
- Janoub Al-Qunfudah Hospital, Ministry of Health, Al Qunfudhah, Saudi Arabia
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DesLauriers N, Sambai B, Mbogo L, Ludwig-Barron N, Kingston H, Chohan B, Gitau E, Sinkele W, Masyuko S, Herbeck J, Bukusi D, Guthrie BL, Farquhar C, Monroe-Wise A. Alcohol use among people who inject drugs living with HIV in Kenya is associated with needle sharing, more new sex partners, and lower engagement in HIV care. AIDS Behav 2023; 27:3970-3980. [PMID: 37318665 DOI: 10.1007/s10461-023-04113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 06/16/2023]
Abstract
We assessed the prevalence and correlates of alcohol use among 870 people who inject drugs living with HIV in Kenya, with attention toward (1) sexual and injecting risk behaviors for HIV transmission and (2) HIV care engagement. We defined heavy alcohol use as > 14 drinks/week for men and > 7 drinks/week for women, moderate alcohol use as any lesser but non-zero amount, and any alcohol use as either moderate or heavy use. Approximately 39% of participants reported any alcohol use and 15% heavy use. In multivariate analysis, any alcohol use compared to no use was associated with needle sharing, > 3 new sex partners in the past 3 months, being unaware of HIV status, never enrolling in HIV care, and not being on ART (all p < 0.05). Heavy alcohol use as compared to no use was associated with needle sharing (aOR = 2.72; 95% CI 1.43, 5.13), injection equipment sharing (aOR = 1.80; 95% CI 1.00, 3.16), > 3 new sex partners in the past 3 months (aOR = 1.99; 95% CI 1.12, 3.49), and being unaware of HIV status (aOR = 2.77; 95% CI 1.46, 5.19). There was no association between any measure of alcohol use and unsuppressed viral load. Alcohol use among people who inject drugs living with HIV may carry elevated risk of HIV transmission mediated by sexual and injecting practices and is associated with lower engagement in multiple stages of the HIV care cascade.
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Affiliation(s)
- N DesLauriers
- Department of Medicine, University of Washington, Seattle, USA.
| | - B Sambai
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - L Mbogo
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - N Ludwig-Barron
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - H Kingston
- Institute for Public Health Genetics, University of Washington, Seattle, USA
| | - B Chohan
- Department of Global Health, University of Washington, Seattle, USA
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - E Gitau
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - W Sinkele
- Support for Addiction Prevention and Treatment in Africa, Nairobi, Kenya
| | - S Masyuko
- Department of Global Health, University of Washington, Seattle, USA
- National AIDS and STI Control Programme (NASCOP), Kenya Ministry of Health, Nairobi, Kenya
| | - J Herbeck
- Department of Global Health, University of Washington, Seattle, USA
| | - D Bukusi
- HIV Testing and Counseling and HIV Prevention, Kenyatta National Hospital, Nairobi, Kenya
| | - B L Guthrie
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - C Farquhar
- Department of Medicine, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
- Department of Epidemiology, University of Washington, Seattle, USA
| | - A Monroe-Wise
- Department of Global Health, University of Washington, Seattle, USA
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Geremew H, Kebede FA, Negash A, Mengstie MA, Geremew D. Khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia: a community-based study. Front Psychiatry 2023; 14:1253128. [PMID: 38034922 PMCID: PMC10684754 DOI: 10.3389/fpsyt.2023.1253128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Despite its deleterious consequences, khat chewing is escalating worldwide. However, there is a lack of evidence about the extent of khat chewing among pregnant women in Ethiopia, particularly in the current study area. Therefore, this study aimed to assess the prevalence of current khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia. Methods This community-based cross-sectional study was conducted in Chiro district from November 1 to 30, 2022 G.C. Study participants were selected using the systematic random sampling technique. An interview-administered structured questionnaire was used to collect data through a house-to-house survey. The data were entered into EpiData version 3.1 and analyzed in STATA 14 software. Characteristics of study participants were summarized using descriptive analysis, and binary logistic regression was used to identify determinants of khat chewing. Results A total of 409 pregnant women participated in this study, with a response rate of 99%. The overall prevalence of khat chewing was 60.4% (95% CI: 55.5%, 65.2%). Religion (AOR: 2.08; 95% CI: 1.13, 3.82), khat cultivation (AOR: 0.43; 95% CI: 0.25, 0.77), partner khat use (AOR: 5.54; 95% CI: 3.11, 9.88), pre-pregnancy khat use (AOR: 9.95; 95% CI: 5.55, 17.81), antenatal care (ANC) visit (AOR: 2.71; 95% CI: 1.41, 5.21), and mental distress (AOR: 4.89; 95% CI: 2.38, 10.02) were significantly associated with current khat chewing. Conclusion The majority of pregnant women in the study area practice khat chewing. Thus, accessible and comprehensive pre-conception and pre-natal care incorporating the prevention and management of antenatal khat chewing is crucial to overcome this problem. Provision of mental healthcare involving partners of pregnant women is also important to reduce the extent and impacts of khat chewing during pregnancy. Further longitudinal studies triangulated with qualitative designs are recommended.
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Affiliation(s)
- Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Fekadu Abera Kebede
- Department of Nursing, College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Demeke Geremew
- Immunology and Molecular Biology Unit, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, 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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Principales plantes et champignons psychotropes. ACTUALITES PHARMACEUTIQUES 2022. [DOI: 10.1016/j.actpha.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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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: 19] [Impact Index Per Article: 9.5] [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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Phyllys K, Ziro OW, Kissinger G, Ngari M, Budambula NLM, Budambula V. Poly-drug use among female and male commercial sex workers visiting a drop in centre in Mombasa County, Kenya. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001247. [PMID: 36962634 PMCID: PMC10045590 DOI: 10.1371/journal.pgph.0001247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
The relationship between commercial sex work and drug use is complex and the two exacerbate each other. In Kenya, Mombasa County has one of the highest populations of drug users and commercial sex workers. Despite documentation of drug use among sex workers, most of the studies are based on self-reported history which is prone to social desirability and memory recall biases. It is in this context that we sought to establish actual drug use is this sub-population. A cross-sectional study was conducted to determine self-reported and confirmed drug use among 224 commercial sex workers accessing services at Mvita Drop-in. Actual drug use was determined qualitatively using 6 panel plus alcohol Saliva Test kit. The overall prevalence of self-reported and confirmed current use for at least one drug was 98% and 99% respectively. Regardless of the technique used, alcohol and tobacco products were the most consumed substances. Alcohol use increased significantly with age (P = 0.03). Risk of cigarette use and testing positive for cotinine was higher among those age 18 to 35 years compared to >35years at P = 0.001 and P = 0.002 respectively. Poly-drug use was common with 98% testing positive for more than one drug. The reason for drug use was sex work related pressure (88%) with 60% of the respondents reporting they cannot transact this business without drugs. Almost every commercial sex worker is a poly-drug user. We recommend targeted interventions for commercial sex workers.
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Affiliation(s)
- Kemunto Phyllys
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Onesmus Wanje Ziro
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - George Kissinger
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | - Moses Ngari
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
| | | | - Valentine Budambula
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
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Al-Duais MA, Al-Awthan YS. Khat Chewing and Lipid Profile in Human and Experimental Animals. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6001885. [PMID: 34977243 PMCID: PMC8719995 DOI: 10.1155/2021/6001885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Catha edulis, also known as khat or qat, is a plant that grows in East Africa and southern Arabia. Several millions of people chew the leaves and twigs of khat plant for their central stimulating amphetamine-like effects. Khat chewing is becoming more common in Europe and the United States, owing to worldwide migration. OBJECTIVE This review examines the khat ingredients, global prevalence, and legal status as well as its effects on lipid profile. Methodology. A literature search was performed using PubMed, Scopus, and Google Scholar to collect information within articles published up to April 2021 with the goal of identifying relevant studies. The proposed mechanisms of cathinone effects on total cholesterol and triglyceride were also discussed. CONCLUSION The khat chewing habit is considered as a serious economic and health issue that needs specialized programs to assist those people to quit or reducing this habit.
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Affiliation(s)
- Mohammed A. Al-Duais
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Biochemistry Unit, Chemistry Department, Faculty of Science, Ibb University, Ibb, Yemen
| | - Yahya S. Al-Awthan
- Department of Biology, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Department of Biology, Faculty of Science, Ibb University, Ibb, Yemen
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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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Soares J, Costa VM, Bastos MDL, Carvalho F, Capela JP. An updated review on synthetic cathinones. Arch Toxicol 2021; 95:2895-2940. [PMID: 34100120 DOI: 10.1007/s00204-021-03083-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023]
Abstract
Cathinone, the main psychoactive compound found in the plant Catha edulis Forsk. (khat), is a β-keto analogue of amphetamine, sharing not only the phenethylamine structure, but also the amphetamine-like stimulant effects. Synthetic cathinones are derivatives of the naturally occurring cathinone that largely entered the recreational drug market at the end of 2000s. The former "legal status", impressive marketing strategies and their commercial availability, either in the so-called "smartshops" or via the Internet, prompted their large spread, contributing to their increasing popularity in the following years. As their popularity increased, the risks posed for public health became clear, with several reports of intoxications and deaths involving these substances appearing both in the social media and scientific literature. The regulatory measures introduced thereafter to halt these trending drugs of abuse have proved to be of low impact, as a continuous emergence of new non-controlled derivatives keep appearing to replace those prohibited. Users resort to synthetic cathinones due to their psychostimulant properties but are often unaware of the dangers they may incur when using these substances. Therefore, studies aimed at unveiling the pharmacological and toxicological properties of these substances are imperative, as they will provide increased expertise to the clinicians that face this problem on a daily basis. The present work provides a comprehensive review on history and legal status, chemistry, pharmacokinetics, pharmacodynamics, adverse effects and lethality in humans, as well as on the current knowledge of the neurotoxic mechanisms of synthetic cathinones.
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Affiliation(s)
- Jorge Soares
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
| | - Vera Marisa Costa
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Maria de Lourdes Bastos
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Félix Carvalho
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - João Paulo Capela
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
- FP-ENAS (Fernando Pessoa Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), Faculty of Health Sciences, University of Fernando Pessoa, Porto, Portugal.
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Tulu SN, Al Salmi N, Jones J. Understanding cardiovascular disease in day-to-day living for African people: a qualitative metasynthesis. BMC Public Health 2021; 21:745. [PMID: 33865359 PMCID: PMC8052642 DOI: 10.1186/s12889-021-10781-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, cardiovascular disease (CVD) accounts for 45% of all chronic non-communicable disease deaths and 31% of all deaths. CVD has remained the primary cause of death in the world for the past fifteen years. Compared to other continents, CVD and its risk factors are highly prevalent in Africa, but the continent also displays a low-level of knowledge and awareness of CVD, and poor perception of its risk factors. Little research has been done on the connection between the daily lived experiences of African people and the high prevalence and poor perception of CVD and its risk factors on the African continent. The aim of this study is to provide an in-depth understanding of the daily, lived experiences of African people and the connections between these experiences and the prevention, control, and management of CVD and its risk factors. METHODS A systematic search was performed in PubMed, CINAHL, EMBASE, Psych INFO, and Web of Science databases to identify published English qualitative studies of CVD and its risk factors. Qualitative metasynthesis included structured techniques of data immersion and quality appraisal, thematic synthesis, and reciprocal translation. RESULTS Seven studies met the inclusion criteria. Four major themes were identified from the metasynthesis: 1) understanding and beliefs about CVD; 2) perceived causes/risk factors for CVD; 3) understanding and belief about obesity; 4) perceived treatment options for CVD. The metasynthesis identified a consistent disconnect among African people between seeing CVD as a deadly and chronic disease and their perceptions of the minimal signs and symptoms of the disease in the early stages. This was further compounded by the gap between traditional healers and health care professionals. CONCLUSIONS Perceptions of CVD, its risk factors, and treatments were influenced by religious and cultural factors. Given the minimal signs and symptoms experienced in the early stages of the disease, there was a consistent disconnect among African people between seeing CVD as a deadly and chronic illness. Further investigations of the religious and cultural influences and educational programs related to these areas of disconnect are needed to improve the knowledge, attitudes, and beliefs of African people.
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Affiliation(s)
- Seifu Nigussie Tulu
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Nasser Al Salmi
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Quality of Sleep and Its Correlates among Yemeni Medical Students: A Cross-Sectional Study. SLEEP DISORDERS 2021; 2021:8887870. [PMID: 33542840 PMCID: PMC7841446 DOI: 10.1155/2021/8887870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/17/2020] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
Background Sleep disturbance is particularly common among medical students worldwide and affects their wellbeing and academic performance. However, little is known about this issue in Yemen. This study looks at sleep quality and its association with personal and life-style factors and self-reported academic performance among medical students at the largest Yemeni university. Methods A cross-sectional survey was conducted at Sana'a University, Yemen, in 2017. The Pittsburgh Sleep Quality Index (PSQI), consisting of 19 items and 7 components (score range = 0‐3), was used to assess sleep quality. The summation of the components' scores yields the global PSQI score (range = 0‐21). A global PSQI value higher than 5 indicates poor quality of sleep. Logistic regression was applied to look at relationships. Results 240 male (41%) and female (59%) medical students took part in the study with 54% being preclinical and 46% clinical with an average age of 23.3 years (SD = 1.7). The mean global score (SD) was 6.85 (2.8), and 68% of the students (N = 163) were identified as poor sleepers. The mean global PSQI score (SD) and proportion of poor sleepers were higher among males (7.7 (2.8) and 81%, respectively) than females (6.27 (2.42) and 59.2%, respectively), p ≤ 0.001. Good sleep quality was more likely (OR (95% CI)) among females (3.4 (1.3-8.8)), the unmarried (2.8 (1-7.8)), those in good health (2.3 (1.1-4.5)), and nonkhat chewers (4.9 (1.4-17.1)). Nonsmokers were less likely to have good quality sleep compared to occasional smokers (0.185 (0.071-.485)). Stress (30%) and academic workload (21%) were the most commonly reported causes of poor sleep quality. Almost two-thirds of the students (65%) mentioned that disturbed sleep undermined their academic performance. Conclusions Poor sleep quality is common among Sana'a medical students and impacts their academic performance. Specific stress management and sleep hygiene promoting programs should be incorporated early on in medical education.
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Abstract
We describe a case of Catha edulis (Khat) drug-induced liver injury in a 28-year-old man from Yemen. The patient presented with jaundice, fatigue, and anorexia. Extensive workup, including liver biopsy, was performed. This is the first reported case in the United States without definite autoimmune hepatitis. Diagnosis requires high clinical suspicion and extensive workup. Increasing migration and differences in cultural practices lead to the need for an increased awareness of this type of cases, which is underreported.
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Jones NS, Comparin JH. Interpol review of controlled substances 2016-2019. Forensic Sci Int Synerg 2020; 2:608-669. [PMID: 33385148 PMCID: PMC7770462 DOI: 10.1016/j.fsisyn.2020.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.
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Affiliation(s)
- Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
| | - Jeffrey H. Comparin
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
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Carroll FI, Lewin AH, Mascarella SW, Seltzman HH, Reddy PA. Designer drugs: a medicinal chemistry perspective (II). Ann N Y Acad Sci 2020; 1489:48-77. [PMID: 32396701 DOI: 10.1111/nyas.14349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/28/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022]
Abstract
During 2012-2018, the clandestine manufacture of new psychoactive substances (NPS) designed to circumvent substance control regulations increased exponentially worldwide, with concomitant increase in fatalities. This review focuses on three compound classes identified as synthetic opioids, synthetic amphetamines, and synthetic cannabinoids and highlights the medicinal chemistry precedents utilized by clandestine laboratories to develop new NPS with increased brain penetration, longer duration of action, and greater potency. Chemical approaches to illicit drug abuse treatment options, particularly for opioid use disorder, are also discussed.
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Affiliation(s)
- F Ivy Carroll
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina
| | - Anita H Lewin
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina
| | - S Wayne Mascarella
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina
| | - Herbert H Seltzman
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina
| | - P Anantha Reddy
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, North Carolina
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Synthetic cathinones – From natural plant stimulant to new drug of abuse. Eur J Pharmacol 2020; 875:173012. [DOI: 10.1016/j.ejphar.2020.173012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/29/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023]
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Youyou Z, Yalei Y, Yanfei D, Shuquan Z, Zhaoyang L, Liang R, Liang L. Effects of Methcathinone Exposure during Prenatal and Lactational Periods on the Development and the Learning and Memory Abilities of Rat Offspring. Neurotox Res 2020; 38:86-95. [PMID: 32140923 DOI: 10.1007/s12640-020-00184-2] [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: 11/22/2019] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to investigate the effects of prenatal and lactational methcathinone exposure on the development and the learning and memory abilities of rat offspring using a Sprague-Dawley rat model. Pregnant and lactating rats were administered a consecutive daily dose of methcathinone (0.37 mg/kg) or an equivalent volume of saline by injection on gestational days 7-20 and postnatal days 2-15, respectively. The physical development and neurobehavioral test results of rat pups were recorded throughout the lactation period. Morris water maze (MWM) and novel object recognition (NOR) tests were performed from postnatal day 35 to day 42 to assess the learning and memory abilities of rat offspring in adolescence. The occurrence of hair growth and developments in neurological reflexes, such as improvements in limb grasp, righting reflex, and gait, were delayed in pups after perinatal methcathinone exposure compared with that in the control. Results from MWM and NOR tests indicate that perinatal methcathinone exposure induced deficits in spatial memory, learning ability, and novel object exploration in the adolescent offspring compared with that in the control. The impairment of spatial learning and memory was greater in the prenatal exposure group, while the impairment of novel object exploration was greater in the lactational exposure group. These data show that the prenatal and lactational methcathinone exposure induced the delay of physical and neurological reflex development and impaired learning and memory in rat offspring.
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Affiliation(s)
- Zhang Youyou
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Yalei
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Deng Yanfei
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Chongxin Judicial Expertise Center, Wuhan, 430030, China
| | - Zhao Shuquan
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Li Zhaoyang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ren Liang
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Liu Liang
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Ordak M, Nasierowski T, Muszynska E, Bujalska-Zadrozny M. The Psychiatric Characteristics of People on a Mephedrone ("bath salts") Binge. Subst Use Misuse 2020; 55:1610-1617. [PMID: 32306799 DOI: 10.1080/10826084.2020.1753775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Despite solutions presented by the European Union and national regulations introduced by many countries, the problem of mephedrone (4-MMC) is growing. Objectives: The aim of this study was to investigate the effect of regular mephedrone intake with other psychoactive substances on the clinical picture of patients, including self-harms and suicide attempts. Methods: The study involved a group of 601 patients addicted to mephedrone who were admitted to a psychiatric hospital between 2010 and 2018 due to regular mephedrone intake. Results: There was a statistically significant relationship between sleep disorders and mephedrone combined with alcohol (p < .05) or cannabinols (p < .05). However, the highest number of statistically significant correlations was reported when mephedrone was combined with opioids. There was a growing year-on-year percentage of people who attempted suicide because of regular mephedrone intake (p < .001). The more psychoactive substances were combined with mephedrone, the greater the risk of attempted suicide (p < .01). 20% of the examined group were hospitalized several times. Among those hospitalized several times, significantly more people took more than one additional psychoactive substance (p < .01). Conclusions: The more psychoactive substances combined with mephedrone, the more clinical symptoms are associated with it.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | | | - Elzbieta Muszynska
- Department of Medical Biology, Medical University of Bialystok, Bialystok, Poland
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
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Association between qat chewing and dyslipidaemia among young males. J Taibah Univ Med Sci 2019; 14:538-546. [PMID: 31908642 PMCID: PMC6940620 DOI: 10.1016/j.jtumed.2019.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This study investigated the association between qat chewing and prevalence and patterns of dyslipidaemia among young Yemeni males. Methods In this cross-sectional study, we used a multistage random cluster sampling method. Data were obtained using a questionnaire. Additionally, anthropometric measurements and fasting blood samples were collected. We used Program-Adult Treatment Panel III. The blood samples were analysed for lipid profile measurements including levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Results A total of 440 Yemeni male with mean age of 21.4 ± 3.6 years were enrolled. The students were divided into the following two groups—qat chewers (n = 283) and non-qat chewers (n = 77). The overall occurrence of dyslipidaemia was significantly higher in qat chewers than that in non-qat chewers (89.8% versus 80.5%) (P < 0.05). Hypercholesterolaemia, hypertriglyceridaemia, high LDL-C level, and mixed hyperlipidaemia were lower in qat chewers than in non-qat chewers (16.6%, 58.3%, 16.3%, and 10.6%, respectively, versus 20.8%, 64.9%, 18.2%, and 20.8%, respectively). Isolated hypertriglyceridaemia was slightly higher in qat chewers than in non-qat chewers (47.7% versus 44.2%). However, the incidence of low HDL-C level, isolated low HDL-C level, and isolated hypercholesterolaemia were generally higher in qat chewers than in non-qat chewers (83%, 25.1%, and 6%, respectively, versus 75.3%, 15.6%, and 0%, respectively). Conclusion This study showed high prevalence of dyslipidaemia among Yemeni male qat chewers. Low HDL-C level was the main lipid variable, followed by hypertriglyceridaemia. Genetic factors, war conditions, physical inactivity, and low-fat traditional Yemeni diet were considered the determinants of the study findings.
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