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Background: Chewing Khat (Catha edulis) releases cathine and cathinone, which may reduce appetite via an unknown mechanism. This study investigated the peripheral and central effects of fresh leaves and buds of Catha edulis water extract (CEWE) on appetite biomarkers, gene expression, and body weight, using in vivo, ex vivo, and in silico models. Methods: Rats of both sexes were orally administered CEWE at different doses and durations in three different experiments. Liquid chromatography-mass spectroscopy (LC-MS)-MS was used to detect cathinone and cathine in the murine blood. The effect of Khat on serotonin receptors was studied in isolated rat fundus samples. Docking of the two Khat ligands was performed on G (The 5-hydroxytryptamine-type 2C receptor (5-HT2C) in an agonist-bound active conformation) and H (5-HT2C in an antagonist-bound inactive conformation) proteins to determine which ligands are most likely to act as agonists or antagonists. Results: Significant differences (P < 0.05) in body weight were observed between the CEWE-treated groups and the controls over eight weeks. However, the plasma leptin and ghrelin levels did not change significantly (P > 0.05). The expression of the ghrelin and leptin genes was also unaffected, but the expression of the 5-hydroxytryptamine (5-HT) gene decreased (P < 0.05) with CEWE treatment. CEWE antagonizes 5-HT receptors in isolated rat fundus samples. Docking findings indicated that the khat ligands bound to 5-HT2C receptors. Cathine and cathinone levels in rat plasma were measured. Conclusion: Khat extract may suppress appetite by antagonizing the 5-HT receptors. Further research is required to understand its mechanism and potential applications. [ABSTRACT FROM AUTHOR]

This paper aims to explore the possibility of utilizing vision transformers (ViTs) for on-edge medical diagnostics by experimenting with the Kvasir-Capsule image classification dataset, a large-scale image dataset of gastrointestinal diseases. Quantization techniques made available through TensorFlow Lite (TFLite), including post-training float-16 (F16) quantization and quantization-aware training (QAT), are applied to achieve reductions in model size, without compromising performance. The seven ViT models selected for this study are EfficientFormerV2S2, EfficientViT_B0, EfficientViT_M4, MobileViT_V2_050, MobileViT_V2_100, MobileViT_V2_175, and RepViT_M11. Three metrics are considered when analyzing a model: (i) F1-score, (ii) model size, and (iii) performance-to-size ratio, where performance is the F1-score and size is the model size in megabytes (MB). In terms of F1-score, we show that MobileViT_V2_175 with F16 quantization outperforms all other models with an F1-score of 0.9534. On the other hand, MobileViT_V2_050 trained using QAT was scaled down to a model size of 1.70 MB, making it the smallest model amongst the variations this paper examined. MobileViT_V2_050 also achieved the highest performance-to-size ratio of 41.25. Despite preferring smaller models for latency and memory concerns, medical diagnostics cannot afford poor-performing models. We conclude that MobileViT_V2_175 with F16 quantization is our best-performing model, with a small size of 27.47 MB, providing a benchmark for lightweight models on the Kvasir-Capsule dataset. [ABSTRACT FROM AUTHOR]

Objective: The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. Methods: This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. Results: A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p < 0.001), shisha use (20.3% vs. 17.2%, p < 0.01), and cigarette smoking (8.8% vs. 2.6%, p < 0.001). Male gender, older age, poor knowledge, khat chewing, parents' low education level, and parents' and peers' smoking habits were significant determinants of adolescents' cigarette smoking status. Private education, male gender, older age, poor knowledge, parents' low education level, and parents' and peers' khat chewing habits were significant determinants of adolescents' khat chewing status. The participant's knowledge of and attitudes toward tobacco use and khat chewing were inadequate. Conclusion: The prevalence of khat chewing, shisha use, and to lesser extent cigarette smoking among Yemeni adolescents is high that needs immediate intervention. The results highlight the urgent need to implement prevention strategies to tackle these habits among the youth in Yemen. [ABSTRACT FROM AUTHOR]

This study investigates the use of manganese oxide-biochar-nanocomposites synthesized from coffee husk (CH) and khat leftover (KL) for Cr(VI) removal from water. Two pristine biochars of CH and KL were separately synthesized by pyrolyzing their biomasses at 300 C for 1 h. Similarly, biochar-based nanocomposites were synthesized by pretreating 25 g of each biomass with 12.5 mmol of KMnO4 and pyrolyzing at 300 C for 1 h. The pristine biochars, synthesized by pyrolysis of CH and KL, removed 74.98% and 84.78% of Cr(VI) from aqueous solutions containing 20 mg L-1, respectively. However, the resulting nanocomposites exhibited a maximum removal efficiency of 99.63% with manganese oxide-coffee husk biochar nanocomposite (MnOX-CHBNC) and 99.84% with manganese oxide-khat leftover biochar nanocomposite (MnOX-KLBNC) of the Cr(VI). The adsorption isotherm fitted well with the Langmuir isotherm, indicating favorable monolayer adsorption. The kinetics of adsorption followed the pseudo-first-order model. The MnOX-CHBNC and MnOX-KLBNC demonstrated satisfactory removal efficiencies even up to six cycles, indicating their potential effectiveness for large-scale use in removing Cr (VI) from wastewater. [ABSTRACT FROM AUTHOR]

Leaves of the Khat plant are widely consumed in the Horn of Africa, Yemen and the Jazan region of Saudi Arabia. I have investigated the mode of cardiovascular and autonomic actions of the stimulant cathine from Khat in terms of direct or indirect adrenergic actions in anaesthetised male and female rats, and in isolated tissues. Male and female rats were anaesthetised with pentobarbitone and changes in diastolic blood pressure and cardioaccelerator responses were examined in vehicle‐treated or chemically sympathectomised rats. Cathine produced marked tachycardia and smaller blood pressure responses in vehicle‐treated animals, with significant rises in heart rate occurring at cathine (0.1 mg/kg). In sympathectomised rats, cardiac actions were greatly attenuated in both male and female animals, with no differences between male and female rats. Although pressor responses to cathine were relatively small, sympathectomy significantly reduced these responses in female, but not male, rats. In rat aorta and spleen, cathine produced almost no direct contractions. It is concluded that cathine acts predominantly indirectly, presumably by the release of noradrenaline, in both male and female rats to produce cardiovascular actions. This may have implications for adverse cardiovascular actions of consumption of the plant Khat, particularly with dried Khat, in which actions of cathine may predominate over those of cathinone. [ABSTRACT FROM AUTHOR]

Abstract This study aimed to evaluate the effects of oral contraceptive (OC) use, khat chewing, and their combined effect on telomerase level and tumor suppressor genes, p53 and p21 in breast cancer (BC) patients and normal volunteers. 140 Yemeni women aged 25–40 years old enrolled, 60 newly diagnosed pretreated BC patients, and 80 control subjects. Venous blood (5 ml) was collected and the results showed BC patients to have significantly raised levels of telomerase, p53, and p21 compared to the control group. The use of OCs significantly raised telomerase in control group with no effect in BC patients; whereas p53 and p21 were significantly increased in BC patients. On the other hand, khat chewing significantly increased p53 in controls and BC patients, whereas p21 was significantly raised in BC patients. The combined use of OCs and khat chewing significantly increased telomerase and p53 in control group, and significantly increased p53 and p21 in BC patients. Telomerase was shown to be a risk factor (OR 4.4) for BC, and the use of OCs was a high-risk factor for increasing telomerase (OR 27.8) in normal subjects. In contrast, khat chewing was shown to be protective (OR 0.142), and the combined use of OCs and khat chewing decreased the risk factor of telomerase from OR 27.8 to 2.1.

Abstract Khat, a naturally growing stimulant, has seen a significant increase in both consumption and cultivation in eastern Ethiopia. This reliance on khat in the region comes despite its known physiological complications, with users unable to restrict khat use due to its pervasive impact on their livelihood. This qualitative study sought to understand the meaning that those in eastern Ethiopia attribute to khat and explore their firsthand experiences with the substance. In June and July of 2023, six unstructured interviews were conducted among residents of the Haramaya District in Ethiopia. To promote a holistic comprehension of the participants’ lived experiences, an interpretative phenomenological analysis approach was employed when collecting and analyzing the data. Participant responses were coded independently from one another by two different researchers identifying superordinate and corresponding subordinate themes. Among the participants, six superordinate themes were captured: economic backbone of the region, market disruption & fluctuation, pesticide use, societal relationships around khat, applications of khat, and access to healthcare. The participants’ responses indicated that the normalization of khat use, coupled with the downplaying of its addictive potential, has established a framework where khat consumption is not only allowed but, in some cases, even encouraged. The unique interplay between communal practice and individual preservation creates a cyclical effect of using khat to supplement energy to farm khat and then sell or stimulate further work on their farm. This study illuminates the transitionfrom what was once the traditional or spiritual use of khat, to a more practical use for ensuring economic livelihood.

Khat (Catha edulis) also known as “Mairungi” in Uganda, is a green shrub whose leaves are chewed in social gatherings and designated hotspots mainly for its euphoric effect. The socio-economic and health impacts of khat have been previously reported. However, the nutritional implications of khat chewing need to be investigated. A cross-sectional study with a descriptive approach was done to assess the nutritional status of adult male users of khat in the Nakawa division, Kampala city. Using chain sampling, khat users and hot spots were mapped, identified, and listed. Using simple random sampling, 100 khat users were targeted to consent for structured interviews and an assessment of nutritional status over a 3-month persuasion period. Anthropometric data were used to compute the Body Mass Index (BMI) and dietary information was assessed based on food groups consumed and thresholds of Recommended Dietary Allowances (RDA). The degree of relationship among variables was statistically evaluated using, chisquare analyses and the ANOVA test. Statistical significance was considered at P < 0.05. Confidentiality was observed by the use of anonymous questionnaires and coded datasheets. The majority of khat users chewed khat daily 56.0% and mixed khat chewing with other intoxicants such as alcohol 35.0%, cigarettes 15.0%, and cannabis 12.0%. The main driver towards khat chewing in Nakawa was peer pressure 60.0%. The Dietary Diversity Score (DDS) was low, medium and high among 20.0%, 57.0% and 23.0% of khat users, respectively. The DDS was significantly associated with the hours spent on khat chewing X²(4) 10.156, P = 0.025 with most users spending more than four hours, and the frequency of khat chewing X²(4)14.423, P = 0.038. Of the 100 respondents, 26.0% were underweight and 3.0% were overweight. The BMI was significantly associated with age P = 0.029, marital status P = 0.023, frequency of khat chewing P = 0.038, the number of meals P = 0.013 and the dietary diversity scores P < 0.001 in khat users. Khat chewing and its associated habits predispose khat users to a double jeopardy of malnutrition and non-communicable diseases (NCDs). There should be tighter control of khat use through policy and legislation with community-based measures to regulate its demand and supply. [ABSTRACT FROM AUTHOR]

AbstractThe objective of the current study is to conduct a meta-analysis of the existing literature concerning the potential impact of khat on the reproductive systems. Five international databases, Embase, Medline/PubMed, Scopus, Web of Knowledge (ISI), and ProQuest, were searched from inception up to the end of January 2024. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used for quality assessment of included studies. After several screening phases,10 articles were included in the final analysis. The pooled meta-analysis showed that women who use khat during pregnancy had a significantly higher chance of having low birth weight (LBW) (OR= 2.51, 95% CI: 1.61-3.95, p-value < 0.001) and congenital anomalies (OR= 3.17, 95% CI: 1.31–7.73, p-value = 0.011) compared to nonusers. The obtained results of the meta-analysis showed that the consumption of khat significantly reduces semen volume (standardized mean difference = −0.903, 95% CI: −1.801 to −0.007, p = 0.048). In conclusion, our study show that significant associations with LBW, congenital anomalies, and reduced semen volume underscores the necessity for additional research to delve deeper into the intricate complexities of how khat affects reproductive health in both women and men. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effects of oral contraceptive (OC) use, khat chewing, and their combined effect on telomerase level and tumor suppressor genes, p53 and p21 in breast cancer (BC) patients and normal volunteers. 140 Yemeni women aged 25–40 years old enrolled, 60 newly diagnosed pretreated BC patients, and 80 control subjects. Venous blood (5 ml) was collected and the results showed BC patients to have significantly raised levels of telomerase, p53, and p21 compared to the control group. The use of OCs significantly raised telomerase in control group with no effect in BC patients; whereas p53 and p21 were significantly increased in BC patients. On the other hand, khat chewing significantly increased p53 in controls and BC patients, whereas p21 was significantly raised in BC patients. The combined use of OCs and khat chewing significantly increased telomerase and p53 in control group, and significantly increased p53 and p21 in BC patients. Telomerase was shown to be a risk factor (OR 4.4) for BC, and the use of OCs was a high-risk factor for increasing telomerase (OR 27.8) in normal subjects. In contrast, khat chewing was shown to be protective (OR 0.142), and the combined use of OCs and khat chewing decreased the risk factor of telomerase from OR 27.8 to 2.1. [ABSTRACT FROM AUTHOR]

Khat, a naturally growing stimulant, has seen a significant increase in both consumption and cultivation in eastern Ethiopia. This reliance on khat in the region comes despite its known physiological complications, with users unable to restrict khat use due to its pervasive impact on their livelihood. This qualitative study sought to understand the meaning that those in eastern Ethiopia attribute to khat and explore their firsthand experiences with the substance. In June and July of 2023, six unstructured interviews were conducted among residents of the Haramaya District in Ethiopia. To promote a holistic comprehension of the participants' lived experiences, an interpretative phenomenological analysis approach was employed when collecting and analyzing the data. Participant responses were coded independently from one another by two different researchers identifying superordinate and corresponding subordinate themes. Among the participants, six superordinate themes were captured: economic backbone of the region, market disruption & fluctuation, pesticide use, societal relationships around khat, applications of khat, and access to healthcare. The participants' responses indicated that the normalization of khat use, coupled with the downplaying of its addictive potential, has established a framework where khat consumption is not only allowed but, in some cases, even encouraged. The unique interplay between communal practice and individual preservation creates a cyclical effect of using khat to supplement energy to farm khat and then sell or stimulate further work on their farm. This study illuminates the transitionfrom what was once the traditional or spiritual use of khat, to a more practical use for ensuring economic livelihood. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the potential of incorporating catha edulis extract into polycaprolacton/gelatin scaffolds using electrospinning technique for the treatment of diabetic wounds in a rat model. Methods: The in vitro characterization of the scaffolds was performed using various assays, including anti-inflammatory assay, microstructure study, DPPH radical scavenging assay, cell viability assay, hemocompatibility assay, and bacterial penetration assays. The scaffolds were then seeded with bone marrow-derived stem cells and cultured before implantation into the rat model. Results: The results of the in vitro study showed that the produced scaffolds were nanofibrous, antioxidative, and non-toxic to skin cells. In vivo study demonstrated that the stem cell and catha edulis extract-loaded scaffolds had the highest rate of wound closure and histomorphometric parameters compared to other groups. Moreover, gene expression studies showed that the developed wound dressings increased the expression of VEGF gene and reduced the expression of glutathione peroxidase gene. Conclusion: These findings suggest that the catha edulis extract-loaded polycaprolacton/gelatin scaffolds could be a promising therapeutic option for diabetic wounds. [ABSTRACT FROM AUTHOR]

This study examined the effects of khat chewing on oral gingival conditions by adopting a targeted process which combined physicochemical analyses of the teeth, histopathological examinations of the gums, and bioinformatics modeling. The physicochemical evaluation of teeth in khat consumers compared to non-consumers was carried out using specific analytical techniques; hence, the results of this initial investigation revealed significant erosion of the tooth enamel due to khat chewing, as well as an alteration of the essential chemical composition of the teeth. Additionally, the histopathological analyses complemented preliminary studies by showing severe inflammation of the gums and oral mucosa in khat users. The understanding of these studies was enriched by bioinformatics analysis, where modeling was carried out via computational methods. This analytical phase examined molecular docking mechanisms, including the interaction between cathinone, the main alkaloid of khat, and the protein receptors involved in the protection of gingival tissues against infections. In summary, this multidisciplinary research provided an in-depth view of the oral health issues related to khat chewing, combining experimental studies with bioinformatics perspectives. [ABSTRACT FROM AUTHOR]

Wastewater from the textile and dyeing industries contains hazardous dyes. This study aims to determine the effectiveness of magnetic biochar nanocomposites synthesized from khat leftovers (KLs) and coffee husks (CHs) in removing methylene blue (MB) from wastewater. Magnetic biochar nanocomposites were synthesized by pretreating 25 g of biomass with a 12.5 mmol mixture of FeS and FeCl3 at a 1:1 molar ratio, followed by pyrolyzing at 300°C for 1 h. The resulting products were analyzed using X‐ray diffraction, Fourier transform infrared, scanning electron microscope, and Brunauer‐Emmett‐Teller. The results showed that the adsorbents are amorphous, and the activated biochars, are more porous and contain various functional groups such as C‐O, C = C, O‐H, C‐H, and Fe‐O. When 0.2 g of pristine biochars of CH and KL were applied to 20 mL aqueous solutions containing 20 mg/L of MB at pH 7.5 and 25°C, they removed 44.73% and 75.26% of MB, respectively. However, the resulting nanocomposites exhibited a maximum removal efficiency of 99.10% and 99.23% with magnetic iron oxide‐CH biochar nanocomposite (Fe3O4‐CHBNC) and magnetic iron oxide‐KL biochar nanocomposite (Fe3O4‐KLBNC), respectively, with maximum adsorption capacities of 51.02 and 78.13 mg/g. The reusability study also showed removal efficiencies of 77.57% and 83.49% up to six‐cycle reuse. [ABSTRACT FROM AUTHOR]

In this paper, dispersive micro-solid phase extraction technique was developed for the purpose of extracting and preconcentrating organochlorine pesticide residues in juice samples before their separation and quantitative analysis by gas chromatography-mass spectrometry. A sorbent composed of a silica-supported Fe2O3-modified khat leftover biochar nanocomposite (SiO2-Fe2O3-KLBNC) was implemented in the process. To improve the dispersion of the sorbent in the solution, vortex mixer was employed. Experimental parameters influencing the performance of the method were optimized, and the optimal conditions were established. With these conditions, linear dynamic ranges ranged from 0.003 to 100.0 ng/mL were achieved, with a correlation coefficient (r2) ≥ 0.9981. The limits of detection and quantification, determined by signal-to-noise ratios of 3 and 10, respectively, were found to be in the ranges of 0.001–0.006 ng/mL and 0.003–0.020 ng/mL. Intra- and inter-day precision, values ranging from 0.3–4.8% and 1.7–5.2% were obtained, respectively. The matrix-matched extraction recoveries demonstrated favorable outcomes, falling within the range of 83.4–108.3%. The utilization of khat leftover as an adsorbent in contemporary sample preparation methodologies offers a cost-effective alternative to the currently available, yet expensive, adsorbents. This renders it economically viable, particularly in resource-constrained regions, and is anticipated to witness widespread adoption in the coming future. [ABSTRACT FROM AUTHOR]

Maladaptive metacognitive thoughts about sleep often precede incidences of sleep disturbances. While the relationship between sleep disturbances and khat dependence is known, no research has examined the function of metacognition as a potential mediator between khat dependency and sleep problems in polysubstance users. This study used a brief structured questionnaire to measure the sleep problems, the severity of khat dependence (SDS-khat), and a metacognition score on khat-chewing polysubstance users (n = 374, age = 26.95 ± 3.80 years). The association was determined using Baron and Kenny's mediation effect model. The average SDS-khat score was 6.66 ± 1.41, and the metacognition score was 26.40 ± 4.09. Severity of khat dependence showed significant negative correlation with metacognition (b = −.53, standard error (SE) =.15, p <.001), and metacognition showed significant negative correlation with complaints of sleep disturbances, sleep deficit-related daytime problems, and sleep deficit-related socio-occupational disturbances (b = −.17, SE =.03, p <.001), (b = −.19, SE =.03, p <.001), (b = −.12, SE =.05, p <.05) respectively. Polysubstance users with khat dependence and comorbid sleep disturbances were more likely to have poor metacognition. [ABSTRACT FROM AUTHOR]

Khat leaves, indigenous to eastern Africa, have been chewed for centuries for their stimulant effects, attributed to alkaloids such as cathinone and cathine. Although associated with gastric disorders like gastritis and gastro-oesophageal reflux disease, the underlying molecular mechanisms remain unclear. This study aimed to examine the morpho-anatomy of khat leaves using light microscopy and histochemistry and to assess the effects of leaf extracts and alkaloids on human gastric epithelial cells (GES-1). The study identified specific cells in the palisade–spongy transition zone as storage sites for psychoactive alkaloids. Leaf extracts were prepared by mimicking the chewing process, including a prolonged salivary phase followed by a gastric phase. Cytotoxicity and cell viability were evaluated using LDH and MTT assays, respectively. Additionally, the impact on IL-8 secretion, a key chemokine in gastric inflammation, was analysed under normal and TNF-α-stimulated conditions. The results showed no increase in cytotoxicity up to 250 µg/mL. However, there was a significant decrease in cell metabolism and a reduction in both basal and TNF-α-induced IL-8 secretion, but cathinone and cathine were inactive. These findings suggest that khat may not directly cause the gastric issues reported in the literature, which would rather be attributed to other confounding factors, highlighting the need for further research to clarify its biological impacts. [ABSTRACT FROM AUTHOR]

Khat contains many bioactive compounds that are beneficial for chickens' health. Most of the chemical constituents found in Khat are biologically active and are used worldwide for the treatment of many diseases. However, there are few studies on the use of Khat in poultry as a nutrition, antioxidant, and antimicrobial activity. Therefore, the present study evaluated the effects of dried Khat leave (DKL) as a natural feed additive on the White Leghorn layer's performance, serum chemistry, and hematology. A total of 180 White Leghorn chickens, aged 168 days were randomly divided into four groups consisting of 45 chickens in three replications. Thirteen layers and two cocks were assigned to each replication and reared on a deep litter system. The diets of layers in T1, T2, T3, and T4 were supplemented by DKL at proportion of 0%, 0.2%, 0.4%, and 0.6%, respectively. The layers were evaluated for feed intake, body weight gain, egg production, feed conversion ratio, and some blood parameters, such as total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, albumin, globulin, red blood cells, hemoglobin, packed cells volume, white blood cells, and total protein. Feed intake in T1 (103.5 g) was significantly higher than T4 (98.5 g) and T3 (98.9 g). Layers in T1 significantly gained higher body weight than layers in other treatments. The use of DKL in layer chickens' diet did not affect egg production, egg mass, and feed conversion ratio. An increase in the level of DKL in the layers diet significantly reduced the serum high-density lipoprotein, cholesterol, and albumin. The present study showed that chickens that received a higher proportion of dried khat leaf (0.6%) significantly recorded lower levels of low-density lipoprotein and total cholesterol in their blood. [ABSTRACT FROM AUTHOR]

In June 2014, the UK Government made khat (Catha edulis) a Class C drug under the UK Misuse of Drugs Act. Based on limited evidence, this decision went against the Government's own Advisory Council on the Misuse of Drugs and has divided members of the British–Somali diaspora, where khat is a popular form of recreation. The Government's decision to ban khat highlights broader questions regarding how ethical legislation is implemented within post-industrial societies, exposing postcolonial power systems that 'Other' migrant groups through synoptic control. Based on qualitative interviews with members of the Somali diaspora and external agencies in Northern England, the research explores how this system fails to consider khat's complex moral position while framing users and those living within the diaspora as deviant. [ABSTRACT FROM AUTHOR]

Chewing dystonia, a variant of focal task-specific dystonia, is a rarely reported condition that causes remarkable decrement in quality-of-life, social embarrassment, and associated mental stress. In this article, we present two case studies that extend previous observations, which indicate a putative association between khat (Catha edulis) consumption and chewing dystonia. While pharmacological treatments such as botulinum toxin injections may be an option, a substantial proportion of affected individuals do not achieve optimal outcomes. If preventable, a medical condition ought to be prevented. The observations presented in the two case studies discussed indicate that khat consumption may be a modifiable risk factor for chewing dystonia.

Background: Chewing fresh leaves of Catha edulis (khat) is a popular pastime activity among Ethiopians where 12% women chew it. Reports show that khat use has been associated with poor nutritional status. This study aimed to determine whether khat chewing is linked to underweight and anemia. Method: We analyzed data from the 2016 Ethiopian Demographic and Health Survey (EDHS). The EDHS used two stage stratified cluster sampling to collected data from 16,650 households. We used data from a total of 15,683 respondents and 1904 respondents who chewed ever chewed khat in their lives. We used Pearson's chi-square, and logistic regression while stratifying by residence (urban vs rural) to control for confounders. Result: Our results indicated 10.7% (95%CI: 10.92,11.26) of women chewed khat for an average of 16.5 days in the previous month. A woman's current khat chewing status was significantly associated with age, educational level, region, religion, wealth group, and marital status. Women aged 40–44 were significantly more likely to chew (AOR = 2.89,) compared to those aged 15–19. Compared with Protestant women, Muslim women were 210 times more likely (AOR = 210, 95% CI 102,435.7) to chew and women in the poorest wealth quintile had 73% higher odds (AOR = 1.73, 95% CI 1.22,2.44) of chewing khat when compared with the richest. Anemia was not associated with a woman's chewing status, whereas rural women who chewed khat for more than 26 days in a month had a 78% increased risk (OR = 1.78) of being underweight when compared to non-chewers. Conclusion: Khat chewing is associated with sociodemographic factors and current khat use is associated with a higher risk of underweight among women living in rural areas. Implementing targeted awareness campaigns for women about the risks of khat chewing is recommended. [ABSTRACT FROM AUTHOR]

Background: Congenital anomalies represent a significant contributor to infant mortality, morbidity, and enduring disability. With this in mind, the present investigation endeavour to ascertain the pooled prevalence of congenital anomalies and associated determinants among neonates in Ethiopia. Method: PubMed, Google Scholar, CINAHAL, Hinari, and Global Health databases were systematically searched. Joanna Briggs Institute (JBI) assessment checklist was used to assess quality of included studies. Data were extracted from database and exported to stataMP-17 for analysis. Pooled prevalence was determined using DerSimonian-Laird random effects model. The degree of heterogeneity and Publication bias were assessed using I2 statistics and Eggers test, respectively. Study protocol was registered under PROSPERO ID CRD42021229140. Result: A total of 18 studies with 519,327 participants were included in the study. Pooled prevalence of congenital anomalies in Ethiopia was 2% (95% CI: 0.02, 0.03%). Among affected newborns neural tube defect (48%) was the most common congenital anomaly in Ethiopia, followed by orofacial cleft (19%). Risk factors such as alcohol consumption (pooled OR: 2.28, 95% CI: 1.54, 3.38), lack of folic acid supplement (pooled OR: 2.83, 95% CI: 1.09–7.36), medication during pregnancy (pooled OR: 2.58, 95% CI: 1.03–6.47), khat (Catha edulis) chewing (pooled OR: 2.44, 95% CI: 1.61–3.71), exposure to pesticides (pooled OR: 4.45, 95% CI: 2.44–8.09) and maternal illness (pooled OR:1.79, 95% CI: 1.03, 3.10) had statistically significant association with congenital anomalies in Ethiopia. Conclusion: In this review, prevalence of congenital anomalies in Ethiopia was high with considerable regional variation. The most common type of congenital anomaly in Ethiopia was neural tube defects, followed by oro-facial cleft. Alcohol consumption, inadequate intake of folic acid, khat chewing, maternal diseases, exposure to pesticides, and use of medication during pregnancy were identified as potential contributors to congenital abnormalities in Ethiopia. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Khat (Catha edulis Forsk) is a stimulant plant grown in East Africa and the Arabian Peninsula. Heavy metal pollution has been a global concern due to its acute and chronic health effects and the major route of exposure is the consumption of contaminated foods. In this study, the determination and health risk assessment of heavy metals (Mn, Cu, Zn, Ni, Cr, Cd, and Pb) in khat and its support soil samples was carried out. Materials and Methods: Khat and its support soil were analyzed for the levels of 7 toxic heavy metals by Atomic Absorption Spectrophotometer. Samples were randomly collected from 3 districts of khat farming kebeles and digested using mixture of strong acids. Results: The concentrations (mg/kg) of analytes in soil and khat samples were: Cu (6.78-35.80); Zn (24.30-199.02); Mn (7.59-1855.40); Ni (6.37-64.80); Cr (0.82-169.20); Cd (14.2-38.8), and Pb (ND). Among the analyzed heavy metals in soil, Mn was with the highest concentration, followed by Zn, Cr, Cu, Ni, and Cd while that of Zn was the maximum followed by Cu, Mn, and Cr in khat. The levels of Zn, Cr, and Cd in soil samples from all study sites and detected concentrations of Cr in khat samples exceeded the recommended FAO/WHO levels. Conclusion: The hazard index (HI) of metals in khat from study areas was less than 1 indicating a less likelihood of non-carcinogenic toxicological health effects. However, the presence of these toxic chemicals in soil and khat indicates product contamination and needs extensive further investigation involving other heavy metals. [ABSTRACT FROM AUTHOR]

Synthetic cathinones, derived from cathinone found in the plant Catha edulis, represent the second largest and most frequently seized group of new psychoactive substances. They are considered as β-keto analogs of amphetamine, sharing pharmacological effects with amphetamine and cocaine. This review describes the neurotoxic properties of synthetic cathinones, encompassing their capacity to induce neuroinflammation, dysregulate neurotransmitter systems, and alter monoamine transporters and receptors. Additionally, it discusses the rewarding and abuse potential of synthetic cathinones drawing from findings obtained through various preclinical animal models, contextualized with other classical psychostimulants. The review also offers an overview of current abuse trends of synthetic cathinones on the illicit drug market, specifying the aspects covered, and underscores the risks they pose to public health. Finally, the review discusses public health initiatives and efforts to reduce the hazards of synthetic cathinones, including harm reduction methods, education, and current clinical management strategies. [ABSTRACT FROM AUTHOR]

Copyright of Itobiad: Journal of the Human & Social Science Researches / İnsan ve Toplum Bilimleri Araştırmaları Dergisi is the property of Itobiad: Journal of the Human & Social Science Researches and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Khat is a kind of common drug plant. Many experiments have shown that the content of cathinone norpseudoephedrine and norephedrine in some varieties of Khat are similar. However, some studies showed that there are differences in the intensity of psychoactivity between these varieties. Therefore, it is speculated that other substances in Khat may affect the psychoactive strength of Khat. But currently there are some difficulties in non-targeted screening of unknown compounds without mass spectrometry database information and standard solutions. In this paper, the unknown cathinone alkaloids in Khat were discovered and resolved by HPLC-Q-TOF MS in-source fragmentation multistage mass spectrometry. The separation was carried out on a ZORBAX Eclipse Plus Phenyl-Hexyl column (3.0 mm×100 mm×1.8 μm) with a gradient elution using 0.1% formic acid in water (A)-acetonitrile (B) as the mobile phase. The mobile phase flow rate was 0.3 mL/min, and the column temperature was 30 ℃. The screening of unknown cathinone alkaloid components was realized by the in-source cleavage characteristics of cathinone alkaloids in single-stage mass spectrometry under full-scan mode using an ESI ion source, and then the molecular structures of the unknown cathinone alkaloid components were deduced from the multi-stage MS cleavage patterns of the unknown cathinone alkaloid components in the target ion acquisition mode. The results showed that this method can effectively realize the screening and resolution of the unknown alkaloid components in Khat. A total of three cathinone alkaloid components, including methcathinone, ethcathinone and 2-amino-1-phenyl-1-butanone, were identified in Khat. Methcathinone and ethcathinone were corroborated using standard substances, and 2-amino-1-phenyl-1-butanone needs to be further corroborated due to the lack of corresponding standard substances. The work provides a guideline for the further study of the psychoactive components in Khat, and a reference for the analysis of unknown compounds in other fields. [ABSTRACT FROM AUTHOR]

Introduction: Khat chewing has been a common habit throughout the Horn of Africa and the Arabian Peninsula for thousands of years. It is estimated that more than 20 million people in Africa and the Arabian Peninsula are adolescents. This study aimed to assess the knowledge, attitude, and self-efficacy of khat chewing among adolescents in Mogadishu, Somalia. Method: A cross-sectional study with a sample of 284 adolescents was used. A self-administered pretested questionnaire was used after obtaining an ethical approval from Universiti Putr Malaysia. Data were coded, entered, and statistically analyzed. Results: The prevalence of khat chewing among respondents was 10.2%. Almost more than half of the participants had poor knowledge (184, 64.8%) and self-efficacy (154, 54.2%), while 140 (49.3%) respondents had positive attitudes. Significant predictors of the students' knowledge of khat chewing included monthly income of more than 500$ (AOR: 2.145), family history such as cousin (AOR=0.347), fathers with a high school (AOR=1.75) and a college degree (AOR=2.21). Significant predictors of the students' attitude towards khat chewing included family income of 100-299 USD (AOR=0.5), fathers' with a high school (AOR=2.5) and college (AOR=2.4). Significant predictors of the students' self-efficacy to resist khat chewing included family income of 100-300$ (AOR=2.25), fathers with a high school (AOR=2.6), and khat accessibility that is fairly difficult (AOR=0.63) and fairly easy (AOR=0.55). Conclusion: The study highlights the need for increased awareness and education about the adverse effects of khat chewing and the importance of addressing social norms and peer pressure in shaping adolescent attitudes toward Khat. [ABSTRACT FROM AUTHOR]

Background: Khat has a stimulating and addictive effect and can induce consequences on the health and socioeconomic status of khat chewers. Objectives: This study aims to assess knowledge, attitude, and practice of khat chewing among parents in Jazan and its consequential effect on their children. Methods: This cross-sectional investigation was conducted in the Jazan region of Saudi Arabia. Data was collected via a web-based, self-administered questionnaire measuring demographics, knowledge, attitudes, and practices concerning khat chewing. The Chi-square test or Fisher's exact test was used to assess factors associated with khat chewing among parents and its consequential effect on their children. Results: A total of 724 parents were included. The sample had an overall good knowledge about the health hazards of khat chewing and an attitude against khat chewing. Nonetheless, the number of parents who reported that they had ever tried khat chewing was 200 (27.6%) and 106 parents (14.6%) confirmed that their children were khat chewers. Additionally, 98 (13.5%) parents declared that they practiced khat chewing in front of their children. Higher frequencies of parents who reported providing khat to their children were identified among parents with higher attitude levels that favor khat chewing (P value = 0.04). Conclusions: Efforts should be made to develop targeted preventive and educational strategies to reduce khat chewing among parents who have favorable attitudes toward khat chewing. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of data on factors associated with khat chewing among women of reproductive age using multilevel analysis. Furthermore, the effects of some potential factors like stressful life events, knowledge about and attitude toward the effects of khat have been given little attention and are not well understood. Therefore, this study aimed to examine the prevalence and multilevel factors associated with khat use among women of reproductive age in Halaba zone, South Ethiopia. Methods: A community-based cross sectional study was conducted in Halaba zone from February to July, 2023. Systematic random sampling technique was used to include 1573 study participants. The dependent variable was current khat use, which is operationalized as using khat within 30 days preceding the study. An interviewer administered questionnaire was used for the data collection. Results: The prevalence of current khat use among women of reproductive age was 65.9% [95%CI (63.5-68.2%)]. Factors significantly associated with khat use were; ages of women 35 and above years [Adjusted Odds Ratio (AOR) = 6.35, 95% CI: (3.62, 11.13)], ever married [AOR= 2.41, 95% CI: (1.10, 5.31)], secondary and above education [AOR= 0.28, 95% CI: (0.15, 0.49)], belong to richer household [AOR= 1.75, 95% CI: (1.12, 2.75)], mass media use [AOR = 3.12, 95% CI: (1.85, 4.81)], low knowledge about khat effects [AOR = 3.12, 95% CI: (1.85, 5.24)], positive attitude towards khat use [AOR = 11.55, 95% CI: (6.76, 19.71)], and strong social support [AOR = 0.43, 95% CI: (0.28, 0.64)] and non-user friend [AOR= 0.31, 95% CI: (0.20, 0.48)]. From the community level variables: rural residence [AOR = 5.06, 95% CI: (1.82, 14.09)] was significantly associated with khat use. Conclusion: Khat use among women of reproductive age was found to be very high. From individual-level factors: advanced ages of women, secondary and above education, live in the richer wealth quintile, mass media exposure, low knowledge on khat effects, positive attitude towards khat use, strong social support, and from community-level variables: residing in rural area were significantly associated with khat use. Khat use screening for all women of childbearing age, as well as referral to substance use disorder centers for those women identified as having khat use disorder, should become a standard of care in all health facilities. [ABSTRACT FROM AUTHOR]

Recent works with the BERT-based models demonstrate their generalization ability and high performance on the new domain tasks. However, this kind of model requires a large amount of data. Collecting this data can be error-prone, and it is important to know: how the errors in data affect the quality of the model. In this work, we study the impact of data with different errors – noisy data on the training of the question answering-over-text BERT-model. We use the concept of random, structural and irrelevant question noises. We study the robustness of QAT models during the training process with different settings, datasets and noise types and discuss possible reasons. We also propose a real-world domain dataset to probe our findings in a real-world scenario. The results of an experimental study showed that following developed recommendations allowed performance improvement up to 3.6% in a real-world setting. [ABSTRACT FROM AUTHOR]

Background: Khat has a stimulating and addictive effect and can induce consequences on the health and socioeconomic status of khat chewers. Objectives: This study aims to assess knowledge, attitude, and practice of khat chewing among parents in Jazan and its consequential effect on their children. Methods: This cross-sectional investigation was conducted in the Jazan region of Saudi Arabia. Data was collected via a web-based, self-administered questionnaire measuring demographics, knowledge, attitudes, and practices concerning khat chewing. The Chi-square test or Fisher's exact test was used to assess factors associated with khat chewing among parents and its consequential effect on their children. Results: A total of 724 parents were included. The sample had an overall good knowledge about the health hazards of khat chewing and an attitude against khat chewing. Nonetheless, the number of parents who reported that they had ever tried khat chewing was 200 (27.6%) and 106 parents (14.6%) confirmed that their children were khat chewers. Additionally, 98 (13.5%) parents declared that they practiced khat chewing in front of their children. Higher frequencies of parents who reported providing khat to their children were identified among parents with higher attitude levels that favor khat chewing (P value = 0.04). Conclusions: Efforts should be made to develop targeted preventive and educational strategies to reduce khat chewing among parents who have favorable attitudes toward khat chewing.

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. [ABSTRACT FROM AUTHOR]

In this study, we investigated the use of manganese oxide-biochar nanocomposites (MnOx-BNC), synthesized from coffee husk (CH) and khat leftover (KL) for the removal of methylene blue (MB) from wastewater. Pristine biochars of each biomass (CH and KL) as well as their corresponding biochar-based nanocomposites were synthesized by pyrolyzing at 300°C for 1 h. The biochar-based nanocomposites were synthesized by pretreating 25 g of each biomass with 12.5 mmol of KMnO4. To assess the MB removal efficiency, we conducted preliminary tests using 0.2 g of each adsorbent, 20 mL of 20 mg·L−1 MB, pH 7.5, and shaking the mixture at 200 rpm and for 2 h at 25°C. The results showed that the pristine biochar of CH and KL removed 39.08% and 75.26% of MB from aqueous solutions, respectively. However, the MnOx-BNCs removed 99.27% with manganese oxide-coffee husk biochar nanocomposite (MnOx-CHBNC) and 98.20% with manganese oxide-khat leftover biochar nanocomposite (MnOx-KLBNC) of the MB, which are significantly higher than their corresponding pristine biochars. The adsorption process followed the Langmuir isotherm and a pseudo-second-order model, indicating favorable monolayer adsorption. The MnOx-CHBNC and MnOx-KLBNC demonstrated satisfactory removal efficiencies even after three and six cycles of reuse, respectively, indicating their potential effectiveness for alternative use in removing MB from wastewater. [ABSTRACT FROM AUTHOR]

The characteristic alkaloid component of the leaves of the catnip shrub (Catha edulis) is cathinone, and its synthetic analogs form a major group of recreational drugs. Cathinone derivatives are chiral compounds. In the literature, several chiral methods using cyclodextrins (CDs) have been achieved so far for diverse sets of analogs; however, a comprehensive investigation of the stability of their CD complexes has not been performed yet. To characterize the enantioselective complex formation, a systematic experimental design was developed in which a total number of 40 neutral, positively, and negatively charged CD derivatives were screened by affinity capillary electrophoresis and compared according to their cavity size, substituent type, and location. The functional groups responsible for the favorable interactions were identified in the case of para-substituted cathinone analog mephedrone, flephedrone, and 4-methylethcathinone (4-MEC) and in the case of 3,4-methylendioxy derivative butylone and methylenedioxypyrovalerone (MDPV). The succinylated-β-CD and subetadex exhibited the highest complex stabilities among the studied drugs. The complex stoichiometry was determined using the Job's plot method, and the complex structures were further studied using ROESY NMR measurements. The results of our enantioselective complex formation study can facilitate chiral method development and may lead to evaluate potential CD-based antidotes for cathinone analogs. [ABSTRACT FROM AUTHOR]

Copyright of Forensic Science & Technology is the property of Institute of Forensic Science, Ministry of Public Security and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Contamination of farm produce by toxic heavy metals has become a serious global health concern. These metals can bioaccumulate in plant tissues and are precursors for major public health problems such as cancer and neural impairment. Khat (Catha edulis) also referred to as miraa has the potential to sequester and accumulate both micronutrients and potentially toxic heavy metals in its consumable parts—tender leaves and soft barks of young shoots which are known to possess psychoactive properties when consumed. Therefore, the motivation behind this contribution is to determine the levels of six heavy metals, namely, cadmium (Cd), copper (Cu), chromium (Cr), lead (Pb), iron (Fe), and nickel (Ni) in consumable Meru khat samples, compare these levels with the permissible limits of World Health Organization (WHO) in order to predict associated health risks, and to estimate the noncarcinogenic risks of these metals by total health quotient (THQ) and health index (HI) on khat consumers. 1.0 g of dry ground khat samples was digested in 0.05 M HCl and allowed to stand for 5 hours before being analyzed for heavy metals using inductively coupled plasma atomic emission spectroscopy (ICP-AES). The mean heavy metal concentrations (mg/kg) in dry khat samples of six toxic heavy metals were Cd (7.81 ± 1.56), Cr (15.98 ± 2.22), Cu (15.81 ± 2.84), Fe (97.35 ± 32.67), Ni (0.37 ± 0.02), and Pb (32.36 ± 9.95). Based on the results, the mean levels of Pb, Cd, and Cr exceeded WHO permissible limits. In addition, the Pb and Cd THQ values and the HI of the six heavy metals investigated in the khat samples exceeded the threshold value of 1.0. Furthermore, the THQ and HI values showed that Pb and Cd were potentially the major contributors to noncarcinogenic risks on regular khat consumers. This is a matter of concern on the excessive consumption of Meru khat-based products, which over time may cause a toxicological response. Based on the findings of this study, the use of agrochemicals should significantly be minimized in khat farming. Accordingly, the Meru khat farmers should be sensitized on alternative farming practices that do not potentially cause heavy metal contamination in khat. [ABSTRACT FROM AUTHOR]

Introduction: Restriction in the growth of the fetus is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity. Documented existing scientific evidence have shown the effects of maternal drugs use, alcohol drinking, tobacco smoking, cocaine use and heroin use on fetal growth restriction. However, data is lacking on the effects of khat chewing during pregnancy on fetal growth status and newborn size at birth. Therefore, the aim of the present study was to measure the effect of chewing khat during pregnancy on fetal growth and size at birth in eastern Ethiopia. Method: A cohort study was conducted in selected health institutions in eastern Ethiopia. All pregnant women fulfilled the eligibility criteria in the selected health institutions was the source population. The calculated sample size of exposed and unexposed groups included in the study, in total, was 344. Data collection was performed prospectively by interviewers administered questionnaires, and anthropometric, clinical and ultrasound measurements. Data was analyzed using SPSS version 27 and STATA version 16 software. The survival analysis (cox proportional hazards model) and generalized linear model (GLM) for the binomial family analysis were performed to estimate the crude and adjusted relative risk and attributable risk (AR) with corresponding 95% CI of chewing khat on fetal growth restriction. The mediation effect has been examined through Generalized Structural Equation Modeling (GSEM) analysis using the Stata 'gsem' command. Statistically significant association was declared at p-value less than 5%. Results: In the present study, the incidence of fetal growth restriction (FGR) among the study cohorts was 95 (29.7%); of this, 81 (85.3%) were among khat chewer cohorts. The relative risk of fetal growth restriction among khat chewer cohort mothers was significantly higher (aRR = 4.32; 95%CI 2.62–7.12). Moreover, the incidence of small for gestational age at birth among the present study cohorts was 100 (31.3%); 84 (84%) were from khat chewer cohorts' deliveries. More importantly, in the present study, 98.95% of the ultrasound-identified fetuses with FGR were found to be SGA at birth. Hence, in the current study, FGR was highly associated with SGA at birth. In additional analysis, the regression coefficient of khat chewing during pregnancy on fetal growth restriction has been decreased in size from path o, β = 0.43, p < 0.001 to path o', β = 0.32, p < 0.001, after adjusting for gestational hypertension and maternal anemia. Conclusion: In sum, the present study showed khat chewing during pregnancy is not simply affected the mothers, but it also affected the unborn fetuses. Therefore, the health workers as well as the local community and religious leaders should give high emphasis on provision of health education regarding the damage of chewing khat by pregnant mothers, with especial focus of the effects on their fetuses. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionThis study examines the opinions of khat-chewers and local social service providers about the current regulatory framework for khat and their preferred policy option(s).Interviews were conducted with 102 khat-chewing individuals, five habitual groups, and ten social service providers in Jimma, Ethiopia.Most of the participants believe that neither laissez-faire nor prohibition policies are appropriate. Reasons for supporting the reform of the current laissez-faire approach include: worries about the escalating use of khat, concerns about the safety of the khat supply, the adverse effects of khat on the city’s aesthetics and hygiene, and negative impacts on economic security. Reasons for opposing the introduction of a policy of prohibition include: prohibition would be counterproductive, and it would undermine the socioeconomic significance of khat. However, the study participants did suggest several regulatory activities, which can be thematized into primary and secondary preventive strategies.The preferred regulatory approaches include addressing the structural causes of (problematic) khat use, empowering khat-chewers with awareness about appropriate use, managing the supply of khat, and restricting the age of users and place of use. These regulations are intended to reduce supply, demand and harm, and they depict the khat problem as a complex system. [ABSTRACT FROM AUTHOR]

In several countries, including Ethiopia, the shrub Catha edulis (khat) leaves are chewed for their stimulant properties. The present review summarizes evidence on the prevalence of khat use in Ethiopia and forwards recommendations for future action. PubMed, Embase, and Scopus were searched for studies examining the prevalence of Khat chewing among adolescent and/or adult populations in Ethiopia. A random-effects model was employed to estimate the pooled prevalence of khat chewing. Of the 568 articles identified, 26 were included in the review. The pooled prevalence of current and lifetime khat use was 19.55% (95% CI 14.62–25.64) and 26.14% (CI 17.66–36.87), respectively. The current prevalence of khat use was higher in men, 23.72% (CI 13.42–38.41), than in women 8.45% (CI 4.94–14.08). Lifetime prevalence of khat use was higher in men, 29.8% (CI: 22.80–37.99) than in women 13.02% (CI 8.96–18.56). The results of the meta-analysis demonstrated a higher odds of current (OR = 4.00, CI 2.80–5.73) and lifetime (OR = 2.84, CI 2.50–3.23) khat use in men than in women. Our review found a high prevalence of current (19.55%) and lifetime (26.14%) khat chewing in Ethiopia and demonstrated higher odds of current and lifetime khat use in men than in women. Awareness creation and integrated management of khat use problems at the primary health-care level is highly recommended. [ABSTRACT FROM AUTHOR]

Chewing dystonia, a variant of focal task-specific dystonia, is a rarely reported condition that causes remarkable decrement in quality-of-life, social embarrassment, and associated mental stress. In this article, we present two case studies that extend previous observations, which indicate a putative association between khat (Catha edulis) consumption and chewing dystonia. While pharmacological treatments such as botulinum toxin injections may be an option, a substantial proportion of affected individuals do not achieve optimal outcomes. If preventable, a medical condition ought to be prevented. The observations presented in the two case studies discussed indicate that khat consumption may be a modifiable risk factor for chewing dystonia. [ABSTRACT FROM AUTHOR]

Prolonged stress is a risk factor for the development of mental health problems. This is particularly concerning among immigrant communities because many experienced multiple stressful life events. This study aimed to gain better understanding about attitudes toward mental health and addition, and perspectives about health research among Somali immigrants. Eight focus groups (n = 47) were conducted in the Twin Cities, Minnesota. Comprehensive notes were taken during the session and were translated into English. An open-coding method was used to identify general patterns of responses. Stress, personal commitment, and stigma were related to mental health and addiction. There were gender and generational differences in ideas about addiction. Health research was perceived as acceptable under culturally appropriate conditions. This study provided novel information about mental health and addiction as well as the feasibility of research on mental health and addiction in East African communities. [ABSTRACT FROM AUTHOR]

Khat is a plant that is commonly used for its stimulating effects and is chewed for its psychoactive properties. It creates feelings of euphoria that are similar to when taking amphetamines. There is an association between khat and liver injury, but the mechanism is not well known. We present three cases of khat-induced liver injury. All cases have elevated IgG and either positive antinuclear antibodies (ANA) or anti-smooth muscle antibody (ASMA); each case has a different course and requires different management. One case improved only by stopping khat, one required a short course of steroids and the last case required treatment such as that for autoimmune hepatitis (AIH).

IntroductionKhat, a green leafy plant grown in East Africa and throughout the Arabian Peninsula, is chewed for its psychoactive and amphetamine-like effects, serving as a significant aspect of culture, economic livelihood, and global trade. Khat consumption during pregnancy has been associated with adverse effects, including anemia, premature rupture of membranes, and low birth weight, among others.MethodsThis cross-sectional, explanatory sequential mixed methods study was conducted in the Haramaya District of eastern Ethiopia using a questionnaire and focus group discussions. Questionnaires assessed socio-demographic information, pregnancy history, and diet, including khat use. Data were analyzed using SPSS v28 to include descriptive statistics, proportions, odds ratios, binary logistic regression, and chi-square analysis. FGDs expanded on the knowledge, attitudes, and practices of khat in the region, including pregnant or lactating women from two different kebeles. Two independent reviewers conducted a qualitative content analysis to examine the qualitative findings from the FGDs. Transcripts from the focus groups were entered into NVivo 14 to aid in capturing salient themes.ResultsA total of 444 pregnant women with a median age of 25 years completed the questionnaire. Two-thirds of the women, 66.9%, reported currently consuming khat while pregnant, and 72.7% of them reported daily consumption. The FGD analysis resulted in the discovery of five themes: Economic Livelihood, Maternal Significance, Medicinal Implications of Khat, Pesticide Use, and Social and Cultural Applications.DiscussionThis study revealed an alarming high prevalence of khat consumption among pregnant women in the Haramaya District, highlighting the pressing need for long-term studies to assess the health consequences. The role of khat as both an economic staple and an energy source for daily activities underscores the challenges in curbing its use. The documented health risks associated with the chemicals used in khat cultivation, including cancer, call for interventions to enhance safe agricultural practices in households involved in khat farming.

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.

Khat leaves, indigenous to eastern Africa, have been chewed for centuries for their stimulant effects, attributed to alkaloids such as cathinone and cathine. Although associated with gastric disorders like gastritis and gastro-oesophageal reflux disease, the underlying molecular mechanisms remain unclear. This study aimed to examine the morpho-anatomy of khat leaves using light microscopy and histochemistry and to assess the effects of leaf extracts and alkaloids on human gastric epithelial cells (GES-1). The study identified specific cells in the palisade–spongy transition zone as storage sites for psychoactive alkaloids. Leaf extracts were prepared by mimicking the chewing process, including a prolonged salivary phase followed by a gastric phase. Cytotoxicity and cell viability were evaluated using LDH and MTT assays, respectively. Additionally, the impact on IL-8 secretion, a key chemokine in gastric inflammation, was analysed under normal and TNF-α-stimulated conditions. The results showed no increase in cytotoxicity up to 250 µg/mL. However, there was a significant decrease in cell metabolism and a reduction in both basal and TNF-α-induced IL-8 secretion, but cathinone and cathine were inactive. These findings suggest that khat may not directly cause the gastric issues reported in the literature, which would rather be attributed to other confounding factors, highlighting the need for further research to clarify its biological impacts.

Context: Catha edulis (khat) is a prevalent plant in Yemen and other African regions. In Yemen and other countries, most people chew this plant, which may change the pharmacokinetics of many drugs, such as anti-diabetics (glibenclamide and metformin). Aims: To evaluate the effect of C. edulis presence in the gastrointestinal tract (GIT) on the intestinal perfusion and bioavailability of metformin and glibenclamide and its effectiveness. Methods: The present study was conducted in situ using the closed-loop Doluisio’s method. Rat intestinal perfusion of a reference standard of each test drug alone was compared to the drug intestinal perfusion in the presence of C. edulis (three types of C. edulis agriculture in different regions of Yemen). The type of C. edulis that produced the most influence on the absorption of the drug reference was then re-investigated using the same in situ method against a pharmaceutical dosage form (tablets) of the drug. Results: The intestinal absorptions (perfusion) of reference standards of metformin and glibenclamide were decreased in the presence of C. edulis by 30.53-35.9% and 14.71-27.93%, respectively, while such decrease with pharmaceutical dosage form (tablets) of the two drugs was 24.24 and 19.77%, respectively. Conclusions: Based on the results reached from this study, the anti-diabetic bioavailability was significantly reduced in the presence of C. edulis, and this effect may affect the drug efficacy.

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.

In this study, iron oxide biochar nanocomposites made from khat leftover (KL) and coffee husk (CH) are investigated as possibly useful adsorbents for the removal of Cr (VI) from water. Biochar-based iron oxide nanocomposites were synthesized by pretreating 25 g of biomass with a 1:1 M ratio of FeS to FeCl3 and pyrolyzing at 300 °C for 1 h. Pristine biochar, synthesized through biomass pyrolysis of CH and KL at 300 °C, removed 74.98% and 84.78% of Cr (VI) from aqueous solutions containing 20 mg L−1, respectively. The corresponding nanocomposites showed a maximum removal efficiency for Cr (VI) of 99.83% with the iron oxide-coffee husk biochar nanocomposite (Fe3O4–CHBNC) and 99.86% with the iron oxide-khat leftover biochar nanocomposite (Fe3O4-KLBNC). A pseudo-second-order model and the Langmuir isotherm are both well-fitted by the adsorption process, suggesting advantageous monolayer adsorption. The Fe3O4–CHBNC and Fe3O4-KLBNC demonstrated satisfactory removal efficiencies even up to six cycles, indicating their potential effectiveness for large-scale use for treating wastewater contaminated by Cr (VI).

Smallholder farmers in the Wondo Genet were forced to switch from long-standing, diverse traditional home gardens to monoculture khat production due to increasing population pressure-induced farmland constraints. The composition of woody species and the biomass carbon stock are thought to drop as homegardens transition from polyculture to monoculture; however there is little quantitative evidence to support this claim. This study was started to assess the effects on woody species, enset, and biomass carbon of converting traditional homegardens to a fast spreading perennial monocropping of khat (Catha edulis Forskal). In 10 m × 10 m (100m2) plots from 43 farms with neighboring land use patterns for each homegarden and khat, woody species and enset were inventoried, the total number of tree, shrub, and enset species counted, as well as the height and diameter of each species measured. To determine the biomass carbon stock of each land use type, both general and species-specific allometric equations are used. Simpson's diversity index, Shannon-Wiener, and Shannon equitability were used to evaluate the diversity of enset and woody species. There were 27 different types of woody species identified, with trees making up 67 % of the total and shrubs accounting for 33 %. Shannon, Simpson, and the richness of woody species all decreased by 46 %, 51 %, and 38 %, respectively, in comparison to residential gardens. For homegardens and khat, respectively, the mean Evenness values were 0.876 and 0.539. In homegardens, Coffea arabica was the most valuable woody species, followed by Cordia africana Lam, Persea americana, Eucalyptus camaldulensis, and Grevillea Robusta. In contrast, Catha edulis was the most valuable woody species in the Khat land use type, followed by Coffea arabica, Croton macrostachyus Del, and Cordia africana. In comparison to homegardens, the above-ground, below-ground, and total biomass carbon reported in khat land use types were reduced by 18 %, 63 %, and 42 %, respectively. Grevillea and Eucalyptus species made up 51 % of the total biomass carbon stock in the homegardens, which suggests that khat and quickly expanding fast-growing plants have displaced native woody species.Understanding the long-term effects of agro-biodiversity loss requires greater research on the implications of the decline in woody species diversity and biomass carbon stock on soil fertility and sustainable farming. This is due to the numerous functions that woody species and enset play.