Khat Chewer Research Articles

Poor sleep quality and associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Poor sleep quality is linked to physiological dysfunction, which increases the risk of obesity, cardiovascular disease, cognitive impairment, and other medical conditions. Despite the known health risks of sleep disturbances, literature is still scant regarding sleep quality and its associated factors among healthcare professionals in Ethiopia. Therefore, this study aimed to determine the prevalence of poor sleep quality and its associated factors among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A total of 418 healthcare professionals participated in the study. The study participants were chosen using the stratified random sampling method. Data were collected using a structured, self-administered questionnaire. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of participants. Bi-variable and multivariable logistic regression models were used. p≤ 0.05 was used to declare statistically significant variables. The mean age of the study participants was 30.7 years (SD ± 6.3). The overall prevalence of poor sleep quality was 58.9% [95% CI (54.2, 63.6%)]. Being female [adjusted odds ratio (AOR) = 1.9, 95% CI (1.2, 2.9)], being a shift worker [AOR = 5.7, 95% CI (2.3, 14.3), not performing regular exercise [AOR = 2.08 (1.2-3.6)], being a khat chewer [AOR = 3.1, 95% CI (1.2, 7.6)], and having depressive symptoms [AOR = 2.6, 95% CI (1.3, 6.8)] were significantly associated with higher odds of having poor sleep quality. The prevalence of poor sleep quality among healthcare professionals was found to be high. As a result, we recommend that healthcare providers at the University of Gondar Comprehensive Specialized Hospital focus on early regular screening for sleep disturbances and pay special attention to shift work schedules and behaviors such as khat chewing, exercise, and depressive symptoms.

Impact of Khat (Catha edulis) Chewing on Inflammatory Markers and Advanced Glycation End Products among Yemeni Women

Khat chewing has spread widely among women in Yemeni society. This modifiable lifestyle may increase the level of inflammatory markers and advanced glycation end productions (AGE, s). Limited data are available. There is limited data on the impact of khat chewing on inflammatory markers and AGE, s. Therefore, this project aimed to study the effect of khat chewing on inflammatory markers and AGE, s in Yemeni females. One hundred and eighty Yemeni females signed the consent form and donated blood 60 of them were non-khat chewers (control group), and 120 were daily khat chewers. The levels of high-sensitivity C-Reactive Protein (hs-CRP) and interleukin were higher in khat chewers than in non-Khat chewers. There were no differences in total white blood cells, neutrophils, and lymphocytes between khat chewer and non-Khat chewer females. The levels of (AGEs) were similar between khat chewers and non-khat chewers females (P=0.612). Analysis of covariantcet (ANCOVA) showed that khat chewing increased hs-CRP and interleukin-6 levels among khat chewers (p < 0.005; p < 0.034) compared to non-khat chewer. In conclusion, khat chewing increased hs-CRP, a cardiovascular risk prediction factor, and interleukin-6, which is associated with obesity, insulin resistance, and type 2 diabetes mellitus (T2DM). Therefore, women with continuous khat chewing are at a high risk of developing cardiovascular diseases and T2DM.

Khat chewing habit among high school students in Kabridahar City of Somali regional state, Ethiopia: prevalence and determining factors

ABSTRACT Background & Objective Khat has been used by about 10 million people in Somalia, Yemen, Ethiopia, Djibouti, and Kenya. Several epidemiological studies highlighted the adverse health and social problems associated with excessive khat use. The aim of this study was to estimate the prevalence of khat use in secondary schools in Kabridahar where the use of khat is widely seen as problematic. Methods and Materials We conducted a cross-sectional study with a random sample of 251 children from three secondary schools in Kabridahar, Somali region of Ethiopia. We used demographic and khat questionnaires to collect data. Descriptive statistics and logistic regression analyses were employed to examine associations between variables. Result The study found a 16.7% lifetime prevalence of khat chewing and 8.4% current use among the secondary school children, respectively. Being a male student, having a smoking habit, befriending a khat chewer, having a family member who chews, and low level of literacy in the students’ responsible individual were found to be significantly associated with khat chewing habit among students. Conclusion The overall result of the present study indicates that the lifetime and current khat chewing prevalence were high for school children.

Impact of Khat Chewing on Serum Uric Acid and Albuminuria Levels in Yemeni Type II Diabetes Mellitus Patients

Background: Diabetes mellitus is the major cause of end-stage renal disease and is a common endocrine illness defined by chronic hyperglycemia. In addition to diabetes, substance addiction is considered to be a cause of renal issues. The World Health Organization has classed khat (Catha edulis) as an illicit substance. Khat interferes with regular physiological activities, which may have negative health impacts on organs and systems. 
 Objectives: To determine the effect of khat and uric acid on nephropathy in type II diabetes mellitus.
 Materials and Methods: This is an analytical, cross-sectional study that was conducted on 215 males aged 35 to 55 years who had previously been diagnosed with type II diabetes mellitus and were visiting AL- Thawra General Hospital in Ibb City. The diabetic person was corresponded in age and BMI by the control participant. The subjects were divided into two groups. There were 105 people with type II diabetes mellitus (59% chewing Khat and 46% not chewing Khat), 110 people were healthy and did not have type II diabetes (44% of them chewed Khat and 66% did not chew Khat). 
 Results: A significant increase in albuminuria and proteinuria within the normal range in the diabetes mellitus Khat Chewer group compared to the diabetes mellitus Non-Khat Chewer group (p˂0.001). However, no significant differences were seen in the healthy control group.
 Conclusion: Khat chewing has a strong effect on those with type II diabetes and increases the progression of kidney nephropathy. There was an association between khat chewing and higher uric acid levels in both diabetic and non-diabetic patients.

The effect of possible mediators on the association between chewing khat during pregnancy and fetal growth and newborn size at birth in Eastern Ethiopia

IntroductionRestriction 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.MethodA 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%.ResultsIn 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.ConclusionIn 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.

Magnitude and predictors of stroke treatment outcomes in low resource settings: A cross-sectional study

BackgroundStroke is one of the most common causes of morbidity and mortality worldwide. The global burden of disease study indicates that 87% of stroke deaths occur in low- and middle-income regions. Currently, stroke has become an important public health problem in Ethiopia. According to the latest World Health Organization (WHO) data published in May 2018, stroke deaths in Ethiopia reached 32,859 or 5.38% of total deaths. It is the fourth leading cause of death. So the current study was aimed to assess stroke treatment outcomes and their associated factors. MethodA cross-sectional study design was conducted on stroke patients who had been hospitalized in the last two years (April 1, 2020, to March 31, 2022) using a simple random technique. The stroke treatment outcome was the outcome variable. The collected data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Descriptive statistics and logistic regression were done, and P-values less than 0.05 were considered statistically significant with 95% confidence intervals (CI). ResultOf the total 135 hospitalized stroke patients at Mettu Karl Comprehensive Specialized Hospital (MKCSH) and Bedele General Hospital (BGH), the majority 85 (63%) of them were males. About two-thirds of the stroke patients had ischemic strokes 87(64.4%). Regarding their treatment outcomes, nearly two thirds 85(63%) of the patients had poor treatment outcomes. The most commonly prescribed drugs for stroke treatment were Aspirin [ASA] plus Atorvastatin that accounts 50(37%). Age ≥ 65 (AOR: 0.13; 95% CI: 0.027–0.64, P = 0.012), lack of formal education (AOR: 6.5; 95% CI: 1.09–38.81, P = 0.04), chewing a khat (AOR: 2.67; 95% CI: 1.03–6.9, P = 0.043), Glasgow coma scale 8 (AOR: 4.33; 95% CI: 1.68–11.32, P = 0.002), and admission to hospital after 24 h of stroke symptom(AOR: 17.7; 95% CI: 3.78–83.5, P < 0.001) were a predictors of stroke treatment outcomes. ConclusionNearly two thirds of the patients had poor treatment outcomes, and ischemic stroke was found to be the most commonlydiagnosed stroke types at Mettu Karl Comprehensive Specialized Hospital (MKCSH) and Bedele General Hospital (BGH). Along with other socio-demographic factors, delayed admission (after 24 h of symptom onset), low Glasgow coma scale and being a khat chewer were strongly associated with poor treatment outcome. Therefore, health education about the effects of khat chewing and the symptoms of strokes should be given to stroke patients in order to prevent the risk of a delayed admission.

Prevalence of Khat (Catha edulis) Chewing and Its Determinants: A Respondent-Driven Survey from Hossana, Ethiopia.

BackgroundEthiopia is a leading khat producer in East Africa, and almost all regions are involved in khat production. Hossana, a small town in Southern Ethiopia, is also actively involved in khat production and its use. However, very few studies have been conducted to investigate the habit of khat chewing in this area. This study was conducted to assess the prevalence and predictors of khat chewing among Hossana residents.MethodsThe study was conducted on 1700 individuals in Hossana town from March 2018 to June 2019. A structured pre-tested self-administered questionnaire was designed and used for data collection. Descriptive statistics and logistic regression were carried out to study the prevalence and predictors of khat chewing in the study area.ResultsThe overall prevalence of khat chewing among the respondents was 58.0% (95% CI 53.4–63.3) of which 68.4% were daily khat users and 31.5% used it occasionally. About 24.7% of females and 75.2% of males had chewed khat. Muslim religion (AOR 2.37; 95% CI 1.58–4.32), male gender (AOR 3.48; 95% CI 2.16–5.61), Older age (AOR 1.36; 95% CI 0.84–2.21), participants having habitual khat chewing friends or a khat chewer family associate (OR 1.70; 95% CI 1.17–2.20) were found to be independent predictors of chewing.ConclusionSignificant portion of the population in the study area chew khat. Khat use is significantly associated with the Muslim religion, gender, age, and habit of family and friends. Further studies with larger demographic area are warranted from the study area to reproduce these findings.

Habitual khat chewing alters urinary inorganic profile in adult healthy males.

Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24-30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.

Habitual khat chewing alters urinary inorganic profile in adult healthy males.

Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24-30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.

Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

Background:Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia.Objective:Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects.Method:A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement.Result:(Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control.Conclusion:There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects.Recommendation:Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia

Introduction:Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively.Methods:Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant.Results:The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter.Conclusion and recommendation:Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.

Khat Chewing Practice and Associated Factors among Medical Students in Gondar Town, Ethiopia, 2019.

Background:Globally, khat chewing practice becoming an alarming and common among the youth generation, especially in higher educational institutions. It may also lead to frequent misbehavior, poor academic performance, and memory impairment among students. This study aimed to determine the prevalence of khat chewing practice and associated factors among medical students in Gondar town, Ethiopia, 2019.Method:A cross-sectional study was employed on 422 medical students. Data were collected using a self-administered questionnaire and analyzed using SPSS 20 software. Stratified followed by random sampling was employed to select the samples. A multivariable logistic regression model was fitted to identify the predictors. P ⩽ .05 was used to select statistically significant factors.Result:The current prevalence of khat chewing practice among medical students was 21.5%. The odds of khat chewing practice was higher among males (AOR = 3.353; 95%CI [1.460-7.701]), Muslims (AOR = 6.390; 95%CI [1.903-21.460]), fifth and 6 year students (AOR = 3.391; 95%CI [1.354-8.488]), smokers (AOR = 5.081; 95%CI [1.898-13.601]), alcohol users (AOR = 4.872; 95%CI [2.094-11.332]), students who had khat chewer close friends (AOR = 30.645; 95%CI [12.261-76.589]).Conclusion:Since a significant proportion of students were found to be khat chewers, continuous awareness creation on the impact of khat chewing and counseling services are recommended.

Determinants of Virological Failure Among Adult Clients on First-Line Antiretroviral Therapy in Amhara Regional State, Northeast Ethiopia. A Case -Control Study.

BackgroundVirological failure is defined as having viral load measurement greater or equal to 1000 copies/mm3 after at least six-month exposure to antiretroviral therapy. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS-2018) report, globally nearly one in five patients on first-line antiretroviral therapy had experienced virological failure. In line with this, Ethiopia federal ministry of health also reported that one in four patients had experienced virological failure in the year 2016. To date, very little is known about the predictors of virological failure in the local context. Therefore, this study intended to address the determinants of virological failure among patients on a first-line antiretroviral regimen.MethodsA case–control study was conducted among clients on first-line antiretroviral therapy in Amhara regional state, January 2019 with a sample of 257 clients; of these, 86 clients were cases. Data were collected via patient interview and chart extraction for clinical profiles using standardized tools. Binary logistic regression was computed to identify the determinants of virological failure using Stata version 14 and the result was displayed using adjusted odds ratio with a 95% confidence interval.ResultsOut of the proposed samples, 255 clients were considered for final analysis. The odds of virological failure are higher among poor medication adherence (AOR: 10.2:95% CI [4.1–25.8]), age<35 years (AOR: 3.07 95% CI 1.4–6.8), low baseline CD4 (AOR 3.9: 95% CI 1.6–9.6), and Khat chewers (AOR: 9.5:95% CI 2.8–32.4) as compared with their counterparts.ConclusionBeing a young age, poor immunity at the initiation of antiretroviral, Khat chewer, and poor medication adherence significantly associated with virological failure.

Oral Biofilm on Dental Materials Among Khat Chewers.

Nowadays khat chewing habit is increasing among population in southern part of Saudi Arabia, Jazan and till date there is no literature investigating the effect of khat on oral biofilm on dental materials. To evaluate and compare the bacterial biofilm on different types of dental restorative materials used in replacing missing tooth structures among khat chewers and non-khat chewers. Hundred and twenty biofilm samples were collected from different dental restorations, such as All-ceramic (AL), Metal Ceramic (MC), Metal crowns or bridges (M), Composite (C), Glass Ionomer (GI) and Amalgam (A) restorations in non-khat and khat chewers (K). DNA extraction was done and subjected to PCR. Bacterial species, such as Streptococcus, Neisseria, Bacillus, Granulicatella and Veillonella were identified and counted. PCR products were also sequenced to detect similarity. Association between bacterial type and dental materials among non-khat and khat chewers were tested with Chi-Square test (Fishers Exact test). The frequency and percentage of Streptococcus species were marginally higher among khat chewers (42; 70%) compared with non-khat chewers (38; 63.3%) group. But the Veillonella species were higher among non-khat chewers (9: 15%), compared to the khat chewers group (7; 11.7%). No statistically significant difference was detected among species in both groups. In non-khat and khat chewer group, the maximum hits were related to Streptococcus spp. in glass ionomer, amalgam, and composite (restorative materials), followed by metal ceramic and metal (prosthetic materials). Veillonella spp. showed maximum hits in the metal group among non-khat chewers and in all-ceramic among khat chewers. Statically significant differences were recorded among composite and amalgam samples with p values 0.047 and 0.036 in khat chewer group. Khat chewers showed statistically significant differences in oral biofilm in the composite and amalgam restorative materials, but there were no significant differences found among any materials and species between the groups.

Level of Dental Anxiety and Its Relation to Khat Chewing in Jazan Population: A Cross-sectional Study

To investigate and compare the levels of dental anxiety (DA) in relation to khat and non-khat chewer subjects of both genders from Jazan subpopulation, Kingdom of Saudi Arabia (KSA). A cross-sectional study was conducted to assess DA using the modified dental anxiety scale (MDAS). A total of 352 subjects from the city of Jazan who attended dental clinics for regular treatment were recruited for this study. A questionnaire was used to collect the required information, which consisted of three parts. Descriptive statistics including means, standard deviations, and percentages were calculated. Multiple group comparisons were analyzed using Chi-square tests using the Statistical Package for Social Science (SPSS) program. p < 0.05 was considered as the significance level. Among the participants, 75.6% was male, while 71.3% khat chewers, and most of them were male (91.2%). The percentage of the overall mean of MDAS was low; 40% to moderate; 38%, while sever anxiety were present in 4% only. Anxiety related to endodontic treatments represents 33.8% in both genders and 34.3% among the khat chewers, while fear was 42.1% among males and 45.4% among khat chewers. The local anesthesia injection in the gum and tooth drilling items of MDAS were represented by 36.6% for both khat and gender groups and resulted in a fairly and extremely anxious situation during dental treatments. All variables were significantly different. The overall DA level was low to moderate among the majority of the assessed subjects. Endodontic treatments were the first type of dental treatments for the subjects, while fear of pain was the most common cause of irregular dental visits. Significant differences were detected between khat and non-khat chewers and between genders in relation to anesthesia injection, and drilling of teeth in the MDAS items. Community programs focusing on the high DA levels caused by khat chewing might be important in order to minimize the fear of dental treatments and improve and regularize the overall dental treatments.

Khat culture and economic wellbeing: Comparison of a chewer and non-chewer families in Harar city

Khat is one of the most controversial products of our time which is mostly produced and consumed in the eastern parts of Africa and Saud Arabia. This study contributes to the debate on khat by comparing the family wellbeing of khat chewer (consumer) and non-chewer families in Harar city, by using the International Wealth Index’s (IWI) characterization of wellbeing. The study utilized the survey method. Respondents were identified using a cluster sampling method. The data was gathered using an interview schedule, in-depth interviews, and non-participant observation. Appropriate time was considered in dealing with chewer respondents. The findings of the study indicate that there is a great difference between families who chew khat and who did not, in terms of their material well-being, housing, and quality of life. Most of the khat consumer households have no emergency money nor plan for their families. The data from key informant interviews also show that women experience the greatest burdens of the negative impacts of khat consumption habits. Khat culture affects the base of a community, the family, by affecting its social and economic wellbeing and disrupting its unity. There is no simple solution for addressing the problem of khat due to the intricate nature of the problem. Health officials and health institutions can establish rehabilitation institutions and civil societies can establish a voluntary foundation which creates awareness on the impact of khat on a family.

Effect of Khat Chewing on the Salivary pH before and after Using Mouthwashes.

BackgroundSaliva is a biological fluid that has multiple protective functions. These functions can be attained only if the saliva keeps certain physo-chemical properties such as pH. The main purpose of the current study was to compare the salivary pH among khat chewers and non-khat chewers before and after specific intervals (15, 30, and 60 minutes) of using three commercially available mouthwashes (MWs).MethodsIn this cross sectional study, thirty pharmacy student volunteers were divided into three groups of 10 for the three MWs. Each group was then subdivided into 5 volunteers as khat chewer and non-khat chewer. The statistical evaluation was carried out by using paired t-test and analysis of variance (ANOVA) for in vivo study of salivary pH.FindingsLow salivary pH in all khat-user volunteers before and after using MWs was indicated. There was an increase in the salivary pH after 15 minutes of rinsing with the three selected MWs for both groups of volunteers, after that there was a gradual decrease to the initial pH. The difference between the three groups was not significant at baseline and after 15 minutes, but there was a significant difference after 30 and 60 minutes for the non-khat-chewing and khat-chewing volunteers.ConclusionIt can be concluded that using MWs results in altering salivary pH and continuous khat chewing lowers the baseline pH of saliva and ability to compensate the change of salivary pH.

Rifampicin resistant tuberculosis in presumptive pulmonary tuberculosis cases in Dubti Hospital, Afar, Ethiopia.

Ethiopia stood third in drug-resistant tuberculosis (TB) in Africa, and more than 5,000 MDR-TB patients are reported each year. Greater than 90% of rifampicin (RIF) resistant strains are resistant to isoniazid (INH) and hence the objective of this study was to determine the prevalence and risk factors of RIF resistant MTB among presumptive TB cases at Dubti General Hospital, Afar, Ethiopia. In this cross-sectional study, 384 presumptive TB cases were recruited and a structured questionnaire was used to collect socio-demographic and clinical data. Sputum samples were collected and examined using X-pertMTB/RIF assay. Bivariate, multivariate logistic regressions, and fishers' exact analysis were done to assess the associations between the prevalence of TB and MDR-TB with different socio-demographic and clinical variables. In the present study, the overall prevalence of pulmonary TB was 24.5% (94/384), of this 4 (4.3%) isolates were resistant to RIF. History of anti-TB treatment (AOR = 2.4, 95% CI: 1.3-4.4 and TB contact (AOR = 3.6, 95% CI: 2.1-6.2 were significantly associated with gene X-pert MTB/RIF positive TB. Moreover, resistance to rifampicin was statistically associated with the history of TB contact with multi-drug resistant TB (P = 0.027) and khat chewer cases (P = 0.04). The overall prevalence of TB and its drug-resistant were relatively higher than that of in the general population in Ethiopia. History of anti-TB treatment and TB contact were significantly associated with X-pert MTB/RIF positive MDR-TB.

Successful Management of Khat Chewing-induced Gingival Recession by Using Tunnel Technique Utilizing Subepithelial Connective Tissue Graft: A Case Report

Treatment of an unusual gingival recession induced by khat chewing habit. Gingival recession induced by khat chewing was confirmed by many authors. However, there is no proposal for treatment of gingival recession induced by chewing khat. A systemically healthy nonsmoking male khat chewer aged 38 years presented with class III gingival recession around the lower right incisor. The treatment approach involved a subepithelial connective tissue graft with a tunnel procedure. A full coverage of khat-induced recession was achieved by using tunnel technique utilizing subepithelial connective tissue graft at 1-year follow-up. Treatment of gingival recession, including those induced by mechanical trauma such as chewing habits is considered as an esthetic demand and it is the responsibility of the clinician to determine the proper treatment plan for the correcting esthetic and functional defects of the periodontal tissues. How to cite this article: Al-Akhali MS, Successful Management of Khat Chewing-induced Gingival Recession by Using Tunnel Technique Utilizing Subepithelial Connective Tissue Graft: A Case Report. J Contemp Dent Pract 2019;20(10):1235-1238.

Postmortem Distribution of Cathinone and Cathine in Human Biological Specimens in a Case of Death Associated with Khat Chewing

Chewing khat leaves has been associated with several adverse health effects, and there are very few case reports of cardiotoxicity, stroke and death resulting from this. In addition, postmortem distribution of cathine and cathinone, active components of khat, are not yet fully clear. This postmortem case report aimed to identify and determine the concentration of cathine and cathinone in different body organs and green chewed plants found in the mouth of the deceased. Immunoassay and non-targeted GC-MS analysis showed that samples were only positive for amphetamine type stimulants. LC-MS/MS quantitative analysis confirmed that samples were positive for cathinone and cathine. The results showed that cathinone concentration was 0.03, 0.03, 0.06, 0.07, 1.85 and 31 μg/ml in brain, liver, blood, vitreous humor, stomach and chewed green plant, respectively. Whereas, the concentration of cathine was 0.31, 3.28, and 141 μg/ml in kidney, stomach and chewed green plant, respectively. Cathine and cathinone concentrations were found to be changed with respect to site of sampling. The results suggest that stomach and chewed green plants are considered as good samples to show the concentration for both cathine and cathinone at the time of death of the khat chewer.