Non-khat Chewers Research Articles

Association between Chewing Khat (Catha edulis) and Hematological Indices and Helicobacter pylori Infection and Blood Loss in the Gastrointestinal Tract of Yemeni Chewers.

Background: The available data on the effect of Khat chewing on hematological indices are conflicted and mainly based on animal studies. The aim of this study was therefore to investigate the effect of Khat chewing on hematological indices in humans as well as the possible association of Khat chewing with H. pylori infection and blood loss in the gastrointestinal tract. Patients and Methods: This study was a comparative cross-sectional study, carried out on 140 participants aged 18 - 55 years old; 71 were healthy non-Khat chewers serving as a control group and 69 were regular Khat chewers. Complete blood count was analyzed as well as H. pylori antigen and occult blood in stool were investigated. Results: Hemoglobin concentration, MCV, MCH, and PCV were significantly (p = 0.037, 0.034, 0.043, and 0.019 respectively) lower in Khat chewers as compared with non-Khat chewers, whereas platelets count and white blood cells count were significantly (p = 0.006 and 0.007 respectively) higher in Khat chewers. Khat chewing was also associated with H. Pylori infection (OR: 2.7) and blood loss in the gastrointestinal tract (OR: 3.2). Conclusion: Khat chewing adversely affects hematological indices and increases the risk of H. Pylori infection and blood loss in the gastrointestinal tract.

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.

Impact of Khat (Catha Edulis Forsk), During Chewing Session, on Serum RBG Level in T2DM Patients Treated with Metformin

Background: Despite its detrimental effects on health, chewing khat appears to be becoming more commonplace globally as a daily habit, particularly in the nations where it originated. As a result, it is very possible that khat users will take drugs while they chew the drug. That is high among them, increasing the likelihood of harmful khat-drug interactions. In these situations, it is critical to assess the impact of simultaneous khat and clinical medication delivery.Objective: As a preliminary study to evaluate the effect of khat (Catha edulis Forsk) chewing on serum Random Blood Sugar (RBG) level in Type 2 Diabetic Mellitus (T2DM) patients treated with metformin.Material and Method: Seventy-six male participants between the ages of 25 and 70 were included in the trial, 38 of them were already metformin-treated T2DM patients with a prior diagnosis. The remaining 38 people had no family history of diabetes, were healthy, and were not diabetic. Whether the individuals in the aforementioned two groups regularly chewed khat or not was used as a supplementary criterion for division. Using a drop of blood taken from each patient, a calibrated glucometer was used to take three readings of RBG levels.Results: The findings showed that healthy persons (non-khat chewers) had RBG levels at 4 hours after lunch that were significantly different from their corresponding values at 2 hours earlier. Using an independent sample t-test to compare the RBG levels of healthy khat chewers to healthy non-khat chewers, it was discovered that khat chewers had significantly higher RBG levels 3 and 4 hours after lunch (P = 0.042 and 0.000, respectively). RBG levels at 4 h after lunch (2 h after khat chewing) were significantly lower by -54.36 when compared to the level at 2 h after lunch of the same group of diabetic khat chewers taking metformin, whereas levels at 3 h after launch (1 h after khat chewing) were not statistically different.Conclusion: When khat was consumed, healthy volunteers' serum RBG levels went up, whereas diabetic patients receiving metformin saw no change in their RBG levels.

Effect of Chronic Khat Chewing on Intima-Media Thickness of Common Carotid Arteries in Yemeni volunteers

Objective: To assess the changes occurring in both common carotid arteries (CCAs) intima-media thickness (IMT) in Yemeni chronic khat chewers using B-mode ultrasonography.
 Methods: This cross-sectional study was conducted among 195 participants (103 regular khat chewers and 92 non-khat chewers) conveniently selected at the Radiology Department of the University of Science and Technology Hospital (USTH) in Sana’a from August 2017 to August 2018. Data about gender, age, BMI, chewing khat and the period of chewing were collected from participants using a structured questionnaire. B-mode ultrasonography of bilateral CCAs was then performed to measure the IMT. Data were analyzed using suitable statistical tests, and P-values <0.05 were considered statistically significant.
 Results: The majority of participants with CCA-IMT were males (91.8%) and aged 27 years or younger (59.0%), with a mean age of 27.9 ± 6.8 years. Khat chewers constituted more than half of patients with CCA-IMT. There was no statistically significant difference in the mean values of RT CCA-IMT and LT CCA-IMT between khat chewers and non-khat chewers. The CCA-MIT was significantly higher among male khat chewers compared to male non-chewers (P = 0.004). However, there was no statistically significant difference between khat chewers and non-chewers with respect to the age of 20 years or older (P = 0.301) and BMI of 18.5 kg/m2 or higher (P = 0.888). Age showed a significant positive correlation with RT CCA-IMT (r = 0.380; P < 0.001) and LT CCA-IMT (r = 0.458; P < 0.001) in Khat chewers. In contrast, age showed a significant positive correlation with LT CCA-IMT only in non-khat chewers (r = 0.236; P = 0.024). On the other hand, BMI showed a significant positive correlation with LT CCA-IMT (r = 0.254; P = 0.010) among khat chewers, but no significant correlation was found in CCA-IMT of both sides among non-khat chewers. Among khat chewers, there was a significant positive correlation with RT CCA-IMT (r = 0.273; P = 0.005) and LT CCA-IMT(r = 0.194; P = 0.049).
 Conclusion: Khat chewing does not lead to a significant difference in CCA-IMT among Yemeni chewers compared to non-chewers. However, the period of chewing may slightly affect the CCA-IMT among khat chewers. Age has a significant positive correlation with CCA-IMT in khat chewers and LT CCA-MIT in non-khat chewers, which could help to determine the contribution of different predisposing factors to atherosclerosis. A significant positive correlation can be found between BMI and LT CCA-MIT among khat chewers.
 Keywords: Khat Chewing, Intima media thickness, Carotid, Yemen

Effect of Chronic Khat Chewing on Intima-Media Thickness of Common Carotid Arteries in Yemeni volunteers

Objective: To assess the changes occurring in both common carotid arteries (CCAs) intima-media thickness (IMT) in Yemeni chronic khat chewers using B-mode ultrasonography.
 Methods: This cross-sectional study was conducted among 195 participants (103 regular khat chewers and 92 non-khat chewers) conveniently selected at the Radiology Department of the University of Science and Technology Hospital (USTH) in Sana’a from August 2017 to August 2018. Data about gender, age, BMI, chewing khat and the period of chewing were collected from participants using a structured questionnaire. B-mode ultrasonography of bilateral CCAs was then performed to measure the IMT. Data were analyzed using suitable statistical tests, and P-values <0.05 were considered statistically significant.
 Results: The majority of participants with CCA-IMT were males (91.8%) and aged 27 years or younger (59.0%), with a mean age of 27.9 ± 6.8 years. Khat chewers constituted more than half of patients with CCA-IMT. There was no statistically significant difference in the mean values of RT CCA-IMT and LT CCA-IMT between khat chewers and non-khat chewers. The CCA-MIT was significantly higher among male khat chewers compared to male non-chewers (P = 0.004). However, there was no statistically significant difference between khat chewers and non-chewers with respect to the age of 20 years or older (P = 0.301) and BMI of 18.5 kg/m2 or higher (P = 0.888). Age showed a significant positive correlation with RT CCA-IMT (r = 0.380; P < 0.001) and LT CCA-IMT (r = 0.458; P < 0.001) in Khat chewers. In contrast, age showed a significant positive correlation with LT CCA-IMT only in non-khat chewers (r = 0.236; P = 0.024). On the other hand, BMI showed a significant positive correlation with LT CCA-IMT (r = 0.254; P = 0.010) among khat chewers, but no significant correlation was found in CCA-IMT of both sides among non-khat chewers. Among khat chewers, there was a significant positive correlation with RT CCA-IMT (r = 0.273; P = 0.005) and LT CCA-IMT(r = 0.194; P = 0.049).
 Conclusion: Khat chewing does not lead to a significant difference in CCA-IMT among Yemeni chewers compared to non-chewers. However, the period of chewing may slightly affect the CCA-IMT among khat chewers. Age has a significant positive correlation with CCA-IMT in khat chewers and LT CCA-MIT in non-khat chewers, which could help to determine the contribution of different predisposing factors to atherosclerosis. A significant positive correlation can be found between BMI and LT CCA-MIT among khat chewers.
 Keywords: Khat Chewing, Intima media thickness, Carotid, Yemen

Quality of Sleep and Its Correlates among Yemeni Medical Students: A Cross-Sectional Study

Background Sleep disturbance is particularly common among medical students worldwide and affects their wellbeing and academic performance. However, little is known about this issue in Yemen. This study looks at sleep quality and its association with personal and life-style factors and self-reported academic performance among medical students at the largest Yemeni university. Methods A cross-sectional survey was conducted at Sana'a University, Yemen, in 2017. The Pittsburgh Sleep Quality Index (PSQI), consisting of 19 items and 7 components (score range = 0‐3), was used to assess sleep quality. The summation of the components' scores yields the global PSQI score (range = 0‐21). A global PSQI value higher than 5 indicates poor quality of sleep. Logistic regression was applied to look at relationships. Results 240 male (41%) and female (59%) medical students took part in the study with 54% being preclinical and 46% clinical with an average age of 23.3 years (SD = 1.7). The mean global score (SD) was 6.85 (2.8), and 68% of the students (N = 163) were identified as poor sleepers. The mean global PSQI score (SD) and proportion of poor sleepers were higher among males (7.7 (2.8) and 81%, respectively) than females (6.27 (2.42) and 59.2%, respectively), p ≤ 0.001. Good sleep quality was more likely (OR (95% CI)) among females (3.4 (1.3-8.8)), the unmarried (2.8 (1-7.8)), those in good health (2.3 (1.1-4.5)), and nonkhat chewers (4.9 (1.4-17.1)). Nonsmokers were less likely to have good quality sleep compared to occasional smokers (0.185 (0.071-.485)). Stress (30%) and academic workload (21%) were the most commonly reported causes of poor sleep quality. Almost two-thirds of the students (65%) mentioned that disturbed sleep undermined their academic performance. Conclusions Poor sleep quality is common among Sana'a medical students and impacts their academic performance. Specific stress management and sleep hygiene promoting programs should be incorporated early on in medical education.

The Impact of Khat (Catha edulis) on Hemodynamics of the Common Carotid Arteries in Regular Khat Chewers: A Case-control Study Using Doppler Ultrasound.

Background:To evaluate the effect of chewing khat on the hemodynamics of the common carotid arteries (CCAs) using Doppler ultrasound imaging.Methods:This is a cross-sectional case–control study. Fifty volunteers who were chronic regular khat chewers were selected and compared with healthy nonkhat chewers. They were examined using Doppler imaging with a 7–10 MHz linear transducer. The resistivity index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity of the CCAs were determined according to the standard protocol of carotid Doppler ultrasound.Results:The RI and PI of the right and left CCAs were significantly higher in khat chewers compared to controls (P < 0.001). The PSV of the right and left CCAs was considerably higher in khat chewers compared to controls (P < 0.001 and 0.04, respectively).Conclusion:The Doppler values of blood flow velocity, resistivity, and pulsatility were significantly higher in chronic regular khat chewers compared to nonkhat chewers. Khat is a significant contributory factor for increasing the hemodynamics of the CCAs.

Khat Chewing Effect on the International Normalized Ratio in Patients with Mechanical Heart Valves under Warfarin Therapy.

Khat is a plant that contains the alkaloids cathine and cathinone which have some amphetamine-like properties. It is cultivated and it's leaves chewed for their euphoric effect. This study intended to elucidate the effect of khat chewing on blood coagulation by using the International Normalized Ratio (INR) value as a calculable benchmark. In this cohort study, 146 patients with Mechanical Heart Valves (MHV) were assessed for two consecutive visits at one-month intervals. For each visit, the date of surgery, the patient's compliance, the dose of warfarin and the INR reading were assessed by the researcher. Out of 146 patients with MHV, the mean age was 33.72±12.43 years (range, 14-65 years); 82 (56.2%) were female and 64 (43.8%) were male. The results revealed that the mean of absolute INR readings was lower in khat-chewers than non-chewers by average 0.2 on the first and second visits (p = 0.038 and 0.002, respectively). Khat chewing has a significant coagulant effect. There was a significant decrease in the value of INR for khat chewers patients with MHV when compared to non-khat chewers.

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.

Prevalence of Hypertension and Associated Factors among the Outpatient Department in Akaki Kality Subcity Health Centers, Addis Ababa, Ethiopia.

Background Fatalities from hypertension in East Africa are increasing, even though they decreased in western industrial regions. Older age, being female, illiterate, smoking, physical inactivity, and high waist circumferences are major risk factors for the development of hypertension. The prevalence of hypertension among Federal Ministry Civil servants in Addis Ababa, Ethiopia, has found to be high; which is an indication for institution-based hypertension-screening programs. Objective Prevalence of hypertension and associated factors among the outpatient department in Akaki Kality Subcity Health Centers, Addis Ababa, Ethiopia. Methodology. Facility-based cross-sectional study was carried out on systematically sampled 401 out-department patients whose age was greater than or equal to 18 years in four government health centers in Addis Ababa. Data collection took place from March 10, 2018, to April 06 2018. Binary logistic regression analysis was carried out to identify predictors of hypertension. Results Patients had a mean age of 41.17 years (95% CI: 39.77–42.57). The prevalence of hypertension was 14% (95% CI: 13.653–14.347), and 30 (53.57%) were males. Alcohol drinkers were 11.844 times more likely to be hypertensive as compared to non-alcohol drinkers (AOR = 11.844, 95% CI: 3.596–39.014). Cigarette smokers were 16.511 times more likely to be hypertensive as compared to non-cigarette smokers (AOR = 16.511, 95% CI: 4.775–57.084). Khat chewers were 6.964 times more likely to be hypertensive as compared to non-khat chewers (AOR = 6.964, 95% CI: 1.773–26.889). Conclusion The prevalence of patients with hypertension was 14%. Alcohol drinking, cigarette smoking, khat chewing, body mass index ≥25 kg/m2, and age ≥44 years old are major determinants identified by this study. Hence, appropriate management of patients focusing on the relevant associated factors would be of great benefit in controlling hypertension.

Khat Chewing Induces a Floral Shift in Dental Material-Associated Microbiota: A Preliminary Study.

BackgroundThe habit of khat (Catha Edulis Forskal) chewing is widely practiced in the southern regions of Saudi Arabia, Yemen, and East Africa. This social habit has tremendous effects on oral and general health of khat chewers. Khat may affect bacterial species in plaque biofilms on oral rehabilitation materials. This preliminary case-controlled study aimed to assess and compare the effect of khat chewing on bacterial biodiversity between non-khat chewers (NKC) and khat chewers (KC) in oral biofilms on oral rehabilitation materials using polymerase chain reaction (PCR).Material/MethodsFifty participants were organized into 2 equal groups of NKC and KC, each containing 5 subgroups related to filling material type. Some participants had amalgam (A) or composite (C) restorations, while others had feldspathic porcelain (FP), nickel chromium (NC), and zirconia ceramic (ZC) crowns or bridges. Oral biofilm samples were collected from all participants, DNA was extracted, and samples were subjected to PCR. Bacterial species were then identified and counted. PCR products were sequenced to detect similarity. Partial 16S rRNA gene sequences of the current study samples were compared with 16S rRNA gene sequences from GenBank using BLAST on the National Center for Biotechnology Information website.ResultsThe Streptococcus sp. was the most common bacterial species among our participants (40; 80%), followed by Lactobacillus and Veillonella spp., accounting for 12% (6) and 8% (4), respectively. Streptococcus sp. was observed equally among NKC and KC, but Lactobacillus and Veillonella spp. were higher in KC and NKC, respectively. Lactobacillus was associated mainly with prosthetic materials, and Streptococcus was found among all examined dental restorative materials.ConclusionsThis research concluded that khat chewing significantly affects bacterial biodiversity in oral biofilms in the presence of different restorative and prosthetic dental materials.

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Southwestern Saudi Arabia.

BackgroundGastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that has substantial health and economic consequences. Several modifiable risk factors are associated with GERD, hence we conducted the present study to assess the prevalence and risk factors of GERD in a previously understudied population of southwestern Saudi Arabia.MethodsA cross-sectional study was carried out to calculate the prevalence of GERD and assess its risk factors. A structured self-administered questionnaire was distributed on a random sample of 853 participants from Jazan region, Saudi Arabia. The questionnaire consisted of questions on the participants’ sociodemographic and lifestyle characteristics. The presence of GERD was detected using the GERD questionnaire (GerdQ). Data were analyzed using descriptive statistics and chi-square test, with a significance level of P < 0.05 or P < 0.01.ResultsThe study included 853 participants; 69.1% males and 30.9% females. The proportion of participants who scored >8 on the GerdQ (had GERD) was 32.2%. GERD was associated with age (P < 0.01), marital status (P < 0.01), employment status (P < 0.01), fast food intake (P < 0.01), analgesics use (P < 0.01), and smoking (P < 0.01). GERD was more common among Khat chewers compared to non-Khat chewers (P < 0.05) and showed a significant association with the frequency of Khat use.ConclusionThe results show a high prevalence of GERD in the general population of Southwestern Saudi Arabia. Several sociodemographic and lifestyle characteristics were associated with the disease.

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.

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.

SERUM POSITIVITY OF ANA AND ASMA AMONG KHAT AND NONKHAT CHEWERS AS MARKERS FOR AUTOIMMUNE HEPATITIS TYPE 1

Objectives: Autoimmune hepatitis (AIH) is a necroinflammatory liver disease of unknown etiology. It has been proposed that certain herbs such as black cohosh and dai-saiko might trigger AIH. Khat is an ever green tree whose leaves have been chewed by people in Yemen where AIH is common. Aim of present study was to measure antinuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA) as serum markers for AIH type1 in healthy people who chew and do not chew khat. It also aimed to determine some other risk factors for ANA and ASMA positivity. Methods: A total of 100 healthy individuals were enrolled in this study. They were divided into: Daily khat chewers and non-khat chewers. Three ml peripheral blood was withdrawn from each participant. Blood samples were tested for ANA and ASMA using indirect immunofluorescence assay. Results: The age of khat chewers ranged from 30-60 years with mean age 40.4±7.6 years. Non-khat chewer’s age ranged from 30-57 years with mean age 39.9±6.2 years. The majority of khat chewers and non-chewers were in age groups 30-39 and 40-49 years old. There is no association between khat chewing and ANA or ASMA serum positivity (χ2=0.33, P=0.39 and χ2=1.5, P=0.16; respectively). Khat chewing has no association with ANA and ASMA positivity. Nevertheless, ANA and ASMA positivity has an association with aging. Conclusion: Study concludes that Khat chewing has no association with ANA and ASMA positivity. Nevertheless, ANA and ASMA positivity has an association with aging. Peer Review History: Received 18 August; Revised 28 August; Accepted 5 September, Available online 15 September 2017 Academic Editor: Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, alyahawipharm@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Tanveer Ahmed Khan, Hajvery University, Lahore, Pakistan, tanveerahmedkhan754@gmail.com Dr. Hebatalla Ibrahim Ahmed Abdel Hameed, Al-Azhar University, Faculty of Pharmacy (Girls), Nasr City, Cairo, Egypt, hebatalla123@yahoo.com Similar Articles: SERO-EPIDEMIOLOGICAL STUDY OF HEPATITIS B, C, HIV AND TREPONEMA PALLIDUM AMONG BLOOD DONORS IN HODEIDA CITY- YEMEN

Prevalence of under Nutrition and Associated Factors among Khat Chewers in Khat Chewing Shops at Gulalle Sub City, Addis Ababa, Ethiopia

There is studies limitation regarding the effect of khat chewing on nutritional status. Community based comparative cross-sectional study had been conducted from March to June, 2015; with cluster sampling and systematic random sampling techniques for khat chewers and non-khat chewers respectively. The data was collected by using interview administered questionnaire, observation and weight scale measurement among 504 study participants.The study revealed that from entire khat chewers 52(20.5%) of them and of non-khat chewers 34(13.5%) of them were underweight. Khat chewers were 2.102 times more likely underweight compared to those non-khat chewers. khat chewers who had meal twice per day were 2.856 time more likely underweight. Khat chewers who used animal and animal products as their main meal component daily were 0.413 times less likely to be underweight; Whereas the odds of underweight was 26% times less likely among khat users who intake two liters of fluid per chewing session. In other case, those who chewed khat for 2-3 hours per session were 0.231 times less likely to be underweight.Under nutrition is a public nutritional status problem in which khat chewers are more affected. Khat chewing conditions and meal conditions including amount of fluid consumed per chewing session are factors that affect the nutritional status of the khat chewers. Minimizing amount of khat consumed per session, shortening of khat chewing session length and increasing amount of fluid intake more than two liters per chewing session and nutritional management with nutritionist advices are important points.

Effect of Khat (Catha edulis) Use on the Bioavailability, Plasma Levels and Antimalarial Activity of Chloroquine.

This study aimed to evaluate the effect of khat (Catha edulis) on chloroquine (CQ) bioavailability in healthy Yemeni adults and its effect on CQ plasma levels and parasite clearance among malaria patients. This study took place between January and April 2007 in Bajil and Sana'a, Yemen. Two CQ doses (600 mg each) were given to 15 healthy males on separate occasions; the first dose was followed by a khat-chewing session (phase one) while controls abstained from khat-chewing for the second (phase two). Additionally, 103 patients with Plasmodium falciparum-induced malaria, including both regular khat chewers (n = 57) and non-khat chewers (n = 46), were treated with CQ (25 mg/kg) over three days. Pharmacokinetic parameters were analysed among both controls and malaria patients. Parasite clearance was also investigated for the latter group. The mean area under the concentration-time curve (AUC) was 2,108.9 versus 2,797.4 ng/hour/mL, mean peak plasma concentration (Cmax) was 415.6 versus 508.7 ng/mL and mean time to reach Cmax was 3.8 versus 3.6 hours for controls in phase one versus phase two, respectively; both AUC and Cmax levels were significantly reduced by khat-chewing (P <0.050). For khat- versus non-khat-chewing malaria patients, mean plasma CQ concentrations were 266.4 ng/mL versus 427.5 ng/mL (P <0.001). Furthermore, CQ was effective in 71.7% and 75.4% of non-khat and khat-chewing malaria patients, respectively (P = 0.823). Khat-chewing was found to significantly reduce plasma CQ levels among healthy volunteers and malaria patients. While receiving CQ treatment, patients should be advised not to chew khat.

Association Between Khat ( Catha edulis ) Chewing and Infection with Helicobacter pylori : A Case Control Study in Nairobi County

Background : Khat ( Catha edulis ) is a psycho-stimulant substance grown and widely chewed in East Africa. The use of Khat leads to a number of health complications however its adverse effects and prevalence are not well studied. Objective : To compare the prevalence of Khat chewing among H. Pylori infected cases and controls. Design: Individual matched case control study Setting : KEMRI’s Centre for Clinical Research (CCR) and St. Michael’s Digestive Disease and Medical Care. Subjects : Ninety three cases were selected using Rome III criteria for functional dyspepsia, and the controls (n=93) were matched on age and gender. Results : Khat Chewing was associated with infection with H. Pylori . Of the 93 cases, 58.1% were H. Pylori positive with a majority being Khat chewers 67.2% (41/61) and 32.8% (20/61) non-Khat chewers; the two groups were significantly different (p-value=0.007). Functional dyspepsia was associated with H. Pylori. Therefore, participants with functional dyspepsia were twice more likely of being diagnosed with H. Pylori (OR 2.1, 95% CI: 1.2,3.9). Conclusion : The prevalence of H. Pylori infection was found to be higher among khat chewers, indicating that Khat chewing could be a predisposing factor to H. Pylori infection and to gastrointestinal disorders. Community-based awareness creation about the adverse effect of Khat use is thus recommended.

Effect of Habitual Khat Chewing on Glycemic Control, Body Mass Index, and Age at Diagnosis of Diabetes in Patients with Type 2 Diabetes Mellitus in Yemen.

Khat chewing is common in Yemen. We conducted this study to see if it affected diabetes control in patients with type 2 diabetes mellitus (DM). We studied 1540 patients with type 2 DM attending an endocrinology clinic in Sana’a, Yemen, of which 997 were khat chewers (KC) and 543 were non-khat chewers (NKC). The patients answered a questionnaire regarding khat chewing. Hemoglobin A1c (HbA1c) and body mass index (BMI) were measured. KC had a higher mean HbA1c of 9.8 (95% confidence interval (95% CI) 9.6–10) than the NKC, with a mean of 9.1 (95% CI 8.9–9.4) (adjusted odds ratios (AOR) 1.74, P < 0.001) after multivariate regression analysis. KC also had a lower mean BMI, 26.9 (95% CI 26.6–27.2), than the NKC, mean BMI 27.6 (95% CI 27.1–28) (P < 0.01). The mean age at diagnosis of DM among the KC group was 43.3 (10.1) and among the NKC group was 45.9 (11.8) (AOR 1.4 P < 0.008) after multivariate regression analysis. KC patients had a higher mean HbA1c, a lower BMI, and a younger age at diagnosis of type 2 DM when compared with NKC.

Catha Edulis (Khat) Chewing Decreases Serum Levels of Iron, Ferritin and Vitamin B12 and Increases Folic Acid.

Catha edulis (Khat) is customarily chewed to attain a state of stimulation and reduce physical fatigue. In view of the reported common adverse effects of Khat, the aim of this study was to evaluate the levels of iron, ferritin, folic acid, vitamin B(12) and body mass index (BMI) as nutritive indicators in Yemeni Khat chewers. This study was a prospective cohort study, carried out on 90 male workers aged 19 - 23 years old; 45 were healthy non-Khat chewers serving as control group and 45 were regular Khat chewers. Serum iron, ferritin, folic acid, vitamin B(12) and body mass index were measured at baseline and after a year of follow up. Serum iron and BMI were significantly (p < 0.01) lower at baseline in Khat chewers by 9 % and 6 %, respectively; whereas ferritin, folic acid and vitamin B(12) were non-significantly different from non-Khat chewers. In the follow-up one year later, serum iron, ferritin, vitamin B(12) and BMI were significantly (p < 0.001) lower in Khat chewers by 19.0, 31.4, 20.6 and 10.7 %; whereas folic acid was significantly (p = 0.007) higher by 26.7 %. Comparison within groups showed serum iron, ferritin, and BMI to be significantly (p < 0.01) decreased after one year in the Khat chewers with respect to its baseline; whereas folic acid significantly (p < 0.001) increased. This study shows Khat chewers to be more susceptible to malnutrition, which should be considered by the general population and the public health authorities.