Human khat (Catha edulis) chewers have elevated plasma leptin and nonesterified fatty acids

In this study, the effect of regular khat (Catha edulis Forsk) chewing (200 and 400 g) in humans on plasma leptin, nonesterified fatty acid, triacyglycerol, and total cholesterol levels was investigated. The results presented show that khat chewing increases plasma leptin concentration particularly in individuals who chew 400 g of khat leaves. The significance of increased plasma leptin is in explaining the underlying mechanism of the observed effects associated with khat chewing such as loss of appetite, decreased body weight, and hyperthermia. The decreased body weight was evident from the significantly lower body mass index of the khat leaves chewers group as compared to the non–khat leaves chewers group (control). Moreover, like leptin, the plasma levels of nonesterified fatty acids were significantly higher in those chewing 400 g of khat leaves. On the other hand, the plasma levels of triacylglycerol were significantly lower in the 2 khat-chewers groups (200 and 400 g of khat leaves), whereas plasma cholesterol levels were not affected by the 2 levels of khat leaves used in this study. The significance of these results may suggest that khat leaves may contain a component(s) that has the ability to reduce body weight via decreasing appetite.     

The potential adverse effects of habitual use of Catha edulis (khat)

The habit of Catha edulis Forsk (khat) chewing has prevailed for centuries among populations in the horn of Africa and the Arabian peninsula. Fresh leaves of Catha edulis are customarily chewed to attain a state of stimulation. The fact that cathinone has a closer structural similarity with amphetamine, and both share common pharmacodynamic features, led to the conclusion that cathinone is the most important active ingredient of Catha edulis, which causes the major pharmacological effects. Problems associated with repeated consumption of Catha edulis leaves are becoming evident. Literature surveys and clinical diagnostic studies revealed an association with prevalence of psychiatric morbidity. Repeated intermittent oral administration of Catha edulis to laboratory animals lead to development and expression of locomotor sensitisation. Catha edulis also leads to several peripheral effects that include increases in blood pressure and has been associated with the increased incidence of acute coronary vasospasm and myocardial infarction. Catha edulis also accounts for a number of gastrointestinal tract problems, oesophagitis, gastritis and delay intestinal absorption, as well as the development of oral keratotic white lesions at the site of chewing. Administration of Catha edulis extracts showed a deranged systemic capacity to handle oxidative radicals and induces cytotoxic effects in cells of liver and kidney, as well as induction of cell death in various human leukaemia cell lines and in peripheral human blood leukocytes.     

Who develops severe malaria? Impact of access to healthcare,socio‐economic and environmental factors on children in Yemen: a case‐control study

Objective To investigate the impact of socio‐economic and environmental factors on developing severe malaria in comparison with mild malaria in Yemen. Method Case‐control study comparing 343 children aged 6 months to 10 years diagnosed with WHO‐defined severe malaria (cases) at the main children’s hospital in Taiz and 445 children with mild malaria (controls) diagnosed in the health centres, which serve the areas where the cases came from. Results In univariate analysis, age <1 year, distance from health centre, delay to treatment and driving time to health centre were associated with progression from mild to severe malaria. In multivariate analysis, distance to nearest health centre >2 km was significantly associated with progression to severe disease. Environmental and vector control factors associated with protection from acquiring malaria (such as sleeping under bednets) were not associated with protection from moving from mild to severe disease. Conclusions Innovative ways to improve access to antimalarial treatment for those living more then 2 km away from health centres such as home management of malaria, especially for infants and young children, should be explored in malaria‐endemic areas of Yemen.     

Antidiabetic and hypocholesterolaemic effects of fenugreek

The seeds of Trigonella foenum graecum (fenugreek) have been reported to have antidiabetic and hypocholesterolaemic properties in both animal models and humans. Activity has been attributed largely to fenugreek's saponin and high fibre content, and is probably not related to its major alkaloid trigonelline. Antihyperglycaemic effects have been linked to delayed gastric emptying caused by the fibre content, and to (unidentified) components that inhibit carbohydrate digestive enzymes. Fenugreek administration may increase plasma insulin levels in vivo. Its major free amino acid, 4-hydroxyisoleucine, stimulates insulin secretion from perfused pancreas in vitro. The hypocholesterolaemic effect has been attributed to increased conversion of hepatic cholesterol to bile salts due to loss, in the faeces, of complexes of these substances with fenugreek fibre and saponins. Fenugreek treatment selectively reduces the LDL and VLDL fractions of total cholesterol, and HDL-cholesterol has also been reported to increase in alloxan-induced diabetic rats and type II diabetic individuals following treatment with fenugreek. Fenugreek administration has not been reported to cause any toxicological effects. Its regular consumption may therefore be beneficial in the management of diabetes and the prevention of atherosclerosis and coronary heart disease. © 1998 John Wiley & Sons, Ltd.     

Khat use and trait anger: effects on affect regulation during an acute stressful challenge

Khat (Catha edulis) is a widely used stimulating drug often consumed in daily routine in Yemen and East African countries. Chewing khat acutely elicits states of euphoria and feelings of well-being which later shift into emotional instability and low mood. Little is known about emotional regulation in habitual khat chewers. In this study, we compared self-reports on trait anger as well as positive and negative affect responses to a mental arithmetic challenge. Participants included 135 men and women from Yemen who chew khat regularly, occasionally or not at all. Participants attended a laboratory session that involved resting periods and performing a math challenge. Analyses of variance and regression show that regular khat chewing is associated with higher trait anger, more pronounced negative responses during stress and less pronounced positive emotional states. These results suggest that regular khat chewing is associated with disturbances in emotion regulation processes.     

Dysplasia of the Corpus Callosum in Identical Twins with Nonketotic Hyperglycinemia

Nonketotic hyperglycinemia (NKH) is an autosomal recessively inherited disorder of the glycine degradation pathway leading to accumulation of glycine in body fluids and tissues. Identical twins with nonketotic hyperglycinemia and dysplasia of the corpus callosum are described in support of the hypothesis that some patients with NKH have a genetic defect of the glycine degradation pathway resulting in abnormal corpus callosal development. It is important to screen for metabolic defects whenever similar structural defects are present.