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Global perspectives on reproductive medicine
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
Khat, Catha edulis, grows wild or is cultivated in East Africa and southern Arabia (25). Chewing the leaves and young branches provides rapid stimulation, and addiction causes loss of appetite, stomatitis, gastritis, gastric ulcers and constipation accompanied by haemorrhoids. Chemically, the leaves contain alkaloids, including cathinone, a psychoactive alkaloid chemical that stimulates the central nervous system (22).
Khat and the creation of tradition in the Somali diaspora
Published in Jane Fountain, Dirk J Korf, Drugs in Society, 2019
Khat (Catha edulis), also known as qat, chat and miraa, is a shrub that grows wild across much of Africa and Asia, favouring altitudes of between 5,000 and 6,500 feet above sea level. The oldest records show that khat was used in the highlands of Yemen and Ethiopia as early as the fourteenth century. It is also well established in the Meru mountains of Kenya. Somalia, by contrast, is an arid, low-lying country dominated by scrubland and savannah. In the pre-colonial era, the majority of the population were pastoralists, and there were pockets of intensive agricultural production in the river valleys and along the coast. Both as groups and individually, Somalis travelled widely and participated in the regional exchange economy, which was centred on the trade of meat, milk, leather and other animal products in exchange for vegetable produce. The trade between protein-producing lowlands, populated by nomadic groups, and the sedentary farmers of the highlands is a well-established feature in the Horn of Africa. Via this exchange system, Somalis were able to access agricultural produce that they could not grow in their own region. There was therefore a cultural memory and an awareness of exogenous crops such as khat.
Synthetic Cathinones and Related Fatalities in the United Kingdom
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
John M. Corkery, Christine Goodair, Hugh Claridge
Khat (Catha edulis forsk) is a member of the evergreen Celastracae (moonseed or spindle- tree) family (Corkery, 2016). Its fresh leaves contain several phenylpropylamine-type alkaloids, of which the two main psychoactive constituents are the stimulants cathinone (S-(-)-α-aminopropiophenone) and cathine (S,S-(+)-norpseudoephedrine). Cathinone (α-aminopropiophenone) has been isolated in variable amounts from fresh leaves. These molecules act on two main neurochemical pathways—dopamine and noradrenalin. It has been proposed that cathinone, like amphetamine, releases serotonin into the central nervous system (CNS), inducing dopamine release from CNS dopamine terminals, increasing dopaminergic pathway activity (Kalix & Braenden, 1985). Cathinone facilitates the transmission of noradrenalin. It has been suggested that the uptake of noradrenalin is inhibited by cathinone and cathine (Drake, 1988). Cathinone possesses a stronger stimulant effect than cathine and is generally regarded as the more important constituent in khat. However, the presence of oxygen makes cathinone unstable, and it decomposes within just a few days of being picked or if it is dried (Griffiths et al., 1997). Its psychoactivity quickly declines, becoming physiologically inactive after approximately 36 hours.
Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports
Published in Clinical Toxicology, 2022
Michal Ordak, Natalia Sloniewicz, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
The abuse of ephedrone has become a public health problem in several Eastern European countries, although isolated cases have also been noted in Central Europe and Turkey [8,12]. A total of 1.613 notifications of drug-related deaths (including ephedrone) occurring in 2012 in the UK and Islands were submitted to the National Programme on Substance Abuse Deaths [13]. Home synthesis of ephedrone from drugs is related to the reaction of pseudoephedrine with potassium permanganate, acetic acid and water. Crude oxidation ephedrine/pseudoephedrine with potassium permanganate (KMnO4) forms methcathinone (ephedrone) and manganese dioxide. Clinical features of manganism were soon seen in ephedrone users attributed to manganese dioxide (MnO2) contaminating the ephedrone [14,15]. It is structurally very similar to ethcathinone and cathinone – stimulating alkaloids – found in Catha edulis [16].
Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study
Published in Infectious Diseases, 2020
Mohammed Saif Anaam, Alian A. Alrasheedy, Saud Alsahali, Saeed O. Alfadly, Adel H. Aldhubhani
For the independent variables, diabetics were defined as patients diagnosed with diabetes and using anti-diabetic drugs [29]. Patients who habitually and currently chewed khat (Catha edulis) leaves as a stimulant were considered khat chewers. Patients who habitually and currently smoked tobacco were considered smokers. An unemployed person was defined as one who did not have any source of income and relied on the family to meet all needs. Treatment adherence was defined as taking ≥80% of the prescribed doses, usually 56 in the intensive and 168 in the continuous phase [30]. Non-adherent patients were defined as those who had missed at least one month of the total anti-TB treatment [29]. Cavitation was defined as the formation of cavities in the lungs, as a consequence of TB, which could be either single or multiple and generally had thick walls with irregular margins. There could be fluid within these cavities, visualised by an air-fluid level and generally progressing to linear or fibrotic lesions in cured patients [31]. Patients with body weight less than 90% of ideal body weight at time of diagnosis were considered underweight.
Acute toxic kidney injury
Published in Renal Failure, 2019
Nadezda Petejova, Arnost Martinek, Josef Zadrazil, Vladimir Teplan
Amphetamines are synthetic, widely abused psychoactive drugs with significant stimulant, euphoric, anorectic, empathogenic, entactogenic and hallucinogenic properties. Common in clinical psychiatric practice are amphetamine, methamphetamine and 3,4 methylenedioxymethamphetamine (MDMA, Ecstasy). However, in human history some natural amphetamines have been used for centuries through the ingestion or chewing the leaves of the Catha edulis plant (Khat) in East Africa and Arabia or plants of the genus Ephedra e.g. Ephedra sinica. The biochemical structure of amphetamines is similar to the monoamine neurotransmitters with competitive action at membrane transporters of dopamine, norepinephrine and serotonin. The results of competitive membrane action are blocking of reuptake and induction of the reverse transport of endogenous neurotransmitters [102]. The clinical presentation of MDMA poisoning varies from hyperpyrexia, arrhythmias, serotonin syndrome, neurological symptoms with seizures, sudden death or coma. In vitro study using rat and human proximal tubular cells showed no direct nephrotoxicity of MDMA or methylenedioxyamphetamine (MDA) in varied concentrations, but alpha-methyldopamine (alpha-MeDA) itself and conjugation with glutathione (GSH) to 5-(glutathione-S-yl)-alpha-MeDA were extremely potent nephrotoxicants with approximately 70–80% cell death. Thus, the metabolism of ecstasy on the apical membrane of renal proximal tubular cells with the extracellular event of redox cycling appears to be the possible part of pathophysiological pathway of MDMA nephrotoxicity [103].