Establishing reference ranges for ambulatory electrocardiography parameters: meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (22) ◽  
pp. 1732-1739
Author(s):  
Curtis B Williams ◽  
Jason G Andrade ◽  
Nathaniel M Hawkins ◽  
Christopher Cheung ◽  
Andrew Krahn ◽  
...  
Keyword(s):  
Population Distribution ◽  
Data Extraction ◽  
Meta Analysis ◽  
Original Data ◽  
Healthy Adults ◽  
Published Data ◽  
Reference Ranges ◽  
Ambulatory Electrocardiography ◽  
Pooled Prevalence ◽  
Electrocardiogram Monitoring

ObjectiveDespite the widespread and increasing use of ambulatory electrocardiography (ECG), there is no consensus on reference ranges for ambulatory electrocardiogram parameters to guide interpretation. We sought to determine population distribution-based reference ranges for parameters measured during ambulatory electrocardiogram in healthy adults, based on existing literature.MethodsWe searched multiple databases from 1950 to 2020. Articles reporting original data from ≥24-hour ambulatory electrocardiogram monitoring in healthy adults were included. Data extraction and synthesis were performed according to Meta-analysis of Observational Studies in Epidemiology guidelines. The prevalence/mean and SD for common parameters (sinus pauses, conduction abnormalities and ectopy) were extracted by age group (18–39, 40–59, 60–79 and 80+ years).ResultsWe identified 33 studies involving 6466 patients. Sinus pauses of >3 s were rare (pooled prevalence <1%) across all ages. Supraventricular ectopy of >1000/24 hours increased with age, from 0% (95% CI 0% to 0%) in those aged 18–39 years to 6% (95% CI 0% to 17%) in those aged 60–79 years. Episodes of supraventricular tachycardia increased from 3% (95% CI 1% to 6%) in those aged 18–39 years to 28% (95% CI 9% to 52%) in those aged 60–79 years. Ventricular ectopy of >1000/24 hours also increased with age, from 1% (95% CI 0% to 2%) in those aged 18–39 years to 5% (95% CI 1% to 10%) in those aged 60–79 years. Episodes of non-sustained ventricular tachycardia ranged from 0% (95% CI 0% to 1%) in those aged 18–39 years to 2% (95% CI 0% to 5%) in those aged 60–79 years.ConclusionDespite the limitations of existing published data, this meta-analysis provides evidence-based reference ranges for ambulatory electrocardiogram parameters and highlights significant age-dependent differences that should be taken into account during interpretation.

scholarly journals More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Lopez-Leon ◽  
Talia Wegman-Ostrosky ◽  
Carol Perelman ◽  
Rosalinda Sepulveda ◽  
Paulina A. Rebolledo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Original Data ◽  
Long Term Effects ◽  
Pooled Prevalence ◽  
Attention Disorder ◽  
Initial Recovery ◽  
Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

scholarly journals Overweight and Obesity Among Adult HIV Infected Peoples Receiving ART in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
pp. 215013272199364
Author(s):  
Robel Hussen Kabthymer ◽  
Solomon Nega Techane ◽  
Temesgen Muche ◽  
Helen Ali Ewune ◽  
Semagn Mekonnen Abate ◽  
...  
Keyword(s):  
Publication Bias ◽  
Addis Ababa ◽  
Data Extraction ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Obesity And Overweight ◽  
Pooled Prevalence ◽  
Nutrition And Diet ◽  
Prevalence Of Obesity ◽  
Trim And Fill

Background: Over-nutrition and diet-linked non-communicable morbidities are showing increasing trend overtime. Even if there are different factors that affect the change in BMI other than ART, several authors have reported increases in BMI among PLHIV on treatment that are equal to or surpass the general population. This study is aimed to estimate the prevalence of obesity and overweight among adult HIV infected peoples taking ART in Ethiopia. Method: PubMed, CINAHL, Web of science, global health and Google scholar electronic databases were used to perform a systematic literature search. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence. Publication bias was checked using Funnel plot and Egger’s test. Result: Two thousand seven hundred and fifty-one studies were reviewed and 13 studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of 13 studies, comprising 4994 participants resulted in pooled prevalence of overweight to be 17.85% (95% CI: 12.22-23.47). Whereas, the pooled prevalence of overweight was found to be 3.90 (95% CI: 2.31-5.49) but after adjusting for publication bias using trim and fill analysis it has become 3.58 (95% CI: 2.04-5.13). Magnitude of both overweight and obesity was higher in studies conducted in Addis Ababa, studies done after 2016 and studies having sample size of less than 400, in subgroup analysis. Conclusion: The magnitude of overweight and obesity among HIV infected peoples taking ART in Ethiopia is high. There is a need to have a routine screening to PLWHA on the risk of over-nutrition in order to facilitate early detection.

scholarly journals Relationship between hospital or surgeon volume and outcomes in joint arthroplasty: protocol for a suite of systematic reviews and dose–response meta-analyses

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022797 ◽  
Author(s):  
Xiang-Dong Wu ◽  
Meng-Meng Liu ◽  
Ya-Ying Sun ◽  
Zhi-Hu Zhao ◽  
Quan Zhou ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Dose Response ◽  
Data Extraction ◽  
Meta Analysis ◽  
High Volume ◽  
Joint Arthroplasty ◽  
Surgeon Volume ◽  
Published Data ◽  
Records Management ◽  
Meta Analyses

IntroductionJoint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume–outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood. Furthermore, whether elective arthroplasty should be restricted to high-volume hospitals or surgeons remains in dispute, and little is known regarding where the thresholds should be set for different types of joint arthroplasties.Methods and analysesThis is a protocol for a suite of systematic reviews and dose–response meta-analyses, which will be amended and updated in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Electronic databases, including PubMed and Embase, will be searched for observational studies examining the relationship between the hospital or surgeon volume and clinical outcomes in adult patients undergoing primary or revision of joint arthroplasty. We will use records management software for study selection and a predefined standardised file for data extraction and management. Quality will be assessed using the Newcastle-Ottawa Scale, and the meta-analysis, subgroup analysis and sensitivity analysis will be performed using Stata statistical software. Once the volume–outcome relationships are established, we will examine the potential non-linear relationships between hospital/surgeon volume and outcomes and detect whether thresholds or turning points exist.Ethics and disseminationEthical approval is not required, because these studies are based on aggregated published data. The results of this suite of systematic reviews and meta-analyses will be submitted to peer-reviewed journals for publication.PROSPERO registration numberCRD42017056639.

scholarly journals Medication-Related Osteonecrosis of the Jaw in Patients Treated Concurrently with Antiresorptive and Antiangiogenic Agents: Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Akanksha Srivastava ◽  
Graciela M. Nogueras Gonzalez ◽  
Yimin Geng ◽  
Alexander M. Won ◽  
Jeffrey Myers ◽  
...  
Keyword(s):  
Relative Risk ◽  
Data Extraction ◽  
Meta Analysis ◽  
Osteonecrosis Of The Jaw ◽  
Accurate Estimation ◽  
Antiangiogenic Agents ◽  
Study Selection ◽  
Pooled Prevalence ◽  
Exposure Variable ◽  
Retrospective Cohort Studies

ABSTRACT Introduction Medication-related osteonecrosis of the jaws (MRONJ) is a known adverse event related to the use of antiresorptive (AR) drugs. More recently, an association between antiangiogenic (AA) drugs and MRONJ has been suggested. This review aimed to investigate the overall prevalence and relative risk of MRONJ in patients treated concurrently with AA and AR agents in comparison with a single AA or AR drug. Methods A review protocol was registered with PROSPERO (ID: CRD42020214244). A systematic literature search, study selection, quality assessment, and data extraction were carried out following PRISMA guidelines. Random-effects meta-analysis models were used to summarize relative estimates for the outcomes, namely prevalence and relative risk of MRONJ. Exposure variable included type of drug, specifically AA and AR agents administered either concurrently or individually. Results Eleven studies were included in the final qualitative and quantitative syntheses. The overall pooled weighted prevalence of MRONJ with concurrent AA-AR drugs was 6% (95% CI: 3–8%), compared with 0% (95% CI: 0–0%) for AA only and 5% (95% CI: 0–10%) for AR only. However, high heterogeneity was noted among included studies. Retrospective cohort studies showed a higher pooled prevalence of 13% (95% CI: 10–17%) for concurrent AA-AR therapy. The pooled risk ratio for MRONJ revealed a risk with concurrent AA-AR drugs 2.57 times as high as with AR only (95% CI: 0.84–7.87); however, this difference was not statistically significant. Concurrent AA-AR drugs had a risk for MRONJ 23.74 times as high as with AA only (95% CI: 3.71–151.92). Conclusions High-quality, representative studies are needed for accurate estimation of relative risk of MRONJ with concurrent AA and AR therapy.

scholarly journals Epidemiology of Microsatellite Instability High (MSI-H) and Deficient Mismatch Repair (dMMR) in Solid Tumors: A Structured Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-17 ◽  
Author(s):  
Maria Lorenzi ◽  
Mayur Amonkar ◽  
Jacky Zhang ◽  
Shivani Mehta ◽  
Kai-Li Liaw
Keyword(s):  
Literature Review ◽  
Solid Tumors ◽  
English Language ◽  
Meta Analysis ◽  
Evidence Base ◽  
Published Data ◽  
Cancer Type ◽  
Pooled Prevalence ◽  
Tumor Types ◽  
Structured Literature Review

Background. Given limited data on the epidemiology of MSI-H and dMMR across solid tumors (except colorectal cancer (CRC)), the current study was designed to estimate their prevalence. Materials and Methods. A structured literature review identified English language publications that used immunohistochemistry (IHC) or polymerase chain replication (PCR) techniques. Publications were selected for all tumors except CRC using MEDLINE, EMBASE, and Cochrane databases and key congresses; CRC and pan-tumor genomic publications were selected through a targeted review. Meta-analysis was performed to estimate pooled prevalence of MSI-H/dMMR across all solid tumors and for selected tumor types. Where possible, prevalence within tumor types was estimated by disease stages. Results. Of 1,176 citations retrieved, 103 and 48 publications reported prevalence of MSI-H and dMMR, respectively. Five pan-tumor genomic studies supplemented the evidence base. Tumor types with at least 5 publications included gastric (n = 39), ovarian (n = 23), colorectal (n = 20), endometrial (n = 53), esophageal (n = 6), and renal cancer (n = 8). Overall MSI-H prevalence (with 95% CI) across 25 tumors was based on 90 papers (28,213 patients) and estimated at 14% (10%–19%). MSI-H prevalence among Stage 1/2 cancers was estimated at 15% (8%–23%); Stages 3 and 4 prevalence was estimated at 9% (3%–17%) and 3% (1%–7%), respectively. Overall, dMMR prevalence across 13 tumor types (based on 54 papers and 20,383 patients) was estimated at 16% (11%–22%). Endometrial cancer had the highest pooled MSI-H and dMMR prevalence (26% and 25% all stages, respectively). Conclusions. This is the first comprehensive attempt to report pooled prevalence estimates of MSI-H/dMMR across solid tumors based on published data. Prevalence determined by IHC and PCR was generally comparable, with some variations by cancer type. Late-stage prevalence was lower than that in earlier stages.

scholarly journals The association between depression and later educational attainment in children and adolescents: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031595 ◽  
Author(s):  
Alice Wickersham ◽  
Sophie Epstein ◽  
Holly Victoria Rose Sugg ◽  
Robert Stewart ◽  
Tamsin Ford ◽  
...  
Keyword(s):  
Educational Attainment ◽  
Children And Adolescents ◽  
Data Extraction ◽  
Meta Analysis ◽  
Field Studies ◽  
Health Concern ◽  
Published Data ◽  
Eligibility Criteria ◽  
Newcastle Ottawa Scale ◽  
Date Estimate

IntroductionDepression represents a major public health concern for children and adolescents, and is thought to negatively impact subsequent educational attainment. However, the extent to which depression and educational attainment are directly associated, and whether other factors play a role, is uncertain. Therefore, we aim to systematically review the literature to provide an up-to-date estimate on the strength of this association, and to summarise potential mediators and moderators on the pathway between the two.Methods and analysisTo identify relevant studies, we will systematically search Embase, PsycINFO, PubMed, Education Resources Information Centre and British Education Index, manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between major depression diagnosis or depressive symptoms in children and adolescents aged 4–18 years (exposure) and later educational attainment (outcome). Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale. If sufficiently homogeneous studies are identified, summary effect estimates will be pooled in meta-analysis, with further tests for study heterogeneity, publication bias and the effects of moderators using meta-regression.Ethics and disseminationBecause this review will make use of already published data, ethical approval will not be sought. The review will be submitted for publication in a peer-reviewed journal, presented at practitioner-facing conferences, and a lay summary will be written for non-scientific audiences such as parents, young people and teachers. The work will inform upcoming investigations on the association between child and adolescent mental health and educational attainment.PROSPERO registration numberCRD42019123068

scholarly journals Cryptosporidiosis in HIV-positive patients and related risk factors: A systematic review and meta-analysis

Parasite ◽  
2020 ◽  
Vol 27 ◽  
pp. 27
Author(s):  
Ehsan Ahmadpour ◽  
Hanie Safarpour ◽  
Lihua Xiao ◽  
Mehdi Zarean ◽  
Kareem Hatam-Nahavandi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Extraction ◽  
Meta Analysis ◽  
Diagnostic Methods ◽  
Detection Methods ◽  
Hiv Positive ◽  
Pooled Prevalence ◽  
Related Risk ◽  
Study Population ◽  
Staining Methods

Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic methods, geographical distribution and study population. Meta-regression was performed on the year of publication, proportion of patients with diarrhea, and proportion of patients with CD4 < 200 cells/mL. One hundred and sixty-one studies and 51,123 HIV-positive participants were included. The overall pooled prevalence of Cryptosporidium infection in HIV-positive patients was 11.2% (CI95%: 9.4%–13.0%). The pooled prevalence was estimated to be 10.0% (CI95%: 8.4%–11.8%) using staining methods, 13.5% (CI95%: 8.9%–19.8%) using molecular methods, and 26.3% (CI95%: 15.0%–42.0%) using antigen detection methods. The prevalence of Cryptosporidium in HIV patients was significantly associated with the country of study. Also, there were statistical differences between the diarrhea, CD4 < 200 cells/mL, and antiretroviral therapy risk factors with Cryptosporidiosis. Thus, Cryptosporidium is a common infection in HIV-positive patients, and safe water and hand-hygiene should be implemented to prevent cryptosporidiosis occurrence in these patients.

scholarly journals Global, regional and national estimates ofToxoplasma gondiiseroprevalence in pregnant women: a protocol for a systematic review and modelling analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030472 ◽  
Author(s):  
Jean Joel Bigna ◽  
Joel Noutakdie Tochie ◽  
Dahlia Noelle Tounouga ◽  
Anne Olive Bekolo ◽  
Nadia S Ymele ◽  
...  
Keyword(s):  
Public Health ◽  
Toxoplasma Gondii ◽  
Pregnant Women ◽  
Data Extraction ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Published Data ◽  
Representative Study ◽  
Nationally Representative ◽  
Meta Analyses

IntroductionTo set priorities for public health policy, funding for public health interventions, and healthcare planning which will ultimately contribute in bending the burden of toxoplasmosis towards maternal and neonatal health, it is necessary to have accurate data on the prevalence of toxoplasmosis in pregnancy. Therefore, we aimed to estimate the seroprevalence ofToxoplasma gondiiinfection in pregnant women by countries, WHO regions and globally.Methods and analysisWe will search multiple databases to identify studies that reported the prevalence (or enough data to compute this estimate) ofToxoplasma gondiiin the global population of pregnant women up till December 31, 2018 without any language restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently by three pairs of investigators. For each country, we will estimate the prevalence based on empirical studies if there is either one nationally representative study, or two or more not nationally representative studies. Then, we will perform a country-specific random-effects meta-analyses. The heterogeneity will be evaluated using the χ² test on Cochrane’s Q statistic and quantified with H and I² statistics. For countries with one or no empirical studies or where the meta-analysis will result in a wide CI of 0%–100%, we will predict the country’s prevalence by using a Bayesian generalised non-linear multilevel model. The model will have a hierarchical structure in which estimates for each country will be informed by its own data, if available, or by data from other countries in the same WHO region.Ethics and disseminationSince this study will be based on published data, it does not require any ethical approval. Its findings will be published in a scientific peer-reviewed journal. They will also be presented at scientific conferences and to relevant public health sectors.PROSPERO registration numberCRD42019125572.

scholarly journals Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis

BMJ ◽  
2019 ◽  
pp. l4185 ◽  
Author(s):  
Maria Panagioti ◽  
Kanza Khan ◽  
Richard N Keers ◽  
Aseel Abuzour ◽  
Denham Phipps ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Medical Care ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cost Effective ◽  
Mitigation Strategies ◽  
Patient Harm ◽  
Pooled Prevalence ◽  
Preventable Harm

Abstract Objective To systematically quantify the prevalence, severity, and nature of preventable patient harm across a range of medical settings globally. Design Systematic review and meta-analysis. Data sources Medline, PubMed, PsycINFO, Cinahl and Embase, WHOLIS, Google Scholar, and SIGLE from January 2000 to January 2019. The reference lists of eligible studies and other relevant systematic reviews were also searched. Review methods Observational studies reporting preventable patient harm in medical care. The core outcomes were the prevalence, severity, and types of preventable patient harm reported as percentages and their 95% confidence intervals. Data extraction and critical appraisal were undertaken by two reviewers working independently. Random effects meta-analysis was employed followed by univariable and multivariable meta regression. Heterogeneity was quantified by using the I 2 statistic, and publication bias was evaluated. Results Of the 7313 records identified, 70 studies involving 337 025 patients were included in the meta-analysis. The pooled prevalence for preventable patient harm was 6% (95% confidence interval 5% to 7%). A pooled proportion of 12% (9% to 15%) of preventable patient harm was severe or led to death. Incidents related to drugs (25%, 95% confidence interval 16% to 34%) and other treatments (24%, 21% to 30%) accounted for the largest proportion of preventable patient harm. Compared with general hospitals (where most evidence originated), preventable patient harm was more prevalent in advanced specialties (intensive care or surgery; regression coefficient b=0.07, 95% confidence interval 0.04 to 0.10). Conclusions Around one in 20 patients are exposed to preventable harm in medical care. Although a focus on preventable patient harm has been encouraged by the international patient safety policy agenda, there are limited quality improvement practices specifically targeting incidents of preventable patient harm rather than overall patient harm (preventable and non-preventable). Developing and implementing evidence-based mitigation strategies specifically targeting preventable patient harm could lead to major service quality improvements in medical care which could also be more cost effective.

scholarly journals Prevalence of Common Mental Disorder and Its Association with Khat Chewing among Ethiopian College Students: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Birhanie Mekuriaw ◽  
Abriham Zegeye ◽  
Alemayehu Molla ◽  
Robel Hussen ◽  
Solomon Yimer ◽  
...  
Keyword(s):  
University Students ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Data Extraction ◽  
Meta Analysis ◽  
Test Statistics ◽  
Analysis Model ◽  
Khat Chewing ◽  
Pooled Prevalence

Background. Mental disorder is a global burden that affects all groups of people. Young people, particularly college/university students, are more vulnerable to common mental disorders than the general population. Thus, students may use khat to gain immediate relief from their psychological distress which may worsen again after longer time of chewing. In Ethiopia, there are studies showing discrepant and inconsistent results of common mental disorder among college/university students. Therefore, this review sought to determine the prevalence of common mental disorder and its association with khat chewing among Ethiopian college/university students. Methods. Different kinds of literature were searched from the databases of Google Scholar, PubMed/Medline, ScienceDirect, and PsycINFO. A total of 10 primary studies which report the prevalence of common mental disorder among Ethiopian college/university students were included in the review. The data were extracted using a standardized data extraction format prepared in Microsoft Excel. STATA version 14 statistical software was used for analysis. Cochran’s Q test statistics and I2 test were used to assess heterogeneity. A random effects meta-analysis model was used to estimate the pooled prevalence of common mental disorder due to the variability of the studies. Lastly, the association between common mental disorder and khat chewing was conducted. Results. The pooled prevalence of common mental disorder among Ethiopian college/university students was 37.73% (95% CI: 30.43, 45.03). The subgroup analysis showed the highest [51.9% (95% CI: 30.19, 73.70)] and lowest [33.28% (95% CI: 19.95, 46.60)] prevalences of common mental disorder among Ethiopian college/university students found in Amhara and South Nation Nationality and People regions, respectively. The pooled effect (odds ratio) of khat chewing on common mental disorder was 2.01 (95% CI: 1.38, 2.95). Conclusions. In our review, it is found that more than one-third of college/university students suffered from common mental disorder. Khat chewers were found to be twofolds more vulnerable to develop common mental disorder than nonchewers.

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