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Many articles have reviewed the health impact of Khat consumption; however the role of free radicals in the pathogenesis associated with short- and long-term consumption of Khat is absent in the literature. As free radicals and antioxidants converge across various mechanisms in normal physiological function and in disease, this review attempts to uncover the role of endogenous free radicals and the mechanism of cellular injury associated with Khat consumption.

Effect of khat chewing on the levels of cortisol, total-cholesterol, triglyceride and lipoproteins cholesterol (HDLc and LDLc), in healthy khat chewers were studied in fifty healthy Yemeni male adults. After 12 hours fasting (in controls) or after 12 hours from the last session for khat chewing , serum concentration of these parameters were determined. The results showed that the mean levels of serum cortisol as well as the serum concentration of HDL-cholesterol were decreased as compared to non khat chewer individuals (control group) (p<0.05), while the serum triglyceride mean level was consistently higher after chewing khat and differences were statistically significant (p-value<0.05) as compared to the control group. On the other hands the mean concentration of total cholesterol and LDL-c in serum of khat consumers showed a non-significant change, as compared to the control group (non khat chewers).

To assess the Hb F response to hydroxyurea (HU) in Yemeni sickle cell disease, 86 patients attending hospitals in Sana'a City, Yemen, were studied. Group I (short-term follow-up, n = 21) were treated with 500 mg/day HU for 3-6 months; group II (long-term, n = 26) were treated with 500 mg/day HU for 8-48 months; group III were untreated (n = 39). Hb F levels were monitored using cation exchange high performance liquid chromatography (HPLC). Group I showed significant increase in Hb F level after treatment (10.0 ± 5.8 to 13.8 ± 5.9%). Hb F level increased significantly with treatment in group II when compared to group III. The increase in Hb F level was associated with increased hemoglobin (Hb) levels. Hydroxyurea, even at a low dose, appears to be effective in raising Hb F levels in Yemeni sickle cell disease patients without any association of major side effects. Further study is required to investigate its maximum tolerated dose and its effects on increase in Hb F, frequency of acute crisis and any long-term toxicity.

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