Sana'a University Journal of Medical and Health Sciences

A peer-reviewed, open-access journal publishing high-quality research in medicine, dentistry, and medical and health sciences.

It is a refereed scientific journal issued by Sana'a University. The journal aims to provide a platform for publishing research in accordance with approved international scientific standards and to improve production and scientific research in the field of medical and health sciences. The journal is issued every two months in electronic versions and accepts papers and research studies written in English

Honorary president:

Prof. Mohammed Ahmed Al-Bukhaiti
President of Sana'a University

Editor in Chief:

Prof.Abdulsalam M. Al-Mekhlafi: :Editor in Chief of Sana'a University Journal of Medical and Health Sciences.

Announcement for International Researchers

2025-02-23

Vol. 20 No. 3 (2026): Vol. 20 No. 3 (2026): Sana’a University Journal of Medicine and Health Sciences

Current Issue

Vol. 20 No. 3 (2026): Sana’a University Journal of Medicine and Health Sciences

Vol. 20 No. 3 (2026)

2026-06-28

11 Articles

Volume 20 - Issue 3 (2026): Sana’a University Journal of Medicine and Health Sciences

Article

11 Articles

Outcome and Associated Factors of Abortion inAl-Sabeen Maternity and Childhood Hospital

Altaf SALEH HASSAN ALJABR, Alia Abdullah Shoib, Abdulhakim Al-Eryani

562- 572

2026-06-28

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DOI: 10.59628/jchm.v20i3.2739

Abstract

Background: Spontaneous miscarriage is one of the global health concerns, and Yemen has one of the highest burdens in the region. This study aimed to determine the outcomes and associated factors of spontaneous miscarriage at Al-Sabeen Hospital in Sana’a City.
Methodology: A prospective case-control study was conducted over one year, involving 216 women with spontaneous miscarriage (cases) and 216 women with viable pregnancies beyond 24 weeks (controls). Data on sociodemographic characteristics, presenting symptoms, type of miscarriage, and obstetric, medical, and anatomical factors were collected through direct interviews and medical records. SPSS software was used for data analysis, and logistic regression was applied to test the correlation between potential risk factors and miscarriage.
Results: The mean age of cases was 28.4±6.1 years. Missed (36.1%) and incomplete miscarriages (31.0%) were the most common types. Univariate logistic regression identified several risk factors, including rural residency (cOR: 1.78, p=0.017), khat chewing (cOR: 1.48, p=0.043), history of abortion (cOR: 1.65, p=0.028), infections (cOR: 1.51, p=0.043), hyperprolactinemia (cOR: 7.99, p=0.001), and incompetent cervix (cOR: 36.03, p<0.001). In multivariable logistic regression, an incompetent cervix was identified as the strongest predictor of miscarriage (aOR: 29.167, P =0.001). Most mothers were managed and discharged without complications. However, some serious complications occurred, including 6.0% requiring blood transfusion and 3.7% requiring ICU admission for septic shock.
Conclusion: Spontaneous miscarriage in our sample is multifactorial and strongly linked to cervical incompetence and a history of previous miscarriage. Although maternal outcomes were generally good, some severe complications were documented, indicating the urgent need for enhanced preconception counseling, early antenatal screening for high-risk pregnancies, and improved access to emergency obstetric care in the region.

Keywords

Miscarriage Abortion Spontaneous Risk factors Outcome Incompetent cervix Missed Yemen

Prevalence of Iron Deficiency Anemia amongPregnant Women at Al-Jomhori Teaching Hospitalin Sana’a City -Yemen

Ali Yahia Seraj, Jameel Al-Ghazaly

573- 582

2026-06-28

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DOI: 10.59628/jchm.v20i3.2878

Abstract

Background: Iron deficiency anemia (IDA) is widely recognized as a common type of nutritional disorder among pregnant women and poses substantial risk to both maternal and fetal health worldwide, especially in developing countries such as Yemen. This study was designed to estimate the prevalence of IDA among pregnant women attending obstetric clinics at Al-Jomhori Teaching Hospital in Sana’a City, Yemen.
Materials and methods: Between August 2024 and August 2025, a cross-sectional study was conducted on 397 pregnant women. Venous blood samples were analyzed for hematological parameters and iron profile tests to determine IDA using automated methods. Statistical analyses were performed using SPSS version 24.
Results: Among 397 pregnant women, the prevalence of IDA among study subjects was 49.4%, and it was also 87.5% out of the total 224 anemic pregnant women. Statistical analysis showed a highly statistically significant (P = 0.001) role in the development of IDA in pregnant women who were illiterate, had a shorter interpregnancy period of < 1 year, had 4–7 children, and had a low monthly family income.
Conclusion: The high prevalence of IDA among pregnant women in the study area may be attributed to factors such as socioeconomic status, maternal education levels, and reproductive-related factors. This necessitates strengthening health awareness programs that emphasize the importance of birth spacing, improving nutritional care, and providing preventive nutritional supplements to the most vulnerable social groups to reduce health risks.

Keywords

Iron deficiency anemia (IDA) pregnant women Sana’a Yemen

Protective Effects of Alogliptin AgainstIndomethacin-Induced Gastric Ulcers in Rats

Abdulnaser Aklan, Mohammed A. Al-khawlani, Hassan M. Al-Mahbashi, Abdul-Malik Abudunia, Abdullah S.A. Ahmed, Mohammed A.N. Abbas

583- 591

2026-06-28

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DOI: 10.59628/jchm.v20i3.2767

Abstract

Background: Notwithstanding the availability of efficacious antiulcer drugs, concerns over their safety have motivated the lookup of alternate or adjunctive therapies. Drug repurposing is a practical, low-risk, and cost-effective approach. Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as alogliptin, have pleiotropic effects beyond glucose regulation, including antioxidant and anti-inflammatory activities, which may protect the gastric mucosa.
Objectives: To evaluate the gastroprotective potential of alogliptin against indomethacin-induced gastric ulcers in rats.
Methods: Albino rats were assigned randomly to four groups (n = 6): normal control, positive control, omeprazole (20 mg/kg), and alogliptin (3 mg/kg). The treatments were administered for eight consecutive days. All pretreatment groups, except the normal control group, received a single oral dose of indomethacin (50 mg/kg) to induce gastric ulceration. The rats were sacrificed after 6 h, and their stomachs were collected for assessment. Gastric juice volume and pH were measured, and gastric tissues were evaluated both macroscopically and microscopically. Antioxidant markers, including GPx, SOD, and MDA, were measured.
Results: Pretreatment with alogliptin significantly reduced ulcer number by 32.1% and severity by 37.9%. GPx and SOD activities were significantly restored by 44% and 43%, respectively. It also significantly decreased MDA levels by 45.6% compared to the positive control group. Histopathology revealed marked preservation of the gastric mucosal architecture, with reduced necrosis and inflammatory cell infiltration.
Conclusion: Alogliptin exhibits gastroprotective effects, likely via antioxidant mechanisms, suggesting its potential as an adjunct therapy for patients at risk of NSAID-induced gastric ulcers, especially in diabetic populations.

Keywords

Alogliptin Gastric ulcer DPP-4 inhibitor Antioxidant Indomethacin

Assessment of Serum Vitamin D3 and Lipid ProfileLevel in Children with Autism Spectrum Disorder inSana’a City, Yemen

Afrah Abdulsalam Al-Sheapany, Abdulkarim Mohammed Al-Obeidi, Gharibah Abdulrahman Mohammed

592- 597

2026-06-28

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DOI: 10.59628/jchm.v20i3.2716

Abstract

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by persistent deficits in social communication, restricted patterns of behavior, and a wide range of cognitive and sensory processing differences. The global prevalence of ASD has increased significantly over the past two decades, raising scientific interest in understanding its multifactorial etiology. The pathogenesis of autism spectrum disorder (ASD) remains unclear and is considered highly complex. However, current evidence suggests
that ASD arises from a multifactorial interplay between genetic predisposition and environmental factors that alter brain development and neural function. This study aimed to assess the levels of serum vitamin D3 and lipid profiles in children with autism spectrum disorder in Sana’a city, Yemen.
Methods: This case-control study was conducted from January to December 2025. The sample size will be 120, divided into 60 cases and 60 controls each. A venous blood sample (approximately 5 mL) was collected from each participant in the morning after an overnight fast (8-10 hours) into labelled plain test tubes under aseptic conditions. Demographic and clinical information, including age, sex, weight, height, body mass index (BMI), type of birth, and mothers’ and fathers’ ages at childbirth, were collected. Data were entered and analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.
Result: This study population included children with autism spectrum disorder (ASD) who were attending specialized autism centers in Sana’a city, Yemen, to assess the levels of serum Vit D3 and lipid profiles in children with autism spectrum disorder. We found a statistical significance of VitD3 and HDL among cases and controls, with a median (IQR) of VitD3 (18.5 (10.2)) compared to controls (23.5 (11)) with P = 0.01. The median (IQR) of HDL of case 40 (14) compared to control 44 (13), with P = 0.01. Non-statistically significant findings of cholesterol, triglyceride, and LDL with mean ± SD and median (IQR) of the control 159±27.7, 115.5(26), and 87(23), respectively, compared to the mean ± SD and median (IQR) of the case 159±20, 116(50), and 88.5(36), respectively. Although there was a non-significant difference between the case and control groups in terms of BMI, type of birth, and father and mother age at the baby’s birth.
Conclusion: This study highlights whether there are differences in vitamin D3 and lipid profile levels between children and typically developing children in Sanaa City, Yemen.

Keywords

Autism spectrum disorder VitD3 Lipid profile Yemeni children

Histopathology of liver tissue from control (G1), khat extract (G2), and PO+YE (G3a,b). PAS stain [100x -400x, scale bar=50 μm]

Assessment of the Effects of Khat Extract on the Hypouricemic Activities of Allopurinol in Rats

Safia Abdulatef A. Alrezami, Abdulmalik Abdullah Y.Abudunya, Hassan Mohammed Al- Mahbashi, Abdulatef Mohammed M. Abbas

598-610

2026-06-28

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DOI: 10.59628/jchm.v20i3.2592

Abstract

Background: Hyperuricemia is an important metabolic condition that is closely associated with gout and cardiovascular disorders. The first-line treatment is still allopurinol, a xanthine oxidase inhibitor, but little is known about how it interacts with herbal substances. Khat (Catha edulis), which is traditionally consumed in East Africa and the Arabian Peninsula, has recently spread throughout the world because of migration. The purpose of this study was to assess how khat extract affects the hypouricemic action of allopurinol in hyperuricemia rats.
Methods: Forty-eight male albino rats were randomly divided into six groups and given different amounts of allopurinol, khat extract, yeast extract and potassium oxonate. Biochemical investigations included serum and urine analyses for uric acid levels, xanthine oxidase activity, kidney and liver function tests, urine profile, and complete blood count. Histopathological examinations of renal and hepatic tissues were also conducted.
Results: Khat extract significantly elevated the serum uric acid level and xanthine oxidase activity. Moreover, its combination with allopurinol reduced the drug’s hypouricemic efficacy. Coadministration also induced more pronounced alterations in renal and hepatic function parameters, together with histopathological evidence of tissue injury.
Conclusion: Khat extract reduced the therapeutic effectiveness of allopurinol and aggravated both biochemical abnormalities and histological damage under hyperuricemia conditions. These outcomes, based on an animal model, point to a possible interaction between khat and allopurinol and emphasize the need for further investigation in humans.

Keywords

Catha edulis Allopurinol Interactions Hypouricemic activity biochemical and histology alterations Rat model

sagittal reconstruction oriented with the Frankfort horizontal (FH) plane parallel to the floor prior to cephalometric analysis

Three-Dimensional Evaluation of Steiner Analysis and Witt’s Appraisal in The Assessment of Sagittal Skeletal Pattern in a Selected Group of Yemeni Adults

Razan Mohammed Nader Garada, Khaled Alhaddad, Ghamdan Al-Harazi

611-620

2026-06-28

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DOI: 10.59628/jchm.v20i3.2414

Abstract

Background and Purpose: Precise quantification of the sagittal skeletal relationships between the maxilla and mandible is essential to orthodontic diagnosis and treatment planning. This study aimed to comprehensively evaluate the concordance between WITS appraisal and Steiner analysis across distinct sagittal skeletal patterns (SSPs) and to assess potential sexual dimorphism in these measurements in a Yemeni population utilizing cone-beam computed tomography (CBCT) imaging. Materials and Methods: This retrospective cross-sectional study analyzed 120 CBCT scans from a Yemeni population (60 males, 60 females; mean age: 23.39 ± 4.0 years), stratified into three sagittal skeletal pattern groups (n=40 each): Class I, Class II, and Class III, based on the ANB angle. Raw DICOM data were imported into CS 3D Imaging software, where images were oriented to the Frankfort Horizontal plane for three-dimensional reconstruction and segmentation. Cephalometric analysis was performed on standardized sagittal reconstructions to measure the ANB angle and WITS appraisal. These measurements were derived from established skeletal landmarks (including Nasion, Point A, and Point B) and reference planes (specifically the Sella-Nasion plane and the functional Occlusal Plane). Statistical analysis was performed using SPSS, including intergroup comparisons, gender-based comparisons, and Pearson correlation analysis. The level of statistical significance was set at p < 0.05. Results: Statistically significant differences in both ANB angle and WITS appraisal were demonstrated among the three sagittal skeletal patterns (p < 0.001), with Class II subjects demonstrating the highest mean values. No statistically significant sexual dimorphism was detected in either measurement within any skeletal class. A significant positive correlation between WITS appraisal and ANB angle was identified in Class II (r = 0.517) and Class III (r = 0.636) skeletal patterns; conversely, no statistically significant correlation was observed in Class I (r = 0.023). Conclusion: While WITS appraisal and ANB angle demonstrate a significant positive association overall, each measurement provides complementary diagnostic information and should be interpreted in conjunction rather than applied interchangeably when evaluating sagittal jaw discrepancies, particularly in borderline skeletal relationships.

Keywords

Sagittal Skeletal classification ANB angle Wits appraisal

Distribution of blood values of hematological parameters among adolescents’ students

Prevalence of Iron Deficiency Anemia among Schools Adolescents in Bani Al-Harith District, Sana’a City -Yemen

Fateh Mogully Al-Nadeesh, Jameel Al-Ghazaly

621-628

2026-06-28

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DOI: 10.59628/jchm.v20i3.2718

Hematological Markers Associated withRheumatoid Arthritis among Yemeni Patients inSana’a City: A Case- Control Study

Arwa Mohammed Othman, Raja Mohammed Al-Haimi, Hassan Abdulwahab Al-Shamahy, Amr A. Saleh

629- 636

2026-06-28

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DOI: 10.59628/jchm.v20i3.2713

Abstract

Background: Rheumatoid arthritis (RA) is characterized by chronic inflammation and immune dysregulation affecting the hematopoietic system through multiple factors. Various inflammatory hematological markers, such as the neutrophil-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic immune response index (SIRI), represent systemic inflammation and balance of the immune response.
Objective: This case-control study aimed to evaluate and compare the clinical utility of these novel, inflammatory ratios among Yemeni patients with rheumatoid arthritis.
Methods: 200 participants were enrolled in our study, including 100 cases with RA and 100 healthy controls. Peripheral blood samples were obtained from each participant for CBC and serological tests. The NLR, LMR, PLR, NMR, SIRI, and SII were calculated. A receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of RA.
Results: NLR, PLR, NMR, SIRI, and SII were significantly elevated in patients with rheumatoid arthritis, whereas LMR was significantly reduced compared with healthy controls (p < 0.05). Spearman’s rho showed that the NLR (r = .242, P = 0.015; r = 0.224, P = 0.025), PLR (r = 0.425, P < .001; r = 0.360, P < 0.001), and SII (r = 0.298, P = 0.003; r = 0.303, P = 0.002) were positively correlated with both ESR and anti-CCP, while NMR (r = 0.243, P =
0.015) was only positively correlated with ESR. The AUC for SIRI equals to 0.658, NLR (AUC = 0.647), SII (AUC = 0.617), and PLR (AUC = 0.614) are statistically significant but modest discriminative power between patients with RA and healthy controls.
Conclusions: NLR, PLR, SIRI, and SII were significantly higher in RA patients than in control participants while LMR was significantly lower in RA patients. NLR, PLR, and SII were positively correlated with both ESR and anti-CCP, while NMR was only positively correlated with ESR. Therefore, these may be used as complementary diagnostic indicators in the diagnosis of RA, as they are simple, inexpensive, and objective markers. Further studies with larger sample sizes and extended follow-ups are warranted.

Keywords

Rheumatoid arthritis Hematologic parameters NLR LMR PLP NMR SIRI SII

Metabolic Syndrome, Insulin Resistance, and Age Are Associated with an increased Risk of Colorectal Cancer Among Yemeni Subjects

Gamal Othman Dabwan, Zaid Hezam Al-Hamodi, Hezam Al-Hamodi

637- 643

2026-06-28

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DOI: 10.59628/jchm.v20i3.2873

Abstract

Background and objective: Colorectal cancer (CRC) and obesity are major global public health challenges. Colorectal cancer (CRC) is among the most common malignancies worldwide, and growing evidence suggests that obesity contributes to the initiation and progression of colorectal cancer. Therefore, this study aimed to investigate the association between CRC and age, metabolic syndrome (MetS) parameters, and insulin resistance.
Method: A case-control study was conducted between 2023 and 2025 from the endoscopy units of the Replication Teaching Hospital Authority and USTH hospital, including 214 Yemeni adults aged 20 to 90 years. The association between CRC and age, MetS parameters, and insulin resistance was analyzed using binary logistic regression analysis.
Results: CRC patients had a significantly higher age compared to controls. Age, fasting blood sugar (FBS), and HOMA-IR were positively correlated with CRC (r = 0.49, p < 0.001; r = 0.24, p = 0.003; and r = 0.19, p = 0.02, respectively), whereas high-density lipoprotein cholesterol showed a significant negative correlation (r = -0.30, p < 0.001). Logistic regression analysis demonstrated that older age, elevated FBS, increased HOMA-IR, and reduced HDL-C were independent risk factors for CRC (OR = 5.7, 95% CI: 2.7–11.9, p < 0.001; OR = 4.6, 95% CI: 1.5–13.5, p = 0.006; OR = 2.5, 95% CI: 1.1–5.8, p = 0.04; and OR = 3.2, 95% CI: 1.2–8.1, p = 0.016, respectively).
Conclusion: This study demonstrates that age, elevated blood glucose, increased HOMA-IR, and reduced HDL-cholesterol are significantly associated with colorectal cancer (CRC) and may contribute to its development, particularly in older individuals.

Keywords

Colorectal cancer HOMA-IR Fasting blood sugar High-density lipoprotein-cholesterol Low-density lipoprotein-cholesterol Body mass index Metabolic syndrome Insulin Total cholesterol Triglyceride

STROB flow diagram showing the participants’ selection and retainment process

Knowledge, Attitudes, and Practices of Teleorthodontics among Orthodontic Professionals in Yemen: A Cross-Sectional Study

Taha Mohammed Mansoor Al-Saidi, Ameen Abdullah Al-Akwa, Ramy Abdul Rahman Ali Ishaq, Maged S. Alhammadi, Shacker M. Almagaleh, Afaf Hasan Ali Al-Khawlani, Hasan Abdullah Alrubaie, Faris Al-Jobur

644-653

2026-06-28

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DOI: 10.59628/jchm.v20i3.2049

Abstract

Background: Teleorthodontics has the potential to enhance access to orthodontic care in resource-limited settings. This study evaluated the knowledge, attitudes, and practices (KAP) toward teleorthodontics among orthodontic professionals in Yemen. Methods: A cross-sectional survey was conducted among 120 orthodontists and orthodontic residents from two master’sdegree-granting universities in Yemen (Sana’a University and University of Science and Technology) between January and March 2025. A validated 28-item questionnaire assessed KAP using 3-point (knowledge) and 5-point (attitudes/practices) Likert scales. Parametric tests were used to examine the associations between demographics and KAP scores.
Results: Participants (mean age 33.8±4.5 years; 60.0% female; 66.7% residents) demonstrated high knowledge (mean 2.82/3.0, 94.0%), moderately positive attitudes (mean 3.68/5.0, 73.6%), and moderate practices (mean 3.03/5.0, 60.6%) regarding teleorthodontics. Age was significantly associated with attitudes (p=0.023) and practices (p=0.011), with clinicians aged 35–42 years showing more favorable responses. No significant associations were found between sex, education level, practice setting, or experience (all p>0.05).
Conclusion: Orthodontic professionals in Yemen exhibit strong conceptual acceptance of teleorthodontics; however, practical implementation remains limited, likely due to infrastructure and training constraints. Strengthening digital infrastructure and expanding structured teledentistry training may help translate positive perceptions into consistent clinical practice in resource-constrained settings.

Keywords

Teledentistry Teleorthodontics Knowledge At- titudes Practices Orthodontists Orthodontic Residents Yemen.

Impact of Education Program on Intensive CareUnits Nurses toward Endotracheal Tube Care atAl-Thawra Hospital Sana’a– Yemen

Naseem Mohammed Alahdle, Nabil Ahmed Ahmed Al-Rabeei

654- 659

2026-06-28

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DOI: 10.59628/jchm.v20i3.2737

Abstract

Background: Endotracheal tube care is critical in ICU setting to prevent complications and improve patient outcomes. Building nurses’ competence through structured education can enhance adherence to best practices.
Aim: To evaluate the impact of the educational training program on knowledge and practices regarding endotracheal tube care among ICUs at Al Thawra Hospital in Sana’a City-Yemen.
Methods: A pre-experimental, one-group pretest–posttest design was administered. This study was conducted in different ICUs. Data were collected using a questionnaire, face-to-face interviews, and an observational checklist. Data were analyzed using the IBM SPSS Software Program. Paired sample t-test and McNemar-Bowker test were used to examine the differences between pre- and post-educational intervention.
Results: ICNs were predominantly males (55.3%), mostly married (59.2%), with diploma qualifications (61.8%), and > 5 years of experience (84.2%). Post-intervention, total knowledge scores increased from 21.79 ± 4.34 to 25.28 ± 3.02 (t=5.33, p<0.001). total practice scores rose from 83,95± 36.12 to 124.55±43.42 (t=5.69, p<0.001). Changes were observed in the knowledge and practice levels, with highly significant improvements (p<0.001). The McNemar-Bowker test indicated a significant change in knowledge levels pre- and post-intervention (χ2 =22.571; p <0.001) and in practice levels pre- and post-intervention (χ2= 30.000; p <0.001).
Conclusion: The educational program produced significant and practically meaningful improvements in ICU nurses’ knowledge and practice of ETT care. Ongoing training, periodic competency checks, and reinforcement of standardized protocols are recommended to sustain gains and optimize patient safety.

Keywords

Endotracheal tube knowledge practice critical care nurse educational program

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Sana'a University Journal of Medicine and Health Sciences

Vol. 20 No. 3 (2026): Sana’a University Journal of Medicine and Health Sciences

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