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. 4 (2026): Vol. 20 No. 4 (2026): Sana’a University Journal of Medicine and Health Sciences

Current Issue

Vol. 20 No. 4 (2026): Sana’a University Journal of Medicine and Health Sciences

Vol. 20 No. 4 (2026)

2026-08-28

10 Articles

Article

9 Articles

Association of Protein C and Biochemical Parameters with Miscarriage in Yemeni Gestational Diabetes Mellitus

Nabeela A. Al Matari, Abdulkarim M. Al-Obeidi, Ebtesam Al-zabedi

660-665

2026-08-28

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DOI: 10.59628/jchm.v20i4.2815

Abstract

Introduction: Gestational diabetes mellitus (GDM) is a metabolic disorder associated with increased risk of maternal and fetal complications, including miscarriage. Protein C, a natural anticoagulant, has been implicated in pregnancy loss; however, its association with GDM and related metabolic abnormalities remains insufficiently investigated.
Methods: In this comparative cross-sectional study, 400 pregnant women aged 18-41 years were recruited from different hospitals and medical centers between May 2023and May 2024. The study included 200 women diagnosed with GDM and 200 normoglycemic pregnant controls. Participation was voluntary, and biochemical parameters, including protein C levels, were measured using standard laboratory methods Results: Levels of Protein C, fasting blood sugar, random blood sugar, HbA1c, triglycerides, total cholesterol, LDL-cholesterol, BMI, TyG index, TyG-BMI index, TC/HDL-c, TC/LDL-c, creatinine, and urea were significantly higher in the GDM group compared with controls (p < 0.001for all), whereas HDL-cholesterol was significantly lower in the GDM group (< 0.001) .
Conclusion: The study suggests that elevated Protein C concentrations may be linked to insulin resistance in women affected by GDM, potentially contributing to an increased risk of miscarriage.

Keywords

Protein C gestational diabetes miscarriage biochemical parameters Yemeni women

Evaluation of Complete Blood Count in Symptomatic Rheumatoid Arthritis Patients in Sana’a City, Yemen

Omar A. Abdulalem, Mohammed A. Hajar

666- 673

2026-08-28

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DOI: 10.59628/jchm.v20i4.2889

Abstract

Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disorder that can affects several organs and systems in human body. It is frequently associated with hematological alterations that reflect disease activity. Data on complete blood count variations among patients with rheumatoid arthritis in Sana’ a, Yemen, are limited.
Objectives: This study aimed to evaluate complete blood count variations in symptomatic rheumatoid arthritis patients in Sana’a city, Yemen.
Patients and methods: A comparative cross-sectional study was conducted on 200 participants, including 100 RA patients and 100 healthy controls. The CBC parameters were analyzed using an automated hematology analyzer. ACCP antibodies were measured using a chemiluminescence immunoassay, while RF and CRP were measured using spectrophotometric turbidity and nephelometry methods. The ESR was determined using the Westergren method. Statistical analyses were performed using SPSS version 26.
Results: RA patients showed significantly lower Hb, HCT, MCV, MCH, and MCHC, with significantly higher RDW compared with healthy controls (p < 0.05). RBC and total WBC counts were not significantly different between the groups. Neutrophils, monocytes, eosinophils, basophils, platelet count, PCT, NLR, MLR, and PLR were significantly increased, whereas lymphocytes and MPV were significantly decreased in patients with RA (p < 0.05). ACCP, RF, CRP, and ESR levels were significantly higher in patients with RA than in controls (p = 0.001).
Conclusion: Significant CBC alterations are common in RA patients and may serve as accessible markers of inflammation and disease activity. The most prominent findings were anemia-related changes, thrombocytosis, elevated inflammatory cell ratios, and reduced MPV.

Keywords

Rheumatoid arthritis complete blood count hematological abnormalities Sana’a Yemen

Marginal Fit of Metal Copings Fabricated by Selective Laser Melting: An In Vitro Study

Abdullah Al-Mekhlafi, Mohsen Al-Hamzi, Mohammad Al-Baili, Ibrahim Kamel

674-679

2026-08-28

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DOI: 10.59628/jchm.v20i4.2888

Abstract

Introduction: Marginal adaptation is a key determinant of the clinical success and longevity of fixed dental restorations. Poor marginal fit is associated with microleakage, secondary caries, and periodontal disease. Selective laser melting (SLM), an additive manufacturing technique (AM), has been introduced as an alternative for fabricating metal restorations, offering high precision and reduced fabrication errors compared with conventional casting techniques.
Objective: This in vitro study evaluated the vertical marginal gap (VMG) of metal copings fabricated using SLM with two finish line thicknesses.
Materials and Methods: A sound human mandibular first molar was prepared for a porcelain-fused-to-metal crown with standardized dimensions. Two finish line configurations were created: a 1.0 mm round shoulder on the buccal surface and a 0.7mmround shoulder on the lingual surface. The prepared tooth was digitally scanned, and 20 standardized resin dies were fabricated using a three-dimensional (3D) printing system. Twenty metal copings were designed using computer-aided design and manufacturing (CAD/CAM) software and fabricated using SLM under identical manufacturing parameters. The specimens were then cemented and sectioned in the buccolingual direction using a standardized guide. VMG was measured at predefined marginal points under a stereomicroscope at high magnification, and the digital images were analyzed using specialized software. Data were statistically analyzed using the Mann–Whitney U test, with significance set at p ≤ 0.05.
Results: The SLM metal copings showed a total median marginal gap of 24.53 μm (IQR: 10.97–37.68 μm) with total median marginal gap in buccal margins of 20.82 μm (IQR: 9.96–29.18 μm), whereas the lingual margins showed a total median of 29.13 μm (IQR: 19.07–48.60 μm). Additionally, the marginal fit varied significantly between the buccal and lingual surfaces (p < 0.001).
Conclusion: The SLM technique showed there is a marginal gap, though it demonstrated a high marginal accuracy, that remained within clinically acceptable limits. Finish line thickness significantly affected marginal fitness.

Keywords

Selective Laser Melting Additive manufacturing Vertical Marginal Gap Three Dimensional Computer-Aided Design and Manufacturing Subtractive manufacturing Cross Sectional Method

Prevalence and Distribution of Size-Related Dental Anomalies in Yemeni Paediatric population: A Panoramic Radiographic Study

Wedad Ahmed Yahia AL-Washali, Abdulkader Zabara

680- 691

2026-08-28

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DOI: 10.59628/jchm.v20i4.2588

Abstract

Objective: This study aimed to determine the prevalence of size-related developmental dental anomalies (DDAs) Macrodontia and Microdontia and distribution by gender, age, jaw among Yemeni paediatric patients by panoramic radiographs analysis.
Methods: A total of 5006 OPGs collected from a major radiology center in Sana’a City (2021–2024), the OPGs were analyzed from patients aged 10 to 18 years (mean age 13.77 ± 2.71 years). The data were evaluated for Macrodontia and Microdontia (including the peg-shaped subtype). Statistical analysis, including the chi-square test, was performed with significance set at P≤0.05.
Results: Size-related DDAs were observed in 221 instances, yielding an overall prevalence of 4.41% (CI 95%). Microdontia was the predominant anomaly, accounting for 4% (N=200) of all size-related cases, with the pegshaped subtype representing 23.5% of microdontia instances. Macrodontia was significantly less common, representing 0.41% (N=21). A statistically significant association was found with gender, with females exhibiting a higher frequency (61.5%), and age peaking in the adolescent (14–18 years) group (62.2%). Furthermore, a highly significant predilection for the maxilla was noted (81.58%, P<0.001).
Conclusion: Microdontia is the dominant type, and the significant distribution across gender, age, teeth group and jaw location suggest the importance of early radiographic screening and timely intervention in this population.

Keywords

Size Dental Anomalies Macrodontia Microdontia Peg-shaped Prevalence Distribution Yemeni Paediatric Population Panoramic Radiographs Gender Age Jaw Location

Univariate Analysis of Metabolic Determinants and DR Severity

Prevalence and Metabolic Determinants of Diabetic Retinopathy in Type 2 Diabetes: A Cross-Sectional Study from a Tertiary Center in Yemen

Samar Moqbel Al-Zubaidi, Yahya A. Alghassaly, Aziz Said Shaher, AbdulKareem Mohamed Alkhwalani, Ibtisam Noman Al-Towaity, Haitham Mohammed Jowah

692-697

2026-08-28

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DOI: 10.59628/jchm.v20i4.2885

Abstract

Background: In conflict-affected regions, such as Yemen, structural barriers to healthcare lead to chronic glycemic mismanagement and accelerated microvascular damage. This study aimed to determine the prevalence of various stages of diabetic retinopathy (DR) and identify the metabolic determinants associated with disease severity in a tertiary care setting.
Methods: A cross-sectional study of 202 patients with type 2 diabetes was conducted at Al-Thawra General Hospital, Sana’a. Retinopathy was staged using the International Clinical Diabetic Retinopathy (ICDR) scales and the 4-2-1 rule. Metabolic determinants, including HbA1c levels, disease duration, and systemic comorbidities, were analyzed using univariate testing and multivariate logistic regression. Discriminatory performance was evaluated using Receiver Operating Characteristic (ROC) curves.
Results: The cohort (mean age 64.63 years) exhibited poor metabolic control (mean HbA1c 10.07%). The overall prevalence of vision-threatening DR was high: 27.2% of patients exhibited proliferative DR (PDR), while non-proliferative DR (NPDR) stages were distributed as mild (20.8%), moderate (24.8%), and severe (27.2%). Diabetic macular edema was identified in 19.8% of patients. Univariate analysis associated the duration of diabetes (p < 0.001), HbA1c (p < 0.001), and hypertension (p = 0.010) with disease severity. In the multivariate model, only disease duration remained a significant independent predictor (aOR 1.072 per additional year, 95% CI: 1.007–1.141, p = 0.028), overshadowing current HbA1c (p = 0.506). ROC analysis confirmed that duration (AUC 0.643) provided superior discriminatory performance compared to HbA1c (AUC 0.604).
Conclusion: In settings where poor metabolic control is near-universal, cumulative disease duration outweighs current HbA1c levels as a determinant of retinopathy severity, suggesting a saturation effect of glucose-induced damage. Screening protocols in humanitarian zones should prioritize intensive surveillance for patients with diabetes duration exceeding 15 years, with an urgent focus on male patients in the second decade of disease

Keywords

Diabetic Retinopathy Type 2 Diabetes Mellitus Metabolic Determinants HbA1c Yemen Prevalence

Mean Plot over Gender (a) SNA, (b) SNB, (c) HB-C3, (d) C3-Me, (e) HB-PNS, (f) HB-V

Position of Hyoid Bone in Different Classes of Skeletal Malocclusion Using Cone-Beam Computed Tomography

Mohammed Abdulmalik Al Makedhi, Ahmed Ali Obayah, Fuad lutf Al-Mutarreb

698-705

2026-08-28

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DOI: 10.59628/jchm.v20i4.2559

Abstract

Background: The goal of this study was to evaluate and compare the position of the hyoid bone (HB) in different classes of malocclusion using cone-beam computed tomography (CBCT). Gender differences were investigated across the studied groups.
Methods and Materials: The study included 120 CBCTs acquired from equal groups of males and females and evenly distributed among the three classes of malocclusion. The age of the participants ≥ 18 years. Multiplanar reconstruction were generated in axial, sagittal, coronal, and 3D views using Ez3D-i software. Several measurements points including SNA, SNB, ANB, H-Me, H-EB, C3-Me, HC3-Me, H-PNS, HB-H, and H-V were measured following standardized definitions. The data was entered and analyzed using the SPSS. Significance was set a value of P < 0.05.
Results: Across gender-based differences were observed in HB positioning. Males demonstrated greater distances between the third cervical vertebra (C3) and HB (C3-HB, p < 0.001), as well as between C3 and the Menton point (C3-Me, p < 0.001), compared to females. The position of HB compared to the maxilla (H-PNS), its horizontal position (HB-H), and its vertical position (H-V) were all significantly different between males and females. No significance gender differences were found for H-Me, H-EB, and HC3-Me. Significant statistically differences were observed among skeletal Classes groups for H-Me, H-EB, C3-Me, HC3-Me, H-PNS, HB-H, and H-V (p < 0.05). Class III group demonstrated the greatest H-Me value, while Class II showed the lowest.
Conclusions: The study demonstrated significance difference in HB position among male and females and across skeletal Classes. Males showed significantly greater distances and positional differences involving the C3, Me point, and HB compared to females. Additionally, the position of HB varies across different skeletal classes. Class III group exhibited the most inferior and anterior HB position, whereas Class II showed the least.

Keywords

hyoid bone malocclusion CBCT Menton point cervical vertebra

Effect of C. cartilaginea leaf extract (200 mg,400 mg /kg, i.p) on writhing test in rats. Values are expressed as Mean ± SD

Phytochemical Screening and Evaluation of Analgesic Activity of Capparis cartilaginea leafExtract in Experimental Animal Model

Naseem amer, Mohammed AL-Mutawakil

706-710

2026-08-28

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DOI: 10.59628/p78d4g35

Abstract

Background: Pain remains a major therapeutic challenge, and the use of conventional analgesics is often limited by undesirable adverse effects. Capparis cartilaginea is traditionally employed in the Arabian Peninsula to alleviate pain and inflammatory disorders.
Aim: This study aimed to investigate the Phytochemical Profile and Analgesic Activity of Capparis cartilaginea leaf Extract.
Methods: Preliminary phytochemical screening was conducted to identify the main classes of bioactive compounds. The analgesic activity of the ethanolic leaf extract (200 and 400 mg/kg) was evaluated in male albino rats using the acetic acid–induced writhing test as a model of peripheral nociception.
Results: Phytochemical analysis revealed the presence of carbohydrates, fixed oils, glycosides, anthraquinones, phenolic compounds (including tannins and flavonoids), saponins, and gum/mucilage. . The extract produced a significant (P < 0.05), dose-dependent reduction in the number of writhes in the acetic acid model, supporting a peripheral analgesic effect.
Conclusion: The ethanolic extract of C. cartilaginea leaves, enriched with flavonoids, tannins, glycosides, saponins, and anthraquinones, showed a clear dose-dependent antinociceptive activity in the acetic acid writhing assay, with the 400 mg/kg dose exhibiting an effect comparable to diclofenac. These findings suggest that inhibition of inflammatory mediators such as prostaglandins and bradykinin may underlie its analgesic action, thereby providing pharmacological support for the traditional use of C. cartilaginea in pain management.

Keywords

Capparis cartilaginea Writhing test Analgesic activity Diclofenac Phytochemical Screening.

Antibiotic patterns between MRSA and VRSA among clinical samples.

Vancomycin Resistance among Methicillin-Resistant Staphylococcus aureus Isolated from Clinical Samples in Sana’a City,Yemen

Hadeel A.G. Al-Hammadi, Saleh S. Bahaj, Anwar K. Al-Madhagi, Aref N. Alfif-A

711-719

2026-08-28

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DOI: 10.59628/jchm.v20i4.2640

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a critical global public health concern. The emergence of Vancomycin-Resistant S. aureus (VRSA) poses a severe therapeutic challenge. This crosssectional study was conducted to determine the prevalence of VRSA and to assess antibiotic resistance patterns in major hospitals in Sana’a City, Yemen.
Objectives: This study aimed to determine the prevalence of vancomycin-resistant MRSA (VR-MRSA) isolates collected from clinical samples in Sana’a city, Yemen.
Methods: A cross-sectional study was conducted between June 2025 and August 2025. A total of 250 confirmed MRSA clinical isolates (including pus, urine, sputum, blood, vaginal swabs, ear swabs, nasal swabs, and body fluids) were analyzed in this study. Standard phenotypic methods were used to identify S. aureus, and MRSA was detected using cefoxitin disk diffusion. VRSA isolates were confirmed using the Epsilometer test (E-test) method. Antimicrobial susceptibility testing was performed using the Kirby Bauer disk diffusion method. Data analysis was performed using SPSS version 26, with statistical significance (p < 0.05).
Results: Among the 250 MRSA isolates, eight (3.2%) were confirmed to be VRSA. The highest proportion of MRSA isolates was from pus (58.6%), with a higher VRSA rate among males (62.5%). Significant statistical associations (p < 0.05) were found between VRSA and the use of invasive medical devices, central lines, and surgery. Resistance to several antibiotics, including rifampin, teicoplanin, and trimethoprim/sulfamethoxazole, was statistically significant (p < 0.05).
Conclusion: This study confirmed the low prevalence of VRSA but documented its local emergence among clinical isolates, highlighting a critical public health threat. While significant resistance was observed to multiple common antimicrobials, linezolid showed superior efficacy. The frequent recovery of resistant strains from pus samples and their strong association with patients with underlying chronic diseases (notably diabetes and hypertension) underscore the need for targeted antimicrobial stewardship and robust infection control programs guided by continuous surveillance data.

Keywords

Staphylococcus aureus MRSA VRSA Antimicrobial Resistance Chronic Diseases Yemen.

The incidence of postpartum depression among mothers of newborns in the intensive care unit compared to mothers of normal births in Sana’a, Yemen: a prospective cohort study

Souad Sadeq Taha Saeed Bin Naser, Kawkab Al-Haddad, Yahia Ahmed Raja’a

720-725

2026-08-28

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DOI: 10.59628/jchm.v20i4.3049

Abstract

ackground: Postpartum depression (PPD) is a major public health problem affecting women worldwide, with higher rates reported in low and middle income and conflict affected settings. Mothers whose newborns are admitted to the Neonatal Intensive Care Unit (NICU) may experience additional psychological stressors that increase their vulnerability to postpartum depression.
Objective: To estimate the incidence of postpartum depression and examine its association with NICU admission among postpartum mothers in Sana’a City, Yemen.
Methods: A prospective cohort study was conducted among 442 postpartum mothers recruited from four hospitals in Sana’a City. Participants were categorized into exposed (NICU admission) and non-exposed (non-NICU admission) groups and followed up for six weeks postpartum. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of ≥ 13. Data were analyzed using chi-square tests and multivariate logistic regression.
Results: The overall incidence of postpartum depression at six weeks postpartum was 19.9%. The incidencewas higher among mothers exposed to NICU admission than among non-exposed mothers (24.0% vs. 15.8%). A statistically significant association was observed between NICU admission and postpartum depression (χ2 = 4.597, p = 0.032). After adjusting for potential confounders, NICU admission remained an independent predictor of postpartum depression (RR = 1.52; 95% CI: 1.05–2.22; p = 0.033). Recent painful life events were the strongest predictors (RR = 2.68; 95% CI: 2.05–3.55; p < 0.001). Other significant predictors included poor financial status (RR = 1.86) and higher child order (RR = 2.16). Husband support had a protective effect (RR = 0.54).
Conclusion: Neonatal intensive care unit (NICU) admission significantly increases the risk of postpartum depression in Yemeni mothers. The inclusion of early screening using a validated instrument such as the EPDS is highly warranted.

Keywords

Postpartum depression NICU EPDS Yemen prospective cohort

Review

1 Articles

Mechanisms of Campylobacter Pathogenesis and Host Intestinal Response

A Review of Pediatric Campylobacter Infections: Epidemiology, Pathogenesis, and Antimicrobial Resistance Patterns .

Assem Al-Thobhani, Saad Al-Arnoot, Saeed M. S. Alghalibi, Mofeed Al-Nowihi, Mohammed N. Q. Al- Bana, Ammar Mutahar Al-Huthaifi, Basem Al-Khali

726-735

2026-08-28

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DOI: 10.59628/jchm.v20i4.2603

Abstract

Diarrheal diseases continue to be a leading cause of illness and death among children under five years of age, particularly in low- and middle-income countries (LMICs), where inadequate water, sanitation, and hygiene (WASH), food contamination, and limited access to healthcare perpetuate a high burden of disease. Among bacterial pathogens, Campylobacter jejuni and Campylobacter coli are the major causes of pediatric gastroenteritis, most commonly transmitted through contaminated poultry, water sources, and contact with animals. This review summarizes recent evidence on pediatric Campylobacter infections, focusing on epidemiology, pathogenesis, and antimicrobial resistance (AMR), with an emphasis on LMICs and the specific context of Yemen. Infection rates are highest among children aged 6–24 months, coinciding with weaning practices, increased environmental exposure, and immature immune defense. Key virulence factors, including flagellar motility (FlaA), adhesion proteins (CadF, FlpA), invasion antigens (Cia), and cytolethal distending toxin (CDT), enable intestinal colonization, epithelial invasion, inflammation, and impaired nutrient absorption, contributing to growth faltering and environmental enteric dysfunction. Rising resistance to first-line therapies, particularly macrolides and fluoroquinolones, driven by mutations in gyrA and 23S rRNA, erm(B)-mediated methylation, and CmeABC efflux mechanisms, presents significant treatment challenges in pediatric populations. The interconnected roles of human, animal, and environmental reservoirs underscore the need for a One Health approach that integrates WASH improvements, food safety measures, and antimicrobial stewardship. Enhancing diagnostic capacity, AMR surveillance, and vaccine development while addressing vulnerabilities is critical for reducing Campylobacter-associated morbidity and improving child health outcomes in LMICs

Keywords

Campylobacter jejuni Campylobacter coli Pediatric diarrhea Antimicrobial resistance

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