مجلة جامعة صنعاء للطب والعلوم الصحية

The study aims to evaluate endoscopic electric drilling in the correction of nasal septal spur of the vomer as an alternative technique to minimize trauma to the nasal septal flap and reduce intraoperative bleeding and postoperative septal perforation. The bony septum, consisting of the perpendicular plate of the ethmoid superiorly and the vomer inferiorly, divides the nasal cavity into two compartments, resulting in increase of the surface area of the mucosal surface exposed to inspired air. Spurs are located at the junction of the perpendicular plate of the ethmoid and the vomer in the posterior nose; which represents one of the surgical challenges for surgical correction.

Patients and methods: This study is a descriptive cross-sectional study evaluating the use of endoscopic drilling for the correction of nasal septal spur of the vomer in 60 patients between the age of 18 and 50 years old who were admitted to a private clinical setting, Sana’a-Yemen between Mar 2022 and February 2024.

Results: The mean age of patients in this study was (25.17±7.04) years. The study included 32 males (53.3 %) and 28 females (46.7%). The Mean drilling time was (9.49 ± 1.14) minutes, with longer time was (12.0) minutes and shorter time was (7.5) minutes; the mean blood loss during the operation was (110.33 ± 10.57) ml, with a maximum blood loss of (130.0) ml and a minimum blood loss of (90) ml.

Conclusion: It can be concluded that the endoscopic electric drilling is a quick, safe and an effective technique for correction of nasal septal spur of the vomer with much reduced intraoperative bleeding and postoperative septal perforation.

Background:

 Intertrochanteric fractures are common injuries, especially in elderly, and require effective management to minimize complications. This study aimed to evaluate the demographic characteristics, treatment modalities, and early postoperative complications of patients with intertrochanteric fractures admitted to the Al Sammad General Hospital, Amran, Yemen, from May 2020 to May 2022.

 Methods:

 A retrospective analysis was conducted on 90 patients diagnosed with intertrochanteric fractures during the study period. Data on age, sex, mechanism of injury, fracture type, treatment methods, and postoperative complications were collected and analyzed.

Results:

 Among the 90 patients, 51% were male and 49% female, with the highest incidence in those aged > 60 years (46.7%). The primary mechanism of injury was falling from a standing height (73.4%). Fracture classifications included 46.7% stable , 44.4% unstable , and 8.8% reverse oblique. Surgical treatment was performed in 96.7% of the cases, predominantly using dynamic hip screws (53.3%). Early postoperative complications were noted in 9.9% of the patients, with deep vein thrombosis (DVT) being the most common (3.3%).

Conclusion:

Intertrochanteric fractures are more common in males aged > 60 years, with falls from standing height being the leading cause. Surgical treatment is preferred, and the complication rate is relatively low. Continued efforts to improve surgical outcomes and manage complications are vital to enhance patient recovery.

Background: A common issue during pregnancy is anemia, which is defined as a decline in the blood's ability to carry oxygen, mainly as a result of lower hemoglobin levels. There are two possible types of declines: absolute and relative. It is well known that the most prevalent nutritional condition is iron deficiency.

Objective: In order to ascertain the prevalence of anemia and related risk factors among pregnant women in Sana'a, Yemen, a cross-sectional study was conducted.

Subjects and methods: Two hundreds pregnant women between the ages of 17 and 40 years participated in this study. Calculations were made for socio-demographic, menstrual history, and haematological characteristics. Platelet counts were ascertained along with anemia proxies such as hemoglobin (HB), hematocrit (HCT), mean corpuscular volume (MCV), packed cell volume (PCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC).

Results: The mean hemoglobin level among our pregnant females was 12.8 mg/dL, with 26% diagnosed with anemia (<11.9 mg/dL). Notably, 38% of patients exhibited PCV levels below the norm, while none in >46 PCV (above the normal level). The average RBC count stood at 4.5 cells x 10⁶/μl, ranging from 3.6 to 5.9 cells x 10⁶/μl, with none falling below the normal range for adult females. The mean MCV was 81.3 fl, with 34% displaying microcytic anemia (<80 fl). Additionally, the mean MCH was 28.3 p/cell, with 22% experiencing iron deficiency anemia and 8% showing elevated counts (>31 p/cell) suggestive of anemia due to low folic acid or vitamin B12 levels. The mean MCHC was 34.6 g/dl, with 18% having levels exceeding 36 g/dl, indicating anemia. Age played a significant role, with anemia being notably associated with those under 19 years, exhibiting an odds ratio of 2.8. Other significant associations included illiteracy (OR = 2.3, p =0.01), being in the third trimester (OR=2.1, p=0.04), multigravida (OR=2.2, p=0.05), having a menstrual cycle longer than 5 days (OR=7.5, p <0.0001), and experiencing bleeding during pregnancy (OR=5.6, p<0.0001).

Conclusion: The prevalence of anemia during pregnancy among Yemeni pregnant women was moderate, but at a significant rate. Multigravidy and the third trimester were associated risk factors with a higher incidence of anemia during pregnancy. Other risk factors were women younger than 19 years, a longer menstrual cycle >5 days, bleeding during pregnancy, and a low level of education.

Anaphylaxis is a severe life-threatening allergic reaction. This is a type I hypersensitivity reaction. Antibody-antigen reaction induces the release of inflammatory mediators. In this article, we report the case of a 55 years old female patient who presented with generalised urticaria, pruritus, skin edema, fever, abdominal pain, and dyspnea. Investigations showed only neutrophilia. The patient was immediately received intravenous (IV) chlorpheniramine 10 mg and intravenous hydrocortisone 100 mg with a slight response. The patient then received intravenous methylprednisolone 500 mg with dramatic improvement. This drug was administered once daily for three consecutive days.  

 Background: Dental crowding, a common orthodontic issue, arises due to a mismatch between tooth size and jaw dimensions, significantly affecting dentofacial aesthetics. This study focused on maxillary anterior crowding (M x AC) to investigate its relationship with the tooth size and jaw dimensions.

Materials and Methods: This retrospective cross-sectional study included 80 participants divided into two groups: 40 with normal occlusion (control) and 40 with MxAC occlusion. Dental casts were prepared using alginate impressions and dental stones, and measurements were taken for mesiodistal dimensions, arch width, arch depth, overbite, overjet, and arch length discrepancy using a modified sliding caliper gauge. Differences between the two groups were compared using an independent t-test. Statistical significance was set at P < 0.05.

Results: Significant differences were observed in tooth dimensions and arch measurements between the M × AC and control groups (P< 0.001). The M × AC group had larger dental crowns (except for the first molar), smaller overjet, and greater arch length discrepancy. The control group exhibited larger arch widths in the first premolar, second premolar, and first molar positions, but not in the canine position (P=0.420). Additionally, the M x AC group had significantly smaller arch depths at the canine, first, and second premolar positions (P< 0.001). However, no significant difference was observed between the groups in dental arch depth at the first molar position (P=0.120).

 Conclusion: The study found significant differences in tooth dimensions and dental arch measurements between the M × AC and control groups. The M × AC group had larger dental crowns (except for the first molar), less overjet, and greater arch length discrepancy. Arch widths for the premolars and the first molar were larger in the control group, while the M x AC group had smaller arch depths at the canine and premolar positions. These findings underscore the need for customized orthodontic treatment.

Abstract: Factor V Leiden (G1691A) mutation is a significant biomarker for the evaluation of tendency for venous thrombosis. The objective of our study was to investigate the association between the Factor V Leiden (G1691A) mutation and thrombophilia in Yemeni patients residing in Sana'a City. Methods: The study included 267 subjects (125 thrombophilia patients as cases, and 142 healthy subjects as controls) who were genotyped using the Single Nucleotide Polymorphism (SNP) Genotyping Assay (FVL Real Time PCR Kit), and the genotypic and allelic frequencies of the factor V Leiden (G1691A) mutation were calculated. The laboratory data of the patients and controls were reviewed and analyzed in Aulaqi specialized medical laboratories. \ Results: Factor V Leiden (G1691A) mutation was present in 11.2 \% of all cases (heterozygotes, GA: 10\%, homozygote mutant, AA: 0\%) and 1.4 \% of all control subjects (heterozygotes: 1.4 \%, homozygote mutant: 0\%). The prevalence of heterozygote (GA) genotype for Factor V Leiden (G1691A) mutation was significantly more frequent in the group of subjects with the thrombophilia than in the control healthy subjects, OR (95\% CI) = 8.83 (1.97 - 39.66), P= 0.0045). The Factor V Leiden (G1691A) mutation risk (mutant) allele A frequency was significantly associated with thrombophilia [OR (95\% CI) = 8.36 (1.01 - 68.96), P = 0.048].  Conclusion From this study, we conclude that the Factor V Leiden (G1691A) mutation is significantly associated with an increased risk of thrombophilia.

Background: Beta-thalassemia major (ß-TM) is the most common hereditary hemoglobin synthesis disorder, often requiring blood transfusions, which, along with splenectomy and iron supplementation, increases the risk of bacterial infections and alters the immune profile of affected individuals.

Beta-thalassemia major (ß-TM) is the most common hereditary hemoglobin synthesis disorder, often requiring blood transfusions, which, along with splenectomy and iron supplementation, increases the risk of bacterial infections and alters the immune profile of the affected individuals.

Objective:  This study aimed to assess the serum concentrations of immunoglobulins (IgG, IgM and IgA) and complement components (C3 and C4) in both splenectomized and non-splenectomized ß-TM patients and; correlate these levels with ferritin, blood transfusion and iron chelation therapy.

\Methods: A cross-sectional comparative study involving 100 ß-TM patients in Sana'a  City-Yemen, was conducted, categorizing the participants into splenectomized and non-splenectomized groups. Sociodemographic data were collected via a structured questionnaire,, ferritin levels were assessed using the Cobas e411 method, and immunoglobulins and complement factors were quantified using the immunoturbidimetry method.

Results:  The results indicate that ß-TM patients who have undergone splenectomy exhibit higher serum ferritin and immunoglobulin (IgM, IgG, IgA) levels than non-splenectomized ß -TM patients, with stable C3 and a non-significant decline in C4. Additionally, significant correlations were found between IgG, IgA, blood transfusions and iron chelation therapy, whereas C3 and C4 levels were not significantly associated with these treatments.

Conclusion: The findings indicated that splenectomy alters the immunological profile of ß-TM patients, although the precise mechanism underlying this alteration remains ambiguous; thus, analyzing serum immunoglobulins and complements levels may prove beneficial in assessing infection severity in these patients.