Sana'a University Journal of Medical and Health Sciences

Background: Appropriate feeding is important in improving nutritional status & child survival. UNICF reported that malnutrition due to food insecurity in Yemen is alarming (> 15%). The water situation in Yemen is in severe crisis and 50% of Yemen's population does not have access to safe drinking water or sanitation. The aim of this study was to identify knowledge, attitude and practices of caregivers toward nutrition and WASH of their children under 5 years old in Hajjah and Hodeidah governorates, Yemen. Methods: This was a KAP study with two-stage cluster sampling using the nutrition survey model. The principal tool to understand or define previous and current KAP towards recommended nutrition and WASH practice followed nutrition survey model which was adopted from the UNICEF’s guideline for assessing nutrition. KAP survey assesses both the short-term outcomes of social behavior change activities like a change in knowledge or attitudes but also the medium and long-term outcomes, such as a change in actual behavior and the resultant practices. Results: There is good knowledge on breastfeeding, and its initiation within one hour after birth; and the breast milk ideal food for 0-6 months aged child. However, benefits of breastfeeding on mother is absolutely unknown by 39.9%. Average duration of breastfeeding is 18.5 months; however, cease of breastfeeding among 42.1% mothers was due to lack of breast milk. Only 1 in 5 children received daily 4+ items of food which indicates low rate of minimum diet diversity. 44% of households are using unprotected wells as a main source for their domestic/drinking water needs. In addition, there is potential contamination of water during handling inside house that highlights importance of providing more training about water handling at household level. Open defecation is practiced by 57.9% of households, 53.6% dispose the wastes behind the house. Overall 38.46% of HHs have latrines. About half of women wash hands after using the toilet, 38.2% before cooking, 65.7% before eating and 35.5% before feeding the child. No hand-wash premises among almost all households. Conclusion: There is a positive return on good nutrition practice and WASH practices of DRC investment.

Abstract

Objective: To evaluate the anti-mullerian hormone (AMH) and follicular stimulating hormone (FSH) in polycystic ovary syndrome patients (POCS) and their potential as markers of PCOS.

Methods: This was a comparative cross-sectional study carried out on 80 women aged 18-50 years: 40 were healthy women with non-polycystic ovary syndrome serving as control group and 40 were patients with PCOS. Fasting venous blood (6 ml) was collected from each individual in the second day of the menstrual cycle and AMH, FSH, luteinizing hormone (LH), prolactin and estradiol (E2) as well as fasting blood glucose (FBG) and lipid profile were measured.

Results: Serum AMH was significantly (p = 2x10-4) higher in PCOS patients by 3.5-folds with respect to the control group, whereas FSH was significantly (p = 0.01) lower by 36.5%. In contrast, LH, prolactin, estradiol, FBG and the lipid profile were non-significantly different between the two tested groups. Serum AMH was negatively correlated with age (r = - 0.355, p = 0.001) and FSH (r = - 0.454, p = 2x10-6).

Conclusion: This study shows that AMH can be used as a diagnostic and prognostic marker in POCS.

Background: Subglottic stenosis is one of the most complex and challenging issues in the field of otolaryngology. The management involves a multidisciplinary approach with multiple procedures. The main aim of the management is to keep the airway patent and preserve voice production. The aim of the study was to evaluate the results of treatment methods of subglottic stenosis.

Methods: The prospective study was conducted on 40 patients between January 2012 and March 2018 at

Otorhinolaryngology Department, Al Thawra Teaching Hospital, Sana’a, Yemen.

Results: Of the subglottic stenosis patients studied, 30 (75%) were male and 10 (25%) were female. The mean age was 18.6 years. High incidence of 60% was found in the age group (15-24 years) while less was found in the age group >34 years (7.5%). Grade III stenosis represented (50%) and grade IV (25%). Endoscopic dilation was successful in grade I (100%) and grade II (80%). The external approach was successful in 18/31 (58.1%), while the success rate in all grades was (67.5%). About 50% of the patients were presented with tracheostomy in place.

Conclusion: Acquired subglottic stenosis causes airway compromise and significant morbidity to the patients. The management involves a multidisciplinary approach with multiple procedures. A large number of endoscopic and open procedures are currently in use for the treatment of this condition. There is no single method of treatment that is universally successful. Results of treatment are not very satisfactory due to multiple factors.

Background: Coronary artery disease (CAD) accounts for the greatest proportion of CVDs and is one of the most common causes of death in the developed countries. It is one of the main etiologies of disease burden in developing countries. There is increase in the number of patients with coronary artery disease in Yemen. The number of patients undergoing elective diagnostic coronary angiography is increasing among different age groups. This study was aimed to identify and compare the prevalence of the risk factors, clinical presentation, management, and angiographic characteristics of CAD between young patients (age ≤ 40 years) and older patients (age ≥ 40 years) presented with ischemic heart disease (IHD).      Methods: A total of 555 patients were were enrolled between January 2013 and June 2013. Patient admitted in ward as one-day admission and discharged 6 hours after the procedure. Demographic data, clinical findings, and details of electrocardiographic and echocardiographic findings were recorded. The traditional cardiovascular risk factors (smoking, hypertension, Khat chewing, family history and diabetes mellitus, dyslipidemia) were noted. The patient included were patients with sable angina, post myocardial infarction and pre-operative coronary angiography before valve replacement. Results: The older group accounts for 90.3% while younger group accounts for 9.7% of the patients. The majority of patients in both groups were male (81.5% in the young and 74.5% in the older group). Most of the patients in the study were diagnosed as post MI angina. High incidence of diabetes and hypertension among the older group in comparison to the younger group (24.4% diabetes and 43.1% hypertensive Vs. 11.1% diabetes and 29.6% hypertensive). 50% of the younger group were smokers in comparison to 23.8% in older group with statistically significant difference (p=0.0001). Family history of IHD was higher in the younger age group (24.1%) than that in the older age group (16%) (p = 0.129). Dyslipidemia was not common risk factor among both groups. The percentage of Khat chewing did not differ between the two groups (70.4% and 62.5% in younger and older group respectively). Significant left main disease was more than double in younger group (3.7%) when compared older group (1.9%). About one-third (31.5%) of patients of younger group had significant LAD lesion while small number of older patients had significant LAD lesion (1.6%) (p = 0.037). The involvement of right coronary artery (RCA) was significantly higher in older group than in younger group (27.7% and 7.5% respectively; with p = 0.001). Although the incidence of left circumflex artery (LCX) disease was higher in older group (28.8% and 16.7% respectively) it did not reach statistical significance. The left anterior descending artery (LAD) was commonly involved vessel in the young group (31.5%) in comparison to older group (1.6%) while left circumflex artery and right coronary artery was common in in the older group. Conclusion: Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Smoking, male gender as well as family history of cardiovascular diseases showed high prevalence in the in younger patients ≤ 40 years, while hypertension and diabetes were common in the older patients. Khat chewing was highly prevalent among both groups.

Background: Malaria has been killing millions of people worldwide. World Health Organization estimates that there are 300 million to 500 million of people infected with malaria. Therefore, the aim of this study is to explore the prevalence of malaria parasites among the blood donors attending the National Center for Blood Transfusion and Research in Sana’a, Yemen over a period of 6 months. Methods: Data collected from the National Center for Blood Transfusion and Research records for the year of 2012 and 2020. Secondary data were taken from 12.000 donors from 2012 and 18,000 from 2020. The records contain the patient’s number, blood bag, type of examination: cassette and confirmatory tests such as ELISA and type of malaria test. Results: In 2020, there were 814 Malaria-infected blood donors (97.8%), whereas, in 2012, there were only18 Malariainfected blood donors (2.2%). The male donors more infected (99.2%) than female donors (0.8%). The number of donors with blood group O+ were the highest infected people (50.4%), while the least infected donors is AB- (0.1%). The number of infected people with Plasmodium falciparum (24%) is the highest compared with other types of malaria (4%). The most packed cell volume (PCV) ratio among donor was 49%, the lowest PCV ratio in donors is 95% and 60% respectively. Conclusion: The study showed that the war played a significant role in increasing the number of people suffering from malaria and that the situation is worsening due to lack of awareness, migration and weak economic conditions.