Vol. 20 No. 2 (2026): Sana’a University Journal of Medicine and Health Sciences

Background and aim: Burn injuries are prevalent globally, and Pseudomonas aeruginosa is the primary etiological agent in these patients. This study aimed to determine the prevalence of P. aeruginosa isolated from burn wound specimens and evaluate its antibiogram susceptibility patterns.
Methods: Swabs were collected from 424 patients with burns, between October 2023 and May 2024. Standard microbiological methods were employed for isolation, identification, and susceptibility testing of P. aeruginosa.
Results: The most frequent isolate was P. aeruginosa (168; 39.6%), followed by Klebsiella pneumoniae (115; 27.1%), and Staphylococcus aureus (82; 19.3%). The lowest isolation frequencies were recorded for Acinetobacter spp. and Proteus spp. (0.7% each). Significant statistical associations (P < 0.05) were found between antibiotic resistance and clinical procedures, such as surgical skin transplantation and debridement. P. aeruginosa isolates showed high resistance (90%) to third- and fourth-generation cephalosporins (cefepime, ceftazidime, and ticarcillin). Resistance to carbapenems was moderate (imipenem, 58%; meropenem, 62%), whereas colistin resistance remained exceptionally low (3%).
Conclusion: The isolation rates of P. aeruginosa from burn wound infections (BWI) were high in Sana’a. Resistance is strongly associated with length of hospital stay, surgical intervention, and prior antibiotic exposure

Background: Adult chronic epiglottic hypertrophy with a folded epiglottis obstructing the laryngeal inlet and airway is frequently encountered in our specialty. Partial epiglottectomy to resolve obstruction is performed using diathermy, laser, and transoral robotic surgery. Coblation is a plasma-mediated ablation technique that has recently been used in laryngeal surgery.
Objectives: This study aimed to evaluate the effectiveness and outcomes of endoscopic partial epiglottectomy (EPE) using coblation.
Methodology: A retrospective study was conducted on nine patients who underwent EPE using coblation.
Results: All patients were men between the second and fifth decades of life, who presented with stridor, muffled voice, and odynophagia. These symptoms improved postoperatively, with mild transient aspiration encountered in three cases and minimal granulation tissue observed in four cases. Supraglottic stenosis was noted in three cases, with no respiratory obstruction. Conclusion: Endoscopic partial epiglottectomy by coblation is safe, effective, and a better alternative than diathermy and laser, with less operative time, control of bleeding, less tissue damage, and no need for precautions.

Background: Chronic liver disease (CLD) is frequently associated with hematological abnormalities, contributing significantly to patient morbidity and mortality. However, data on this topic are scarce in Yemen.
Objectives: This study aimed to evaluate the spectrum and magnitude of hematological abnormalities in patients with CLD who attended the Republican Teaching Hospital Authority in Sana’a City, Yemen.
Methods: A cross-sectional study was conducted from September 2024 to June 2025, involving 400 patients with CLD diagnosed clinically and by ultrasonography. Three milliliters of venous blood was collected for complete blood count analysis. Data were analyzed using SPSS version 26.
Results: The mean age of the participants was 41.1 ± 14.4 years, with a male predominance (68.8%). Anemia was observed in 60.5% of the patients (27.3% mild, 56.6% moderate, and 16.1% severe). Leukopenia affected 43.0% (87.8% mild, 11.6% moderate, and 0.6% severe) of the patients, whereas leukocytosis was rare (5.5%). Thrombocytopenia was highly prevalent at 65.8% (42.6% mild, 47.1% moderate, and 10.3% severe), with thrombocytosis noted in only 0.5% of patients. Chi-square analysis showed that the distributions of anemia, leukopenia, and thrombocytopenia were statistically significant (p < 0.001).
Conclusion: Hematological abnormalities, particularly anemia and thrombocytopenia, are highly prevalent among CLD patients in Sana’a, Yemen, often presenting in moderate to severe forms. Early detection and management of these complications are crucial for improving patient outcomes.

Background:
Cyclophosphamide (Cyclo) is a widely used chemotherapeutic agent that induces nephrotoxicity via oxidative stress and dysregulation of gamma-glutamyl transpeptidase (GGT). Acetaminophen (Aceta) may exacerbate these effects by increasing the oxidative burden, whereas amlodipine (Amlo), a calcium channel blocker with antioxidant properties, may confer nephroprotection.
Objective :
This study aimed to evaluate the protective role of amlo against cyclophosphamide- and acetaminophen-induced nephrotoxicity, focusing on GGT modulation and oxidative stress markers.
Methods:
Fifty-six male albino rats were randomly assigned to seven groups: control, cyclophosphamide (Cyclo), amlodipine (Amlo), acetylsalicylic acid (Aceta), Cyclo + Amlo, Cyclo + Aceta, and Cyclo + Amlo + Aceta. Treatments were administered for 14 days, with a single intraperitoneal dose of cyclo (200 mg/kg) on day 10. Renal function (BUN, serum creatinine, and urea), renal GGT activity, and oxidative stress parameters (GSH, GPx, MDA, CAT, NO, and SOD) were assessed at the study endpoint. Histopathological analysis, including glomerular capillary space measurements, was also performed.
Results:
Cyclo and Aceta significantly increased renal GGT and MDA levels and reduced antioxidant enzyme levels (GSH, GPx, CAT, NO, and SOD), confirming oxidative nephrotoxicity. Amlo alone preserved renal function and antioxidant status. Co-administration of amlodipine with cyclophosphamide markedly attenuated oxidative stress, restored antioxidant enzyme activity, and improved histological integrity. Conversely, the combination of Cyclo and
Aceta exacerbated oxidative and structural renal damage. Notably, the triple combination (Cyclo + Amlo + Aceta) demonstrated partial protection, highlighting the dominant nephroprotective effect of amlodipine.
Conclusion:
Amlodipine demonstrated a protective effect against cyclophosphamide- and acetaminophen-induced nephrotoxicity by reducing oxidative stress and preserving renal structure. In contrast, acetaminophen exacerbated renal injury. Cyclophosphamide-induced nephrotoxicity may not be detected by conventional renal function tests but is evident at the oxidative and histopathological levels. These findings highlight the importance of oxidative stress biomarkers, including GGT, and support amlodipine as a potential renoprotective strategy; however, caution is advised when it is combined with acetaminophen.

Background: Celiac disease (CD) is an immune-mediated enteropathy in individuals genetically susceptible to gluten and its related proteins. It is an important but often under-recognized cause of short stature in children, frequently presenting without gastrointestinal symptoms. This study aimed to determine the seroprevalence of CD among children with short stature in Sana’a City, Yemen.
Methods: A retrospective cross-sectional study was conducted at the main Pediatric Endocrinology Center in Sana’a, from August to November 2024. Medical records of 385 children with short stature aged <20 years were reviewed. Data on demographic, clinical, and laboratory characteristics were extracted, and anti-tissue transglutaminase immunoglobulin A (anti-tTG IgA) was used to determine the prevalence of CD. Data were described using frequency and percentage.
Results: The mean age of children was 9.8 ± 4.4 years, with males comprising 58.7%. More than half of the children (51.4%) were older than 10 years. Gastrointestinal manifestations were uncommon, with only three children (0.8%) presenting with diarrhea. Seropositivity for anti-tTG IgA was found in 6% of the tested children, while growth hormone deficiency and low IGF-1 levels were detected in 27% and 41% of the cases, respectively. More than half of the children (51.6%) had a vitamin D deficiency. Concurrent chronic diseases were identified in 17.9% of children, most commonly type 1 diabetes mellitus (6.2%), while Turner syndrome was the most frequent associated genetic disorder (1.8%).
Conclusion: CD is relatively common among children with short stature in Yemen, even in the absence of gastrointestinal symptoms. Growth failure in children with short stature is likely to result from a combination of endocrine, nutritional, and immunological factors. Routine screening for CD should be incorporated into the diagnostic evaluation of all children with an unexplained short stature.

Background and Objective: The United Nations considers the situation in Yemen to be one of the world’s worst humanitarian crises. The fastest-spreading viral infection has been recorded among dialysis patients. Therefore, this study was conducted at the Dialysis Unit of Al-Thawra Modern General Hospital to estimate the prevalence of Hepatitis B virus (HBV) infection among patients undergoing dialysis during the dialysis crisis in Yemen.
Methodology: The study included all patients who continuous dialysis from January 2023 to December 2024 who free of HBV infection at the start of dialysis. Patients who discontinued dialysis before the end of the year due to death or transfer were excluded. Patients were tested for hepatitis B surface antigens (HBsAg). Data for each patient were collected using a pre-designed questionnaire that included demographic data on dialysis frequency, probability of associated HBV infection, and laboratory results.
Results: The study of 226 patients undergoing dialysis at Al-Thawra Modern General Hospital in Sana’a showed a demographic distribution of 56.6% males and 43.4% females, with a mean age of 40.5 years. The 26-35 age group comprised 27.9% of the patients. The prevalence of hepatitis B surface antigen (HBsAg) was 11.7% in males and 0.0% in females, peaking at 26.3% in the 16-25 age group. Primary antibody positivity for HB-core was 49.2% in males and 58.2% in females, with a low prevalence of 21.4% among those aged ≤ 16 years. Living in rural areas was strongly associated with HBV infection (66.3%). Previous hepatitis B infections were also statistically significant, and non-vaccination was strongly associated with an infection rate of 73.7%.
Conclusion: In conclusion, the spread of hepatitis B virus infection in dialysis patients in our environment after dialysis was very common and could lead to a disaster for dialysis patients.

Background: Internally displaced persons (IDPs) often experience forced migration, loss of home and livelihood, and disruption of social networks. Women in these settings are more vulnerable to post-traumatic stress disorder (PTSD), which adversely affects their mental health. This study aimed to estimate the prevalence of PTSD and examine its distribution by sociodemographic, household, and food insecurity factors among internally displaced women in Sana’a, Yemen.
Methods: A cross-sectional study was conducted among 420 internally displaced women residing in Sana’a City. Participants were selected using systematic random sampling. Data were collected through face-to-face interviews conducted in the participants’ homes using a structured questionnaire. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD. Data were entered into Microsoft Excel and exported to Stata for
further analysis. Categorical variables were summarized using proportions, and variables were described using standard deviations. Statistical significance was set at P < 0.05.
Results: The prevalence of PTSD among internally displaced women was 15.9%. It was significantly higher among women with chronic illnesses (29.0% vs. 13.0%, p = 0.002), women whose husbands had primary or secondary education compared with university education (20.0% and 17.6% vs. 6.7%, p = 0.024), those displaced for ≤5 years (23.9% vs. 12.1%, p = 0.002), and women experiencing severe food insecurity (17.4% vs. 7.0%, p = 0.048).
Conclusion: This study highlights a substantial burden of prevalence of PTSD among internally displaced women in Sana’a City, Yemen. Internally displaced women are highly vulnerable to PTSD owing to overlapping health, economic, and displacement-related stressors. Integrated interventions addressing mental health, chronic illness care, livelihood support, and food security are urgently needed to reduce the psychological burden on these individuals.

Background: Rheumatoid arthritis is a common autoimmune inflammatory disorder leading to disability and joint deformity. Assessment of rheumatoid arthritis disease activity is a significant step in improving its management.
Aim: To assess the Rheumatoid arthritis disease activity and association factors among Yemeni patients.
Methods: This cross-sectional study included 140 cases of Rheumatoid arthritis at the rheumatology clinic in Sana’a and Ibb cities. Patients were diagnosed according to the American College of Rheumatology and European Alliance of Associations for Rheumatology 2010 and divided into three groups based on the Disease Activity Score-28 joints (low, moderate, and high). Laboratory tests, including CBC, erythrocyte sedimentation rate, rheumatoid factor, and serum anti-cyclic citrullinated peptide levels, were evaluated.
Results: Among 140 RA patients, 115 (82.1%) were female and 25 (17.9%) were male. A total of 86% of patients had moderate to high disease activity (DAS28-ESR ≥3.2) with a mean DAS28-ESR score of 4.95±1.03. A significant correlation of tender and swollen joint counts, erythrocyte sedimentation rate, and anti-cyclic citrullinated peptide with DAS28-ESR was observed (P<0.05), whereas no correlation was observed between the duration of disease and RF with disease activity.
Conclusion: This study indicates that the majority of patients experience moderate to high disease activity. The results revealed that the factors associated with disease activity were the number of tender and swollen joints, ESR, and anti-cyclic citrullinated peptide levels. These findings underscore the critical importance of early diagnosis and improved access to effective treatment options.