Sana’a University Journal of Medicine and Health Sciences

Background: Tumors of the larynx include all masses in the larynx, neoplastic or non-neoplastic. Non-neoplastic are inflammatory, traumatic, or degenerative in origin. Neoplastic tumors are benign or malignant. The symptoms produced by tumors depended on the location and size of tumors.  

Objective: To evaluate the incidence and methods of treatment of laryngeal tumors.

Patients and Methods: Prospective study was carried out from January 2015 to December 2019 at ENT Department, at Al-Thawrah Teaching Hospital Sana'a, Yemen. A total of 130 patients were enrolled in this study,100 males and 30 females. All patients who had laryngeal tumors underwent clinical examination, investigations, and treated according to the type of tumors.

Results: A total of 130 patients were enrolled in this study,100 males and 30 females, mean ages were 48.1 years. Neoplasm (62.3%), malignant (96.3%), benign (3.7%), non-neoplastic tumors (37.7%), laryngeal polyps constituted (65.4%) of benign lesions. Hoarseness (100%), difficulty of breathing (34.6%). Left side involved in (61.5%). Advanced malignant (64.1%). Early malignant (30.8%), in situ (5.1%), glottic area (76.9%), supraglottic (14.2%), while transglottic was (10.3%).   Modalities of treatment, excision by laryngoscope (35.4%), radiation (32.3%), total laryngectomy (27.7%) speech therapy (3.1%), external approach (1.5%).

Conclusion: Malignant tumors were the commonest tumors of the larynx, and Laryngeal polyps were the commonest non-neoplastic tumors in the larynx. Surgical intervention was the main standard method of treatment either neoplastic or non-neoplastic tumors followed by radiation for malignant lesions.

Background: The ABO and Rh blood group system is essential for blood bank inventory, blood transfusion services, and organ transplants. Relatively very little data is available about ABO and Rh (D) blood groups distributions in the Amran governorate. Therefore, this study aimed to determine the distribution of ABO and Rh (D) blood group and their genotypes in the Amran governorate, Yemen. Methods: A cross-sectional prospective and retrospective study was carried out from January 2020 to December 2021, on 1949 volunteer blood donors; 414 medical students were obtained from Amran University and 1535 from clinical records in the blood bank of Maternity and childhood hospital at Amran Governorate. The ABO and RhD grouping was done by using commercially available monoclonal antibodies (anti-A, anti-B, and anti-D) by slide methods. The allele and genotype frequency of the donors was determined by the Hardy-Weinberg equilibrium assumption. Descriptive statistics were analyzed using the SPSS program. The difference between the observed and expected frequency was tested by an online Chi-square calculator. A P-value of <0.05 was considered statistically significant. Results:  Out of 1949 participants; were 78.8% of hospital donors, 92.2% of males, and 63.5% of rural areas. Blood group O was the most prevalent (51.2%), followed by A (31.5%), B (13.9%), and AB (3.5%) with statistically significant differences (P= 0.002). The Rh (D) positive was present in 86.8% of participants and 13.2% were Rh (D) negative. Moreover, the allele frequencies were in the order of (I^O > I^A > I^B > AB), where (I^O i = 0.513, I^A = 0.313, I^B = 0.138, and AB= 0.035). While the Rh(D) and d allelic frequencies were 0.868 and 0.132, respectively. Also, there was no statistically significant difference between observed and expected allele and genotype frequency (P-value >0.05). Conclusion: The frequency of distribution of ABO and Rh (D) blood group and their genotypes among the study population was found to be similar to those reported from most Asian populations. This crucial information may be helpful in planning for future health challenges, particularly planning with regard to blood transfusion services.

Background: This study aimed to determine the association between Helicobacter pylori (H. pylori) infection and the total serum IgE antibodies.

Methods: This case-control study was conducted during a period from August 2018-July 2020. Two hundred individuals were enrolled in this study. They were divided into 100 individuals infected with H. pylori (case group) and 100 individuals were not infected with H. pylori (control group). Three ml peripheral blood was withdrawn from each individual. The blood sample was used for the detection of total IgE antibodies using an electrochemiluminescence immunoassay. A stool sample was collected from each individual for the determination of H. pylori antigen using a rapid immunochromatography assay.

Results: Total IgE antibodies were positive among 46% of H. pylori-infected cases versus 19% of controls. There was a statistically significant association between H. pylori infection and total IgE antibodies (p=0.001). Regarding the risk factors for H. pylori infection, there was a statistically significant association between smoking and H. pylori infection. In contrast, there was no statistically significant association between the type of water, washing vegetables, washing and chewing qat, and family history with H. pylori infection.

Conclusions: It could be concluded that total IgE antibody level increased in patients infected with H. pylori compared to the non-infected individuals.

Background: Rheumatic heart disease (RHD) is still a major public health problem and remains the most common cardiovascular cause of death among children and young adults. The recurrent episodes of acute rheumatic heart disease may cause the rapid progressive damage of the heart valves and chronic residual deformity resulting in stenosis or regurgitation or a combination of both stenosis and regurgitation.

Methodology: A cross sectional Study, consecutive patients with RHD were enrolled from outpatient cardiac clinics and inpatient department of cardiac center of Al-thawra hospital in Sana’a city, Yemen between January and July 2020. Demographic, clinical, echocardiographic, and coronary angiography characteristics of patients were recorded.

Results: 261 consecutive patients with rheumatic heart disease were analyzed with mean age of 33 ± 12.65, female patients represented 62.8% (165), illiterate patients represented 63.6% (166).  The majority of the patients about 79.7% (208 patient) had mitral valve disease, 63.6% (166 patient) had aortic valve disease, 10.7% (28 patient) had organic tricuspid valve disease  but the  Isolated  Mitral valve disease 23%( 60) , Isolated Aortic valve disease 10.3% (27)  and Isolated organic tricuspid valve disease represent 4.2% (11)  , double valve disease (mitral & aortic ) represent 56% (146), triple valve disease (Mitral + Aortic + Tricuspid )represent 6.5% (17).A lot of complications of RHD detected in our study; CHF 36%(94) with low EF <50% in  55.0%(144) and 34% (89) had dilated LV , 33.7%(86) developed AF , 14%(37) of the patient complicated by IE , spontaneous echo contrast 11%(29) but  only  7.3%(19)  developed  Intra cardiac thrombus   and new stroke 9.5% ( 25) , pericardial effusion 5.4% (14)  and Active ARF 2.3%(6). Conclusion:

Rheumatic heart disease is a big medical problem in Yemen and it affects children and young adults of poor and illiterate patients of both genders.  The most common valvular lesion reported in our study was multivalvular lesion the predominant pure lesion was Mitral regurgitation followed by Mitral stenosis, Aortic regurgitation, with high organic affection of the tricuspid valve.

Background and objective:    ​​ Gingival crevicular fluid (GCF) provides an exceptional window for investigation of the periodontal condition in which levels of inflammatory mediators, which, as a consequence of the increased local destruction of connective tissue structural elements, are ideal markers of disease activity can be appreciated in the GCF. This study aimed to investigate the levels of tumor necrosis factor-alpha (TNF-α) in the human gingival sulcus of healthy subjects and the influence of host factors such as age, sex, and tooth type used on pro-inflammatory biomarkers.

Methods: Eighty-seven patients, 54 (62.1%) female and 33 (37.9%) males (aged 12–34 years; mean 19.58±4.4 years), participated in this study. Each subject underwent a session on professional oral hygiene and received oral hygiene instructions. Gingival crevicular fluid (GCF) sampling was conducted (baseline). GCF was collected from the central incisor, the lateral incisor, the Canine, the First premolar and the Second premolar in this study.  The concentration of the pro-inflammatory cytokine (TNF-α) present in the GCF was evaluated by Enzyme-Linked Immunosorbent Assay (ELISA), following manufacturers' recommendations. Differences in mean TNF-α concentrations (pg/ml) of the teeth selected for sample collection for each individual with variables that included age, sex, and tooth type for GCF samples, were determined.

Results: In total, the mean ± SD of central incisor TNF-α was 31.88 ± 4.99 pg/ml, and ranged from 20.22 to 40.47 pg/ml; the variance in all individual values ​​was significantly distributed on the normal curve with t-test of 59 and p < 0.001. For males the TNF-α concentration (mean ± SD) of central incisor was 39.25 ± 7.26 pg/ml Vs. 40.98 ± 9.24 pg/ml for females. For the lateral incisor, Canine, First premolar and Second premolar: total, males and females; the mean ± SD of TNF-α level were roughly similar to that of the central incisor. A lower level of TNF-α was in <16 years (37.54 ± 9.5 pg/ml). These findings differ from those of the 16-25 years age group and 26-34 age group in which a significantly higher value was recorded (p=0.035).

Conclusion: This study provides the upper limit of normal values ​​for TNF-α levels for people aged 12-34 years in the GCF. These upper limits of normal values ​​will guide dentists in Yemen when considering the diagnosis of periodontal disease, as well as its role during orthodontic tooth movement as they play an important role in the activities of Osteocytes, and will provide useful baseline data for future studies of interventions against periodontal disease; and the movement of teeth by orthodontic appliances, in Yemen. Also, this data can also be applied to neighboring Yemeni cities and neighboring countries.

Background: Defective vision of one eye and strabismus, influence daily life and pertinent to education and occupation. This study outlined the prevalence rate and etiology of amblyopia suspect in Yemeni males who came to fulfill visa applications for works outside the country.

 Method: A cross sectional community-based study enrolled adult males, ages 18 to 55 years.  From an 8827 visa applicants, sample of (1162) referred to the outpatient clinic for visual clearance, these had defects in visual acuity equal or less than 6/12, glasses wear and abnormal looking eyes, lid or orbit. In the clinic, they underwent documentation of their basic data, unaided, aided vision, refraction, anterior and posterior eye segment evaluation to outline the defective vision cause. The amblyopia limited by unable to see the 6/9 line or worse in one eye after best correcting glasses without any organic eye lesion.

Results: out of (1162) referred for visual clearance applicants, there were (472) eyes, with prevalence rate 5.3%, had amblyopia of variable degrees from could not attain 6/9 in visual acuity to less than 6/60. Among the amblyopic eyes, (411) 4.66% in prevalence rate had a preventable refractive elements with a percentage of 87.08%. These who were drivers would lose their target work. (53) 22.9 % of these having decreased visions were illiterate. The study found (948) 81.6% had no glasses at time of screening. Conclusion: The prevalence rate of amblyopia was high 5.3%, the controllable refractive amblyopia occupied 87.08%.