Sana'a University Journal of Medical and Health Sciences

Background: Blunt thoracic injuries are directly responsible for 20-25% of all deaths, and chest trauma is a major contributor in another 50% of death. This kind of death usually occurs immediately after the trauma has occurred. Aim: The aim of this study was to assess and manage of blunt chest trauma in patients admitted to AMGH, Sana'a-Yemen. Methods: A hospital-based study was administered among 102 cases of blunt chest trauma presented to AMGH, Sana'a.Yemenbetween1 January 2013to February 2014.One hundred two consecutive patients with blunt chest trauma, admitted in the ward through emergency department were evaluated in regard to age, sex, type of trauma, cause of the trauma, specific type of blunt chest injuries and treatment modality. Results: There were 83 male (81.4%) and 19 female (18.6%). The most common causes were Road traffic accident in 79 cases (77.45%), falling from height 16 cases (15.6%) and others 7 cases (6.86). The common clinical presentation is rib fracture in74cases (72.55%), then pulmonary contusion in 39 cases (38.23), hemo-pneumothorax in 38cases (37.25%), pneumothorax in 26cases (25.49%), diaphragmatic injury 3 cases (2.94%). Out of 102 patients (11.76%) were treated conservatively, thoracostomy tube insertion for 86 cases (84.31%), thoracotomy done for 1cases (0.98%), laparotomy fore diaphragmatic injuries for 2 cases (1.96%) and laparotomy with thoracotomy also for one case. Conclusions: Blunt chest trauma is an important public health problem accounting for a substantial proportion of all trauma admission among emergency patients admitted to the surgical department at AMGH. The pattern of blunt chest trauma and its management was almost similar to many studies. This study showed the pattern of injuries following blunt chest trauma. Furthermore, it was found that chest tube insertion and emergency resuscitation was adequate for majority of cases.

Objective: The hand is among the most frequent sites of burns contracture deformity. It represents a common problem and a difficult challenge for many reconstructive surgeons. It is important to restore length, function, and provide good quality skin cover. Our aim is to evaluate the different surgical procedures for resurfacing after release of post burn hand contractures in terms of functional recovery and aesthetic outcome. Methods: Totally 30 cases of post burn hand contractures were reconstructed between May 2018 and November 2019 according to site and type of contracture with individualization for each case. All cases were followed up with physiotherapy and splinting devices, functional and aesthetic outcome for each procedure. Results were analyzed as per successful reconstruction, type of procedure, complications, functional and aesthetic outcome. Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z- plasties with proper planning gives maximum length gain with no donor morbidity as other procedures and acceptable appearance. Conclusion: Postoperative physiotherapy and splinting are must for better outcome in all cases.

Objectives: To evaluate the blood transfusion practices, the quality and quantity and the use rate of blood and blood components among patients at Al-Thawra Teaching Hospital. Methods: This a descriptive study that has been conducted for the purpose of studying the blood transfusions fate and practices for all crossmatched units in the blood bank at Al-Thawra hospital during one month period, from December 2003 – December 2004. Data were collected from blood bank and from different departments in the hospital. Results: 960 units were crossmatched during the period of the study. The study showed that crossmatched units for male patients (56%) were higher than for female (44%). The recipient male/female ratio was 1.27: 1. The mean age of recipients was 31.6 years ± 18.3 SD. The commonest type of blood was blood group O (48%). 87.5% of crossmatched blood was done for stored whole blood in spite of availability of other components. Medical indications represented the highest percentage (40%). 26% of all crossmatched blood units were returned to the bank. The majority of collected blood was by family donation system. It was obvious that there was over-ordering and irrational use of the blood from the high percentage of unused crossmatched blood and the use of stored whole blood. Conclusion: Blood transfusion is necessary for saving the life of the patient who is in need, but blood should be only given when necessary, to minimize its complications and to cut off extra cost for cross matching of unneeded blood. The collection of blood from voluntary non-remunerated blood donors from low- risk populations should be encouraged. Modernization of blood banks with automated separator of the blood components is mandatory.

Introduction: The prevalence of type 2 diabetes mellitus (T2DM) is widely different across different races and the genetic linkage of diabetes could be varies from population to other. The aim of this study was to investigate the influence of ethnicity on the association of genetic polymorphisms of plasminogen activator inhibitor-1 (PAI-1) 4G/5G and tissue plasminogen activator (tPA) Alu repeat I/D with T2DM in Malaysian subjects. Methods: The genetic polymorphisms were genotyped by allele specific PCR in 231 normal subjects without diabetes (114 Malays, 71 Chinese and 46 Indians) and 303 T2DM (149 Malays, 51 Chinese and 103 Indians). Results: The PAI-1 4G/5G polymorphism was strongly associated with T2DM among Chinese (the dominant and additive genetic models odds ratio are 6.45, P = 0.005; 2.26, P = 0.02 respectively), whereas the tPA Alu repeat I/D polymorphism was associated with T2DM among Indian subjects (dominant genetic model odds ratio is 3.27, P = 0.03). Conclusions: The ethnicity significantly impacted the association of PAI-1 4G/5G and tPA Alu repeat I/D polymorphisms with T2DM.

Objective: To evaluate the Paraoxonase-1 (PON1) activity in Yemeni patients with Type 2 DM and examine its association with the atherogenic risk factors. Methods: This was a case-control study carried out on 97 subjects: 46 healthy subjects from both genders (control) and 51 Type 2 DM patients. Biochemical parameters include PON1, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and lipid profile were analyzed. Results: Serum PON1 was significantly (p = 0.001) lower in Type 2 DM patients by 10.1% with respect to the healthy control subjects. Moreover, FBG, HbA1c and total cholesterol were significantly higher in Type 2 DM patients as compared to the healthy controls. Serum PON1 activity was positively correlated with high-density lipoprotein cholesterol – HDL-c (r = 0.383, p = 0.006) and inversely correlated with HbA1c (r = - 0.341, p = 0.014). Conclusion: Paraoxonase-1 was lower in Type 2 DM patients and being positively correlated with HDL-c and inversely correlated with HbA1c.

Background: Down syndrome can be associated with autoimmune diseases such as Celiac disease, autoimmune Thyroiditis, Type 1 DM and other diseases. Aim: The aim of this study was to determine the prevalence of hypothyroidism, Type 1 DM, and Celiac disease in Yemeni children with Down syndrome as well as the most common mother's age for the occurrence of this syndrome. Method: This study was cross-sectional study involving one hundred and six Yemeni children with Down syndrome selected by simple random sampling from Special Needs Centers for Down syndrome in Sana'a city, Yemen, during 2019. These children were investigated for the presence of anti-thyroid peroxidase antibodies, TSH, and T4 for hypothyroidism; random blood sugar, anti-glutamic acid decarboxylase antibodies for Type 1 DM; and antitransglutaminase immunoglobulin A, and G antibodies for Celiac disease. Results: The prevalence of autoimmune diseases in the 106 Yemeni children with Down syndrome was 5.77% hypothyroidism, 2.8% Type 1 DM, and 0.94% Celiac disease. The highest number of Down syndrome babies were born at 41 to 50 years of mother's age. Conclusion: Hypothyroidism was the most prevalent autoimmune disease in Yemeni children with Down syndrome and Celiac disease was the least prevalent. Down syndrome can occur at any maternal age, but may increase with age. Children suffering from Down syndrome should be monitored periodically for autoimmune diseases to make early diagnosis, start early treatment, and decrease the occurrence of complications.