Sana’a University Journal of Medicine and Health Sciences

Background: Barrier membranes such as resorbable collagen and platelet-rich fibrin (PRF) are commonly used in surgical procedures to enhance healing and reduce the risk of neurosensory disturbance (NDs). While collagen membranes act as passive barriers, PRF, an autologous, cost-effective alternative, actively promotes tissue regeneration through sustained release of growth factors.

Objective : To compare the efficacy of platelet-rich fibrin (PRF) and resorbable collagen  membranes in protecting the inferior alveolar nerve (IAN) and enhancing healing following nerve injury.

Methods: A prospective, randomized clinical trial involving nine edentulous posterior mandible sites requiring inferior alveolar nerve lateralization (IANL) was conducted in Yemen from July to November 2024. Following implant placement, patients were randomly assigned to receive either a collagen membrane or autologous platelet-rich fibrin (PRF) membrane placed between the nerve and implants. The nerve function and implant success were monitored postoperatively. Data were analyzed using Friedman and Wilcoxon tests, with significance set at p < 0.05.

Results: The study included patients aged 24–72 years with a mean age of 56.22 ± 16.49, with a male predominance (77.78%). Surgical procedures were performed on the right side in 55.56% and on the left side in 44.44% of cases.

A statistically significant difference in ND was observed across follow-ups on day one, week one, month one, month three, and month six (χ² = 30.3, p < 0.001). Pairwise comparisons revealed significant improvements from day one to month one (p = 0.03), day one to month three (p = 0.008), and day one to month six (p = 0.005), whereas the difference between day one and week one was not significant (p = 1.00). No significant correlations were found between ND recovery and patient age or membrane type at any follow-up interval (P  > 0.05).

Conclusions: This preliminary study demonstrated that IANL with immediate implant placement is an effective technique for rehabilitating atrophic posterior mandibles. ND improved significantly within six months post-surgery, with most patients recovering fully or experiencing only mild symptoms. Implant success was high, and no significant link was found between nerve recovery and the membrane type.

Brucellosis is an enzootic infection caused by gram negative coccobacilli, the most important species is Brucella melitensis. Acute illness is associated with high swinging fever, rigors, lethargy, headache, myalgia and arthralgia. Localized infection occur in 30% of patients, particularly if treatment is delayed. We aimed in our manuscript to record a case of a female patient presented with convulsion and high grade swinging fever, admitted to the medical ward, investigation revealed the diagnosis of brucellosis. The patient was treated as a case of brucellosis until symptoms improved and discharged to continue medication for up to 6 weeks. Our study highlights the necessary of high suspicion for unusual presentations in dealing with medical cases.        

Background and Aims: Visual impairment (VI) is a significant public health issue, especially in low-resource and conflict-affected regions like Yemen. VI affects academic performance, well-being, and future prospects, particularly among university students. Despite its impact, data on VI among medical students in Yemen are limited. Therefore, this study aimed to determine the prevalence of VI and identify associated factors among medical students in Sana’a, Yemen.

Subjects and Methods: A cross-sectional study was conducted from August to October 2023 among 152 medical students in the fourth to sixth academic levels at the Faculty of Medicine and Health Sciences in Sana’a University. A proportionate stratified sampling technique was used, with systematic random selection. Data were collected via a structured, self-administered questionnaire covering demographics, visual health, and selected behavioral factors. Visual acuity was measured using a Snellen chart to determine the presence and severity of VI. Data were analyzed using appropriate statistical tests at a p-value < 0.05.

Results: Of the 152 medical students assessed, 28.9% were diagnosed with VI, although 57.9% reported having visual difficulties. Only 40.1% used corrective measures such as glasses, and 13.2% had concurrent eye conditions. More than half of students reported experiencing VI for 6 to 10 years. Mild VI was most prevalent (50%), followed by moderate (43.2%) and severe VI (6.8%). Higher VI rates were observed among female students, those from lower-income households, and students studying more than 10 hours daily compared to their counterparts, but these differences were not statistically significant. On the other hand, the presence of a pre-existing history of low vision before university enrollment was significantly associated with VI [odds ratio = 3.9, 95% confidence interval: 1.81–8.46; p = 0.001), while other factors showed no significant associations.

Conclusion: VI is a common health problem among medical students in Sana'a, with a substantial proportion reporting long-standing symptoms and underuse of corrective measures. A history of low vision prior to university enrollment is significantly associated with VI status among medical students. Implementing regular screening and targeted interventions, especially for students with pre-existing conditions, could improve academic outcomes and long-term quality of life

Introduction: Diabetes mellitus is a common public health problem with high morbidity and mortality. One of the factors that may affect the morbidity and mortality of diabetes mellitus is zinc level. This study assessed the relation between zinc level and diabetic control and its complications.

Methods: A cross-sectional study was conducted from December 2021 to June 2022 on 149 diabetic patients on the main diabetic center in Sana'a, Yemen (Dr. Zayed Atef center). Collected data contained demographic characters, diabetic history and the level of serum zinc for each participant. Zinc level was tested using BIO SYSTEMS BTS-350 spectrophotometer using ZINC solution. Data was analyzed by SPSS. Test was considered to be significant on p-value<0.05.

Results: Out of 149 patients included in this study, the majority were female (51.7%), aged less than 50 years (50.3%), had low income (61.7%), were overweight (58.4%), had DM more than 5 years (51.7%), used oral anti-diabetic drugs (78.5%). Zinc deficiency was seen in the majority of patients (51%), aged over 50 years (51.3%), females (56.6%) and among overweight patients (53.9%). The majority of patients were nonsmokers. Nutritional status didn't show a relation with the serum zinc level (Vegetable intake (p = 0.218), fish (p-value = 0.096), beans (p = 0.465) and ginger (p = 0.645)). There was no relation between zinc and diabetic complications (hospitalization, ischemic heart disease, renal, liver disease, diabetic foot, lung, thyroid, neurological and ophthalmological disease) with non-significant p-value. Glycemic control determined by HbA1C showed no statistical significance with serum zinc (p = 0.207), as lipid profile, liver and renal function tests.

Conclusions: Low zinc level is observed among diabetic females, patients aged over 50 years and overweight patients. Negative relation is noted between zinc and all variables. We recommend further study for evaluation of relation with taking a large sample.

Background: Pancytopenia, a decrease in all three major blood cell types (white blood cells, platelets, and red blood cells), is a common blood disorder among individuals living with HIV. It is caused by multiple factors, including direct effects of the virus, opportunistic infections, nutritional deficiencies, and antiretroviral therapy. The prevalence and severity of pancytopenia varies among different populations, but there are limited data regarding its incidence among HIV patients in Yemen. This study aimed to determine the prevalence of pancytopenia and its associated factors among HIV-infected individuals attending the HIV Center for treatment at Al-Jumhuri Teaching Hospital Authority in Sana’a, Yemen.

Materials and Methods: The time frame for this cross-sectional research was July 2024–January 2025.  There were 238 HIV-positive individuals in all, both male and female.  Structured questionnaires were used to gather demographic information, and the Sysmex XN-550 hematological analyzer was used to examine blood samples.  SPSS version 26 was used for the statistical analysis, and P < 0.05 was chosen as the significance threshold.

Results: The avarage age of patients was 35.4 ± 11.6 years, with males comprising 71.8% of the study population. Anemia was the most prevalent hematological abnormality, affecting 52.1% of patients, while leukopenia and thrombocytopenia were observed in 35.3% and 10.5% of cases, respectively. Pancytopenia was the least common, occurring in 4.2% of patients. Anemia was more frequent in males (55%) than females (44.8%), but the difference was not statistically significant (P = 0.157). However, leukopenia was significantly more prevalent in females (49.3%) than in males (29.8%) (P = 0.005). Thrombocytopenia was observed in 12.3% of males and 6% of females, despite this, there was no statistically significant change (P = 0.153).

Conclusion: In Yemen, pancytopenia, especially anemia, is quite common among people with HIV, with a significant association between female sex and leukopenia. These findings highlight the importance of routine hematological monitoring and early intervention to manage cytopenias in HIV patients. Further studies are needed to explore the underlying mechanisms and the impact of antiretroviral therapy on hematological abnormalities in this population.

Objectives: Red cell alloimmunization is a major complication in sickle cell disease (SCD) patients, resulting in delayed hemolytic transfusion reactions (HTR) and hyperhemolysis. The rate of SCD alloimmunization in Arabic countries varies from 4.3% to 65.5%. This study is the first research that aimed to determine the prevalence and phenotypes of red cell allo/autoimmunization in transfusion-dependent SCD patients at the Yemeni Society of Thalassemia and Genetic Blood Disorders (YSTGBD) in Sana'a city, Yemen. Materials and methods: This cross-sectional study was carried out on a total of 153 SCD patients who received multiple blood transfusions during the period from December 1, 2023, to April 30, 2024. Data was collected using a standard-designed questionnaire. Blood samples were used for blood group determination, Rh typing, and RBC alloantibody/autoantibody detection. Data was analyzed using SPSS version 26. Results: Among 153 SCD patients, there were 88 males and 65 females, aged 1-56 years. The most common blood group was O (58.2%), followed by A (30.7%), B (9.8%), and AB (1.3%). There were 86.3% of patients who had RhD+, while 13.7% had RhD-. The prevalence of alloantibodies and autoantibodies was 9.15% and 1.3%, respectively. Anti-E alloantibody had the highest prevalence (35.7%), followed by anti-K alloantibody (28.6%), anti-c antibody (21.4%), and anti-C and anti-e alloantibodies (7.1% each). Conclusion: Alloimmunization and autoimmunization were found with a low rate among transfusion-dependent sickle cell disease patients in Sana'a City, Yemen. The most frequent alloantibodies identified were anti-E, anti-K, anti-c, anti-C, and anti-e antibodies.

Introduction: This study aimed to evaluate the functional outcomes of pediatric femoral shaft fractures treated with a Titanium Elastic Nailing System (TENS) in two tertiary hospitals in Sana'a, Yemen, between 2021 and 2023. The primary objective of this study was to assess the efficacy and safety of TENS for achieving bone union, restoring limb function, and minimizing complications in a resource-limited setting.

Materials and methods: This prospective observational study was conducted at Al-Thawra Modern General Hospital and Al-Kuwait University Hospital, Sana'a, Yemen. Twenty children aged six–13 years with closed unilateral femoral shaft fractures were treated using TENS. Functional outcomes were assessed using Flynn's criteria, which evaluates alignment, leg length discrepancy, and perioperative complications. Follow-up visits were conducted four, eight, 12, and six months postoperatively.

Results: The mean age of the participants was 9.06 ± 1.9 years, with 14 males (70%) and six females (30%). Road traffic accidents were the most common cause of injury (10 cases, 50%). Excellent functional outcomes were observed in 15 cases (75%), and satisfactory outcomes in five cases (25%). Complications were minimal, with pain at the nail insertion site reported in three patients (15%), limb length discrepancy in one patient (5%), and malalignment in one patient (5%). No major complications such as nonunion or infection were observed.

Conclusion: TENS is a safe and effective treatment for pediatric femoral shaft fractures with high rates of excellent functional outcomes and minimal complications. These findings support the use of TENS as a first-line treatment in resource-limited settings, offering a practical alternative to traditional methods, such as spica casting. Future research should focus on larger multicenter studies to validate our findings and explore the long-term outcomes.

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. In recent years, they have drawn widespread interest due to their holistic influence on human well-being. These helpful bacteria — predominantly from Lactobacillus, Bifidobacterium, and Saccharomyces genera — are vital to preserving gut microbiota equilibrium, enhancing digestive well-being, and fortifying the immune system. Probiotics help prevent and treat conditions of the intestine, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), diarrhea, and constipation, by increasing intestinal walls function, regulating inflammation, and rival with harmful microbes. Apart from their digestive benefits, probiotics have been linked with a range of systemic benefits. They are also beneficial for metabolic health, as they help keep blood sugar levels steady, improve insulin sensitivity, and decrease inflammation associated with obesity. There are also investigations into their impact on cardiovascular health, with studies indicating potential advantages in cholesterol reduction, optimization of blood pressure, and enhancement of endothelial function. Also, studies conducted on gut-brain axis indicate that probiotics might help improve mental health conditions such as anxiety, depression and stress & the related disorders after modulating the neurotransmitters modulation and reduced systemic inflammation. Probiotics also ferment dietary fibres and create short-chain fatty acids (SCFAs) (like butyrate) which are energy sources for intestinal cells and decrease inflammation. While their effects are promising, several challenges remain in clinical applicability including strain specificity, dosage, delivery route and variability in individual microbiota  

Introduction: The pathophysiology of type 2 diabetes mellitus involves both resistance to insulin and insufficient insulin secretion by the pancreatic β-cell. According to earlier genomic studies, T2D is associated with slight changes in single-nucleotide polymorphisms (SNPs) essential for insulin release. The study aimed to investigate the correlation between T2D with a specific genetic variant (SNP) in the KCNQ1 gene, known as rs2237892, among Yemeni people.

  Method: In a case-control study, an allelic discrimination assay and TaqMan Real-Time PCR technology were used to genotype 150 Yemeni adults with diabetes and 150 without it.

  Results: Triglyceride, total cholesterol, and LDL-C levels were significantly higher in the T2D group compared to healthy controls (P < 0.001). After adjusting the age and BMI, neither the dominant nor the additive genetic models showed a statistically significant association with T2D (OR = 0.335, P = 0.153; OR = 1.489, P = 0.15, respectively). However, the recessive genetic model for the KCNQ1 SNP rs2237892 demonstrated a significant association with T2D among Yemeni individuals (OR = 2.69, P = 0.01).

  Conclusion: This study identifies a significant correlation between the recessive model of KCNQ1 rs2237892 polymorphism and T2D susceptibility among Yemeni individuals

  Keywords: KCNQ1; SNP; type 2 diabetes; Yemeni individuals.