The second volume - the first issue - 2023 in the Sana'a University Journal of Medicine and Health Sciences

Objectives: Anemia in pregnancy is a serious public health problem in developing countries. The aim of this study was to determine the prevalence of anemia and associated risk factors among pregnant women in Sana’a, Yemen. Materials and Methods: This cross-sectional study included 260 pregnant women attended some government and private hospitals in Sana'a from November 2021 to January 2022. Sociodemographic data were collected using structured questionnaires Blood samples were collected and analyzed for hemoglobin (Hb) concentrations using a hematology Sysmex analyzer. The data was analyzed using SPSS version 26 software. Descriptive, bivariate chi-square and logistic regression analyses were done. Results and discussion: The prevalence of anemia among pregnant women was 44.2%. The prevalence of mild, moderate and severe anemias were 18.8%, 25.0%, and 0.4%., respectively. Moderate anemia was the most common anemia. Risk factors associated with anemia were low family monthly income, the presence of health problems, and lack of supplements taken. Conclusion: The prevalence of anemia was high and represents a severe problem among pregnant women. Identification of risk factors may help in the prevention and control of anemia.

Objectives: Sickle cell anemia (SCA) and glucose-6-phosphate dehydrogenase (G6PD) deficiency are the most common inherited red blood cell (RBC) disorders. The aim of this study was to determine, compare, and correlate G6PD activities with hematological parameters in SCD patients with deficient and non-deficient G6PD and healthy controls in Sana'a, Yemen. Materials and Methods: This cross-sectional study included 150 SCD patients (SCA = 84; SCT = 66) and 150 controls who attended some hospitals in Sana’a from April to June 2022. Five milliliters of venous blood were used for the estimation of CBC and G6PD activity. Data were analyzed using SPSS version 26 software. Results: The SCD patients had significantly lower Hb, PCV, and RBC and higher reticulocytes than controls (P ˂ 0.020). The SCA patients were significantly lower in Hb, PCV, and MCHC and higher in reticulocytes than SCT. G6PD deficiency was found in 26% of the SCD patients, and it was more prevalent in SCA than in SCT and in males than in females. The deficient patients had significantly lower Hb and PCV and higher reticulocytes than non-deficient patients. G6PD activity was found to be positively related to Hb and PCV. Conclusion: G6PD deficiency was more common in SCA patients and had an impact on hematological parameters, which could lead to increased RBC hemolysis. As a result, screening SCA patients for G6PD levels during diagnosis and treatment is advised.

Background: Anencephaly is a type of neural tube defect characterized by abnormal development of the brain and the bones of the skull. Aims: to investigate the association between consanguinity and anencephaly which is the most severe form of neural tube defects and to assess the magnitude of the problem. Methods :A case-control study was conducted between January and December 2014, all women with anencephaly that were admitted to the obstetric department of al Thawra General hospital , Sana'a , were enrolled in this study .The subjects were divided into study ( n = 72 ) and control groups (n=25).  Results: From a total of 11283 deliveries, 97 women were having anencephaly giving the overall incidence as 8.5/1000 births. We found significant number   (74.2%) of these affected women had consanguineous marriage (95% CI 62.5-83.7; p = 0.0001). The first cousin union was present in (68%). Compared with control, the study cases were characterized by poverty, low education, absence of antenatal care, and mostly from rural setting. Conclusion: Consanguineous marriage is common in our societies and strongly associated with fetal congenital anomalies particularly anencephaly.

Background: Peripartum hysterectomy is a major operation and is invariably performed in the presence of life threatening hemorrhage during or immediately after abdominal or vaginal deliveries. Aim: To determine the incidence and indication of cesarean hysterectomy, among women attending to the obstetric unit in Al-Thowrah modern general hospital, Sana, a City, Yemen.  Methods: A total of 60 women cesarean underwent hysterectomy were enrolled in the study. Data were collected from labor registers, theater records, patient cases notes, ward registers and intensive care unit records. Results: During the period of study there were 60 cesarean hysterectomy and 54500 deliveries, representing an incidence rate of 1.1 cases per 1000. Vaginal delivery was the most common mode of delivery (83.3%) followed by a cesarean section (16.7%), and cesarean hysterectomy (0.11%). Most of the women with cesarean hysterectomy were in the age group of 30-39 years (56.7%), 23.3% of women were older than 40 years,  and the least were at age group less than 30 years (20%).  The majority of women were grand multipara (80%) while 16.7% were multipara and only two women (3.3%) were primigravida.  Cesarean hysterectomy was performed in two-thirds of women at the gestational age of 37 weeks or more and in one third at the gestational age of less than 37weeks.  The most common indication for cesarean hysterectomy was rupture uterus (58.3%), massive hemorrhage due to the placenta (15%). Placenta previa, uterine atony, and placenta adherent were indicated in 11.7%, 8.3%, 6.7%, respectively.  There were 53 stillbirths and 7 alive birth. The most common causes of death were placental abruption, ruptured uterus, and prematurity. There was 10 maternal death (16.7%) due to DIC in 6 women as a complication of massive hemorrhage and acute renal failure in 4 patients.  There were 42 maternal complications. These were due to shock (bleeding) in 14, DIC in ten, anemia in eight, acute renal failure in seven, and ureteric ligation in three. Conclusion: The incidence of cesarean hysterectomy was very high, and the most common causes were found to be due to rupture uterus and PPH due to uterine atony and abruption placenta and placenta previa. The maternal mortality rate was found to be very high and the prenatal mortality rate also was very high.  

Background :The duration of infertility should be considered as a factor that may affect the outcome of assisted reproductive techniques (ART).Aim :The aim of this descriptive study was to examine the outcome of infertility treatment in relation to duration of infertility. Methods: Sixty nine couples from Allow in vitro fertilization center (IVF) were involved in this work. Intrauterine insemination (IUI) had been done for all couples using the same ART. Results: The mean age of men was 29.37±0.16 years and the duration of infertility was 4.38±0.25 years with range of 1-12 years. Higher pregnancy and life-birth rates were demonstrated in males suffering from infertility for less than 4 years as compared to those who had infertility for more than 10 years (P<0.003,  r = -0.869). Moreover, abortion rate was higher in men who had infertility for more than 10 years as compared to those who have infertility for less than 4 years (P<0.0014).. The linear life-birth rate, in both IVF centers, shows decrease by increase in the duration of infertility. Conclusion: The researchers conclude that by increase in the duration of infertility the outcome of assisted reproductive techniques –IUI will be decreased markedly. In addition to the duration of infertility, the present work recommended to consider the different techniques of sperm preparation in relation to the ART outcome.

Background: Latent tuberculosis infection (LTBI) is the presence of Mycobacterium tuberculosis in the body without evidence of tuberculosis (TB) disease. Healthcare workers (HCWs) are at occupational risk of contracting & transmitting TB. Therefore, identifying of persons with LTBI is an essential TB prevention & control strategy. The aim of this study was to evaluate the performance of interferon-gamma release assay (IGRA) in diagnosis of LTBI among HCWs, in comparison to tuberculin skin test (TST); as well as identifying risk factors fortest positivity.Methods: A cross-sectional study was conducted in 2015 on 90 HCWs tested with TST and IGRA. All Participants were subjected to a questionnaire to assess their risk factors. Differences between categorical variables were analyzed by X2. Kappa coefficient used to detect the agreement between TST and IGRA. Also, accuracy of both tests was calculated.  Results: Of the 90 HCWs; 54.4% were females and 45.6% were males with an age ranged between 20-60 years. The participants were classified as 38.9% nurses, 34.4% physicians, 16.7% technicians and 10% were administrators. The highest prevalence of LTBI was found in female 14.3% & 28.6% by TST and IGRA, respectively. In general, the positivity by both tests increased with increasing age. 27.8% of HCWs were Bacille Calmette-Guérin (BCG) vaccinated and most of the positivity occurs among vaccinated HCWs. The crude prevalence for LTBI was 12.2% by TST and 20% by IGRA; overall agreement between TST and IGRA results was poor (k= 0.39).Conclusion: Most HCWs with LTBI were females, nurses, older age, BCG vaccinated and in a group of profession of close contact with TB patients'. The higher positivity was found by IGRA than by TST with poor agreement between them.Superior specificity was observed with IGRA; whereas TST had a higher sensitivity.

Background: Intestinal parasitic infection is the most common endemic infection worldwide and represent major public health problems, mainly in developing countries like Yemen.Aim: The study aim is to identify the prevalence and associated factors of intestinal parasitic infection among basic school children in Sana'a city Yemen.Methods: A crosssectional descriptive study involved 500 basic school children was conducted from April to May 2013. 500. Stool specimens were collected from all participants and examined for intestinal parasitic infection using direct microscopy, wet concentration method then sedimentation method. Data entered and analyzed using SPSS software. Results: The overall prevalence of intestinal parasite infection among the participants was 31.2% and it was higher in Azal district 35.5%. The predominant parasites were Giardia Lambela 48%. The highest prevalence of intestinal parasitic infection 34.4% was among participants from public school and lesser 10.4% among participants from private school. The result was statistically significant (P>0.001). Prevalence of intestinal parasite infection was found among participants for illiterate mothers to be 35.1%, it was high 36% if there is only one bath room in house and the result was statistically significant (P>0.001). Prevalence of intestinal parasite infection 63% was among participants who did not follow hand washing practice after defecation and the result was statistically significant (P>0.001). Most of participants 70.6% don’t have water supply during observation. Conclusions: Intestinal parasites were prevalent in varying magnitude among the schoolchildren. The prevalence of infections were higher for protozoa compared to helminthes. Measures including education on personal hygiene, environmental sanitation, water supply and treatment should be taken into account to reduce the prevalence of intestinal parasites

Background: The incidence of gastroesophageal cancer has shown a rapid change in several areas of the world.Aim: to determine the sub site distribution of upper gastrointestinal cancer among patients underwent endoscopic clinic at AlThowrah hospital, Sana’a city, Yemen. Methods: Descriptive, hospital based study was carry out to study the sub site distribution of upper gastrointestinal cancers in Yemen. 1006 patients referred to Al-Thawra hospital-Sana'a from several public and privet hospitals. All gastric and esophageal cancer patients diagnosed during the period from January 2008 and July 2012 were included in the study. All patients admitted to this study were studied according to clinical protocol consisting of a standard questionnaire, clinical examination and endoscopic findings. The questionnaire was included demographic characteristics and endoscopic findings. The data were analysis using statistical package for social sciences (SPSS, Version 18.0.) descriptive statistics were apply. Results: A total of 1006 patients with upper gastrointestinal cancers were identified, 31.2% of the patients were referred from Amran, followed by 26.8% from Sana’a and 25.9% from Saada. 54.7% of the patients' had EC and 43.3% had GC. Adenocarcinoma accounts for 46%.Conclusion: There were considerable variations in the sub site of upper gastrointestinal cancers in the Yemen. Keywords: Cancer, Upper GI cancer, Gastric cancer, esophageal cancer, Yemen.