Vol. 19 No. 4 (2025): Sana’a University Journal of Medicine and Health Sciences

ABSTRACT

Background and aims: Leukemia, a common childhood cancer, is caused by abnormal lymphoid cell changes, affecting bone marrow, blood, and organs. Chemotherapy is the most effective treatment, but oral complications, such as carious lesions, gingivitis, and gum inflammation, can occur due to oncologic therapy.

Objective:  Aims of this study was to evaluate the oral health condition of children with acute lymphoblastic leukemia receiving chemotherapy.

Methods: A total of 95 children of both sexes who were newly diagnosed with acute lymphoblastic leukemia and already undergoing different phases of intensive chemotherapy were selected for the study. This study was conducted in the leukemic center of Al-Kuwait Hospital in Sana’a City, Yemen. The gingival status of the oral cavity was examined using the modified gingival index (MGI) to avoid induced bleeding, and probes were not used for gingival examination. The diagnosis of carious lesions was based on the criteria established by the World Health Organization. Mucositis (using the WHO oral toxicity scale) and saliva collection was done in calibrated cylinder and flow rate was measured using standard formula.

Results: The study involved a total of 95 children aged 4-14 years, with a mean age of 8.2 ± 3.4 years. The prevalence of gingival inflammation was highest in the mild inflammation group (46.3%). Oral hygiene status was rated as good (62.2%), moderate (36.8%), or poor (1.1%). Oral mucositis was highest in severe (45.3%) and moderate (31.6%) groups.

Conclusion: Children with acute lymphoblastic leukemia undergoing chemotherapy face increased oral health complications like mucositis, gingival inflammation, opportunistic infections, and dental caries. Early dental assessment, regular monitoring, and tailored care strategies are crucial for effective dental management.

Background: After achieving high vaccination coverage, vaccine failure may occur. Sufficient knowledge, practices, and safety practices of workers in the expanded immunization program are factors that affect the prevention of this failure.

Method: This quasi-experiment was conducted to assess the knowledge and practices of HCWs involved in the EPI, as well as their safety practices, before and after an educational intervention in Sa’adah, Yemen, in 2025. The study included 26 HCWs from 26 health facilities in 11 districts of the Sa’adah Governorate, Yemen. Data were collected through field visits to hospitals and health centers in the targeted districts between January 1 and January 20, 2025, to collect the data required for the pre-intervention knowledge, practice, and safety practice questionnaires. The second phase, four months after the intervention, from May 3 to May 13, 2025, collected post-intervention data. Data were analyzed using SPSS version 26.
Results: HCP knowledge scores improved after the educational intervention, from 26.9% ’good’ to 65.4%. HCP practices improved, with correct practices increasing from 76.9% to 92.3% (p = 0.015). Injection safety practices did not significantly improve. General secure safety practices increased from 26.9% to 92.3% for good practices after the intervention; the statistical significance was marginal (p=0.063).
Conclusion: Educational intervention programs in Sa’adah, Yemen, effectively improved healthcare providers’ immunization knowledge and practical skills.

Background: Penetrating rectal trauma (PRT) presents a formidable challenge in conflicting settings. This study aimed to evaluate the management and outcomes of PRT at a tertiary military hospital in Yemen.

Methods: A retrospective review of 32 patients who underwent PRT was conducted between January 2019 and March 2022. We analyzed the data on patient demographics, injury patterns, management strategies, and clinical outcomes. Results: All patients were male (93.8%) aged < 30 years. The injuries were caused by gunshots (62.6%) or bombs (37.4%). The majority (53.2%) presented > 24 hours post-injury. Most injuries were extraperitoneal (62.5%) and American Association for the Surgery of Trauma (AAST) Grade II (96.9%), with pelvic fractures being the most commonly associated injury (53.1%). Management predominantly involves a diversion colostomy. Complication rates were high, including rectocutaneous fistula (34.1%) and necrotizing fasciitis (31.0%). The overall mortality rate was 6.2%. Among survivors, 31.3% experienced significant morbidity. Conclusion: Delayed presentation is a key driver of the high complication rates observed in PRT within this conflict setting. Although fecal diversion helps to manage mortality, the burden of morbidity remains a significant concern, highlighting the challenges of trauma care in resource-limited environments.

The global rise of antimicrobial resistance threatens the efficacy of current antibiotics and underscores the limitations of the single-target drug paradigm. In response, plant-derived phytochemicals offer a rich, historically validated source of multitarget antimicrobial agents. This review highlights the diverse classes of phytochemicals including alkaloids, flavonoids, terpenoids, and phenolic compounds and their pleiotropic mechanisms of action. These include disrupting microbial membranes, inhibiting key enzymes, interfering with nucleic acid and protein synthesis, and targeting virulence factors like biofilms and quorum sensing. Crucially, many phytochemicals exhibit synergistic interactions both within complex extracts (entourage effect) and when combined with conventional antibiotics, thus enhancing therapeutic potential and mitigating resistance. Despite promising in vitro data, challenges remain in standardization, bioavailability, and regulatory approval. However, integration of ethnobotanical knowledge with modern technologies such as nanotechnology, chemical fingerprinting, and clinical trials offers a viable path forward. Embracing the multitarget nature of phytochemicals is not only innovative but essential in overcoming AMR and revitalizing antimicrobial therapy. This review is based on a structured and systematic search of peer-eviewed literature from major databases including PubMed, Scopus, ScienceDirect, and Google Scholar, covering the period from 2000 to May 2025. Keywords related to phytochemicals and antimicrobial resistance were used, with a focus on original studies, reviews, and credible epidemiological reports from WHO, CDC, and FAO.

Background and Aim: The association between infection with Giardia lamblia and malnutrition in school-age children is well documented. Because both conditions are common among Yemeni schoolchildren, this study aimed to determine the prevalence of Giardia infection and its associated factors and to assess its association with adverse nutritional outcomes among rural schoolchildren in Sana’a Governorate, Yemen.
Subjects and Methods: A school-based, cross-sectional study was conducted among 445 schoolchil-dren aged 6–15 years. Giardia lamblia and other intestinal protozoa were detected by microscopic examination of stool specimen sediments after concentration with the formal-ether technique. Sociodemographic, behavioral, and environmental data were collected using a structured questionnaire through face-to-face interviews, and nutritional status was assessed using anthropometric measurements. Univariate analysis was used to test the significance of the associations, and multivariable binary logistic regression was employed to identify the independent predictors of Giardia infection.
Results: Giardia infection was prevalent among 20.2% [95% confidence interval (CI): 16.6, 23.8] of schoolchil-dren.  Age 11 years (adjusted odds ratio [AOR] = 1.9, 95 % CI: 1.05, 3.31; textitp= 0.029), farmland ownership by children’s families (AOR = 2.4, 95% CI: 1.30, 4.34; p = 0.014), and not washing hands after playing with soil (AOR = 3.1, 95% CI: 1.05, 8.89; p = 0.047) were independent predictors of Giardia infection. In terms of adverse nutritional outcomes, Giardia infection was significantly associated with stunting among children aged 6–11 years (OR = 1.9, 95% CI: 1.10, 3.22; p = 0.022) but was not associated with wasting or underweight.

Conclusion: One in five rural schoolchildren in Sana’a Governorate is infected with G. lamblia. Younger age, not practicing handwashing after playing with soil, and belonging to families owning farmland can inde-pendently predict infection. Giardia infection is associated with stunting among schoolchildren. Therefore, improving the nutritional status of rural schoolchildren warrants the prevention and control of Giardia infection.