Al-Razi University Journal for Medical Sciences

Angiographic Characteristics of Young and Older Yemeni Patients Undergoing Diagnostic Coronary Angiography at Cardiac Center in Al-Thowrah Hospital, Sana, a City-Yemen

Mohammed Al-Kebsi — 2020-12-22

Background: Coronary artery disease accounts for the greatest proportion of CVDs and is one of the most common causes of death in the developed countries. Aim: to identify the risk factor and angiographic characteristics of CAD among young and older patients presented with IHD. Methods: A total of 555 patients underwent diagnostic coronary angiography were enrolled between January and June 2013. Patient admitted in ward as one-day admission and discharged 6 hours after the procedure. Demographic data, clinical findings, details of electrocardiographic and echocardiographic findings were recorded. The traditional cardiovascular risk factors (smoking, hypertension, Khat chewing, family history and diabetes mellitus, dyslipidemia) were noted. The patient included were patients with stable angina, post-myocardial infarction and pre-operative coronary angiography before valve replacement. A written consent form was signed by the patient and his or her relatives was obtained before the procedure. Results: Most of the patients in the study were diagnosed as post MI angina. High percentage of diabetes and hypertension among the older group in comparison to the younger group (P-value <0.05). 50% of the younger group were smokers in comparison to 23.8% in older group with statistically significant difference (P-value =0.000). Family history of IHD was higher in the younger age group than that in the older age group but not significant (P-value = 0.129).. Significant left main disease was more than double in younger group (3.7%) when compared older group (1.9%). about one-third of younger group had significant LAD lesion while small number of older patient had significant LAD lesion (P-value = 0.037). The involvement of RCA was significantly higher in older group than in younger group (P-value=0.001). Although the prevalence of LCX disease was higher in older than younger group (P-value = 0.59). It is found that LAD was commonly involved vessel in the young group (31.5%) in comparison to older group (1.6%) while left circumflex artery and right coronary artery was common in in the older group. Conclusion: Smoking, family history of cardiovascular diseases, and Khat chewing high in the young patients but hypertension and diabetes were high in old patients.

Knowledge and Skills of Midwives toward Eclampsia In Public Hospitals In Sana’a, City-Yemen

rujms ojs — 2020-12-22

Background: Eclampsia affects 5 to 10% of all pregnancies and contributes to 10 to 15% of maternal
deaths worldwide. Estimated case fatality rate due to eclampsia is 14 times higher in developing
countries compared to developed countries. Aim: To assess the level of knowledge and skills of
midwives regarding management of eclampsia at public hospitals in Sana, a city. Methods: A
descriptive cross-sectional study was carried out from May to June 2018. Stratified random sampling
was administered to selected 50 midwives during the period of this study. The data was collected
using a self-administered questionnaire. A questionnaire was divided into 4 sections namely;
demographic characteristics of midwives, training information in managing eclampsia, midwifery
general knowledge on eclampsia, knowledge on emergency care in managing eclamptic convulsions,
barriers and suggestion in managing eclamptic patients. Data were analyzed using SPSS version 20.
Descriptive analysis, and Chi-square and ANOVA tests were used and the level of significance was
<0.05. Informed oral consent was obtained from the participants. Results: In this study, the mean of
the midwives age was the 28.5 year. Above half (68%) of the midwives were unmarried. A majority
(88%) of midwives had a diploma degree. The mean of work experiences was 7 year. More than half
(60%) of midwives were not attended courses training. 60.4% of the midwives don't know about the
current management of Eclampsia. Staff shortage and equipment were among the major leading
barriers reported by midwives in managing eclampsia. Most of the midwives suggested the need to
have training/seminars for managing eclampsia. Conclusion: The findings of this study revealed that
the majority of the midwives lack enough knowledge about the management of eclampsia. There
should be a need for the development of in-service training programs for midwives regarding the
managing eclampsia.

Misoprostol versus Oxytocin for the Prevention of Postpartum Haemorrhage among Women in Al-Thowrah Hospital, Sana'a City, Yemen

Intisar Ali Mohammed — 2020-12-23

Background: PPH is the leading cause of direct maternal death in developing countries. PPH is a real complication that should be studied and dealt with seriously. Aim: To compare the safety and efficacy of rectal misoprostol versus intravenous oxytocin in preventing PPH. Methods: A randomized control study was done for 6 months from 1st of May to 31 of October 2017. In the labor room of the obstetric unit at AMGH in Sana’a. The subjects were included 98 women divided into two groups: group I included 51 women were received 600 μg (3 tablets) misoprostol rectally and 2ml saline in Ringers lactate intravenously as placebo. Group II: included 47 women were received 30IU intravenous oxytocin in Ringers lactate and two lactose tablets rectally as placebo. The collected data for every woman, Patient kept under close observation for 4 hours, for any vaginal bleeding, nausea, vomiting, fever, shivering and etc. Then estimated of blood loss and side effects of uterotonic drugs by direct observation. Results: Incidence of PPH in the misoprostol group 23.5% was more than that found in the oxytocin group 6.4% (p-value<0.05). Risk factors were not significantly different in the two groups, except the prior history of PPH which is more in group I. Side effects: Shivering was more incidences in group I, 54.9% than group II, and 4.3%. While nausea was found in one case 2.1% in group II and no case found in group I. Pyrexia and vomiting were not found in the two groups. Additional uterotonic TTT was used to prevent PPH, within 4 hours of observation: 17.6% of group I needed 3 tablets misoprostol rectally and 6.4% of group II needed 30IU oxytocin infusion was added to prevent PPH. Conclusion: Misoprostol 600μg given rectally is less effective to control the PPH in the management of the third stage labour.

Nutritional Status and Associated Factors among Basic School children in Sana'a City-Yemen

Afrah Al-Dubhani — 2020-12-23

Background: Malnutrition is an increasing health problem among children in developing countries. Few
studies were conducted about school students' malnutrition in Yemen but this study focused on children in
this age group in Sana'a city. Aim: To assess the nutritional status of basic school children in Sana'a city.
.Methods: A cross-sectional study was conducted from March 2017 to May2018. A multistage random
sampling technique was applied to select 198 basic school students. .Data on demographic characteristics
of students and their parents and anthropometric measurements of students were collected using structured
questionnaire as face to face interview .Data was analysis using SPSS software program.. Statistical
significance was considered when p-value <0.05. Results :The mean + SD of students' age were 10.96 + 2
.59 years with (50.5% to 49.5%) male to female percentage respectively. Out of 198 basic school children
about 26.3% of them were underweight, 15.7% were healthy weight, 3.5% overweight and 2.5% obese
based on CDC growth reference standard. The distribution of the children nutritional status based on their
height for age showed that the majority of children were stunted 53.5%. There was strong statistically
significant difference between children nutritional status and their sex, mother and father education, birth
order. Conclusion: The most common form of malnutrition among basic school children in Sana'a city
was underweight at the rate of (26.3%). Sex, mother and father education, birth order were key factors
contributing to malnutrition in children. Nutrition education should be apply to community.

Seroprevalence of HIV, Hepatitis B and C Virus Infections Among Voluntary and Replacement Blood Donors Attending Al-Sabeen Hospital, Blood Bank, Sana' a City

Amal Banafa — 2020-12-23

Background: Blood donation saves millions of lives. The blood donor program is the life force of any
transfusion service. Aim: To assess the seroprevalence of transfusion-transmissible infections (HIV,
HBV, and HCV) in the voluntary and replacement donors. Methods: The study included 2475 blood
donors both voluntary and replacement blood donors attended at the blood bank, at Al-Sabeen
Hospital, Sana'a, Yemen. The blood samples of all the blood donors were. Few milliliters of each
donor’s blood were dispensed in a small clean test tube labelled with the name and sample number for
mandatory screening of the Transfusion. All the blood donors' samples over the period of study were
centrifuged to obtain the serum samples in a small clean test tube labeled with the name and sample
number were analysed and tested by the immunoassay analyser assay (ELIZA) Cobas e-411 IInd
generation for anti HIV IgG and IgM antibodies, detection of HBsAg and anti-HCV IgG and IgM.
Results: The total Seroprevalence of HIV, HBsAg and HCV was 359 donors in the present study, out of
them 263 (14.3%) were replacement blood donors and 96 (15.2%) were voluntary blood donors. The
total seroprevalence of HIV among blood donors was 42 donors in the present study, out of them 1.8%
among replacement blood donors and 1.7% among voluntary blood donors. The total seroprevalence
of HBsAg among blood donors was 286 donors out of them 11.2% among replacement blood donors
and 12.6% of HBsAg among voluntary blood donors. The total seroprevalence of HCV among blood
donors was 31 donors out of them 1.3% were replacement donors and 1.1% were voluntary blood
donors. Conclusion: It has been observed that replacement blood donation is safe as compared to
voluntary as a high prevalence of HIV, HBsAg, and HCV are observed in replacement donors. It is
recommended to following the international standers for the blood collection criteria and screening.

Urine Microalbumin and other Nephropathy Markers in Yemeni Patients with Type 2 Diabetes Mellitus

Amal M Banafa — 2020-12-26

Background: Diabetic nephropathy (DN) is a severe complication of diabetes mellitus (DM).
However, it can be detected early by periodic laboratory investigations in particular urine
microalbumin and urine albumin to creatinine ratio (ACR). Aim: To assess the levels of urine
microalbumin, ACR and other nephropathy markers in Yemeni diabetic type 2 patients. Methods: A
random sample of 50 Yemeni diabetic patients who had not to develop any signs of nephropathy was
included in this study. The subjects were selected during visit the DM unit at the internal medicine
department in Al-Thawra hospital, Sana`a-Yemen. The sample includes 36 males and 14 females. The
laboratory investigations were performed on early-morning samples of the subjects and included
random blood sugar (RBS), serum creatinine (SCr), blood urea nitrogen (BUN), ACR and urine
microalbumin. Results: The mean levels of the 5 tested parameters in both male and female subjects
were higher than normal levels. The difference in such parameters was significant between males and
females in SCr, BUN and urine microalbumin while found insignificant in RBS and ACR. Conclusion:
The levels of DN markers including urine microalbumin, ACR, SCr and BUN are high in Yemeni
diabetic type 2 patients which indicates a high prevalence of early stage of nephropathy. The levels of
urine microalbumin, SCr and BUN are significantly higher in male subjects.