Al-Thawra Hospital Research Articles

Correlation Between Vitamin D Deficiency and Calcium, Phosphorus, Alkaline Phosphatase in Preterm Libyan Infants: Case-Control study

Vitamin D plays a vital role in regulating calcium and phosphorus levels and in bone mineralization. Vitamin D deficiency is a widespread issue contributing to metabolic bone disease in preterm infants. This study aimed to evaluate the biochemical parameters associated with varying levels of vitamin D deficiency. Serum samples were collected from preterm infants at the Neonatal Intensive Care Unit of Althawra Hospital Center, Al Beyda, Libya, from Feb-July 2019. The study included two groups: 62 preterm infants and a control group of 34 full-term infants. Serum levels of calcium, phosphorus, alkaline phosphatase, and 25OH-Vitamin D were measured using enzyme immunoassays and standard method. The study involved 62 preterm neonates, with a median gestational age of 32 weeks (range 28-36) and median birth weight of 1960 gm (range 900-2800 gm). The median levels recorded were calcium at 8.7 mg/dl (p=0.000), phosphorus at 4.1 mg/dl (p=0.584), ALP at 458 U/L (p=0.008), and vitamin D at 13.6 ng/ml. The prevalence of varying degrees of vitamin D deficiency was noted: very severe (9.7% < 5 ng/ml), severe (19.4% 5-10 ng/ml), and overall deficiency (45% 10-20 ng/ml), and suboptimal (25.8% 20-30 ng/ml). Comparing preterm infants to the control group revealed statistically significant differences across all parameters (Vitamin D p=0.000, Ca p=0.007, PO4 p=0.036, and ALP p=0.000). All preterm infants exhibited inadequate vitamin D levels, and there was an inverse relationship between the biochemical parameters and vitamin D deficiency. Notably, the elevated ALP level could serve as a crucial marker for diagnosing vitamin D deficiency in clinical settings.

Clinical presentation, management and outcomes of myocardial infarction in the Heart Center, Al-Thawra Hospital, Sana'a City, Yemen: Stemi cardiac arrest management outcomes

Background and aim: Acute ST-segment elevation myocardial infarction (STEMI) is a critical medical emergency requiring emergency evaluation, diagnosis, and intervention. The aim of the study was to evaluate the clinical presentation, type of treatment, and outcomes of patients with acute ST-segment elevation myocardial infarction at the Heart Center of Al-Thawra Hospital, Sana'a. Methods: prospective study. We enrolled all patients with a final diagnosis of STEMI who have been admitted to the cardiac CCU in the cardiac center in AL-Thawrah Hospital during one year, January to December 2023. Results: A total of 358 patients with STEMI were analyzed. The mean age was 55 ± 8 years old, with male patients representing 80% (286)). The traditional risk factors among these patients were: hypertension 28.23% (101), smoking represents 26.05% (93), diabetes mellitus represents 19% (68), BMI > 30 kg/m2 represents 16.34% (57), and khat chewing represents 78.2% (279). STEMI patients who managed by primary PCI were 14% (50). Patients who have been managed by thrombolytic therapy were 28% (101) and the conventional medical treatment was managed for those who arrived after 12 hours and represent 58%% (204). The most commonly used thrombolytic was streptokinase in 96% (97) of patients who received thrombolytics. Primary PCI within 24 hours has been done in 14% (50) of cases. Heart failure (EF < 50%) represented (26%) (93), cardiovascular shock was 13% (46 cases), and mortality rate was 11% (39 cases))

The Prevalence and Associated Factors of Hepatitis B and C Virus in Hemodialysis Patients in Ibb Governorate, Yemen.

Introduction Hepatitis C virus (HCV) and hepatitis B virus (HBV) among patients receiving hemodialysis (HD) remain a major public health problem. However, information is limited about these infections among HD patients in Yemen. This study aimed to estimate the prevalence and associated risk factors of HBV and HCV infections among HD patients in the Ibb governorate, Yemen, and to identify the risk factors for infections in such patients. Methods A cross-sectional study of 374 patients with renal failure who regularly underwent HD at the Al-Thawra Hospital in Ibb city, Yemen, was performed after they agreed to participate and signed informed consent. Enzyme-linked immunoassay (ELISA) was used to test the serum levels of anti-HCV antibodies and hepatitis B surface antigen (HBsAg). Patient data (demographic characteristics and risk factors) were collected via an interview questionnaire and medical records. Logistic regression analysis and chi-square tests were used to analyze the results. Results The overall prevalence of HCV was 31% (n=116), whereas that of HBV was 6.15% (n=23). Three (0.8%) patients had both HCV and HBV. The logistic regression analysis revealed a significant association between an increased number of units of blood transfused (OR = 3.1; 95% CI: 1.7-5.6; p< 0.001), a long duration of dialysis (OR = 3.2; 95% CI: 1.9-5.2; p = 0.001), and HCV infection in HD patients. On the other hand, a history of cupping therapy (Hijama) was significantly associated (OR = 3.4; 95% CI: 1.3-8.77; p < 0.011) with HBV infection in HD patients. Conclusion HCV and HBV infections are more common among HD patients in Yemen than in most Middle Eastern countries. However, the current prevalence rates are declining compared with previously published data among Yemeni HD patients. The duration of HD and number of blood units were independent risk factors for HCV infection, and patients with a history of cupping were identified as having an increased risk of HBV infection. These findings underscore the need to implement strict infection control in HD units.

Effect of psychoeducational program and relaxation training on critical care nurses' stress regarding care of patients with delirium.

Critical care nurses (CCNs) face difficulties and stress when caring for patients with delirium, and the level of delirium-related stress may be related to gaps in their knowledge and skills. This study aimed to assess the impact of a psychoeducational and relaxation program on reducing the stress of CCNs caring for patients with delirium in intensive care units (ICUs) in Taiz city, Yemen. From June to the end of December 2022, a quasi-experimental study was conducted among 60 CCNs from two ICUs of Al-Thawra Hospital in Taiz. Demographic characteristics were collected using a pre-designed data collection sheet, and the levels of CCNs' stress were measured using the Delirium Nursing Stress Scale (DNSS). To assess the impact of the developed psychoeducational and relaxation program, stress levels were measured before and after the program, as well as at a 3-month follow-up for long-term impact. The association of demographic characteristics with delirium-related stress was also studied. Data were then analyzed using appropriate statistical tests at a significance level of <0.05. Before the program, the mean score of CCNs' stress was 60.48 ± 9.51, corresponding to a moderate stress level of 86.7%. However, this score was significantly reduced to 30.98 ± 4.35 immediately after the program and was sustained at 33.13 ± 5.31 3 months after the program, corresponding to a mild stress level. The highest mean score of CCNs' stress related to caring for patients with delirium was observed before the program for all causes of stress on the DNSS, being 4.95 ± 1.77 for the nursing environment, 9.37 ± 2.16 for relationships with peers, 14.40 ± 4.02 for knowledge about delirium, and 31.77 ± 5.78 for nursing practice and work. However, the mean stress scores related to all these causes showed a significant reduction after the program (2.85 ± 0.95, 4.70 ± 1.33, 7.20 ± 1.67, and 16.23 ± 2.80, respectively) and at the 3-month follow-up (3.15 ± 1.05, 4.95 ± 1.23, 7.67 ± 1.66 and 17.37 ± 3.57, respectively). On the other hand, the mean score of total stress for all DNSS items showed a significant reduction from 60.48 ± 9.51 before the program to 30.98 ± 4.35 after the program and 33.13 ± 5.31 at the 3-month follow-up. There were no statistically significant differences in the mean scores of delirium-related stress before and after the program, or at the 3-month follow-up for any of the demographic characteristics of CCNs. Psychoeducational and relaxation programs have a positive impact on stress reduction in CCNs caring for patients with delirium, improving the standard of care provided to these patients. Regular assessment of CCNs for delirium-related stress and educating them to acquire knowledge and skills are recommended to reduce this stress when caring for delirious patients.

The Effect of Transformational Leadership on Crisis Management at Al-Thawra General Hospital Authority, Hodeidah Governorate, Republic of Yemen

This study aimed to investigate the impact of transformational leadership on crisis management at Al-Thawra General Hospital Authority in Hodeidah. It also explored potential variations in crisis management perception based on employee demographics (gender, qualification, job title, and experience). A descriptive analytical approach was employed. The target population consisted of all Al-Thawra Hospital employees (n=1362). A sample of 300 individuals (22%) was selected. A pilot study (n=30) assessed validity and reliability before main data collection. Data analysis using SPSS revealed a significant positive impact of transformational leadership dimensions on crisis management. Besides, during a crisis, male employees exhibited higher confidence in crisis response compared to females. Additionally, employees with less than five years of experience displayed a stronger perception of their ability to contribute to crisis management across various phases. Based on these findings, the study recommends that Al-Thawra leadership prioritize the development of transformational leadership skills and implement a comprehensive crisis management plan encompassing all crisis stages.

Pattern of Autoimmune Connective Tissue Diseases Among Patients Attending Al-Thawra Teaching General Hospital, Sana'a-Yemen

Background: Connective tissue is also called connectivum. Many autoimmune diseases affect the connective tissue and blood vessels, are often referred to as connective tissue disorders. Autoimmune diseases currently are estimated to affect 2-5% of the population in the developed countries. Aim: The aim of this study was to determine the pattern of autoimmune inflammatory connective tissue diseases among patients attending Al-Thawra teaching general hospital, Sana'a-Yemen. Method: This study is observational prospective study conducted at Al-Thawra hospital, Sana'a-Yemen, department of internal medicine, duration of the study was 12 months. Sample size was 137. Results: The results showed that systemic lupus erythematosus, antiphospholipid syndrome and rheumatoid arthritis have the highest prevalence. The main clinical presentations are arthritis, leg swelling and dyspnea. The main drugs used are corticosteroids, low molecular weight heparin, and rituximab. The proportion of females to males is 3.55 to 1. The age range 20 – 30 years is the highest representing 47% of the total patients. Patients from Sana'a, Taiz, and Ibb being the most common. Illiterates represent 63%, housewives represent 72% of the total patients. Conclusion: We conclude that autoimmune connective tissue diseases affect 8% of the total patients admitted to the internal medicine department. SLE is the most common autoimmune connective tissue disease encountered and represents 43% of total cases. Arthritis and leg swelling are the most common clinical presentations encountered; both represents 48% of the total presentations. Corticosteroids are the most common prescribed drugs, 45%. The aetiology of autoimmune connective tissue diseases is still not fully known. Immuno-modulators are needed to regulate the immune system. Physiotherapy is recommended beside medical therapy.

Bacterial Infection versus Viral Infection Preference of ABO Blood Group Phenotype Patients.

Several studies have established an association between the blood group type and susceptibility to infections. This study aimed to evaluate a correlation between the blood group type and the susceptibility to infection. A total of 558 patients were enrolled in this study who attended at the Althawra Hospital, Ibb City, from March to August 2018. Blood samples were analyzed for complete blood count and blood group. We observed a high frequency of infections affecting the digestive system (26.4%), while the least affected system was the urogenital system 5.9%. Patients with A blood group exhibit an increased probability to be infected by viruses than they do for bacteria (odds ratio [OR] = 1.430; 95% confidence interval [CI] = 1.005 to 2.035; P = 0.05 and OR = 0.098; 95% CI = 0.064 to 0.148; P < 0.0001, respectively). It was observed that blood group A individuals were more susceptible to infection with hepatitis B virus than were the other groups (P = 0.041; OR = 1.704, 95% CI = 1.053-2.773). The liklihood of O blood group patients experiencing urogenital infections was less than that of non-O blood group patients one third (OR = 0.353, 95% CI = 0.158-0.789; P = 0.014). This study corroborates previous findings that demonstrated that certain blood groups are more prone to infection by one agent than are patients with other blood groups.

Acute heart failure complicating acute coronary syndromes in patients admitted to Coronary Care Unit - Cardiac Center , Al-Thawra Hospital - Sanaa, Yemen

Background: Heart Failure with all its types and presentation is the end result of acute coronary syndrome. Coronary artery disease and its acute manifestations of ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina are remarked as acute coronary syndromes (ACS). Yemeni patients usually present themselves to hospital late due to a lack of society awareness of the symptoms of ischemic heart disease, absence of medical insurance, poverty, lack of medical aid and intensive care units (ICU), absence of ambulance services, and long distance to the facilitated hospital with equipped ICUs. Late presentation prevents giving thrombolytic therapy or performing invasive interventions within the right time. These factors in addition to other factors may contribute to the large number of heart failure post ACS. We designed this study to study the heart failure complicating acute coronary syndrome. Results: Out of 637 patients with ACS, 294 (39%) were in heart failure complicating ACS, with a median age of 51 years. Males represent 66% (194 patients) and females 34% (100 patients). Smoking represents 36%, khat chewing 88%, hypertension 53%, dyslipidemia 31%, past history of MI 29%, and diabetes mellitus 40%. Ischemic-type chest pain represents 49% and Dyspnea as primary symptom occurred in 29% with heart failure (HF). Late presentation of more than 12 hours represents 53% (111 patients) among patients with HF complicating STEMI or LBBB MI. These patients did not receive thrombolytic therapy or primary PCI. Patients who received thrombolytic therapy represent 45% (95 patients) of patients with HF-complicating ACS. No patients received primary PCI. Conclusions: Heart failure complicating ACS is common among our patients and associated with high in-hospital death and is mainly among young patients and related to late presentation, management with non-fibrine specific thrombolytic agents (streptokinase), and lack of STEMI catheterization team for 24 hours, seven days a week.

Patterns of Rheumatic Heart Disease Among Yemeni Patients in Cardiac Center of Al-Thawra General Hospital

Background: Rheumatic heart disease (RHD) is still a major public health problem and remains the most common cardiovascular cause of death among children and young adults. The recurrent episodes of acute rheumatic heart disease may cause the rapid progressive damage of the heart valves and chronic residual deformity resulting in stenosis or regurgitation or a combination of both stenosis and regurgitation.&#x0D; Methodology: A cross sectional Study, consecutive patients with RHD were enrolled from outpatient cardiac clinics and inpatient department of cardiac center of Al-thawra hospital in Sana’a city, Yemen between January and July 2020. Demographic, clinical, echocardiographic, and coronary angiography characteristics of patients were recorded.&#x0D; Results: 261 consecutive patients with rheumatic heart disease were analyzed with mean age of 33 ± 12.65, female patients represented 62.8% (165), illiterate patients represented 63.6% (166). The majority of the patients about 79.7% (208 patient) had mitral valve disease, 63.6% (166 patient) had aortic valve disease, 10.7% (28 patient) had organic tricuspid valve disease but the Isolated Mitral valve disease 23%( 60) , Isolated Aortic valve disease 10.3% (27) and Isolated organic tricuspid valve disease represent 4.2% (11) , double valve disease (mitral &amp; aortic ) represent 56% (146), triple valve disease (Mitral + Aortic + Tricuspid )represent 6.5% (17).A lot of complications of RHD detected in our study; CHF 36%(94) with low EF &lt;50% in 55.0%(144) and 34% (89) had dilated LV , 33.7%(86) developed AF , 14%(37) of the patient complicated by IE , spontaneous echo contrast 11%(29) but only 7.3%(19) developed Intra cardiac thrombus and new stroke 9.5% ( 25) , pericardial effusion 5.4% (14) and Active ARF 2.3%(6). Conclusion:&#x0D; Rheumatic heart disease is a big medical problem in Yemen and it affects children and young adults of poor and illiterate patients of both genders. The most common valvular lesion reported in our study was multivalvular lesion the predominant pure lesion was Mitral regurgitation followed by Mitral stenosis, Aortic regurgitation, with high organic affection of the tricuspid valve.

Job Satisfaction And Its Effects on Staff Performance of Al Thawra Hospital in Sana'a, Yemen

Job satisfaction - or lack of it - hinges on a productive, accomplishing relationship between staff and management; indeed, the success of any organization depends on staff members who enjoy their jobs and feel rewarded by their efforts. Ultimately, of all the people in the health care institutions may suffer the most when this vital success factor is lacking. In the past, many scholars have been directed on job satisfaction but this still remains an issue for many organizations. &#x0D; Aim: This study aimed to determine the job satisfaction of Al Thawra Hospital's staff in Sana'a and its effect on their job performance. &#x0D; Methodology: A self-administered questionnaire was used for data collection from several departments of the mentioned hospital. Convenient sampling technique was used and 200 questionnaires were circulated and returned back for analysis. SPSS application was used for data analysis statistically. &#x0D; Results: The results showed that the general job satisfaction level for health workers of Al Thawra Hospital was low (mean = 2.45, SD = 0.64). Health workers' job satisfactions have affected on their job performance (13%) ranged from work environment (15%) to salary (4%). &#x0D; Conclusion and recommendations: Authority of the hospital has to meet its workers' social and economic needs especially salary and rewards. They have to provide a suitable work environment that plays an important role in enhancing workers performances&#x0D;

Clinical Patterns and Outcomes in Patients After Penetrating Lower Limb Vascular Injury in Taiz, Yemen

Background: Popliteal arterial injury is associated with a high risk of limb loss of any peripheral vascular injury. The purpose of this study was to review our experience with complex penetrating popliteal arterial injuries, thereby focusing on initial presentation and early outcomes. Methods: We conducted a retrospective study of 85 patients with popliteal arterial injuries who underwent surgical treatment from 2015 to 2019 at Authority of Althawra hospital in Taiz, Yemen. Variables were retrospectively collected included patient demographics, mechanism and type of injury, limb ischemia time, clinical status at presentation, type of vascular reconstruction, associated complications, limb salvage, and mortality

Blood Transfusion Practices at Al-Thawra Teaching Hospital, Sana'a-Yemen

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.

PATTERN OF LIVER DISEASE ADMISSIONS AT A TERTIARY GOVERNMENT HOSPITAL IN SANA’A, YEMEN

Back ground and objectives: Liver disease causes major public health problems international, especially in poor countries, and it is associated with poor long-term clinical outcomes and results in the deaths of millions worldwide annually. The aim of this study is to ascertain the virtual frequencies of liver disease and to assess etiological factors among patients admitted to Al-Thawra tertiary Hospital in Sana'a City, Yemen.&#x0D; Methods: This was a descriptive retrospective analysis study of gastrointestinal patients admitted from January 1, 2021 to December 31, 2021 to the medical wards of Al-Thawra Hospital. This is a tertiary hospital located in the Yemeni capital, Sana'a City. Data were extracted from patient case folders for the period of under review. Data validated with Microsoft Excel version 13 and exported to SPSS version 23.0 for windows; for statistical analysis. Data were evaluated for demographic and other clinical characteristics as definite variables.&#x0D; Results: Of the 516 gastroenterology patients admitted to the gastroenterology service in medical wards during a one-year period, liver disease accounted for 30% of all gastroenterology in the same period. There were 155 patients diagnosed with liver disease. There were 86 (55.5%) males and 69 (44.5%) females, with a male to female ratio of 1.2:1. The mean overall age of patients and the age range were 46.14±16.5 and 8-85 years, respectively. The peak incidence of age occurred during the fifth and sixth decades of life at 38.1%. The most common liver disease was; autoimmune hepatitis 43 (27.7%), followed by nonalcoholic fatty liver disease 35 (22.6%), viral hepatitis 32 (20.6%) and schistosomiasis 10 (6.5%).&#x0D; Conclusion: Current findings show that autoimmune hepatitis was the most common cause among gastrointestinal diseases in Sana'a city, Yemen; the male to female ratio was roughly the same. In light of this, health education and public awareness about hepatitis virus screening tests and schistosomiasis screening and treatment is the primary preventive strategy to be considered.&#x0D; &#x0D; Peer Review History: &#x0D; Received: 4 July 2022; Revised: 12 August; Accepted: 7 September, Available online: 15 September 2022&#x0D; Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, gehankandeel9@yahoo.com &#x0D; UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. &#x0D; Received file: Reviewer's Comments:&#x0D; Average Peer review marks at initial stage: 6.0/10&#x0D; Average Peer review marks at publication stage: 7.5/10&#x0D; Reviewers:&#x0D; Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com&#x0D; Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg&#x0D; Dr. Rima Benatoui,Laboratory of Applied Neuroendocrinology, Department of Biology, Faculty of Science, Badji Mokhtar University Annaba, Algeria. benattouiryma@gmail.com&#x0D; Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com&#x0D; Similar Articles: &#x0D; PREVALENCE OF HEPATITIS G VIRUS AMONG PATIENTS WITH CHRONIC LIVER DISEASE AND HEALTHY INDIVIDUALS, SANA'A CITY-YEMEN

HUMAN BRUCELLOSIS AMONG PYREXIA OF UNKNOWN ORIGIN CASES IN TWO TERTIARY HOSPITALS, IN SANA'A, YEMEN

Background and objectives: Brucellosis continues a most important health problem in numerous parts of the world and in the Middle East regions is a significant origin of acute febrile illness. This study was conducted to determine Brucella antibodies among patients with PUO, the association of brucellosis with demographic characteristics, identify clinical symptoms and risk factors for Brucella infection among PUO cases. Materials and Methods: This cross-sectional research study was conducted in two health institutions; Al-Jumhouri Hospital and Al-Thawra Hospital, between January 2021 to January 2022. The required data were gathered from each patient by using pre-defined standardized questionnaire. Five mL of sterile whole blood was collected from each patient and then tested for Brucella antibodies using a standard tubular agglutination test. The data were then analyzed using the statistical software Epi Info version 6. Results: Among the 241 PUO patients, females were 72.2% and males 27.8%. The mean ± SD for total age was 28.8±15.8 years. The rate of Brucella antibody among patients with PUO was 29%, females 78.6% higher than males by 21.4%. Clinical characteristics of PUO patients were persistent fever (36.9%), intermittent fever (63.1%), sweating (63.5%), shivering (61.4%), joint pain (78.4%), muscle pain (78.4%), back pain (74.7) back head pain (66.4%), headache (60.4%), weight loss (52.9%), body weakness (89.2%), loss of appetite (50.6%), and nausea (46.1%). The risk factors for brucellosis among the PUO patients was handling of animals during parturition (69.2%, OR=7, p&lt;0.0001). Conclusion: These findings revealed a high prevalence of human brucellosis among PUO patients in Sana'a city and will becoming a serious problem that threats the health care system in Yemen. So, awareness programs should be provided to doctors, population about Brucella infection and its risk factors. Peer Review History: Received: 4 January 2022; Revised: 16 February; Accepted: 10 March, Available online: 15 March 2022 Academic Editor: Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, amalbgadley@pnu.edu.sa UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, edress2020@gmail.com Similar Articles: PATTERNS OF ANTIMICROBIAL RESISTANCE AMONG MAJOR BACTERIAL PATHOGENS ISOLATED FROM CLINICAL SAMPLES IN TWO TERTIARY’S HOSPITALS, IN SANA'A, YEMEN

Knowledge, attitudes, and practices toward COVID-19 among Yemeni health care workers during the COVID-19 pandemic: A single-center survey in Al-Thawra Hospital, Ibb Governorate, Yemen

Background and Objective: Health care workers (HCWs) are at the highest risk of contracting COVID-19, so their knowledge about the disease and their preventive attitude and practice toward COVID-19 are of concern. The present study aimed to assess the knowledge, attitudes, and practices of HCWs toward COVID-19 in Al-Thawra Hospital, Ibb Governorate, Yemen. Materials and Methods: We conducted a cross-sectional survey among HCWs in Al-Thawra Hospital, Ibb, Yemen, from January 1 to March 31, 2022. Results: Of the 80 participants, 50 (62.5%) were males and 30 (37.5%) were females with a mean age of 29.33±7.86 years. About 51.2% of respondents were aware that sneezing is a recognized symptom of COVID-19, while most were unaware of the extrarespiratory symptoms of the disease, such as diarrhea and confusion. About 28.7% of respondents believed that eating or contacting wild animals would result in infection by the COVID-19 virus, with the majority (71.3%) agreeing that wearing a well-fitting face mask effectively prevents COVID-19 infection. Approximately 48 respondents (60.0%) believed that washing hands could prevent contracting COVID-19, and only 31 (38.7%) agreed that if a patient shows signs and symptoms of COVID-19, they can confidently participate in that patient’s treatment. In response to avoid COVID-19, about 23 respondents (28.7%) had always gone to crowded places, and 35 (43.6%) had always worn face masks at every contact with patients, while only 14 (17.5%) of participants refrained from shaking hands and 37 (46.3%) always washed their hands before and after handling each patient. Conclusion: This study showed that most respondents have poor knowledge regarding the clinical picture of COVID-19 and its mode of transmission as most of them failed to detect an extrapulmonary manifestation of COVID-19 and were unaware of the possibility of transmission of the disease from wildlife. In addition, the attitude and preventive practice of the respondents were unsatisfactory in containing the transmission of the disease. Keywords: COVID-19, Health care workers, Knowledge, Attitude, Practices.

Characteristics and Risk Factors of Yemeni Patients Presenting with Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA).

Background:Myocardial infarction with non-obstructive coronary artery (MINOCA) is a syndrome, which requires both clinical documentation of ST-elevation myocardial infarction (STEMI) (abnormal cardiac biomarker, ischemic symptoms, and electrocardiography changes) and detection of nonobstructive coronary arteries. The purpose of this study is to determine the incidence of and characteristics of patients with MINOCA in the Yemeni population.Methods:Consecutive patients admitted between January and June 2019 at Al-Thawra Hospital, Sana’a (Yemen), with STEMI diagnosis were enrolled in this study. Demographic, clinical, echocardiographic, and coronary angiography characteristics of patients were noted.ResultsMINOCA was identified in 63 patients (25%) out of 249 admitted with STEMI diagnosis at Al-Thawra Hospital. The mean age of MINOCA patients was similar to obstructive coronary group; however, they were more often females and less frequently with diabetes and family history of coronary artery disease. Other risk factors like smoking, arterial hypertension, dyslipidemia, and oral tobacco were similar. Conversely, the percentage of Khat chewers was significantly higher in the MINOCA patients (P < 0.01) as compared to obstructive group.Conclusions:The relatively high incidence of MINOCA in our country and the long list of multiple potential causes of MINOCA should open further working diagnosis after coronary angiography and further efforts for defining the cause of myocardial infarction in each individual patient in Middle East countries.

Management of Complicated Appendicitis in Al-Thawra Modern General Hospital Sana'a -Yemen from November 2019 to November 2020

Background: Complicated appendicitis causes morbidity and mortality more than simple appendicitis. Complicated appendicitis includes appendicular mass, appendicular abscess, perforated appendicitis. Objective: To study presentation of complicated appendicitis regarding to age, sex and complain duration, also to study management of complicated appendicitis and his response to conservative management. Methods: A prospective, observational study was conducted in the department of general surgery at AL-Thawra hospital during the period from Nov 2019 to Nov2020. The data was collected using clinical examination and follow up, and was analyzed using SPSS 24. Results: A total of 57 patients diagnosed as complicated appendicitis, aged from 6 to 60 years were admitted, mean age was 28 years. Male to female ratio was 1.6:1. The complaint duration was more than 3 days in 34 cases (59%), total leucocytes count was &gt;18 × 103 in 28 cases (49.1%). Twenty patients (35.1%) diagnosed as generalized peritonitis, 18 cases (31.6%) diagnosed as localized peritonitis, 14 patients (24.6%) diagnosed as appendicular mass, and 5 cases (8.8%) diagnosed as appendicular abscess. Forty cases (70.2%) underwent surgical intervention, whereas 17 cases (29.8%) improved with conservative management. Fifteen cases (37.5%) of operated patients underwent simple appendectomy and 13 cases (32.5%) underwent appendectomy with drain, and 12 cases (30%) underwent midline laparotomy. Most appendicular mass cases 12 (85.7%) were managed conservatively and 2 cases (14.3%) were operated. Three cases (60%) of appendicular abscess were aspirated, 2 cases (40%) were drained. Surgical site infection was 27.5% of operated cases. Conclusions: Complicated appendicitis can be suspected through clinical presentation, duration of complains and inflammatory response. Management of complicated appendicitis varies accordingly from conservative conventional to midline laparotomy.

"Prevalence of Hypertension Among Doctors and Risk Factors in Al-Thawra Hospital, Sanaa in 2019"

Haroon Ahmad Thabit* and Mohammed Ahmed Abdullah Author Affiliations Department of Community Health, National University of Malaysia, Malaysia Received: May 24, 2021 | Published: June 08, 2021 Corresponding author: Haroon Ahmad Thabit, Department of Community Health, National University of Malaysia, Malaysia DOI: 10.26717/BJSTR.2021.36.005838

Acute Coronary Syndrome with Normal or Near-Normal Coronary Angiography:Prevalence and Clinical Outcomes among Yemeni Patients

Abstract Background: Nonobstructive acute coronary syndrome or acute coronary syndrome with normal or near-normal coronary angiography (ACSNONCA) occurs in 10% to 25% of patients undergoing coronary angiography and in up to 6% of patients with troponin-positive ACS. Prevalence of ACSN-NOCA and its clinical outcomes were not discussed in previous studies in Yemen. Aim of Study: Our study aimed to compare demographic and clinical findings and prognosis in patients who have ACS with stenosis 50%) with 213 patients (27.6%). During the period January 2010 through September 2015, patients were admitted at Algamhoria Teaching Hospital, Aden and undergone cardiac catheterization in Cardiac Surgery Center at Althawra Hospital, Sana'a. Results: Group I Patients (stenosis <50%) were signifi-cantly younger were more likely to be female, younger, with fewer risk factors, compared to Group I Patients. We isolated and defined two subgroups within Group I: Group IA: Patients with normal angiograms (n=60, 52.6%) and Group IB patients with stenosis of 20-50% (n=54, 47.4%). Patients with stenosis of 20%-50% were relatively older males, with an increasing frequency of nondiabetic, with a history of chronic heavy chewing and with a worse prognosis, during long-term eval-uation. Follow-up data revealed that myocardial infarction was found in 1.8% of Group IA and in 5.2% of Group IB patients. Follow-up revealed no deaths in Group IA patients and two cardiac deaths (3.7%) in Group IB patients. Conclusions: Prognosis of patients with nonobstructive stenosis was significantly better than that of patients with critical obstructive stenosis. However, patients with stenosis of 20-50% had a worse prognosis than did those with normal coronary arteries.

Penetrating Popliteal Vascular Injury: Surgical Management and Early Outcome During Current War in Taiz –Yemen

Background: Popliteal vascular injury remains a challenging entity, and carries the greatest risk of limb loss among the lower extremity vascular injuries. Operative management of traumatic popliteal vascular injuries continues to evolve. We aim to review our experience with complex penetrating popliteal vascular injuries, thereby focusing on initial presentation, therapeutic challenges, and early outcomes. Methods: From September 2015 to December 2019, we managed total of 728 penetrating vascular injuries with 157 popliteal vascular injury presented to the Authority of Althawra hospital in Taiz- Yemen. Of 125 patients, 103 patients were fulfilling the inclusion criteria. Traumatic limb amputations were excluded from this study. Variables were retrospectively collected included patient demographics, mechanism and type of injury, limb ischemia time, clinical status at presentation, type of vascular reconstruction, associated complications, limb salvage, and mortality. Results: 157 vascular reconstructions were performed for 103 patients with penetrating popliteal vascular injuries, 94 (91.3%) were males and 9 (8.7%) were female. The mean age was 27.3 ± 12.3 years. There were 84 (18.6%) penetrating gunshot high-velocity injuries, and 19 (18.4%) blast injuries. Popliteal vascular injuries were the second most common accounting for 35% of lower extremity vascular injuries and 22.4% of the total vascular injuries. Nearly half 54 (52.4%) of the patients sustained complex popliteal vascular injuries (arterial and venous injuries), 85 (82.2%) isolated arterial injuries, and 72 (69.9%) isolated venous injuries. Management of vascular injury was repaired by saphenous venous interposition graft in 68 (66%), end-to-end anastomosis in 15 (14.5%), ligation in 1 (1%), and venous patch in 1(1%). Venous injury was repaired in 53 (51.4%) and ligated in 18 (17.5%). Less than 6 hours from injury to completed revascularization was achieved in 58 (56.3%) patients. The overall fasciotomy was 28 (27.2%) which significantly increased the length of hospital stays (17 days vs. 7 days, P=0.0003). The overall limb-salvage rate in our study was 94.2%. During the study period, the most common complication was 14 (13.6%) wound infection, 14 (13.6%) graft thrombosis, 6 (5.8%) bleeding, 4 (3.9%) graft infection. Early limb loss occurred in 6 (5.8%). In our study, the mortality rate was 2 (1.9%). Conclusions: Wartime penetrating popliteal vascular injury is a real challenge. However, team approach and promptly vascular repair found to associate with a remarkable limb salvage rate of 94.2%. We advocate repair of arterial injury with vein graft as the treatment of choice whenever possible.