Yemeni Journal for Medical Sciences is the official journal of the Faculty of Medicine and Health Sciences, University of Science and Technology, Aden - Yemen. The YJMS is a peer-reviewed, open-access journal published Monthly. However, all accepted manuscripts are published online as in-press articles after their acceptance. The YJMS welcomes articles that contribute to a wide spectrum coverage of scientific work including medical, dental, pharmaceutical, public health and other biomedical disciplines from all sources. Originality, high quality and significance of the scientific content are essentially considered. Online ISSN: 2227-961X Print ISSN: 2227-9601
YJMS publishes Open Access articles under the Creative Commons Attribution (CC BY) license. If author(s) submit their manuscript for consideration by YJMS, they agree to have the CC BY license applied to their work, which means that it may be reused in any form provided that the author(s) and the journal are properly cited. Under this license, author(s) also preserve the right of reusing the content of their manuscript provided that they cite the YJMS.
Prevalence of Low Back Pain and Work- Related Stress among Nurses in LRH Peshawar
Background: Low back pain is highly prevalent worldwide, significantly impairing quality of life and increasing the risk of disability, particularly among working populations. Objective: This study aimed to assess the prevalence of low back pain and work-related stress among nurses. Methods: This research was a cross-sectional study, and was performed at Lady Reading Hospital (LRH) Peshawar. Convenience sampling technique was adopted for data collection in this study. A consent form, a low back pain specific questionnaire, and a perceived stress questionnaire were administered among 152 nurses at LRH Peshawar. Results: Of the total 152 respondents suffering from low back pain, 10 (6.6%) nurses were mildly disabled due to their condition, 56 (36.8%) were moderately disabled, 76 (50%) nurses had severe disabilities, and 10 (6.6%) nurses were severely disabled due to their low back pain condition. In relation to work-related stress, all 152 respondents suffering from stress reported their stress levels in the perceived stress questionnaire. It was discovered that 10 (6.6%) nurses had low levels of stress, 139 (91.4%) nurses had moderate levels while only 3 (2.0%) experienced high stress. Conclusion: In summary, the results indicate that these conditions are prevalent amongst nurses, greatly affecting their day-to-day life, making simple tasks hard to perform and preventing them from being fully involved.
Prevalence; Back Pain; Stress; Nurses; Occupational Exposures.
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Management of Pyogenic Granuloma Associated with Transdermal Contraceptive Implant: A Case Report
A form of inflammatory hyperplasia known as pyogenic granuloma (PG) can develop in reaction to hormone fluctuations and local irritation like calculus. It is typical for young adult girls in their second decade of life. Lesions mostly affect the face or buccal aspect and are more frequent in the maxillary gingiva than the mandibular gingiva. Pyogenic granuloma is infrequently linked to bone loss and rarely grows larger than 2 cm in diameter. This paper presents a massive gingival pyogenic granuloma in a 24-year-old female Yemeni patient who had used a transdermal contraceptive implant for two years. In November 2025, it was effectively treated with surgical excision.
Pyogenic granuloma, Transdermal contraceptives, Hormonal influence, Reactive lesions.
Pattern of Help-Seeking Behaviour among Mentally Ill Patients in Aden, Yemen: An Exploratory Qualitative Study
Background: Mental health services in Yemen are highly underexploited in the country with an abiding humanitarian crisis. In this regard, no comprehensive research has addressed the help-seeking pathways of mental illness. Objective: This study investigates the patterns and determinants of help-seeking behavior among mentally ill patients in Aden. Methods: An exploratory qualitative study involved a total of 48 semi-structured interviews with patients, caregivers, laypersons and key informants (psychiatrists and faith healers). The interviews were recorded on tape, transcribed, translated and subjected to directed content analysis Results: The mean age of patients was 32.2 years ±6.7SD and majority of participants were male (62.5%), married (54.2%), and had low family incomes (median ~57,000 YER/month). Analysis showed that a predominant sequence in which mentally ill help-seekers prioritize faith healers, and therefore, excessive delay in treatment and in some cases, harm. Explanatory models that explained illness in terms of spiritual (e.g., jinn, evil eye) and stigma were also influential in decisions, as well as limited financial capacity and poor mental health knowledge. The key facilitators for accessing formal care were social support and referral from faith healers themselves. Conclusion: Help-seeking for mental illness in Aden is complicated and guided by cultural and religious beliefs towards non-psychiatric treatment. Effective interventions should also embed cultural knowledge, use faith healers as collaborators, combat stigma, and enhance access and awareness to mental health facilities.
Conflict, Faith healers, Yemen, Stigma, Psychosis, Psychiatrists
Study the Effect of Water Used for Reconstitution on Stability of Azithromycin Oral Suspension under Various In-Home Storage Conditions in Aden, Yemen
Background: Concerns have been raised about home storage conditions and the appropriateness of the temperature of the water used to reconstitute azithromycin oral powders. Objective: To investigate the stability of Azithromycin oral suspension using two types of water, at different storage conditions during the recommended in use shelf life. Methods: The analysis was performed using (HPLC). This study was carried out by selection of two brands of Azithromycin dry suspension, exposed to different conditions (refrigerator conditions (2-8°C) and ambient temperature, then the assay test was performed for fourteen days. In addition, physical tests were performed for the samples. Results: HPLC results indicated that the content of Azithromycin decreased in the samples that were exposed to heated water in comparison to the samples exposed to cooled water at ambient temperature. The statistical analysis results of the one way ANOVA indicated that there was no significant difference in the content of the drug in the azithromycin brands. In addition, one way ANOVA results indicated that there was a significant difference (P < 0.05) in the content of the drug in the Azithromycin that was exposed to the various in home storage conditions, namely, refrigerator 2 – 8°c and room temperature 25 – 29°c that were evaluated in the study. Conclusion: The local azithromycin suspension brands demonstrated acceptable stability after reconstitution with cooled distilled water. In addition, storage temperature significantly influences the degradation of the active compound after reconstitution; however, refrigeration is recommended to minimize drug degradation during the recommended use period.
Azithromycin, antibiotic dry suspension, stability, HPLC.
Impact of Socioeconomic Status and Nutritional Health on Academic Achievement among Primary School Students in Aden, Yemen: A Descriptive Analysis
Background: Nutrition is important in the physical development, cognitive and academic achievement of children especially in underprivileged areas where low resources are likely to be coupled with low nutritional and socioeconomic status. Objective: This aim of this study was to determine how nutritional behaviors, health levels, socioeconomic status, and academic achievement are related in primary school children in Aden, Yemen. Methods: A cross-sectional study was done on 202 children in four schools in Aden, primary school learners aged 8-12 years. Structured questionnaires, anthropometric measurements, and biochemical assessments were used to collect the data. Variables comprised the frequency of meals, breakfast, dietary habits, morbidity, family size, a range of macronutrients and micronutrients supports memory, attention, classroom participation, and school readiness, and school performance. The laboratory tests were CBC, serum glucose, total protein, and triglycerides. SPSS version was used for data analysis, and employing descriptive statistics. Results: Overall, 60.4% of students demonstrated high academic performance. The majority of the participants had healthy diets (75.7%), breakfast every day (89.1%), and consumed 4-5 meals per day (80.7%). The consumption "was predominantly carbohydrate-based"(79.2%) with relatively low protein consumption (18.3%). Most of them did not have any recent infections (80.2%) and had an excellent health status (64.4%). The biochemical results were 80% normal such as glucose (92.0%) and triglycerides (88.0%). Frequent breakfast and meals were positively associated linked to improved academic achievement. Conclusion: Decreasing academic performance by food habits, especially by eating breakfast seems to be more effective than socioeconomic status.
nutrition, academic performance, primary school children, socioeconomic status, Yemen.
Clinical Correlation between Hyperandrogenism, Serum TSH Levels, and Hirsutism in Women: A Comparative Cross-Sectional Case-Control Study in Basrah, Iraq
Background: Hirsutism is a common clinical sign of endocrine dysfunction in females. Objective: This study aimed to investigate the association between serum Thyroid-Stimulating Hormone (TSH), Testosterone, DHEA-S levels and degree of hirsutism among Basrah women, Iraq. Methods: The study included a total of 150 subjects (100 females with clinically confirmed hirsutism and 50 healthy controls). The severity of hirsutism was assessed by the Modified Ferriman-Gallwey (mFG) score. Serum TSH, Testosterone and DHEA-S were determined by using Electro-chemiluminescence immunoassay (ECLIA) technology. Endocrine tumors, congenital adrenal hyperplasia, Cushing’s syndrome and hormonal medications were exclusion criteria. Results: The hirsutism group had a significantly higher mFG score (17.5 ± 1.8 vs. 5.5 ± 1.5; P < 0·001), indicating that as follicular density increases, hirsutism scores rise accordingly. Patients with hirsutism had significantly higher levels of testosterone (P < 0.001) and DHEA-S (P = 0.002), as measured via hormonal analysis. Using correlation analysis, mFG scores were strongly positively associated with testosterone (r = 0.68; P < 0.001) and moderately positively correlated with DHEA-S (r = 0.48; P < 0.001). In particular, TSH had a weak inverse non-significant correlation with the severity of hirsutism (r = -0.14, P = 0.082). Conclusion: Hirsutism in this population is driven by androgen excess rather than thyroid dysfunction. Assessment of the androgenic axis should be prioritized in diagnostic strategy: TSH assessment is an ancillary evaluation that should not be regarded as a first-line diagnostic for hirsutism.
Hirsutism, TSH, DHEA, mFG score, Primary hyperandrogenism, correlation analysis.
Risk Factors, Presentation, Diagnosis and Management of Guillain Barré Syndrome in Sana'a City, Yemen: A Ten Years Retrospective Study
Background: Guillain-Barré Syndrome (GBS) is a rare neurological disorder that affects the peripheral nervous system and presents with an ascending flaccid paralysis. With undetermined etiology, it seems that GBS had an immune process following either a respiratory or gastrointestinal infection. Objective: This study aimed to determine the total number, clinical features, and associated risk factors of Guillain-Barré syndrome among patients at the University of Science and Technology Hospital. Methods: A retrospective medical record-based study was conducted at the University of Science and Technology Hospital for ten years (2014-2023) in Sana’a city. Data were collected using a predesigned data sheet containing sociodemographic, risk factors, clinical presentation, diagnostic, and therapeutic tools. Data was analyzed by SPSS v. 24.0. Results: Two hundred fifty-six files recorded as Guillain-Barré Syndrome were analyzed; the mean age was 38.65 ± 19.8 years. Age ranged between 2 and 85 years. There was a male predominance (69.9%), with the most prevalent presentation being bilateral ascending paralysis (47.7%). The majority of patients received physiotherapy alone (43.0%), while IVIG was used in 40.6% of cases. Conclusion: GBS is a peripheral neuropathy disease with the common presentation of ascending flaccid paralysis, but uncommon presentations are not rare, which recommends a high clinical suspicion, especially for the wide range of ages and the occurrence in an area of poliomyelitis infection spread.
Guillain-Barré Syndrome, Paralysis, Areflexia, University of Science and Technology Hospital.
Medical Ethics in Dentistry Practice: A Knowledge, Attitudes, and Practices Analysis of Dentists in Sudan
Background: Adherence to ethical principles is fundamental to dental practice, as it ensures patient trust, professional integrity, and quality of care. Despite this importance, evidence from various countries indicates substantial gaps in dentists’ knowledge, attitudes, and practices. In the context of rapidly advancing dental technologies and increasing patient awareness, dentists are frequently confronted with complex ethical dilemmas that require sound ethical judgment and professionalism. Objectives: The study aim to the assess the knowledge, attitude and practice of dental health professionals regarding health care ethics in Khartoum teaching hospital Methods: Across sectional study on 350 dentists working in Khartoum teaching hospital used self-administrated questionnaire, including both open and close questions on about knowledge, attitude and practice. The returned questionaries were analyzed using SPSS version 26. Chi square test was used to compare between data. Results: Around one third of participant dentist never attended an ethical course during graduation period and three quarter from the total population did not attend any course of ethics after graduation, moreover 40% of them know the Sudan medical oath content. Although 63% of the study group mention that they instruct their assistances about patient confidentiality but they act in opposite way regarded disclosure of patient clinical history. Conclusion: Adequate and sufficient pre and post-graduation ethical courses with updating teaching methodology and an appropriate, continuous training and assessment program is recommended in order to enhance dentist knowledge, attitude and practice in regard to ethical issues.
Medical ethics, dentistry, knowledge, attitudes, practices.
Comparative Maternal Outcomes of Expectant Management versus Immediate Induction in Primigravida Women with Term Prelabor Rupture of Membranes: A Hospital-Based Comparative Study
Background: Term prelabor rupture of membranes (PROM) is a common complications in pregnancy. Objective: The study aims to compare maternal outcomes and complications between conservative management and immediate induction of labor for primigravidas with term PROM. Methods: A prospective comparative study conducted at the Department of Obstetrics and Gynecology, Omdurman Military Hospital in Khartoum State. A total of 222 primigravida with singleton term pregnancies, with confirmed prelabor rupture of membranes (PROM). Among these, 111 women received expectant management, while 111 women received immediate labor induction. Data were collected via structured questionnaire, and analyzed using SPSS. Results: Immediate induction resulted in vaginal delivery in 49.5% of women, cesarean section in 40.6%, and instrumental delivery in 9.9%. In contrast, expectant management showed higher vaginal delivery rates (60.4%), with cesarean and instrumental deliveries at 36.0% and 3.6%, respectively; this difference was statistically significant (p = 0.031). Maternal complications were more frequent with induction, including postpartum hemorrhage (18.9% vs. 3.6%), infections (7.2% vs. 1.8%), and puerperal fever (4.5% vs. 0.9%). Overall, complication rates were significantly higher in the induction group (p < 0.001). Conclusion: A primigravida with term prelabor rupture of membranes, expectant management is more safe and beneficial to the mother. This has been associated with higher rates of vaginal deliveries and fewer rates of caesarian sections, postpartum hemorrhage, infections, and puerperal fever, provided there are no contraindications.
Prelabor rupture of membranes, PROM, Expectant management, Induction of labor, Primigravida, Maternal outcomes.
Impact of Posterior Mucosal Flap Management on Surgical Outcomes in Endoscopic Dacryocystorhinostomy: A Prospective Analysis
Background: Endoscopic dacryocystorhinostomy is a highly effective procedure, increasingly becoming a standard for relieving epiphora and infections, with techniques evolving to improve success rates. Objective: This study evaluated the effectiveness of endoscopic dacryocystorhinostomy (DCR) for the management of acquired nasolacrimal duct obstruction, comparing procedures that preserved posterior mucosal flaps with those that did not. Methods: Prospectively, we examined the outcomes of 50 surgical procedures performed on 46 patients presenting with epiphora due to nasolacrimal duct obstruction at the Al-Nhada Special Surgical Center. The patients were assigned to one of two groups: group A received endonasal DCR with preservation of the posterior mucosal flap, and group B underwent the procedure with its removal. Results: Among 50 procedures, Group A comprised 29 (58%) and Group B 21 (42%), including four bilateral cases. Overall subjective improvement was reported in 93.1% of patients. In group A, 94.1% showed patent rhinostomy on endoscopic follow-up at one month, with one obstruction; group B had two obstructions. Granulation tissue and synechia occurred in two patients in group A (one obstruction) and six in group B (two obstructions). No intraoperative complications were observed. Conclusion: : Endoscopic techniques are a safe and effective treatment for nasolacrimal duct (NLD) obstruction. Our findings indicate no significant difference in surgical outcomes between endoscopic endonasal DCR performed with preservation of the mucosal flaps and without. Furthermore, the size of the created intranasal ostium did not correlate with its functional success.
Endoscopic Dacryocystorhinostomy; Mucosal Flap; Nasolacrimal Duct Obstruction; Surgical Outcomes; Ostium.
Khaled Abdul Hameed Abdul Aziz Mohi Addeen
Assessment of the Endodontic Practices among General Dental Practitioners in Aden, Yemen
Background: Maintaining the standard quality ensures the success of endodontic therapy. Objective: The purpose of this study was to evaluate the endodontic practices currently used by general dental practitioners (GDPs) in Aden, Yemen, focusing on their awareness, attitudes, and clinical procedures. Methods: Google Forms was used to create an anonymous English-language electronic questionnaire. There were thirty multiple-choice questions on the survey. Results: A total of 385 GDPs were surveyed, achieving a response rate of 67.54% (n=260). The results indicated a predominance of female practitioners (59.2%), with a majority having 2-5 years of experience (61.5%). Most respondents (85.4%) performed root canal treatment (RCT) on all teeth, with 59.2% utilizing both single- and multiple-visit approaches. Only 13.8% of the respondents employed rubber dam isolation, highlighting a significant gap in adherence to recommended practices. The study found that 72.3% of practitioners determined working length using both radiographs and apex locators, and 64.6% utilized a combination of manual and rotary instrumentation for cleaning and shaping the canal. Approximately 60% of respondents reported not following up on their endodontic cases. Statistical analysis revealed significant associations between years of experience and various endodontic practices, including methods for testing pulp vitality, irrigation solutions, and obturation techniques used. Conclusion: This study concluded that many of the GDPs adhered to the quality standard principles and had a positive attitude toward endodontic procedures. These findings point out the need for enhanced education and training to improve the quality of endodontic care provided by GDPs in Aden.
Attitude; Endodontic; Knowledge; Procedures; Questionnaire; Techniques.
The Prevalence of Self-Medication Knowledge, Attitudes, and Practices among Engineering and Computing Students at University of Sciences and Technology in Aden
Background: Self-medication is a public health concern, especially among university students facing academic pressure. This practice carries risks, including misdiagnosis and antibiotic resistance. Objective: To determine the prevalence and associated knowledge, attitudes, and practices (KAP) of self-medication among engineering students at the University of Sciences and Technology-Aden, Yemen. Methods: A cross-sectional study was conducted among 277 engineering students, categorized by academic year and department. Results: This study of 277 engineering students found that self-medication is a highly common practice, with 39.7% of students using it more than twice in the last month. The primary reason was "no time to visit doctors" (46.9%). Students most often self-medicated for headaches (34.7%) and fever (17.0%), sourcing medicines primarily from pharmacies (64.3%). A significant knowledge gap was evident, as 33.6% did not know how to define self-medication. Despite 71.8% recognizing that self-medication can be harmful, its practice remains widespread. Crucially, students showed a strong desire for education, with 81.9% believing workshops would be beneficial and 88.8% willing to attend, preferring to get information via social media and from health professionals. Conclusion: Self-medication is highly prevalent among students despite limited knowledge and mixed attitudes. It is mainly driven by time constraints and easy access to pharmacies. The strong interest in educational workshops highlights the need for targeted interventions to reduce associated health risks.
Self-medication, Pharmacies, Health Education, Cross-Sectional Study, knowledge, attitudes, and practices (KAP).
The Dual Role of the Classical Complement Pathway: From Immunoprotection and Immunopathology to Clinical Applications Applications: A Narrative Review
Background: The classical complement pathway is a key component of the innate immune system, playing a critical role in host defense against pathogens and malignant cells. However, its dysregulation can lead to significant immunopathological conditions. Objectives: This narrative review aims to explore the dual role of the classical complement pathway in both immunoprotection and hypersensitivity reactions, as well as its clinical applications. Methods: This review was conducted through a comprehensive analysis of previously published literature retrieved from major scientific databases, including PubMed, Scopus, and Google Scholar. Relevant studies were selected based on their scientific quality, relevance to the topic, and recency. Results: The findings demonstrate that activation of the classical pathway contributes to immune defense through mechanisms such as complement-dependent cytotoxicity, opsonization, and inflammation. Conversely, excessive or uncontrolled activation is implicated in various hypersensitivity reactions, including hemolytic anemia, Arthus reaction, serum sickness, and autoimmune diseases such as rheumatoid arthritis. Furthermore, the complement system has important clinical applications in immunodiagnostic techniques, such as complement fixation tests, and in immunotherapy, particularly through monoclonal antibody-mediated cancer treatment. Conclusion: the classical complement pathway exhibits a dual role in maintaining immune balance, acting as both a protective mechanism and a contributor to disease pathology. Understanding this balance is essential for the development of targeted diagnostic and therapeutic strategies.
Classical complement pathway, autoimmunity, hypersensitivity, monoclonal antibody therapy, complement-dependent cytotoxicity.
Assessment of Dental Students' Awareness and Knowledge of Oral Biopsy Procedures: A Cross-Sectional Study
Background: Dental students' awareness about oral biopsies is found to be low. Oral biopsies are a significant tool for diagnosis. Objective: This cross-sectional study aims to assess the knowledge of dental students in Yemen. Methods: An e-questionnaire was sent to 187 dental students and professionals from six universities in Yemen. The universities included UST Aden, Aden University, etc. The data were analyzed with SPSS v.26 software. The knowledge of the dental students was assessed based on six domains. Results: The mean overall knowledge was found to be 55.1% ± 21.2%. Significant gaps in knowledge were observed in choosing optimal biopsy size (39.0%), biopsy techniques (42.2%), and the role of the oral pathologist (45.5%). On the other hand, students showed high levels of knowledge in the complications that may occur during a biopsy procedure (71.9%). Only 13.4% of the participants showed high levels of competence in the overall knowledge test by scoring ≥80%. Interestingly, clinical experience ≥6 years was not found to be a contributing factor for high levels of knowledge compared to less experienced students (52.2% vs. 55.6%, p = 0.405). Conclusion: This study showed that although students have a high level of knowledge about the indications for a biopsy procedure and the complications that may occur during the procedure, there are significant gaps in knowledge about the technical and interdisciplinary aspects of a biopsy procedure. Moreover, the fact that clinical experience does not improve levels of knowledge shows that the current curriculum does not suffice for high levels of expertise.
Oral biopsy, dental education, clinical skills, pathology awareness, Yemen
Isolation and Identification of Bacterial Contamination on Mobile Phones among Medical Staff in Private Hospitals in Ibb Governorate, Yemen: A Cross-Sectional Study
Background: Frequent use of mobile phones by healthcare workers can serve as reservoirs for pathogenic and drug-resistant microorganisms, increasing the risk of healthcare-associated infections due to inadequate disinfection. Objective: The aim of this study is to separate and identify bacterial contaminants from mobile phones used by medical staff at private hospitals in Yemen's Ibb governorate, as well as to ascertain the antibiotic susceptibility patterns of those contaminants. Methods: In January and March of 2025, a cross-sectional investigation was carried out. A total of 166 mobile phones belonging to doctors, nurses, and lab technicians were used to collect 281 swab samples (phones and covers). MacConkey agar, Eosin Methylene Blue agar (EMB), chocolate agar, and blood agar were used to cultivate the samples. Gram staining and common biochemical assays were used to identify the bacteria. The Kirby–Bauer disk diffusion method was used to test for antimicrobial susceptibility in accordance with CLSI 2024 standards. Chi-square testing and logistic regression were used in the statistical analysis. Results: There were 436 bacterial isolates found. The most frequent isolate was Staphylococcus aureus (34.4%), followed by Vancomycin-resistant Staphylococcus aureus (VRSA) (12.4%), S. epidermidis (10.1%), and Klebsiella pneumoniae (8.7%). VRSA contamination was substantially correlated with phone cover use (P= 0.002). A number of isolates exhibited resistance to widely used antibiotics, especially piperacillin/tazobactam and cefepime. Conclusion: Healthcare workers in the Ibb governorate use mobile phones that are heavily polluted with potentially dangerous and drug-resistant microorganisms. To lower the danger of device-mediated illness transmission, regular cleaning and stringent hygiene practices are crucial.
Mobile phones, bacterial contamination, antibiotic resistance, nosocomial infections, medical staff.
Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) among Medical Students at the University of Science and Technology in Taiz City, Yemen
Background: Antimicrobial resistance is a significant public health threat, particularly in developing countries due to lack of healthcare controls and misuse of antibiotics. Methicillin resistant Staphylococcus aureus (MRSA) is a classic example of this problem. MRSA infections can be hospital-acquired (HA-MRSA) or community-acquired (CA-MRSA). Objective: This study aimed to determine the prevalence of MRSA carriage among medical students at the University of Science and Technology, Taiz branch. Methods: A cross-sectional study was performed on 197 medical students to determine Staphylococcus aureus (S. aureus) nasal carriage. Nasal swab specimens were collected to screen for the prevalence of S. aureus and its antimicrobial susceptibility. Results: Of the 197 students screened, the overall prevalence of S. aureus carriage was 22.8% (n=45). MRSA prevalence was identified in 3.6% (n=7/197) of students, representing 15.55% (n=7/45) of all results are isolates, while the remaining 84.4% (n=38/45) were methicillin-susceptible S. aureus (MSSA). Conclusion: The results of this study reveal a relative prevalence rate of MRSA carriage among medical students, which represent a potential reservoir for MRSA carriage. This presents a serious public health concern, requiring an immediate response by health authorities to establish preventive measure strategies to mitigate such source of MRSA risk in the community and prevent the potential for further transmission.
MRSA, Staphylococcus aureus, Prevalence, Nasal carriage, Antimicrobial resistance, Yemen.
Knowledge, Attitudes, and Perceptions of Artificial Intelligence among Yemeni Dental Students and Interns: A Multi-Institutional Cross-Sectional Study
Background: Artificial intelligence (AI) is rapidly entering dental education and practice, yet preparedness in low-resource settings is unclear. Objective: This study aims to assess the existing knowledge, attitude, and perception levels of incorporation of AI into dental education and practice among Yemeni students. Methods: We conducted a descriptive cross-sectional survey (January–March 2023) among clinical-year dental students and interns at three Yemeni institutions (Sana’a University, University of Aden, and University of Science and Technology). A validated questionnaire assessed demographics, AI knowledge (scored items), perceptions/attitudes (Likert scales), and training needs. Descriptive statistics, χ² tests, and planned multivariable models were used; significance was set at p < 0.05. Results: Of the 761 participants (mean age 24.8±4.2 years), most lived in cities and were either fifth-year students or interns. A substantial correlation (p < 0.05) was found between the participants' feelings towards artificial intelligence (AI), their degree of university education, and their interaction with online social networks. Levels of AI expertise varied among regions. Scores were significantly higher for participants residing in Sana'a and outside of Yemen compared to those from other locations (p=0.012). None of the other demographic variables significantly altered these outcomes. Conclusion: As a whole, dentistry students in Yemen have positive impressions of AI. However, their levels of comprehension varied greatly between regions, indicating that not everyone had the same exposure to and access to instructional resources about AI.
Artificial intelligence; dental education; students; perceptions; knowledge; Yemen; curriculum
Prevalence and Characteristics of Malocclusion among Dental Students at the University of Sciences and Technology in Yemen: A Cross Sectional Study
Background: Malocclusion, the misalignment of teeth and improper relation between dental arches, is a prevalent ailment that can result in a number of oral health problems. Few studies have looked at malocclusion patterns among dentistry students, who may have particular oral health traits, whereas most research focuses on general populations. Objective: The aim of this study was to assess the prevalence and characteristics of malocclusion, such as symmetry, face profile, angle classification, and arch crowding, in a sample population. Methods: A cross-sectional study was performed on 220 subjects, classified according to age, gender, and the severity of malocclusion. The results were analyzed by SPSS: descriptive statistics and chi-square tests. A p-value of less than 0.05 was considered significant. Results: The prevalence of malocclusion was found to be highest in Class I (65.5%), followed by Class II (10.5%) and Class III (8.6%). The most frequent dental anomaly was crowding (38.6%), and significant associations were observed between malocclusion types and arch crowding (p=0.002). The gender and age distribution did not show any significant difference (p > 0.05). Conclusion: Class I malocclusion and crowding were found to be the most predominant among participants, thus underlining the importance of early orthodontic treatment. The findings of this study may serve as a reference for developing policies within dental academic institutions and provide a foundation for future research in orthodontic epidemiology.
Malocclusion, Angle classification, Crowding, Orthodontics, Prevalence.
The Conflict Hematology Phenotype: A Descriptive Cross-Sectional Analysis of Hematological Profiles in Yemeni Adults from a War-Torn Region
Background: There is limited data on normal blood profiles in conflict-affected regions of Yemen. These settings often lack appropriate international reference ranges. Objective: This study characterizes complete blood count and coagulation parameters in healthy adults of Al-Dhale' Governorate, Yemen, providing the idea of a Conflict Hematology Phenotype. Methods: Complete blood counts were conducted on blood samples using a Sysmex XP-3000 tm for 258 healthy Yemeni adults, whereas coagulation tests (PT, APTT, bleeding time) were done through standardized manual tests only. We provide the descriptive statistics focusing on sex-based differences. With this difficult environment in place. Results: Both genders had rather low MCV (about 84 fL) and high platelet counts (>290 x 109/L). Sex differences were expected: the men had better hemoglobin (14.58 +- 0.89 vs. 12.75 +- 0.68 g/dl, p < 0.001) whereas women had longer APTT (39 +- 7 vs. 37 +- 10 sec, p = 0.03). When compared to WHO standards, it is possible to insinuate that about 17% in diagnostic misclassification would be minimized by the use of local reference values. Conclusion: This paper offers a description of what we call the “Conflict Hematology Phenotype in Yemeni adults, which is microcytosis and thrombocytosis. These findings may not be conclusive reference points because of the difficulties of conducting war-related research, but they provide useful principle to clinicians working in comparable humanitarian contexts and also indicate the necessity of conducting additional research on the impact of conflict on human physiology.
Health consequences of conflicts, complete blood count, nutritional deficiency, chronic inflammation, Yemeni adults.
Association between Mandibular Third Molar Impaction Patterns and Pathologies of the Adjacent Second Molar among a Sample of Yemeni Adults: A Radiographic Cross-Sectional Study
Background: Impacted mandibular third molars are prevalent and can result in a number of pathologic conditions of adjoining mandibular second molars, such as distal caries, periodontal bone loss, and root resorption. It is important to know the pattern of impaction and risks involved in its early diagnosis and prophylaxis. Objective: The aim of the study was to evaluate the connection between the impaction of the mandibular third molars and the pathological alteration of second molars in the Yemeni adults. Methods: The study was a cross-sectional radiographic study of 250 panoramic radiographs from private dental clinics and image centers in Taiz, Ibb, and Sana in Yemen. Angulation (Winter classification), depth (Pell and Gregory), and related pathologies of the second molars of the impacted mandibular third molars were examined in 320 cases. Analysis of data was done through descriptive statistics and Chi-square tests. Results: Of the 761 participants (mean age 24.8±4.2 years), most lived in cities and were either fifth-year students or interns. A substantial correlation (p < 0.05) was found between the participants' feelings towards artificial intelligence (AI), their degree of university education, and their interaction with online social networks. Levels of AI expertise varied among regions. Scores were significantly higher for participants residing in Sana'a and outside of Yemen compared to those from other locations (p=0.012). None of the other demographic variables significantly altered these outcomes. Conclusion: Mesioangular and deeper impactions are strongly correlated with increased risk of second molar caries, alveolar bone loss, and root resorption. These complications can be minimized through early radiographic assessment and early intervention.
impacted third molar, second molar pathology, mesioangular impaction, distal caries, panoramic radiograph, Yemen.
Awareness and Knowledge of Salivary Gland Disorders among Dentists: A Cross-Sectional Study
Background: As a primary healthcare provider, the dentist is essential for the early identification and management of salivary gland problems. However, due to the disease's complexity and the salivary gland tumor's rarity, the dentist may have challenges with detecting the disease. Objective: To evaluate Yemeni dentists' knowledge of salivary gland diseases (SGDs) in six domains: risk factors, symptoms, diagnosis, treatment, postoperative care, and common situations. Methods: A multicenter cross-sectional study was undertaken among 162 dentists from eight Yemeni universities between January and April 2024. Participants completed a validated electronic questionnaire assessing their salivary gland dysfunction (SGD) knowledge. Correct and wrong replies were examined using descriptive statistics. Furthermore, SPSS was used to analyze data. Results: There were significant knowledge gaps found. Only 32.1% identified SGD risk factors, 12.3% knew diagnostic techniques, and 45.1% appropriately described mumps. Treatment knowledge was stronger (53.9-64.8% accurate). Early-career dentists (<5 years’ experience) demonstrated lower results. Conclusion: The current study showed that there is a knowledge gap in diagnosing SGD. However, dentists showed a good understanding of the treatment and post-treatment aspects, which highlights a need for education, particularly for early-career dentists.
Salivary gland disorders, dental education, knowledge assessment, Yemen, cross-sectional study.
Systemic Inflammatory and Genotoxic Effects of Shisha Smoking:A Case Control Study in Yenagoa, Bayelsa State, Nigeria
Background: Shisha smoking is linked to oxidative stress and vascular inflammation, which are vital factors in the pathophysiology and advancement of respiratory and cardiovascular disorders, as well as cancer. Objective: This study evaluated and compared systemic inflammatory biomarkers and DNA damage markers between shisha, cigarette, dual, and second-hand shisha smokers and non-smokers. Methods: A case-control study approach was employed involving 150 individuals aged between 16 and 35 years. Participants were divided into five categories: shisha smokers (n=30), cigarette smokers (n=30), dual (both) smokers (n=30), secondhand shisha smokers (n=30), and nonsmokers (n=30). Venous blood samples were obtained and assessed for systemic inflammatory and DNA damage biomarkers using enzyme-linked immunosorbent assay. Data analysis was done with the Statistical Package for Social Sciences (SPSS), with the significance level set at p < 0.05. Results: Compared with the non-smokers, the serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), 8-nitroguanine (8-NO₂-Gua), and malondialdehyde were higher (p<0.05) in shisha smokers, cigarette smokers, and both smokers and secondhand smokers. Serum IL-6, CRP, 8NO₂-Gua, 4-HNE, and MDA levels were slightly higher in shisha smokers than cigarette smokers. Both smokers exhibited significantly higher (p < 0.05) levels of IL-6, CRP, 8NO₂-Gua, and MDA than exclusive shisha or cigarette smokers. Conclusion: The study found that shisha and cigarette smokers had higher levels of indicators of systemic inflammation, oxidative stress, and DNA damage. It also confirmed that smoking cigarettes and shisha concurrently is more harmful than smoking either shisha or cigarettes alone.
DNA damage Marker, Systemic inflammation, shisha smoking
Phytochemical Screening, Antibacterial, Antioxidant, and In Vitro Anti-lithiatic Effects of Ocimum basilicum Leaves Extracts
Background: Ocimum basilicum L., commonly referred to as "Reyhan”. It has various pharmacological effects, such as anti-hypertensive, antioxidant, and anti-inflammatory activities. Objective: In the present study, various phytochemical constituents, antioxidant potential, antibacterial activity, and in vitro anti-urolithiasis properties of Ocimum basilicum leaves were investigated. Methods: Powdered basil leaves were extracted using water, ethanol, methanol, and chloroform by the maceration method. The well-diffusion assay was employed for testing antibacterial activity. Antioxidant capacity was assessed qualitatively by the TLC autography method using two mobile phases and quantitatively by the DPPH radical-scavenging assay using ascorbic acid as a standard. The turbidity method was utilized to assess the anti-urolithiasis efficacy of cystone in vitro. Results: Phytochemical analysis indicated the existence of flavonoids, tannins, alkaloids, amino acids, lipids, fixed oils, and carbohydrates; however, anthraquinones were absent. All extracts demonstrated antibacterial action against Gram-positive and Gram-negative bacteria. An aqueous extract showed the widest diameter of inhibition zones, with S. aureus being 18.71 mm, P. aeruginosa 21.65 mm, and E. coli 20.65 mm. However, it showed very negligible action against K. pneumoniae. The qualitative antioxidant test indicated that all the extracts possessed antioxidant properties. Among these, the methanolic extract possessed the maximum quantitative antioxidant activity; vitamin C was used as a positive control. The in vitro anti-urolithiasis assay showed that the chloroform extract exhibited 61.86% inhibition of crystal formation. Conclusion: Leaves of Ocimum basilicum exhibited marked antioxidant and antibacterial potentials. The plant also exhibited significant anti-urolithiasis property, which justifies its traditional use in herbal medicine.
Treating Bruxism-Related Muscle Spasm and Malocclusion: An Intervention Study Using Local Anesthetic without Vasoconstrictor
Background: Hyperactivity of the masticatory muscles and acute malocclusion in bruxism are problematic conditions that are usually misdiagnosed as occlusal disorders. The therapeutic efficacy of local anesthetic infiltration without a vasoconstrictor in local anesthesia cases is still dubious. Objective: To assess the clinical impact of 2% lidocaine infiltration without vasoconstrictor in bruxism-related masticatory muscle hyperactivity and acute malocclusion, and to determine the impact of dental restorations on the response of treatment. Methods: The clinical interventional study was carried out in a sample of 20 patients (29-40 years), in the form of two groups: Group A (with restorations) and Group B (without restorations), this time. Everyone was infiltrated at the deepest point of the most tender point of the masseter muscle with 2% lidocaine without vasoconstrictor. The measures were assessed using pain (VAS), muscle tenderness, and occlusal stability at baseline, 30 minutes, 24 hours, and 2-3 months. The chi-square and Fisher's exact tests were used to analyze the data. Results: In Group B (100%), all patients improved completely and sustained, and none in Group A responded. The difference between them was very high (χ² = 16.20, p < 0.001; Cramer’s V = 0.90). Conclusion: Local infiltration of plain lidocaine is an effective method to decrease the hyperactivity of muscles and restore the occlusal balance in acute malocclusion due to bruxism in the absence of occlusal interferences. This is an easy, inexpensive technique that can be of much use as an addition to the treatment of muscle-origin occlusal disturbances.
Bruxism, Myofacial pain dysfunction syndrome, Acute malocclusion, Lidocaine without vasoconstrictor, Occlusal interference.
Prevalence of Depression, Anxiety, and Stress among Medical Science Students at Aljanad University for Science and Technology, Taiz, Yemen: A Cross-Sectional Study
Background: Psychological distress is a major challenge among university students, particularly those in medical sciences, due to high academic and emotional demands. Depression, anxiety, and stress are increasingly recognized as serious concerns affecting students’ well-being and academic performance. Objective: This study aimed to assess the prevalence and severity of depression, anxiety, and stress among medical science students at Aljanad University for Science and Technology in Taiz, Yemen. Methods: A cross-sectional study was conducted among 300 students from the departments of nursing, pharmacy, medical laboratories, nutrition, and dentistry. Data were collected using the Depression, Anxiety, and Stress Scale (DASS-21) and a structured questionnaire covering socio-demographic, academic, and psychosocial variables. Results: The findings revealed a very high prevalence of psychological distress. All participants reported symptoms of depression and anxiety, while 98.7% experienced stress. Extremely severe anxiety was the most common condition (84.6%), followed by extremely severe depression (40%) and stress (37.6%). Higher levels of distress were significantly associated with younger age, early academic years, insomnia, lack of emotional family support, and difficulties in communication with faculty members. Dental and pharmacy students showed the highest severity levels of anxiety and depression, respectively. Conclusion: Depression, anxiety, and stress are highly prevalent among medical science students at Aljanad University for Science and Technology, emphasizing the urgent need for targeted mental health interventions and supportive academic environments.
White Blood Cells Parameters among Malnourished Children Under-Five Years, Aden-Yemen
Background: Malnutrition is still a critical public health problem among children under five, with implications for immune function and hematological parameters. Objective: This study aimed to identify abnormal WBC parameters among malnourished children under five in Aden, Yemen, and to determine the socio-demographic characteristics and other risk factors associated with abnormal WBC parameters among those children. Methods: A cross-sectional study was conducted on 101 malnourished children under 5 years. The blood specimens were collected from all children, and an automated hematological analyzer was used to measure the WBC parameters. The SPSS software was used to analyze the data. Results: Among 101 malnourished children, the majority were 52% females, and according to WBC parameters, leukocytosis, neutropenia, and lymphocytosis were observed at rates of 34.7%, 69.3%, and 82.2%, respectively. Elevated WBC counts were significantly associated with age group (p = 0.005), and high lymphocyte counts were linked to residence (p = 0.017), while no significant associations were found between WBC abnormalities and acute malnutrition or between low WBCs and socio-demographic characteristics and other risk factors. Conclusion: acute malnutrition remains a significant health challenge among children under five years of age, with notable sex disparities, as females were more affected. The leukocytosis, neutropenia, and lymphocytosis were noted among malnourished children. The associations were significant between leukocytosis and age groups and between lymphocytosis and residence of children. In contrast, lacking the significant differences between abnormal WBCs parameters and acute malnutrition, and between low WBCs parameters and socio-demographic characteristics and other risk factors.
Yemen, hematological parameters, malnutrition, children under five years old.
Burnout, Safety, and Job Satisfaction among Surgeons in Conflict-Affected Taiz, Yemen
Background: Surgeons work under substantial occupational stress. In conflict settings, this burden is amplified by resource shortages, long working hours, financial strain, and threats to personal safety. Data on burnout in such environments, particularly in Yemen, are scarce. Objective: To assess the prevalence of burnout and its association with workplace safety and job satisfaction among surgeons in Taiz, Yemen, during ongoing conflict. Methods: A descriptive cross-sectional study was conducted from 1 to 28 May 2025 among surgeons in public, private, and NGO hospitals in Taiz. A 35-item questionnaire included demographics, the MBI-HSS, and measures of job satisfaction and perceived safety. Burnout was evaluated using standard subscale scores. Statistical analyses were performed using SPSS. Results: Eighty surgeons participated, 55% male and 53.8% aged 31 to 40 years. Most were government hospital trainees, and 43.8% had less than five years of experience. High emotional exhaustion (EE) was present in 67.5%, high depersonalization (DP) in 15%, and low personal accomplishment (PA) in 36.3%. Overall, 70% met burnout criteria in at least one domain. PA correlated positively with job satisfaction and perceived safety, and safety correlated with job satisfaction, all p < 0.001. EE was higher among females, p = 0.032. PA increased with age, p = 0.034. No significant differences were observed by specialty, hospital type, marital status, or rank. Conclusion: Burnout is highly prevalent among surgeons in Taiz and is closely linked to safety concerns and job satisfaction. Interventions addressing workplace safety and professional fulfillment are urgently needed in conflict-affected surgical settings.
Burnout, workplace safety, job satisfaction, surgeons, conflict zone, Yemen/Taiz, healthcare workers.
Pharmaceutical Quality Evaluation of Commercial Baclofen Tablets in the Yemeni Market: An In Vitro Study
Background: For good health and improved trust in the pharmaceutical products, quality control tests must be conducted continuously for both local and imported products to ensure safety and effectiveness. Objective: To evaluate the in vitro characterization of different imported and local pharmaceutical products of the muscle relaxant (baclofen 10 mg) available in Taiz City. Methods: According to the USP standards, different quality control tests were conducted to physicochemically characterize various baclofen 10 mg tablets (one local and two imported brands) available in the Yemeni market. Results: The results of the three brands of baclofen 10 mg tablets showed that product (C) disintegrated more slowly (6.39 minutes) than products (B) and (A) (0.35 and 3.00 minutes, respectively). Every brand has a satisfactory level of friability below 1% loss. The maximum assay content (98.39%) and drug release (105%) were displayed by local product (A). Although product (B) test content was lower (88.98%), its drug release was still satisfactory (96%). By contrast with product (B) (5.35 kg) and product (A) (5.38 kg), C product's hardness (2.26 kg) was below USP standards (4-6 kg), and its drug release was 85%; however, the assay content was significantly satisfactory (96.98%). Conclusion: The outcomes of this study show a high dissolution rate and quick disintegration time, with assay content falling inside the acceptable range. While the imported products decomposed slowly, within the drug content limit, and had a lower hardness value than USP criteria, the local product had the best results in different characterizations. All results confirm the necessity of continuous monitoring for pharmaceutical products.
Baclofen, Quality Control, Pharmacopeial Standards, Yemen, Generic Drugs
Knowledge, Attitude, and Practice of Self-Medication among Medical Students at UST, Aden, Yemen
Background: Self-medication is known as using drugs to treat self-diagnosed diseases without consulting a physician. Self-medication is a widespread practice worldwide. Objective: This study investigates the knowledge, attitudes, and practices related to self-medication among medical students at the University of Science and Technology (UST), Aden, Yemen. Methods: This study is a descriptive cross-sectional study with a sample of 265 among medical students at UST. Results: The results revealed that 86.04% of participants practiced self-medication, primarily using analgesics (61.1%), and 85.29% of participants identified self-medication as using medication without a doctor's consultation, 10.56% said it is associated with incorrect dosing or herbal remedies, and 40.0% believed self-medication should be encouraged among medical students. Conclusion: The findings indicate prevalent misconceptions about the risks associated with self-medication, emphasizing the need for enhanced educational programs to promote responsible healthcare practices.
Determinants of the Cholera Outbreak in Taiz City, Yemen: A Cross-Sectional Study
Background: Cholera continues to pose a serious public health challenge in Yemen, with Taiz City among the most heavily affected areas. Prolonged armed conflict, deteriorated infrastructure, and limited access to safe water and sanitation have exacerbated the spread of the disease. Objective: This study aimed to assess the key factors contributed to the cholera outbreak in Taiz City, Yemen, to support effective prevention and control strategies. Methods: A cross-sectional exploratory study was conducted between November 24, 2024, and January 24, 2025, at Aljumhuri General Teaching Hospital and the 22 May Center in Taiz. A purposive sample of 100 laboratory-confirmed cholera patients was included. Results: Most participants were female (59%), over 40 years of age (27%), and residents of urban areas (81%). Half of the patients reported insufficient monthly income, and one-third were illiterate. Major risk factors included the absence of water purification practices (78%), poor sewage systems (70%), shortage of safe drinking water (65%), and residence in conflict-affected areas (91%). Significant associations were identified between cholera infection and visiting endemic areas (p = 0.007), consumption of food prepared outside the home (p = 0.049), poor nutritional status related to low income (p < 0.001), and lack of health facilities in rural settings (p < 0.001). Participation in awareness programs was significantly associated with improved knowledge of transmission routes (p = 0.027). Conclusion: Cholera transmission in Taiz is driven by a complex interaction of inadequate water and sanitation infrastructure, poverty, low health awareness, and conflict-related disruption of public services.
Cholera, Taiz City, Yemen, Risk Factors.
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