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.
Assessment of Dietary Supplement Use, Awareness, and Energy Expenditure among Gym-goers in Aden Governorate, Yemen
Background: Dietary supplements (DS) containing vitamins, proteins, and minerals are widely used by gym-goers to enhance health, recovery, and performance. However, awareness of their safe use, nutritional adequacy, and energy balance varies considerably. Objective: To assess dietary supplement use, awareness, and energy balance among gym-goers in Aden Governorate, Yemen. Methods: A cross-sectional study was conducted among 270 gym-goers selected from five gyms using stratified multi-stage sampling. Data on supplement consumption, calorie intake, expenditure, and awareness were collected and analyzed. Results: Of the 270 participants, 64.8% reported using nutritional supplements. Protein powder (26.7%) and creatine (33.7%) were the most commonly consumed, followed by vitamin D (20%), zinc (18.9%), and multivitamins (18.5%). Calcium (8.9%) and biotin (4.4%) were less frequently used, while fat burners, herbal products, and ginseng were reported by fewer than 3%. Most respondents were aware of potential adverse effects (67%) and supplement misuse risks (66.6%); 67.8% sought medical advice, and 51.1% were able to interpret product labels. Reported benefits included muscle building (55.6%), increased energy (33.7%), and weight loss (29.3%). Dietary analysis showed inadequate intake, with all gym-goers consuming <6 g/kg of carbohydrates, 78.9% consuming <20% of calories from fat, and 95.9% consuming ≤1.6 g/kg of protein. Supplement use was significantly associated with education, occupation, income, and awareness (p = 0.001), and protein powder use correlated with higher TDEE (p = 0.007). Conclusion: Supplement use is common among gym-goers but is accompanied by nutritional imbalances and limited awareness of risks. Educational programs are recommended to promote balanced diets and informed, evidence-based supplement use.
Dietary supplements, gym-goers, energy, awareness, metabolic equivalent.
Copyright (c) 2025 Yemeni Journal for Medical Sciences http://creativecommons.org/licenses/by/4.0
The Influence of Age and Gender on Hematological and Hemostatic Parameters among Healthy University Students in Aden, Yemen
Background: Hematological parameters are vital indicators of health, influenced by demographic factors. Objective: This study aimed to investigate the association between age and gender with hematological and hemostatic parameters in a cohort of Yemeni university students. Methods: A cross-sectional study was conducted on 100 apparently healthy students. Data on age and gender were collected via questionnaire. Venous blood was drawn for Complete Blood Count (CBC), Prothrombin Time (PT), and Partial Thromboplastin Time (PTT) analysis using automated analyzers. Statistical analysis was performed using SPSS. Results: Significant gender-based disparities were observed. Females exhibited a markedly higher prevalence of abnormal hemoglobin (Hb) levels (58.1%, p=0.0001) compared to males (3.5%). Abnormalities in red blood cell indices (RBCs, MCHC) and platelet (PLT) count were also more common in females, though not always statistically significant. Regarding age, the 18-21 years group showed the highest prevalence of abnormalities suggestive of nutritional deficiencies, specifically in Mean Corpuscular Volume (MCV) (75.9%) and Mean Corpuscular Hemoglobin (MCH) (82.8%). On the other hand, we found that a prolonged APTT was most common in the small group of participants aged 26-29 years (88.9%, n = 9). Conclusion: Gender significantly influences hematological status, with females showing a higher susceptibility to anemia. Age also affects certain hematological indicators, as mild coagulation changes may emerge in the late twenties, while younger individuals are more prone to nutritional deficiencies. Regular screening and targeted nutritional interventions are recommended for these at-risk populations.
Hematological Parameters, Hemostasis, Age, Gender, University Students, Yemen, Anemia, Coagulation.
Efficacy of Chlorhexidine Mouthwash in Preventing Dry Socket: A Prospective Comparative Study in Taiz City, Yemen
Background: One of the most frequent postoperative complications following teeth removal is the development of the so-called dry socket (alveolar osteitis), which is characterized by severe pain and impaired healing. Chlorhexidine has been recommended as a form of preventative treatment. Objective: To determine the efficacy of 0.12% chlorhexidine mouthwash in the prevention of dry socket and to identify potential risk factors among patients undergoing tooth extraction in Taiz, Yemen. Methods: A prospective comparative study was done at the University of Science and Technology, Taiz, Yemen, from October 2023 to May 2025. Eighty patients undergoing simple tooth extraction were randomly allocated to one of the two groups, i.e., the chlorhexidine group (n=40) or the control group (n=40). Such data were obtained as age, sex, smoking, qat chewing status, and oral hygiene status. Dry socket was the main outcome, measured at 3- and 7-day follow-ups after the extraction. Chi-square and logistic regression were used in statistical analysis. Results: There was a smaller occurrence of dry socket in the chlorhexidine group (5.0%) in contrast to the control group (12.5%), but this was not significant (p>0.05). The association of poor oral hygiene, smoking, and qat chewing with higher risk of dry socket was significant (p<0.05). Conclusion: There was a preventive dry socket effect when using chlorhexidine mouthwash, but the results were not statistically significant. Significant associations were identified between dry socket and smoking, qat chewing, and poor oral hygiene. Despite the non-significant result, chlorhexidine may be a beneficial and low-cost adjunct to postoperative care in Yemen.
Dry socket, alveolar osteitis, chlorhexidine, tooth extraction, Yemen
Antibacterial Resistance Patterns of Urinary Escherichia coli Isolates in Taiz City, Yemen
Background: Antibacterial resistance is a major threat to health, leading to reducing the efficacy of antibacterial agents against infections caused by bacteria. The most causative of bacterial UTIs, especially in Yemen, is E. coli bacteria. Objective: The current study aimed at evaluating the percentage rate and potential causes of isolated urine E. coli resistance to some conventional antibacterial drugs in Taiz city, determining which is the most effective, and comparing the results with other studies. Methods: Thirty urine-isolated E. coli from laboratories in Taiz City, Yemen, were collected, and susceptibility tests to determine the E. coli resistance against some conventional antibacterial drugs were performed. After incubation for 24 hours, the diameter of the inhibitory zones was measured, and the results were recorded. Finally, the average and percentage rates were calculated. Results: The result was as follows: Highest susceptibility to nitrofurantoin (90% S), with no resistance (0% R). Complete resistance to cefotaxime (100% R), contrasting sharply with ceftriaxone (26.7% R). Alarming levofloxacin resistance (56.7% R). Intermediate sensitivity to co-amoxiclav (56.7% I), suggesting dose-dependent efficacy. High resistance (56.7% R) with low sensitivity (33.3% S) to co-trimoxazole. Conclusion: In Taiz City, the current study demonstrates E. coli resists the conventionally used antibiotics that were previously considered the most effective antibiotics used for its UTIs, particularly cefotaxime (100% R) and co-trimoxazole (56.7% R). Nitrofurantoin remains highly effective, while ceftriaxone and levofloxacin have variable susceptibility.
urine isolated, E. coli, resistant, antibacterial, UTIs, conventional, Taiz, Yemen
Knowledge and Perception of Occlusion among Dentists in Aden, Yemen: A Cross-Sectional Study
Background: Occlusion is vital in dental diagnosis and treatment, yet little is known about dentists’ knowledge and practices in resource-limited settings such as Aden, Yemen. Objective: To assess the knowledge and perception of occlusion among dentists in Aden and identify gaps related to training, tools, and clinical practice. Methods: A cross-sectional study was conducted in 2025 involving 188 licensed dentists selected through stratified random sampling. Data were collected using a validated questionnaire assessing knowledge (15 MCQs), clinical practices, and perceived barriers. Analysis included descriptive statistics, chi-square tests, and logistic regression (p < 0.05). Results: Only 41.5% accurately defined the centric relation. Dentists with postgraduate training were 3.2× more likely to understand functional occlusion (p < 0.001) and had 22% higher knowledge scores (t(186) = 4.1, *p* < 0.001). A hierarchical regression model confirmed that receiving training (β = 0.38, *p* < 0.001) and having tools available (β = 0.29, *p* = 0.002) were significant predictors of higher self-reported confidence in occlusal management, explaining 37% of the variance (Adjusted R² = 0.37, F (5,179) = 18.6, *p* < 0.001). . Public-sector dentists reported significant resource limitations, including a lack of articulators (68% vs. 29% in private clinics). Only 9.8% use digital tools. Conclusion: Knowledge and practice gaps were associated with limited training and resources. Dentists with postgraduate training were 3.2× more knowledgeable, and public-sector clinicians faced major resource shortages. Curricular improvement and wider access to digital tools are recommended.
Occlusion, Dental Education, Clinical Practice, Digital Tools, Yemen
The Influence of Social Media Content on Teeth Whitening Practices among Adults in Taiz, Yemen
Background: Teeth whitening is becoming increasingly popular among adults in Yemen, and part of this is the social media marketing of cosmetic products and procedures. Nevertheless, no research has studied this point in Yemen. Objective: To assess how the content of social media affects teeth whitening behavior, awareness of risks, and use of various platforms among the adults in Taiz, Yemen. Methods: A cross-sectional study was carried out among 398 subjects older than 18 years in Taiz. Data were collected with a structured questionnaire including demographics, social media use, whitening awareness, practices, and perceptions of risk. Descriptive statistics, chi-square, and odds ratio were calculated using SPSS. Results: More than two-thirds of participants (73.4%) had used at least one whitening technique, principally whitening toothpaste and home whitening. More than half (57.8%) reported being directly influenced by social media in their decision to try whitening. Awareness of potential risks (75.9%) did not limit participation in whitening practices. The influence of social media was significantly correlated with whitening behavior (p<0.001), whereas heavy users (>4 h/day) were less likely to whiten than moderate users (p=0.0002). Gender differences were not significant, but undergraduates were more likely than other education groups to whiten (p<0.001). Conclusion: Whitening behaviors in adults in Taiz are strongly affected by social media. People still engage in risky behaviors even though they are aware of them. These conclusions are important, as they reflect that health authorities and professionals in the field of dentistry have to provide clear and evidence-based messages via social media.
Teeth whitening, Social media, cosmetic dentistry, Yemen
In-Vitro Quality Evaluation and Comparative Analysis of Five Diclofenac Sodium Tablet Brands Marketed in Hodeida, Yemen
Background: In developing countries like Yemen, political instability and economic sanctions have led to compromised pharmaceutical quality control. Objective: This study aimed to evaluate and compare the quality control tests of five brands of enteric-coated 50 mg diclofenac sodium (DS) tablet formulations on the Yemeni market. Methods: Physical parameters such as diameter, thickness, hardness, friability, disintegration time, dissolution profile, and assay were evaluated. Validated UV spectroscopic and RP-HPLC methods assessed accuracy, linearity, and precision and were used to determine the drug content. Each brand was tested according to pharmacopeial standards for solid oral dosage forms. All tested brands (coded DS1–DS5) conformed to pharmacopeial specifications. Results: Weight variation ranged from 1.01±0.29% to 2.01±0.14%, with hardness between 58.9 ± 2.21 N and 146.1±0.7 N. Potency results from UV and HPLC methods were statistically similar with the paired test. The potency values ranged from 92.68% to 100.51%. Friability assessments showed less than 1% mass loss in all samples, adhering to USP limits. Disintegration times averaged ≤ 20 minutes across brands. In vitro drug release after 2 hours in 0.1 N HCl was minimal drug release (2.55±0.24% to 4.47±0.31%), indicating limited dissolution in gastric conditions, while in phosphate buffer (pH 6.8), all formulations released over 90% of the drug within 60 minutes, indicating efficient release of the drug in the more alkaline environment of the intestine. Conclusion: The evaluated diclofenac sodium tablets marketed in Yemen met pharmacopeial standards and possessed the quality parameters necessary for effective therapeutic use.
Diclofenac Sodium, Enteric-coated tablets, Pharmaceutical quality control, Dissolution profile, RP-HPLC and UV spectrophotometry, Yemen.
Prevalence and Severity of Depression among Women in Aden, Yemen: A Cross-Sectional Study
Background: Depression is more common among women than men. Objective: This study aimed to determine the prevalence and severity of depression among adult women in Aden, Yemen, and to determine the associated sociodemographic factors contributing to increasing the prevalence of depression among those women. Methods: A total of 240 women were enrolled in this analytical cross-sectional study. The PHQ-9 structured questionnaire was used for evaluation of the depression and its severity, and data were analyzed using the SPSS. Results: the response rate was 69.97% (240/343). The majority of women were 75.8% single, 80.8% postgraduate educated, and 78.8% had medium socioeconomic status. The prevalence of depression among women was 83.3%. The highest significant depression rates were 92.5% and 90.7% in the age group 25-28 years and the age group >28 years, respectively (p=0.023), and 100% among divorced women (p=0.0001). According to the severity of depression, 33.8% of women had mild depression, 16.3% had moderate depression, and 33.3% had severe depression. The highest significant prevalence for severe depression was 89.8% among women in the age group >28 years, 100% among divorced women, 70.6% among postgraduate-educated women, and 45.3% among those women who had a medium income (p=.0001). Conclusions: The prevalence of depression among women in Yemen was the highest compared to global rates. The depression among women is associated with age and marital status. The severity of depression is strongly associated with different sociodemographic and socioeconomic factors, including age, marital status, education, and income. Severe depression is significantly associated with the age group 25–28 years, divorced women, postgraduate-educated women, and medium-income women.
Persistent Unexplained Diarrhea in a 4-Month-Old Infant: A Case Report from a Limited-Resource Setting
Background: Persistent diarrhea in young infants is a significant contributor to morbidity and mortality in low-resource settings. Etiologies are diverse, including infectious, immunological, and metabolic causes. However, diagnostic limitations often obscure the underlying pathology. Case Summary: We report the case of a 4-month-old female infant with persistent watery diarrhea since the neonatal period, unresponsive to empirical treatments. Initial findings included severe hypernatremia, hyperkalemia, azotemia, and elevated liver enzymes. Stool tests revealed reducing substances, suggestive of carbohydrate malabsorption. Despite multiple dietary trials and supportive care, the infant failed to thrive. Differential diagnoses included secondary lactose intolerance, cow’s milk protein allergy, immunodeficiency, and rare congenital enteropathies. Referral to a tertiary center was recommended, but a definitive diagnosis could not be achieved due to limited diagnostic resources. Conclusion: This case highlights the challenges of managing persistent infantile diarrhea in low-resource settings and underscores the need for simplified diagnostic algorithms, provider training, and expanded access to tertiary care.
Persistent diarrhea, infant, malabsorption, lactose intolerance, immunodeficiency, limited-resource settings, failure to thrive
The Growing Trend of Filter Khaini Smokeless Tobacco Use among Male University Students in Aden, Yemen: A Cross-Sectional Survey
Background: Smokeless tobacco products, particularly Filter Khaini (locally known as AL-HOT), are increasingly popular in Yemen, especially among young adults. Objective: This study aimed to estimate the prevalence of AL-HOT use among male university students in Aden and explore its associations with demographic factors, concurrent risk behaviors, and health perceptions. Methods: A cross-sectional survey was conducted between February and April 2025 among 1,000 male undergraduate students aged 18–30 years from public and private universities in Aden. Data were collected using a culturally adapted, self-administered questionnaire based on the WHO Global Adult Tobacco Survey. Descriptive statistics summarized participant characteristics, and chi-square tests (p < 0.05) assessed associations between AL-HOT use and independent variables. Results: Overall, 82.9% of participants were aware of AL-HOT, and 27.1% reported ever using it. Among users, 68.3% reported daily use and 31.7% less frequent use. AL-HOT use was significantly associated with cigarette smoking, e-cigarette use, qat chewing, and energy drink consumption (all p = 0.001), but not related to demographic factors. Daily users were more likely to perceive AL-HOT as less harmful than cigarettes (81.8%), consider it socially acceptable (84.8%), and report higher dependence and gastrointestinal symptoms. While most users acknowledged its addictiveness and supported awareness campaigns, daily users were less supportive of campus bans. Conclusion: AL-HOT use among male university students in Aden is common and closely linked to other risky behaviors, shaped by misconceptions of reduced harm and social acceptance. Culturally tailored prevention and policy interventions are urgently needed to curb smokeless tobacco use in this population.
Smokeless tobacco, Shammah Al-HOT, Filter Khaini, University students, Aden, Yemen.
Utilization of Contraception Methods and Side Effects among Women Attending the Maternal and Child Healthcare Centers in Mukalla City, Hadhramout, Yemen
Background: One of the main methods of family planning involves use of contraceptives to reduce the chance of pregnancy. Objective: The present study was designed to evaluate the utilization of contraception methods and the side effects among women attending the maternal and child healthcare (MCH) centers in Mukalla city, Hadhramout, Yemen. Methods: A Cross-sectional study was conducted from April to May 2022 among 422 women were attending the maternal and child healthcare (MCH) centers in Mukalla city and using contraception method. The data was collected by face to face interview and by using structured questionnaires. The data was analyzed by using statistical package for social science (SPSS version 24) software. Results: We analyzed data from 422 participants: 210 oral contraceptive pills users, 108 implanon users, 81 intrauterine device users and 23 injectable users. Most of the women (49.5%) were using oral contraceptive pills for birth control. A total of 78.7% of participants experienced at least one side effect, of which hair loss (48.6%), abnormal vaginal bleeding (44.4%), amenorrhea (43.5%) and mood swings (37.0%) were most common. Survey results showed a significant association between side effects and duration contraception use (p < 0.05). Conclusion: The use of modern method of contraceptive among the women was high. Also, the side effects observed were high. Greater attention should be paid to understanding the unique contributions of side effects to contraceptive behavior using population based data. Providing greater individualized care that includes information and counseling about common side effects.
family planning; contraception methods; side-effects; oral contraceptives; intrauterine device; Yemen.
Prevalence, Risk Factors, Clinical Presentation and Management of Cerebral Palsy in Sana'a City, Yemen
Background: Cerebral palsy (CP) is the leading cause of physical disability in children, with prevalence varying widely between high-income and low- and middle-income countries. Objective: This study aimed to determine the prevalence, risk factors, clinical features, investigations, and management strategies of CP among children in Sana’a, Yemen. Methods: A retrospective, cross-sectional study was conducted at two tertiary hospitals in Sana’a for 2 years; from January 2016 to December 2017. A total of 304,000 pediatric records were reviewed, of which 105 complete records of CP patients were analyzed. Data on sociodemographic factors, risk factors, clinical presentation, investigations, and management were collected and analyzed using SPSS version 24.0. Results: The prevalence of CP was 0.03%. The majority of patients were male (66.7%) and under five years of age (61.9%). In more than half of the cases, the etiology was unknown (52.4%), while perinatal asphyxia was the predominant identifiable risk factor (29.5%). Gross motor delay (69.5%) and quadriplegia (59.0%) were the most frequent clinical features. Pediatric and orthopedic referrals were the predominant consultations, and CT scans often revealed mild brain atrophy (31.4%). Antispastic medications were the most frequently used management strategy (58.1%). Conclusion: CP in Sana’a, Yemen, shows a predominance in males and young children, with perinatal asphyxia as a leading risk factor. Gross motor delay and quadriplegia were the main clinical features. Improving perinatal care and establishing a multidisciplinary management approach may reduce the burden of CP in similar settings.
Current Insights into Epstein - Barr virus Prevalence and Clinical Impact among Kidney Transplant Recipients in Iraq: An Updated Review
Background: Epstein–Barr virus (EBV) is a major concern in kidney transplantation, contributing to post-transplant lymphoproliferative disorder (PTLD), graft dysfunction, and allograft loss. In Iraq, data on EBV prevalence among kidney transplant recipients (KTRs) are scarce, with most evidence derived from hemodialysis patients. Objective: To systematically review the prevalence and clinical impact of EBV in Iraqi KTRs and assess associated risk factors, diagnostic approaches, and management strategies. Methods: A systematic search of PubMed, Scopus, Web of Science, Google Scholar, and Iraqi repositories was conducted. Eligible studies on EBV prevalence and outcomes in KTRs and hemodialysis were screened, appraised, and synthesized following PRISMA guidelines. Results: Available Iraqi studies indicate variable EBV prevalence in KTRs and hemodialysis, with risk factors including intensive immunosuppression, lymphocyte-depleting therapies, donor and graft characteristics, co-infections, recipient age, and post-transplant timing. Diagnostic strategies reported include donor-recipient serostatus, quantitative EBV PCR, and histopathology. Emerging therapeutic options, particularly EBV-specific adoptive T-cell therapy, show promise in reducing reactivation and preserving graft function. Conclusion: EBV poses a significant but understudied risk in Iraqi KTRs. Consolidating regional evidence with international insights highlights the urgent need for targeted EBV surveillance and management strategies to improve transplant outcomes in Iraq.
Epstein–Barr virus; Kidney Transplant Recipients; PTLD; Immunosuppression; Iraq
Evaluation of Diuretic and Antibacterial Activities of Tribulus terrestris Ethanolic Extract
Background: Renal disorders like urinary tract infections and imbalances in body fluids and electrolytes still create significant health and economic challenges, particularly in areas with fewer resources. Objective: This study aimed to assess the diuretic and antibacterial effects of the ethanol extract of Tribulus terrestris (EETT) through both in vivo and in vitro experimental approaches. Methods: The diuretic activities of ethanol extract of Tribulus terrestris (EETT) were evaluated in rodent models, while its antibacterial potential was investigated in vitro. Diuretic activity was assessed in rats by measuring urine output and electrolyte excretion (sodium, potassium, and chloride) following administration of EETT at the different doses; furosemide served as the reference diuretic. Antibacterial activity was tested in vitro using the disc diffusion technique on four bacterial strains: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. Results: EETT produced a dose-dependent diuretic effect, with the highest dose (450 mg/kg) significantly increasing urine output (p < 0.05) and sodium excretion (p < 0.01) to levels comparable with furosemide. Potassium excretion also rose significantly, whereas chloride excretion decreased at higher doses, suggesting a possible chloride-sparing mechanism. Antibacterial testing revealed moderate inhibition of Staphylococcus aureus (15 mm) and Pseudomonas aeruginosa (23 mm), while Escherichia coli and Klebsiella pneumoniae exhibited no detectable susceptibility under current testing conditions. Conclusion: The ethanol extract of Tribulus terrestris showed dose-dependent diuretic effects and moderate antibacterial activity. These findings support further research, including clinical studies, to explore its potential as a complementary treatment for kidney-related disorders.
Awareness and Knowledge of Drug-Laboratory Test Interferences among Medical Laboratory Technologists in Yemen
Background: Drug-laboratory test interactions (DLTIs) can mislead the health care professionals and provide incorrect information regarding the patient’s health status. To date there are no specific courses in medical laboratory science curricula in Yemen that specialize in this topic. Objective: This study aims to reveal the knowledge about DLTIs among laboratory technologists in Yemen. Methods: A cross-sectional study was conducted in 11 governorates in Yemen to evaluate the awareness about DLTIs among laboratory technologists. An electronic questionnaire was distributed, and responses were analyzed. Results: A total of 396 laboratory technologists participated in this study. The majority of respondents (96.4%) reported that certain medications can affect laboratory test results, and 89.4% of participants showed knowledge about common medication interferences, but specific drug class awareness varied considerably. Only 53 (13.3%) had received formal training on drug-laboratory test interference and scored the highest in the knowledge questions. Conclusion: Formal training on DLTIs is important to ensure accurate laboratory test results.
Knowledge and Practices of Radiation Protection among Dental Students in Aden, Yemen
Background: Dental radiography is indispensable for diagnosis, but unnecessary exposure to ionizing radiation should be minimized according to ALARA/ALADA principles. Objective: This study aimed to assess knowledge and practices related to radiation protection among fourth- and fifth‑year dental students in Aden, Yemen. Methods: Analytic cross‑sectional survey of fourth- and fifth‑year students from public and private dental schools in Aden. A total of 400 students were invited, 270 responded, and 21 incomplete questionnaires were excluded, leaving 249 valid responses (response rate 62.25%). A web‑based questionnaire with 15 multiple‑choice items covered knowledge and practice domains. Sampling was convenience‑based due to logistical constraints. Chi‑square tests compared responses by year (α = 0.05). Results: Overall, 79.9% agreed that dental X‑rays are harmful. Significant differences (Level 4 vs Level 5) were observed for awareness of collimators/filters (32.3% vs 51.3%; p = 0.012), preference not to hold films by hand (58.6% vs 85.3%; p < 0.001), recognition that high‑speed film reduces dose (40.4% vs 70.7%; p < 0.001), and knowledge of operator safety distance (44.4% vs 80.7%; p < 0.001). Lead apron use was reported as preferred by 65.1%, but non‑availability was the most cited barrier. Most participants (86.3%) intended to adhere to radiation‑protection protocols in future practice. Conclusion: Important gaps persist in specific protection concepts (e.g., rectangular collimation, film holding, and distance rule). Targeted curriculum reinforcement and reliable access to protective resources are needed to translate knowledge into consistent practice.
Dental radiography, radiation protection, awareness, dental students, Yemen
Prevalence of Nosocomial Bacterial Infections and their Patterns of Antibiotics Susceptibility among Hospitalized Patients: A Seven-Year Retrospective Study
Background: Nosocomial infection (NI) is a major public health challenge among patients having surgical sites infections (SSIs), blood stream infections (BSIs), and urinary tract infections (UTIs). These illnesses, if not perfectly treated, may cause a high rate of morbidity and mortality. Objective: This study aimed to evaluate the profiles of resistance to antibiotics of pathogenic bacteria involved in nosocomial SSIs, UTIs, and BSIs. Methods: This retrospective descriptive study involved hospitalized patients enrolled in hospitals at Mukalla city, Hadhramout, Yemen for 7-years period (2014-2020). Clinical samples of UTIs, SSIs and BSIs were collected. Bacterial isolates were identified by the standard procedures of sampling culture and biochemical methods. Standard disc diffusion (Kirby-Bauer) method was performed for antimicrobial susceptibility testing. The variables of sex, age, and type of infection were obtained from study population. Results: Of 653 hospitalized patients, 326 (49.9%) tested positive for bacterial infection. Of these (58.0%) were UTIs, (29.1%) SSIs and (12.9%) BSIs. In terms of bacterial strains distribution, (47.9%) were Gram-positive, and (52.1%) were Gram-negative bacteria. The majority of bacterial isolated from UTIs were Escherichia coli (48.6%) followed by Staphylococcus aureus (21.6%), and the most bacterial isolated from BSIs were Staphylococcus aureus (50.0%) followed by Escherichia coli 19.0%. Moreover, Staphylococcus aureus (55.7%) and coagulase negative staphylococci (CoNS) (17.8%) were the most prevalent bacteria identified in SSIs. Bacterial isolated showed a significant of antibiotics resistance. Conclusions: Treatment of bacterial NI must be verified by bacterial culturing and the antibiotics susceptibility to select the effective drug and prevent antibiotics resistance development.
High-Dose Radiotherapy for Locally Advanced Pancreatic Cancer: Prioritizing Organ-at-Risk Dose Limitation
Background: Locally advanced pancreatic cancer presents major treatment challenges. Objective: This report highlights high-dose radiotherapy as a palliative option, aiming to relieve symptoms and minimize damage to surrounding organs while enhancing antitumor effects. Case: An 87-year-old woman with a history of type 2 diabetes was referred for palliative radiotherapy due to unresectable, locally advanced pancreatic cancer that had spread to the head of the pancreas. To provide symptomatic relief, including relief from epigastric pain and a feeling of fullness, she received high-dose volumetric modulated arc therapy (66-92 Gy /33 fractions) with an emphasis on limiting the radiation exposure of organs at risk. The radiotherapy plan was designed to administer a dose of 66 Gy to the planning target volume (PTV), ensuring that at least 95% of the PTV received this dose. Concurrently, the maximum permissible dose to a 0.1-ml volume of the small intestine and stomach was strictly limited to less than 66 Gy. The mean dose to these organs was set at 46 Gy. The treatment plan was modified midway through by adapting the PTV after the patient had received 46 Gy. Results: At the six-month follow-up, complete tumor remission was observed, and her symptoms were alleviated. No adverse events were reported during or within six months after radiotherapy. Conclusion: A high-dose adaptive radiation therapy strategy that prioritizes dose constraints to critical organs may serve as an alternative treatment option for elderly patients and those with comorbidities among patients with locally advanced pancreatic cancer.
Pancreatic Neoplasms, Palliative Care, Image-Guided Radiotherapy
Coagulation Profile and Platelet Indices in Yemeni Adults with Type 2 Diabetes: A Cross-Sectional Study in Aden Governorate
Background: Type 2 diabetes mellitus (T2DM) induces a hypercoagulable state that increases thrombotic risk. Objective: This study evaluated coagulation parameters and platelet indices in Yemeni adults with T2DM and their correlation with glycemic control. Methods: A hospital-based cross-sectional study was conducted on 140 T2DM patients and 100 healthy controls from major hospitals in Aden Governorate between January and February 2025. Coagulation tests (PT, APTT) were performed using STA-R Evolution, and platelet indices (MPV, PDW) were analyzed via Sysmex XN-550. Glycemic control was assessed by HbA1c. Statistical analysis was performed using SPSS v26. Results: Most patients (86%) had poor glycemic control (HbA1c ≥ 7%). Diabetic patients demonstrated significantly prolonged prothrombin time (PT) compared with healthy controls (13.69 ± 1.74 sec vs. 12.10 ± 1.20 sec, p < 0.001), shortened APTT (31.38 ± 4.16 sec vs. 35.20 ± 3.50 sec, p < 0.001), and elevated MPV (9.03 ± 0.92 fL vs. 8.70 ± 1.10 fL, p = 0.015) and PDW (16.8 ± 2.1% vs. 15.2 ± 1.8%, p = 0.01) compared to controls. A strong positive correlation was found between HbA1c and MPV (r = 0.52, p < 0.001). An MPV cut-off > 11.5 fL predicted thrombotic risk with 78% sensitivity and 85% specificity (AUC = 0.82). Conclusion: Yemeni T2DM patients demonstrate significant hemostatic abnormalities strongly linked to poor glycemic control. MPV represents a cost-effective, accessible marker for thrombotic risk stratification. We propose its integration into routine diabetic care protocols in Yemen and similar resource-limited settings.
Type 2 Diabetes Mellitus, Coagulation, Platelet Indices, Mean Platelet Volume, Thrombosis, Yemen
Emergency Medication Preparedness in Sudanese Dental Practice: Knowledge, Attitudes, Practices, and Systemic Barriers
Background: Medical emergencies in dental practice, such as anaphylaxis or hypoglycemia, demand timely and competent intervention. Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) of Sudanese dentists regarding emergency medications and identify barriers affecting their preparedness in clinical settings. Methods: A descriptive cross-sectional study was conducted using an online survey targeting Sudanese dental practitioners from January to June 2024. A validated questionnaire was used to assess emergency preparedness among 413 participants, employing convenience sampling. Data were analyzed descriptively using SPSS version 25.0. Results: Most of the respondents were female (59%), under 30 years old (66.8%), and dental interns (66.5%). While 70.5% reported receiving emergency training, only 30% demonstrated excellent knowledge, with notable gaps in identifying tachycardia (17.4% correct). Attitudes were largely neutral (66.3%), despite 83.5% strongly agreeing on the importance of emergency medications. In practice, 44.8% showed excellent performance, yet only 28.1% checked their emergency kits monthly. Medication availability varied, with aspirin (93.9%) and salbutamol (76.7%) commonly stocked, while hydrocortisone (35.7%) and glyceryl trinitrate (19.4%) were deficient. Conclusion: Despite moderate levels of self-reported training, critical gaps persist in Sudanese dentists' knowledge, attitudes, and practice regarding emergency medications, as well as their availability in clinics. The predominance of early-career practitioners combined with systemic constraints highlights the urgent need for curriculum reforms, simulation-based training, and national policy interventions to strengthen emergency preparedness and safeguard vulnerable patients' resource-constrained settings.
Dentists; Emergency Preparedness; Medication Shortage; Sudan; Syncope; Dental Education; Clinical Competence
Analysis of Infertility in Basra Governorate, Iraq
Background: Infertility represents an escalating health and social concern in developing countries. Objective: This study aimed to investigate the medical and demographic factors contributing to infertility among couples attending the Infertility Center in Basra Governorate. Methods: A case-control study was conducted on one hundred couples suffering from infertility. Semen samples were collected from men, while vaginal swabs were obtained from women. Bacterial isolates were then diagnosed microscopically and in vitro, and biochemical tests were performed, such as the oxidase test, catalase test on mannitol, Simmons citrate agar, and Klegar Iron Agar test. Results: Medical evaluation showed that polycystic ovary syndrome (PCOS) was the most frequently identified cause of female infertility (44%). Among males, prostatitis was reported in 28% of cases. Other contributing conditions included pelvic inflammatory disease (20%), hypertension (20%), diabetes mellitus (14%), genetic disorders (10%), and hypothyroidism (3%). Microbiological analysis revealed that Escherichia coli was isolated in 15.65% of samples, followed by Staphylococcus haemolyticus (30.43%), Staphylococcus aureus and Klebsiella pneumoniae (8.69% each), and Proteus mirabilis (8.69%). The prevalence of smoking among infertile males was notably high (90%), while no female smokers were recorded. Conclusion: These findings highlight the multifactorial nature of infertility, with significant influence from both behavioral factors—such as smoking—and medical conditions, including infections and hormonal disorders. The study emphasizes the importance of comprehensive reproductive health strategies that incorporate early diagnosis, infection control, and lifestyle interventions.
Male infertility, female infertility, primary infertility, secondary infertility, bacterial pathogens
Work-Related Stress: Prevalence and Risk Factors among Healthcare Workers in Aden, Yemen
Background: Work-related stress (WRS) is a common problem among healthcare workers (HCWs). This condition is associated with less productivity and serious consequences for patients. Objective: The aim of this study was to find out the prevalence and risk factors for work-related stress among HCWs in Aden in 2025. Methods: A descriptive, cross-sectional, health-facility-based study was conducted. Participants were recruited from public as well as private institutions. A standardized self-administered questionnaire was distributed to gather relevant study data that included sociodemographics and indicators of stress; scoring of severity was based on predetermined criteria. Statistical analysis was conducted using SPSS v26. Results: All participants reported some level of work-related stress, with 76 (58.5%) experiencing moderate stress and 52 (40.0%) severe stress. The most common associated risk factors were gender, work environment, specialty, duration of experience, marital status, and perceived psychological health. However, there were no statistically significant risk factors except the self-perceived psychological health (p=0.01). Conclusion: Work-related stress is common among health professionals in Aden. Mitigating policies are needed to address this problem.
work-related stress, healthcare professionals, occupational health, Aden, Yemen.
Knowledge, Attitudes, and Practices of Family Planning Among Women Attending Primary Health Care Centers in Aden Governorate, Yemen
Background: Family planning (FP) is vital for reducing maternal and child mortality, yet Yemen faces high fertility, low contraceptive use, and persistent cultural barriers. Objective: This study was aimed to assess knowledge, attitudes, and practices (KAP) regarding FP among women attending primary health care facilities in Aden Governorate, Yemen. Methods: A cross-sectional study was conducted using a pre-tested interview questionnaire among women of reproductive age and those over 46. Data were analyzed for sociodemographic associations with FP KAP. Results: According to knowledge among women, 91.9% of participants had heard about family planning (FP), mainly from health services (29.1%) and friends/family (26.3%). Most knew about pills (86.9%), IUDs (79.4%), and condoms (67.2%), but 47.8% believed FP had negative effects (e.g., bleeding, anxiety). The attitudes of respondents were that 89.7% agreed that FP was important for health, but 62.2% feared long-term fertility effects, and 32.8% perceived religious influences. Ninety-three-point eight percent supported male involvement in FP decisions. Regarding the practices, 76.3% had used contraception (pills: 26.3%, natural methods: 24.4%), but only 42.2% were currently using FP. The main reasons for discontinuation were desire for pregnancy (41.6%) and side effects (29.7%). Higher education and income correlated with better FP knowledge (p=0.0001). In contrast, rural and low-income groups had lower KAP scores. Conclusion: High-grade education predicts better FP knowledge and practices. Low-income and rural populations need tailored FP programs. The study reveals strong foundational knowledge and attitudes, but it also highlights significant gaps in method-specific awareness and practice. Family planning utilization and maternal and child health outcomes may be enhanced by interventions.
Family planning, KAP, reproductive health, sociodemographic factors, contraception
Barriers and Attitudes toward Psychotherapy in Pakistan: A Cross-Sectional Study
Background: Psychotherapy is a fundamental kind of treatment for people struggling with meager mental well-being for overcoming emotional obstacles and seeking personal development via the use of psychological tools. Objective: The research explores the barriers to seeking psychotherapy in Pakistan due to the fragile mental health of the population. Methods: The natives were approached through the cross-sectional study for collecting data specifically from adults 15 years and above from all socioeconomic backgrounds. Results: 340 responses were collected, in which the ratio of female participants was 82.4% and of male was 17.6%. The most pervasive reasons for high stress levels among people were self-doubt and negative ways of thinking. The findings indicate that a sizable portion of Pakistan's population is coping with mental health problems, but getting professional help is socially stigmatized. Nevertheless, 17.1% of people stated that they had sought the assistance of a counsellor or psychiatrist, and out of that, 95.3% of those surveyed recommended therapy to others facing any psychological issue. Conclusion: The exploration ends with the conclusion that Pakistani natives are in an utmost need to access mental health, and if not managed, it may lead to social detachment.
Psychotherapy, Pakistan, mental health, stress, stigma
Prevalence of Anemia among Diabetic Population Attending An Urban Primary Health Care Center in Tamil Nadu
Background: Diabetes has been proven to cause various systemic manifestations, including nephropathy, vasculopathy, retinopathy, and neuropathy. Objective: To estimate the prevalence of anemia among the diabetic population attending the primary health care center and to determine the prevalence of anemia based on biophysical profile, including age group and gender. Methods: This is Cross-sectional analytical study. Urban Primary Health Centre (UPHC) of Government Medical College, Omandurar Government Estate, Chennai; Study population: Diabetic patients attending the outpatient division of UPHC. The study was carried out from June 7th to September 1st, 2022. Two hundred participants were included (calculated population: 196) (z= 1.96 for 95% CI, p= 47.91% from a previous study, q=52.09%, n=0.05). After obtaining informed consent from the participants, 5 mL of blood was collected from the patient and analyzed for hemoglobin levels and fasting and postprandial sugar levels. Results: The prevalence of anemia in the diabetic population is 66%. The prevalence of anemia was higher in males suffering from diabetes than in females suffering from diabetes (74% in males in comparison to 54% in females.) Anemia was most common in the 60- to 80-year-old age group, corresponding to a decreasing quality of life with increasing age. Conclusion: About two-thirds of the diabetics were having anemia, with more preponderance towards males and the elderly.
Anemia, diabetics, NCD Clinics, Diabetes control.
Assessment of Knowledge and Practices in Fixed Prosthodontics among Dentists in Yemen: A Cross-Sectional Study
Background: Fixed prosthodontics is essential for restoring oral function and aesthetics, yet its success depends on dentists' adherence to evidence-based practices. Objective: This study was aimed to assess the knowledge and practices of fixed prosthodontics among Yemeni dentists in 2025, evaluating material preferences, adherence to international guidelines, and barriers to optimal care. Methods: A cross-sectional study was conducted among 350 dentists using stratified random sampling in both urban (76.8%) and rural (23.2%) Yemen. Data were collected via a validated questionnaire assessing theoretical knowledge, clinical practices, and barriers. Descriptive and inferential statistics were analyzed using SPSS version 26.0. Results: Only 41.2% of dentists knew the correct occlusal reduction for zirconia crowns (1.0 mm). Advanced-degree holders (18.6% of participants) scored 28% higher on knowledge assessments (p < 0.001). Porcelain-fused-to-metal (PFM) crowns were the most commonly used material (58.7%), with rural dentists using them 3.2 times more frequently than urban counterparts (78.9% vs. 48.3%; p = 0.003). Guideline adherence was low (49.5%), though prosthodontists complied 4.7× more than general dentists (p < 0.001). Cost (82.4%), lack of training (67.1%), and patient affordability (59.3%) were primary barriers. Rural practitioners faced 2.1× higher complication rates (p = 0.007). Predictors of advanced practice included a master’s degree (OR = 4.2), urban practice (OR = 3.1), and continuous education training (OR = 2.8), which correlated strongly with zirconia adoption (p < 0.05). Conclusion: Yemeni dentists exhibit significant gaps in knowledge and adherence, driven by socioeconomic and educational disparities. Interventions such as subsidized materials, mandatory continuing education, and specialty training are essential to align practices with global standards.
Fixed prosthodontics, Yemen, zirconia, guideline adherence, barriers, dental education
Prospective Evaluation of Estrogen-Associated Temporomandibular Disorders and the Efficacy of Different Intra-Articular Therapies
Background: Emerging evidence suggests a potential association between estrogen levels and temporomandibular disorders (TMDs), though the clinical implications remain poorly understood. This study examines this relationship in a defined patient population. Objective: To characterize TMD presentations in patients with elevated estrogen levels, compare treatment efficacy across therapeutic modalities, and identify predictors of treatment response. Methods: A prospective analysis was conducted on 35 female TMD patients (mean age 30.2±6.5 years) divided into three treatment groups: Group 1 (n=6) received corticosteroid injections, Group 2 (n=19) underwent a stepped protocol including autologous blood therapy, and Group 3 (n=10) with comorbid rheumatoid arthritis received PRF therapy. Clinical parameters, including pain characteristics, joint findings, and treatment outcomes, were systematically evaluated. Results: All groups' samples demonstrated high estrogen hormone levels in laboratory tests; in clinical examinations, all participants reported chronic pain (100%), with frequent trigger points (80%) and crepitus (65%). Group 2 exhibited superior outcomes (100% success) compared to Groups 1 (83.3%) and 3 (80%), with autologous blood therapy showing a statistically significant advantage (p<0.05). Refractory cases were associated with more advanced degenerative changes. Conclusion: These findings support an association between elevated estrogen and specific TMD phenotypes, while demonstrating the therapeutic potential of biologic interventions. The results suggest hormonal factors may influence TMD progression and treatment response, warranting further investigation into targeted management strategies.
temporomandibular disorders; estrogen; autologous blood injection; biologic therapy; treatment outcomes.
Interalar-to-Intercanine Distance Ratio in Sudanese Dentate Adults: Anthropometric Foundations for Anterior Teeth Selection in Edentulous Patients
Background: For edentulous patients without pre-extraction records, selecting appropriate measurements for maxillary anterior teeth can be difficult. Objective: To develop a reliable guideline for the Sudanese population, this study examines the relationship between interalar width (IAW) and intercanine distance (ICD). Methods: A total of 114 Sudanese individuals with full natural dentition (45 men and 69 women) participated in a cross-sectional study. A digital caliper was used in a clinical setting to measure IAW, and dental casts were used to get ICD. Independent t-tests (p < 0.05) and Pearson correlation were used in the statistical analysis. Results: The average IAW was 40.00 ± 3.8 mm (p < 0.001) for males (42.7 mm) and for females (38.3 mm). The average ICD was 35.93 ± 2.1 mm (p = 0.003), with males measuring 37.1 mm and females measuring 35.19 mm. Dividing the IAW by ICD gives a 1.1 ratio. Conclusion: A robust association was found between IAW and ICD, endorsing the application of a 1.1 ratio as a dependable reference for choosing anterior teeth in edentulous Sudanese patients.
Interalar width, intercanine distance, maxillary anterior teeth selection, Sudan
Knowledge of Medical Professionals toward Monkey pox virus in Karachi, Pakistan: A Cross-Sectional Study
Background: Monkeypox disease (MPD) is a relatively rare viral infection. Recently, health officials in Pakistan have been alerted to confirmed cases of monkeypox in non-endemic countries, including the United Kingdom. Objective: This study aims to investigate the knowledge of medical professionals about monkeypox disease in Karachi, Pakistan, to better understand the factors contributing to the emergence and management of the disease. Methods: This cross-sectional study was conducted by using an open online self-administered survey through Google Forms. The survey data were taken between January and April 2023. The study respondents were 470. Of the 430 participants included in the final analysis, 54.40% were female, and all were "somewhat knowledgeable" about monkeypox disease. The associations between independent factors and either knowledge or attitude were assessed. Results: A total of 550 questionnaires were distributed via online, but only 470 were received back. Among these 470, forty questionnaires have been found to be incomplete, and they were excluded from the study. The current study included 430 questionnaires with a response rate of 90%. The result showed that 56.27% were aware of monkeypox disease (MPD), while 22.79% were uninformed of it, and 22.94% lacked adequate knowledge of MPD. 40% of respondents believe immunizations can prevent monkeypox disease (MPD). Data strongly depended on gender, with female predominance. The majority of females, 54.40%, determined themselves to be somewhat knowledgeable. Conclusions: This study concludes that there is a gap in awareness among healthcare professionals. Medical professionals might require educational interventions to overcome their lack of expertise, allowing for more accurate diagnosis and treatment.
Medical practitioners, monkeypox disease, knowledge, Karachi
Knowledge, Attitude, and Practice of Early Marriage among Female Secondary Students: A Cross-Sectional Study in Aden, Yemen
Background: Early marriage remains a major challenge in Yemen, which affects development and contradicts human rights. Objective: The present study aims to assess the knowledge, attitude, and practices regarding early marriage among female secondary school students in Yemen. Methods: A cross-sectional study was conducted on 100 female secondary school students aged 14–19. Stratified sampling recruited students in the scientific section of grades 10–12. There were structured questionnaires to gather data for demographic, socioeconomic, and thematic variables of early marriage. Analysis was performed using SPSS. Results: The majority of respondents were unmarried, aged 14–16, and had completed high school or university; nearly 72% had previously been exposed to some information about marriage, and 42% had a family history of underage marriage. 72% of participants believed that early marriage was unfair to girls, and they primarily attributed decision-making to the girls themselves (42%) or their families (38%). The main causes of early marriage were poverty (23%) and customs and traditions (69%), and the most common result was increased divorce rates (80%). The majority of participants (76%) believed that the best way to prevent early marriage is to raise awareness among girls and the general public. Conclusion: The results highlight the necessity of community awareness campaigns, evidence-based policymaking, and educational interventions that empower teenage girls and aid in reducing the incidence and effects of early marriage in Yemen.
Early marriage, Knowledge, Attitude, Practice, Secondary female students