HADHRAMOUT JOURNAL OF MEDICAL SCIENCES

Predisposing Factors of Obstetric Fistula & its Surgical Outcomes, among Al-Sabeen maternal Hospital attendances, Sana`a –Yemen

2023-12-13T09:35:43+00:00

Background : Obstetric fistula, one of the most
devastating consequences of prolonged obstructed
labour, is a historical issue in the developed world.
However, it is still prevalent in developing country
like Yemen. Obstetric fistula is still a persisting
scourge in the developing countries, including Yemen in which >5000 new cases of obstetric fistula were estimated yearly. It occurs in areas where
access to care at childbirth is limited, or of poor
quality and where few hospitals offer the necessary corrective surgery.
Objectives : To study the Predisposing Factors
(social, demographic, cultural and maternal) of
Obstetric Fistula & its Surgical Outcomes, among
Al-Sabeen maternal Hospital attendances, Sana`a
–Yemen.
Materials and methods: A hospital-based
cross-sectional descriptive study was carried out
for 86 medical files of obstetric fistula patients
admitted to gynecological department in Al-Sabeen maternal hospital in Sana’a city during study
during October 2011 to October 2015. Using
available data technique and closed ended questionnaire were used to collect the study data from
medical files available in the hospital. Study data
were analyzed by SPSS software(version 21).
Results : Most of obstetric fistula patient were
in age groupe15-35yrs (76.8%) early age of marriage(82%) illiterate (69.8%) and still married despite having fistula (83.7%) with no antenatal care
attendance in the causative pregnancy (53.5%) and
have history of previous once and more caesarian
section (20.0%,16.3%) most of participants delivered vaginally(53.5%) with prolonged delivery >
2 days (81.4%) most of result with p-value <0.05
statistically significant. With (80.5%) obstructed prolonged labour is leading cause to obstetric
fistula still the iatrogenic cause with high percent
(5.9%).
Most of obstetric fistula (90.7%) with genitourinary type,(25%) with rectovaginal type and
(16.27%) have complex fistula With p-value0.00.
Majority of obstetric fistula patient conducted trans-vaginal approach(65.1%) in one stage
(75.3%) and most of them (79.1%) stay in hospital>3weeks with highly success surgical repair
(97.7%) all result with p-value <0.05 which statistically significant.
Conclusion : The predisposing factors of obstetric
fistula are illiteracy, early age of marriage, early
age get pregnancy <25yrs, no or inadequate antenatal care, obstructed prolonged vaginal delivery,
the iatrogenic cause during cesarean section and
previous once or more caesarian section. Genitourinary fistula is the most predominant Obstetric
fistula type among study patients and the other
types are Rectovaginal and complex fistula. The
most significantly surgical approach are Trans vaginal, one stage of repair, the duration of post-operative stay was significantly more 3 weeks in most
of them and finally there is a significantly success
repair after surgery in the vast majority of study
patients.
Recommendations: The study findings emphasize the obstetric fistula is important problem faced
community and major problem leading to increase
maternal morbidity, significance of both treatment
and prevention activities against obstetric fistula which highly preventable health condition of
women in Yemen. Also needed are interventions
that focus on improving access to maternal health
care, emergency obstetric care, and increased rates
of cesarean delivery when indicated.

Knowledge And Practices Of Malaria Case Management As Per The National Guideline

2023-12-13T09:14:47+00:00

Background:
Malaria is a public health problem in Yemen where
78% of people are at some risk to contract it. After
the emergence of chloroquine resistance in Yemen,
the national anti-malaria policy has been changed
in 2009 to artemisinin-based combination therapy.
To ensure that treatment is effectively utilized and
to prevent drug resistance development, it is important to assess knowledge and practices of physicians regarding the recent national guideline for
anti-malaria case management recommended by
the National Malaria Control Program.
Methods:
A cross-sectional survey was conducted in Aden
(March to April 2014). Two hundreds and ten
physicians involved in managing malaria patients
were enrolled from selected public and private
hospitals. A self-administered semi structured
questionnaire was used to obtain information on
socio-demographic characteristics, and knowledge about the national anti-malaria case management guideline Statistical analysis was done using
SPSS-20. Different descriptive tests were used as
appropriate. Bivariate analysis was set at a significance level of P˂0.05.
Result:
Sixty percent of the participants didn’t know about
the national guideline; 23.8% had the guideline
and only 11% received training on it. The first
line drug treatment for uncomplicated malaria was
identified correctly by the following percentages:
3.3% for adult, 3.8% for children, and 27.1% for
first trimester of pregnancy, whereas none of them
mentioned the correct first line anti-malaria drug
for the second and third trimesters of pregnancy. Regarding physicians’ knowledge about the
first line drug treatment for complicated malaria,
333
84.8%, 66.7%, 49.0 % and 6.2% mentioned the
correct drugs to treat adult, children, first trimester
and the second and third trimesters of pregnancy respectively. No significant difference in the
knowledge was detected between specialists and
general practitioners except for first line treatment
for complicated malaria in first pregnancy trimester. The highest percentage (92.7%) rely on parasitological confirmation in malaria diagnosis.
Conclusion:
This study reveals poor knowledge among physicians regarding national anti-malaria guideline,
especially regarding the treatment of uncomplicated malaria of the vulnerable groups. Involvement of all stakeholders during the adoption and
implementation of new national policies, providing training sessions and refresher courses is recommended to ensure correct and effective use of
current policy.

Association Between Internet Overuse And Mental Health In Hadhramaut University Students

2023-12-13T08:53:22+00:00

Background:
To examine the association between internet overuse and mental health in Hadhramout University
of Science and Technology students.
Metods:
A representative sample of 461students selected
by a multistage sampling method were requested
to fill a self administered questionnaires about internet use and socio-demographic characteristics.
Psychopathology was assessed using the Self-Reporting Questionnaire (SRQ).
Results:
A majority of our respondents (87.2 %) were Internet users. 29.8 % reported spending more than two
hours per day online. There was a significant association between internet overuse and students’
mental health (O.R. = 1.86, 95% C.I. =1.19-2.92).
Conclusions:
These results add to a growing body of evidence
documenting the associating between mental
health and internet overuse. The University of
Hadramaut health and student affairs professionals, particularly those involved with mental health
issues, need to become more aware of the side-effects of inappropriate internet usage

Psychological Stresses among cancer patients in Hadramout ( Yemen )

2023-12-13T09:44:52+00:00

Patient with cancer experiences arrange of challenges and psychological stresses, these may include coping with their health and future. Because
of this importance, the investigators performed
this study. Its objectives are to identify the psychological stress in cancer’s patient in Hadhramout.
To achieve this objective was used test of psychological stress with sample of the study consisted of
( 58 ) patients with cancers attended the National
Oncology Centre/ Mukalla Hadhramout and National Oncology Center in “Saiyon” in the period
from 29/08/2012 to 25/02/2013 were enrolled.
The research concluded that there is a Higher level
of psychological stress among cancer patients in
Hadhramout which is linked to lack of a specialized oncological service in the Valley, prolonged
duration of cancer, reproductive age group and
marital status causing poor psychological and social adjustment .
The present study is a descriptive study.
The investigators recommended to develop medical, psychological and social care services for
cancer’s patients in Hadhramout in general and
particularly in the valley.
The Ministry of Health in Yemen is urged to take
its role in supporting, treating and rehabilitation
of cancer’s patients and that these things to be a
part of the strategic policies of Ministry of Health.
Finally investigators promoted to further researches related to cancers in Hadhramout and its relationship with other local demographic variables in
Hadhramout.

The Pattern Of Mental Disorders Among Yemeni Population

2023-12-13T09:25:37+00:00

Background: Mental illness are becoming a
public health issue in all countries and data in
most developing countries including Yemen are
scarce.
Objectives: This study aims to explore the pattern of mental disorders among outpatients and
admitted patients in the psychiatric hospital.
Aden ,Yemen.
Methodology: The study employed is a hospital based retrospective analysis study. The data
were obtained from the outpatient and admitted
patients register in the hospital to capture distribution by age, gender, residency , treatment
received and clinical diagnosis. Descriptive
statistics used to describe the pattern of mental
disorders among patients. Demographic characteristics of the patients were cross tabulated
with clinical diagnosis and chi-square test was
used to test statistical significance.
Results: Out of 4173 patients registered during
the period from January-December 2013. It is
found 91.8 % patients were treated as outpatient while 8.2% of patients were admitted to
the ward. Male patients were higher than female
patients 74.8% and 24.2 % respectively. The
most age group affected by mental disorders
was between( 16-45 ) years. Schizophrenia and
Depression were the most mental illness among
patients (55.8% and 15% respectively). Epilepsy
was common among patients less than 15 years.
Most of admitted patients diagnosed as schizophrenia received electro convulsive treatment
(86.3%)

Low Back Pain Among Primary School Teachers In AL-Mukalla District

2023-12-13T09:00:29+00:00

Background: More than 80% of the world population will experience an episode of Low back pain
(LBP) at some point during their life. It creates a
substantial personal, community and financial burden globally. The objective of this study was to
determine the prevalence of LBP and associated
factors among primary school teachers in AL-Mukalla district.
Methods: A cross-sectional survey of a representative sample of primary school teachers was
conducted. A total of 420 teachers were recruited
using a validated self-administered questionnaire.
Results: The results of this study showed that the
prevalence of LBP was 52.6%. LBP in female
teachers is significantly higher than male teachers
(57% &41.3% respectively, P-value <0.005). LBP
is more common (58%) in the age group (30-40
years). LBP is significantly higher in overweight
(62%, P-value < 0.01), married people (56%,
P-value < 0.02)and among those who don’t exercise(56%, P-value < 0.01), teachers who spent
more than 10 years in teaching (60%, P-value <
0.02) and teachers of public schools (57%, P-value < 0.01). LBP was significantly higher among
teachers complaining from teaching-related physical activity (87%, P-value <0.001), anxiety & other psycho-social stressors (49%, P-value <.03).
ConClusion & Recommendations: LBP is a
common health problem among primary schools
teachers in AL-Mukalla. This study highlights
the need to increase the care of teachers’ health &
well-being from the government, media and teachers’ unions.

Age And Sex Differences Among Stroke Patients In Mukalla, Hadramout

2023-12-13T08:42:14+00:00

Background & Objectives: Stroke is the third
leading cause of death, and a cause of long-term
disability among survivors, age and male sex are
risk factors for this disease. Hadramout province
is lacking studies about stroke so our aim was to
identify age and sex differences among stroke patients.
Patients and methods: A descriptive retrospective study of stroke patients admitted at Ibnseena
Hospital, Hadhramout, Yemen in between (2011-
2013). Data were collected from patients’ medical
files.
Results: Stroke cases were 1072; ischemic 78.5%
and hemorrhagic 21.5%. Males 56.5% and females 43.5%. Patients with age ˃60 years 72%,
in middle-aged (40-60 years) 25.5%, while young
˂40 years 2.5%. Hypertension was in 63.7% and
53.2% of middle-aged & elderly, and in 29.6% of
young ones. Diabetes in 36.3% and 39.5% of middle-aged and old, while in 7.4% of young ones.
Elderly had ≥2 risk factors (89.9%), 68.9% of middle-aged and 55.6% of the young. Ischemic type
increased with age (63%, 68% & 82.6%), while
hemorrhagic was more in young (37%) than in the
middle-aged (31.9%) and old (17.4%). Coma was
more in the young (29.6%), than in middle-aged
(18.3%) and old (19.6%). Non-significant difference in hypertension between males & females
(54.6%, 56.2%), diabetes (39.3%, 36.3%), previous attack (8.7%, 8.2%) in family history (13.9%,
9.7%). Smoking had significant difference between males & females (29.2%, 3.9%), 94.2% of
males had ≥2 risk factors and females (70%).
Conclusion: stroke increased with age. Ischemic
stroke was more in old in and hemorrhagic in
young patients. Males were generally more affected, but ischemic type was common in females
while hemorrhagic type in males. No sex differences with risk factors rather than smoking was
more in males.

A Study On Some Virulence Factors And Its Relation To Drug Resistance Of Escherichia Coli Isolated From Urinary Tract Infection

2023-12-13T09:51:23+00:00

Urinary tract infection (UTI) is a bacterial infection which can happen anywhere along the urinary
tract, it is a common health problem in the world,
affecting both sexes with different ages. Effective therapy is based on antibiotics, but bacterial
resistance is an ongoing issue for management of
UTI, there is a serious health threats with respect
to drug resistance. This study aimed for focusing
the relation of drug resistance and some virulence
factors of the main UTI causative agent, Escherichia coli, which was conducted in Baghdad hospital. 160 mid stream urine samples were collected
from patients, and processed, to detect virulence
factors of UPEC strains isolated and to compare
the frequency of drug resistance pattern. The results revealed higher proportion of UTI in females
than in males. E. coli isolates were tested against
ten antibiotics. Their effect ranged from resistance
to intermediate susceptibility to full sensitivity.
The results showed that all E. coli strains were
highest rate of resistance with Amoxicillin, Amoxicillin/clavulanic acid and moderately resistant to
Cerfotaxim, CoTrimoxizole (Trmiethoprim-Sulfacmehaxazole), levofloxacin and Nadixic acid ,
where as some isolates had shown lowest rates of
resistance to Nitrofurantion, Ciprofloxacin, Norfloxacin and mipenem. E. coli showed multiple resistances to more than one antibiotic, a collective
result obtained showed that 17 (65.4%) strains
from a total of 26 E.coli isolated from urinary tract
infections, while isolates with low resistance is 9
(34.6%.).