In This Issue

  • Giant Cerebral Cavernoma: A Case Study Measar and Al-Hoothi.
  • Effect of Pulse Steroid Therapy on Visual Acuity and Fundus Picture in Cases of Vogt Koyanagi Harada Syndrome in Yemen: Case Series Study Taresh, et al.
  • Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Acne Vulgaris at Al-Thawrah General Hospital, Sana’a, Yemen Abuarij and Al Qtwani.
  • Prevalence of Hematuria among School Children in Shueub and Bani al-Harith in Sana’a city, Yemen Shaher, et al.
  • Patient Safety Culture among Physicians at Public Hospitals in Sana’a, Yemen: A Retrospective Cross-Sectional Study Alswaidi and Ismail.
  • Abstracts of The 1st Scientific Conference of 21 September University of Medical and Applied Sciences #
Volume-2-Issue-1-Jul-2023

# Giant Cerebral Caver

Mojahed Measar and Esmail Al-Hoothi

Background: Cavernoma is known as cavernous malformation or cavernous angioma. It accounts for 0.5% of brain mass lesions. Giant cavernomas of the central nervous system is quite rare, only 65 cases of cerebral giant cavernous angioma have been included in literature over the last 62 years. They are more common in children and may be misdiagnosed as other intracranial neoplasms. This study presented a very rare giant cavernoma extended from right basal ganglia to the sylvian fissure in a 7-year-old female.
Case description: A 7-year-old female presented with the new onset of recurrent attacks of seizures, with progressive left-sided hemiplegia for the last month. The clinical examination showed that the patient was sleepy and had left-sided hemiplegia. A non-contrast CT scan revealed a spherical slightly hyperdense intraaxial lesion at the right basal ganglia extended to the sylvian fissure measuring 5×4.5×5 cm surrounded by moderate perifocal edema. A brain CT scan, with contrast, revealed slight patchy enhancement. MRI revealed a single large lesion occupying the right basal ganglia extended to the sylvian fissure measuring 5×4.5×5 cm and showed a patchy enhancement. The patient underwent craniotomy through the right fronto-temporal and transsylvian approach, under surgical microscope, with total en bloc resection of lesion. The histopathologic examination revealed cavernous hemangioma (cavernoma). After surgery, she was conscious alert, with no new neurological deficit apart from the pre operation Left-sided hemiplegia. The postoperative follow-up was uneventful with a significant improvement in her left-sided hemiplegia after 3 months.
Conclusion: Pediatric giant cavernous angioma is a rare intracranial lesion that may be best diagnosed with MR/CT, but sometimes, confirmation requires histopathological examination. It should always be included in the differential diagnosis of spontaneous intracerebral hemorrhages or large tumor. The best outcomes correlate with surgical excision, but may be, limited by eloquent tumor location.
In our case, we report a rare case of giant cavernoma that was completely removed by microsurgical treatment. This case provides important points for the practicing neurosurgeon to consider when making a differential diagnosis of large intracranial tumors. Since imaging appearance of giant cavernoma is variable, the possibility of cavernoma should be considered in the case of a large tumor.
Keywords: Cavernoma, cavernous malformation, cavernous angioma, hemiplegia, seizure.

1-8-212023

# Effect of Pulse Steroid Therapy on Visual Acuity and Fundus Picture in Cases of Vogt Koyanagi Harada Syndrome in Yemen: Case Series Study

Nabil Taresh, Hisham Alakhlee, Basma Al-Refai, and Ahmad Labib

Vogt-Koyanagi-Harada syndrome (VKHS) is a rare systemic disease with severe bilateral panuveitis associated with cutaneous, neurological, and auditory abnormalities. This study aims to evaluate the effect of pulse steroid therapy on the visual acuity and fundus picture of cases of VKHS presented at Maghrabi Eye Hospital in Yemen. Method: This retrospective case series was followed up for three years between (2007-2010) for three female patients who presented by bilateral hand motion and complained with headache, neck stiffness and difficulty in hearing. Results: After pulse steroid therapy, the best corrected visual was improved with resolution of optic disc swelling and serous retinal detachment detected by optical coherence tomography (OCT). One eye had complication as sunset glow and suprarational fibrosis. Conclusion: VKHS is uncommon disease in Yemen and affects mostly female. Urgent intervention with pulse steroid therapy and systemic corticosteroid and early diagnosis decrease the complications and improve the visual acuity.
Keywords: Vogt Koyanagi Harada syndrome, pulse steroid therapy, visual outcome, Yemen.

2-8-16-21-2023

# Efficacy of Oral Isotretinoin in Combination with Desloratadine in the Treatment of Acne Vulgaris at Al-Thawrah General Hospital, Sana’a, Yemen

Mutaia Abdullah Abuarij and Amal Ahmed Al Qtwani

Background: Acne vulgaris is one of the most common skin problems in adult life, especially in adolescents.
Objective: This study aimed to evaluate the efficacy of oral isotretinoin in combination with desloratadine in the treatment of acne vulgaris at Al-Thawra General Hospital, Sana’a.
Methods: The study was designed as a prospective comparative clinical trial carried out in the Department of Dermatology, Al-Thawrah General Hospital, Sana’a during the period from Jan. to June 2019. The data were collected from each patient after verbal consent. All patients (60 pt.) were randomized into 2 equal groups (study group and control group). The mean age of the study group was 27.47 ± 4.249 year while 24.07 ± 3.393 year of the control group. Both groups were treated with isotretinoin 20mg per day for 16 weeks. The study group (combined treatment) received 5mg desloratadine daily in 16 weeks. The follow-up was carried in weeks (2, 4, 8, 12, 16) for acne lesion, GAGS score, side effects of drugs and outbreak of acne.
Results: This study found that females were more affected than males and acne lesion at 16 weeks was 16.7 % in the study group in contrast to 40.0 % in the control group. After 16 weeks of treatment, GAGS score showed that both groups had good outputs response to therapy with 86.7% excellent and 13.3% good in the study group compared to 56.7%, excellent, and 40 % good response to therapy. Whereas at 16 weeks most patients had no outbreak (86.7 % in the study group and 53.3 % in the control group), 3% in the study group and 46.7 % in the control group had mild outbreak with > 5 nodules. This study observed only minor side effects of desloratadine among the study group, such as headache and self-limited infection. Side effects of isotretinoin declined more rapidly when desloratadine was added. In contrast, this study showed that 10 % of patients had chelitis, conjunctivitis and 13.3 % of them had priorities at 16 weeks.
Conclusion: This study showed that adding oral desloratadine to the oral isotretinoin provides a better outcome and advantage in terms of efficacy and tolerability than isotretinoin treatment alone.
Keywords: Acne vulgaris, Acne lesion, GAGS score.

3-17-30-21-2023

# Prevalence of Hematuria among School Children in Shueub and Bani al-Harith in Sana’a city, Yemen

Muneera Shaher, Faisal Al-Khurasani, and Nadeem Ismail


Objective: Screening of kidney diseases by urinalysis in school children has been approved in many parts of the world with inexpensive tools such as urinary dipsticks. In this study, we investigated the prevalence of hematuria in a large sample of 6 to 15-year-old Yemeni school students in Shueub (located in the northeast of Sana’a city) and Bani al-Harith (located in the north of Sana’a city).
Design: A total population of 12,347 Yemeni students in primary and middle schools in Shueub and Bani al-Harith were investigated for hematuria during 2021. There were 7,299 students from Shueub and the remaining 5,048 were from Bani al-Harith, aged from 6 to 15 years old. All the examined children were apparently healthy and asymptomatic. Parents’ consents were taken prior to the test. A random fresh mid-stream urine was collected to complete the urine analysis (by dipstick and microscopy) to detect microscopic hematuria, albuminuria, or pus cells for each student.
Results: Among the 12,347 students screened and urine samples provided, 2,745 (22.23%) of the total population had hematuria, 1,822 (14.76%) from Shueub and 923 (7.48%) from Bani al-Harith. Analysis of the prevalence of hematuria in students in Shueub and Bani al-Harith showed that there was a very highly significant difference between the two areas (P value = 0.0000). There were 842 students (7% of the total population) had positive hematuria and 2,678 students (22%) had negative hematuria with a highly statistically significant difference between positive hematuria students and negative hematuria students (P value = 0.0044).
Conclusion: Asymptomatic hematuria might be detected by the school screening program and should be considered as an inexpensive way for early management of some renal diseases.
Keywords: Hematuria, dipstick, urinalysis, proteinuria, glucosuria

4-31-39-21-2023

# Patient Safety Culture among Physicians at Public Hospitals in Sana’a, Yemen: A Retrospective Cross-Sectional Study

Fatima Alswaidi and Aniza Ismail


Background: Patient safety is a critical component to the quality of health care, represents a global public health problem which affects countries at all levels of development. Healthcare organizations endeavour to improve their quality of care. Aims of study were to explore the patient safety culture among physicians according to AHRQ (Agency of Health Research and Quality) dimensions, to determine grade of patient safety at public hospitals, and to determine the rate of event reports.
Methods: A retrospective cross-sectional study, using hospital survey on patient safety culture to measure the 12 dimensions of the patient safety culture at public hospitals in Sana’a, Yemen. SPSS 20. was used for statistical analysis, descriptive analysis, and ANOVA f-test.
Results: Out of 384 physicians, positive response rate was (66%), revealing acceptable level of patient safety. The highest positive response rate was team-work within units (69.1%) while the lowest positive responses was nonpunititve response to errors (29.8%). Majority of respondents did not record any event report during the past 12 months. The results showed that hospital physicians had weak perception toward patient safety culture.
Conclusion: Patient safety is a low priority at public hospitals, there is a tendency for under-reporting of errors. To create a culture of safety and improvement, fear of blame must eliminate, and to create a climate of open communication, continuous learning and focus on leadership should be considered.
Keywords: patient safety culture, public hospitals, Sana’a Yemen.

5-40-53-21-2023

# Abstracts of The 1st Scientific Conference of 21 September University of Medical and Applied Sciences

Abstracts of The 1st Scientific Conference of 21 September University of Medical and Applied Sciences

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Abstracts-of-The-1st-Scientific-Conference-of-21University-of-September-