في هذا الاصدار

  • Comminuted Intraarticular Distal Radius Fractures: Functional Outcome and Short-term Follow-up after Surgical Treatment with Spanning External Fixation AlSaifi1Mohammed, et al.
  • Incidence, Clinical Profile and Prognostic Indicators for Visual Outcome in Traumatic Cataract Surgery in Yemen Alakhlee Hisham, et al.
  • Clinical Presentation Variants of Chronic Subdural Hematoma Cases Me’asar Mojahed, et al.
  • Epidemiological Description of Primary Brain Tumors: A Single-Center Retrospective Study of 75 Cases, Yemen Shamsaldin Mohamed, et al.
  • The Role of Clinical Pharmacists in the Detection and Evaluation of Adverse Drug Events: A Review Article Al-Akhali Khaled and Alyahawi Ali.
  • Application of Genome-Based Therapy in Clinical Pharmacy Practice: Prospects and Challenges Al-kaf Ali G. and Alyahawi Ali.
  • Lumbosacral Nerve Root Compression by Gravid Uterus as a Cause of Sciatica in Pregnancy: Diagnosis by Exclusion.Al-Dofri Saif.
MASJ-COVER-2025-MAY
# Comminuted Intraarticular Distal Radius Fractures: Functional Outcome and Short-term Follow-up after Surgical Treatment with Spanning External Fixation

AlSaifi1Mohammed, et al

Background: Treating a severely comminuted distal radius intraarticular fracture is challenging as it can lead to disability, unless the alignment of the fractured bones is restored as accurately as possible and maintained in an anatomical position.
Objective: This study aims to assess the efficacy of utilizing an AO spanning external fixator in the treatment of comminuted distal radius intraarticular fracture.
Methods: Between January 2020 and September 2022, 38 individuals with isolated closed comminuted intraarticular distal radius fractures (DRFs) were enrolled in this research. The patients underwent clinical and radiological evaluations using the AO classification system in the emergency department. The patients were taken to the operating theatre, where closed reduction techniques and a stable mini-AO spanning external fixator were employed to restore the radiological parameters of the distal radius. The functional status of the patients was assessed at 3,6, and 12 months using the modified Green and O’Brien scale. The collected data were then analyzed to evaluate treatment outcomes.
Results: 32 (84%) patients were males with an average age of 32. Among the cases, 45% of the patients had AO-23C3 fractures, while 55% had AO-23C2 fractures. The procedure duration ranged from 15 to 25 minutes. The external fixator was removed after a median period of seven weeks. Additional percutaneous K-wires were used in 6 patients for enhanced stability. Three patients experienced pin tract infections during treatment. Radiographic measures of the distal radius showed normal values. Functional outcomes were favorable; with 55% of patients had excellent results, 29% experienced good outcomes, and 11% and 5% presented fair and bad outcomes respectively.
Conclusion: Severely comminuted DRFs can be effectively treated with minimally invasive spanning external fixation, restoring anatomical and radiological parameters and achieving favorable functional outcomes.
Keywords: Distal Radius Fracture, External Fixation, Radiological Parameters, Anatomical Parameters, Surgical Treatment

1
# Incidence, Clinical Profile and Prognostic Indicators for Visual Outcome in Traumatic Cataract Surgery in Yemen

Alakhlee Hisham, et al


Background: Traumatic cataract is an important cause of monocular blindness. It poses a formidable challenge to ophthalmologists for achieving optimal visual acuity as visual prognosis shows highly unpredictability and the injured lens is not the only determining of visual outcome.
Objective: The study was conducted to assess the incidence, clinical characteristics, and prognostic indicators for visual outcomes in traumatic cataract surgery.
Methodology: Medical records of 832 patients presented with traumatic cataract and underwent surgical intervention during the study period at Magrabi Eye Hospital, Sana’a, Yemen were reviewed retrospectively. χ2 test, odds ratios, and 95% confidence intervals were used to figure out the prognostic factors for visual acuity ≥ 6/18 at final follow-up after cataract surgery.
Results: The incidence rate of cataract was 0.78 %, or 7.8, patients per 1000 patients of eye OPD. The mean age was 20.51 ± 13.16 SD years old with the majority (83.5%) were ≤ 30 years old and 42.9% ≤18 years old. Males were 82.6%. Open globe injury was the most prevalent trauma type (70%). Cornea damage was the predominant concurrent injury in (58.2%). Anterior capsule rupture presented in 32.3% and was statistically indicator for presence in 46.7% of 122 eyes with posterior capsule rupture (χ² = 13.64, p = < 0.001). Anterior surgical cataract removal approach performed in 61.4% and 38.6% performed pars plana vitrectomy with lensectomy (PPLV). Intraocular lens implanted 75.6%, with 89.5% placed at capsular bag. Posterior capsule opacity was the most late postoperative complication (8.3%). 47% of eyes achieved ≥ 6/18 and 27% were blind in the injured eye < 3/60. Better initial visual acuity (VA) was statistically significant indicator for achieving final VA≥ 6/18, (χ²= 29.4, p = <0.001). Correlation was found between final VA ≥ 6/18 and age and sex, female patients and younger than 18 years old had the best prognosis. Closed globe injury had satisfactory final VA ≥ 6/18 in 58% comparing to open globe injury 46.3%, (χ²= 8.944, p = 0.003). Retinal detachment, endophthalmitis, vitreous hemorrhage, posterior capsule rupture or IOFB and no IOL implanted carried the poorest prognosis for final VA ≥ 6/18, (p = <0.001). A statistically favorable final VA ≥ 6/18 was obtained in anterior approach cataract removal than PPLV (χ²= 102.3, p = < 0.001), capsular bag IOL than non PCIOL (χ²= 11.5, p = < 0.001) and primary IOL than secondary IOL implantation (χ²= 9.9, p = 0.002). No difference was detected between simultaneous globe repair with cataract removal and two-step surgical procedure (χ= 0.926, p = 0.336). Posterior segment complications and significant corneal scaring were responsible for blind eyes (<3/60) in 72% and 39.1% respectively, (p = <0.001).
Conclusion: Traumatic cataract remains a frequent sequel of ocular injuries with nearly one third of patients have monocular blindness with the overwhelming predominance of male, age group (1- 30) years old, and open globe injury. About half of cases have a satisfactory vision after surgical intervention. The worst indicator factors for poor visual outcome are initial VA ≤ 1/60, open globe injury, coexisting posterior segment pathology, posterior capsule rupture, and remained the eye aphakia.
Keywords: Traumatic Cataract, Ocular Morbidities, Cataract Surgery, Visual Outcome, Yemen.

2
# Clinical Presentation Variants of Chronic Subdural Hematoma Cases

Me’asar Mojahed, et al

Background: Chronic subdural hematoma (CSDH) is a prevalent condition in neurosurgical practice, predominantly affecting the elderly. However, there is a paucity of data concerning the characteristics of CSDH patients within Middle Eastern populations including Yemen.
Aim of study: This study aims to systematically evaluate the clinical presentations of patients diagnosed with chronic subdural hematoma.
Methodology: A retrospective descriptive study was obtained from registry medical records of patients with CSDH in Al-Thawra Modern General Hospital (TMGH) over a period of six years from January, 2017 to November, 2022. The collected data encompassed demographic and clinical characteristics including clinical presentation, Glasgow Coma Scale (GCS) at admission, etiology, laterality of the hematoma, management approaches and patient outcomes.
Results: A total of 113 CSDH cases were analyzed, with 77.9% of the patients being male. The mean age was 61.8 years. Motor symptoms were the most common presenting feature, observed in 79.6% of cases, followed by symptoms of increased intracranial pressure (54.0%) and altered consciousness (46.0%). At admission, the majority of patients (54%) had a normal GCS score of 15, while 30.1% had GCS scores between 13 and 14. Left-sided hematomas were identified in 44.2% of patients, whereas 22.1% had bilateral presentations. The etiology remained unidentified in 45.1% of cases, with 30.1% having a history of a ground-level fall and 16.8% having a history of traffic accidents. Surgical intervention via burr hole was performed in 92.9% of patients, with a favorable outcome observed in the majority. The mortality rate was 3.5%.
Conclusion: Chronic subdural hematoma exhibits a wide spectrum of clinical manifestations, with motor symptoms being the most prevalent. The condition predominantly affects elderly males. Most patients were successfully managed through burr hole surgery, with favorable outcomes in the majority. This single-institution, retrospective study presents findings consistent with global data. However, larger, multi-center studies are necessary to better elucidate the epidemiological profile and variable clinical presentations of CSDH.
Keywords: Clinical Presentation, Chronic Subdural Hematoma, Yemen

3-update
# Epidemiological Description of Primary Brain Tumors: A Single-Center Retrospective Study of 75 Cases, Yemen

Shamsaldin Mohamed, et al

Background: Primary brain tumors represent one of the most devastating tumors, characterized by high significant morbidity and mortality with a high rate of neurological sequelae. Only limited studies have described the burden of CNS tumors in Yemen.
Objective: Description of the epidemiological trends of primary brain tumors in a single institution.
Materials and methods: A retrospective study was obtained from registry records of patients with primary brain tumors based on clinical and radiological data or histopathological report at 48 Model Hospital, Sana’a, over a period of 4 years from January 1, 2020 to December 31, 2023. The collected data encompassed demographic and tumor characteristics including patient’s gender and age, and type and site of tumor, as well as WHO grade.
Results: 75 cases of primary brain tumors were reviewed. There were 43 (57.3%) females. Adults were the highest age group involved (68%). The majority of tumors (77.3%) were supratentorial. Gliomas constituted the most common neoplastic category (48%). However, meningiomas was the most common single entity (32%).
Conclusion: This is an institution-based, detailed, and descriptive epidemiological study of Yemeni patients with primary brain tumors. In spite of our study’s matching with most worldwide studies results, the definitive epidemiological rates in reality need a bigger multi-centric and histopathological based studies to be carried out. Limitations of our study included the clinically and radiologically based diagnosis of most cases.
Keywords: Primary Brain Tumor, Prevalence, Yemen

4-update
# The Role of Clinical Pharmacists in the Detection and Evaluation of Adverse Drug Events: A Review Article

Al-Akhali Khaled and Alyahawi Ali

Adverse drug events (ADEs) are a major healthcare systems issue in hospitals. They are difficult to detect because of incomplete or unavailable medication history. Clinical pharmacists have an important role to play in detection and evaluation of adverse drug reactions. The clinical pharmacist’s role in medication management should extend beyond simply dispensing drugs, and this article delineates the rationale and proactive approaches for clinical pharmacist detection and assessment of adverse drug reaction (ADRs). This article was designed to overview the role of clinical pharmacists in detecting and evaluating ADRs. Search and analysis of related articles in web sites revealed that clinical pharmacists have an important role in evaluating, identifying, and preventing ADRs, which leads to proper management and decreased number of morbidity and mortality cases. Therefore, healthcare systems need to be redesigned to more fully utilize health information technologies and clinical pharmacists in detecting and responding to ADRs.
Keywords: Adverse drug events, Clinical pharmacists, Detection, Evaluation, Role

5-update
# Application of Genome-Based Therapy in Clinical Pharmacy Practice: Prospects and Challenges

Al-kaf Ali G. and Alyahawi Ali

Genome-based therapy, an innovative approach to personalized medicine, utilizes insights from genomic research to tailor treatments to individual patients. In clinical pharmacy practice, this emerging field holds promise for improving therapeutic outcomes, minimizing adverse drug reactions, and optimizing drug efficacy by integrating pharmacogenomics into patient care. Genome- based therapies include gene editing technologies (e.g., CRISPR-Cas9), gene therapy for rare genetic disorders, and the use of biomarkers for targeted treatments in oncology and other complex diseases. Despite its transformative potential, the application of genome-based therapies faces significant challenges, including ethical concerns, high costs, limited accessibility, and the need for advanced infrastructure and specialized training. Additionally, regulatory hurdles and the scarcity of robust clinical data impede the widespread adoption of these therapies in routine clinical pharmacy practice. This review explores the prospects of genome-based therapies in clinical pharmacy, emphasizing their potential to revolutionize healthcare delivery. It also examines challenges such as ethical dilemmas, policy gaps, and resource limitations, proposing strategies to address these barriers. The integration of genomic tools into clinical pharmacy practice requires a multidisciplinary effort involving pharmacists, clinicians, researchers, and policymakers to ensure equitable access and effective implementation in diverse healthcare settings.
Keywords: Genome-Based Therapy, Clinical Pharmacy, Challenges, A multidisciplinary Effort.

6-update
# Lumbosacral Nerve Root Compression by Gravid Uterus as a Cause of Sciatica in Pregnancy: Diagnosis by Exclusion

Al-Dofri Saif

A 29-year-old pregnant woman presented with severe left sciatica for three days, which was exacerbated by standing and walking. The patient, who was 11 weeks pregnant, was considering termination of pregnancy due to the debilitating pain. The patient was referred by a neurosurgeon for a lumbar spine MRI (Magnetic Resonance Imaging) as the analgesics did not help much. MRI of the lumbar spine did not reveal any structural abnormalities. The patient’s symptoms were significantly relieved by lying on her right side for a few hours. The diagnosis was made by exclusion, as the patient’s symptoms were not attributable to any identifiable spinal pathology. The patient was managed conservatively with positioning techniques, and her symptoms greatly improved. This case highlights the importance of considering compression of the lumbosacral nerve roots by the gravid uterus as a potential cause of sciatica in pregnant women, especially when other spinal pathologies have been excluded.
Keywords: Sciatica, Female, Pregnancy, MRI

7-update