Background: Numerous studies have linked uterine fibroids to hypertension, suggesting that this condition may be a risk factor unique to women. These days, fibroids are the main cause of myomectomy and hysterectomy. This study aimed to ascertain the relationship between uterine fibroids and hypertension in Saudi women. Methods: This case-control study was carried out between January 2023 and January 2024 on patients with uterine fibroids and non-uterine fibroids who had an appointment for surgery at the gynecological department of the Maternal and Children Hospital (MCH) Sakaka, Aljouf, Saudi Arabia. Blood pressure readings and fibroid diameters are important factors in studying uterine fibroids. Results: The 140 individuals who were split into 70 cases and 70 control groups had average ages of 41.62±2.16 and 44±1.10. 95 participants had menorrhagia, which was the most common ailment in both groups. In contrast to the controls, the uterine fibroid cases had significantly higher rates of anemia (54.2%), OCP (12.8%), infertility (11.4%), and abortion (37.1%) (P<0.001). 48.5% of uterine fibroids had hypertension, compared to 17.1% of controls (P<0.001).Conclusion: There is a considerable relationship between uterine fibroids and hypertension. Anemia, infertility, and abortion are higher in uterine fibroid cases.
Background: There is a lack of data on current tuberculosis (TB) burden in Shabwah Governorates in Yemen. This study aimed to investigate the prevalence, epidemiology, and outcomes of TB disease in Shabwah Governorate, Yemen. Materials and Methods: This cross-sectional study was conducted at the National TB Program (NTP) Center in Ataq City, Shabwah Governorate, Yemen. The study involved TB patients of different ages who were notified at the center between January 1, 2021, and December 31, 2021. Results: We involved a total of 123 new active TB cases, including 86 (69.9%) with pulmonary TB (PTB) and 37 (30.1%) with extrapulmonary TB (EPTB). The total prevalence of TB disease during the year 2021 was 14.5 new TB cases per 100,000 population, while the median age of the study population was 34 years. The majority of the cases (23.6%) belonged to age group 15–24 years. There was a slightly higher preponderance of males 54.5% (n=67). EPTB was detected in 37 (30.1%) patients with lymph node TB being the most common manifestation [17 (46.0%)]. All patients received four-drug anti-TB therapies for 6–12 months. Most patients 111 (90.3%) were cured, and 2 (1.6%) patients died during the course of the disease, while 10 (8.1%) patients were lost during follow-up. Conclusion: The prevalence of TB in Shabwah Governorate was 14.5/100,000 population. Male patients and younger age groups were more affected, while the lymph nodes were the main extrapulmonary sites involved and the cure rate was 90.2%. The results of the study indicate the need to revise the notification form for active TB cases and to expand NTP activities to focus on targeted screening for active TB cases in high-risk groups to close the gap in unidentified TB cases.
Ascaris lumbricoides infestation is a worldwide common soil-transmitted helminths infection mainly affecting children in the developing and low socioeconomic status countries where the transmission is by contamination of soil by human feces or use of untreated feces as fertilizer [1]. However, it is rare in Qatar, and most cases have been reported among non-Qatari residents who visited their home country while on vacation. In this report, we presented a case of A. lumbricoides infection in a preschool child who arrived in Qatar after a trip to the Gaza strip.
Background: Although stroke is a major problem in Hadhramout Governorate, there is a scarcity of reliable information on risk factors of stroke and predictors of in-hospital mortality. The aim of this study was to explore the risk factors and outcomes of stroke patients admitted to Ibn Sina Hospital, Hadhramout, Yemen, and to identify the predictors of in-hospital mortality. Methods and Materials: This retrospective cross-sectional study was conducted in Ibn Sina Hospital in Mukalla district, Hadhramout Governorate, over a 4-month period (from January 1, 2021, to April 30, 2021). Results: During the study period, we recruited 100 cases of stroke, of whom 77 (77%) were male and 23 (23%) were female. Their mean age was 65.42±12.78 years. Hypertension was the most common risk factor, occurring in 81 (81%) patients, while no risk factors were identified in 5 (5%) cases (Cryptogenic). Ischemic stroke was found in 70 (70%) cases, and hemorrhagic stroke was noticed in 30 (30%) patients. The in-hospital mortality was 29 (29%), and the univariate analysis found male sex, hypertension, and hemorrhagic stroke as probable predictors of in-hospital mortality. Only hemorrhagic stroke (adjusted odds ratio [OR]=2.053 and 95% confidence interval [CI]=0.822–1.599; p<0.001) and hypertension (adjusted OR= 1.677; 95% CI=0.555–1.495; p=0.011) were found to be independent predictors of mortality by multivariate logistic regression analysis. Conclusion: Stroke is a major problem in Hadhramaut Governorate with ischemic stroke being more than hemorrhagic. Men were more likely to have a stroke than women and majority of cases were elderly. Hypertension, diabetes mellitus, smoking, and dyslipidemia were the most commonly identified risk factors that were significantly associated with stroke. Hemorrhagic stroke and presence of hypertension were found to be risk factors for in-hospital mortality; therefore, hypertension should be well-controlled to reduce in-hospital mortality.
Background and Objective: Health care workers (HCWs) are at the highest risk of contracting COVID-19, so their knowledge about the disease and their preventive attitude and practice toward COVID-19 are of concern. The present study aimed to assess the knowledge, attitudes, and practices of HCWs toward COVID-19 in Al-Thawra Hospital, Ibb Governorate, Yemen. Materials and Methods: We conducted a cross-sectional survey among HCWs in Al-Thawra Hospital, Ibb, Yemen, from January 1 to March 31, 2022. Results: Of the 80 participants, 50 (62.5%) were males and 30 (37.5%) were females with a mean age of 29.33±7.86 years. About 51.2% of respondents were aware that sneezing is a recognized symptom of COVID-19, while most were unaware of the extrarespiratory symptoms of the disease, such as diarrhea and confusion. About 28.7% of respondents believed that eating or contacting wild animals would result in infection by the COVID-19 virus, with the majority (71.3%) agreeing that wearing a well-fitting face mask effectively prevents COVID-19 infection. Approximately 48 respondents (60.0%) believed that washing hands could prevent contracting COVID-19, and only 31 (38.7%) agreed that if a patient shows signs and symptoms of COVID-19, they can confidently participate in that patient’s treatment. In response to avoid COVID-19, about 23 respondents (28.7%) had always gone to crowded places, and 35 (43.6%) had always worn face masks at every contact with patients, while only 14 (17.5%) of participants refrained from shaking hands and 37 (46.3%) always washed their hands before and after handling each patient. Conclusion: This study showed that most respondents have poor knowledge regarding the clinical picture of COVID-19 and its mode of transmission as most of them failed to detect an extrapulmonary manifestation of COVID-19 and were unaware of the possibility of transmission of the disease from wildlife. In addition, the attitude and preventive practice of the respondents were unsatisfactory in containing the transmission of the disease.
Background and Objectives: The complications of type 2 diabetes mellitus (T2DM) can occur in some organs, such as the heart, blood vessels, eyes, kidneys, and nerves. Stroke, one of such complications, is increasing every year. This study aims to investigate the prevalence of and risk factors for stroke among T2DM patients in Qatar. Methods: This was a secondary post hoc analysis of collected data from our previous study titled “Association of Vitamin D deficiency with dyslipidemia, glycemic control, and microalbuminuria in patients with T2DM in Qatar.” Results: The prevalence of stroke among our patients was 3.8%. A comparison between stroke and no-stroke groups showed a significant association between stroke and other diseases, namely, chronic kidney diseases (CKD) (p=0.007), coronary artery disease (CAD) (p=0.010), peripheral vascular disease (PVD) (p<0.001), retinopathy (p=0.044), prolonged duration of diabetes mellitus (DM) (p=0.041), glycated hemoglobin (HbA1c) (p=0.006), and a high serum creatinine level (p=0.003). In the multivariate analysis, we identified the following variables as independent risk factors for stroke in patients with T2DM: male gender, CKD, CAD, PVD, high HbA1c, a high creatinine level, and prolonged duration of DM. Conclusion: The prevalence of stroke among T2DM patients in Qatar was around 3.8%. The main risk factors were male gender, CKD, CAD, PVD, high HbA1c, prolonged duration of DM, and a high level of creatinine.
Background and Objective: The COVID-19 pandemic affected medical care systems including stroke care, globally. In this study, we investigated the impact of the COVID-19 outbreak on stroke care in Hadramout, in terms of rate of admission, access to care, risk factors, clinical presentation, and outcome. Materials and Methods: A hospital-based cross-sectional study comparing all stroke patients admitted to Ibn-seena University Hospital (ISTH), Mukalla, Hadramout, during two periods, May 1–October 31, 2020, during the pandemic of COVID-19 (COVID-19 group), and from May 1 to October 31, 2019 (pre-COVID-19 group). Data collected from patients’ medical record files into a master sheet, and were processed by the Statistical Package for Social Sciences software. Results: There were 117 stroke patients admitted in COVID-19 pandemic in 2020, and 213 patients admitted in the same period in 2019. Stroke admission declined by 45.1% (Odds Ratio [OR]=0.30, 95% confidence interval [CI] [95% CI]: 0.22–0.42, p<0.0001) with no age and sex differences. Hypertension (HTN) and diabetes mellitus were more frequent in COVID-19 group than the pre-COVID-19 group (OR=1.74, 95% CI: 1.08–2.80, p=0.02) and (OR=1.81, 95% CI: 1.14–2, 88, p=0.01), respectively. No significant difference in other risk factors was found. Patients in COVID-19 group arrived the hospital more late than the patients in pre-COVID-19 group (OR=2.63, 95% CI: 1.64–4.21, p<0.0001). Dysphasia and altered consciousness including coma were more common in COVID-19 group compared with pre-COVID-19 group (OR=4.5, 95% CI: 2.18–9.08, p<0.0001) and (OR=3.2, 95% CI: 2.00–5.12, p<0.0001), respectively. Hospital stay was greatly reduced among COVID-19 group as compared with pre-COVID-19 group (02.9±0.31 days vs. 8.6±0.92 days, p<0.0001) Mortality rate was higher among COVID-19 group than the pre-COVID-19 group (41.9% vs. 27.2%, p=007). Conclusion: The number of stroke patients admitted during the COVID-19 pandemic decreased, they arrived late and spent shorter hospital stays while having higher rates of HTN, diabetes, and impaired consciousness with a high mortality rate.
Background: There is a lack of adequate data about the prevalence and types of tuberculosis (TB) disease in Hadramout Al-Sahel, Yemen. Hence, this study aimed to investigate the prevalence, types, and outcomes of TB disease in Hadramout Al-Sahel, Yemen. Materials and Methods: This cross-sectional study was conducted at the National TB Program (NTP) center in the city of Al Mukalla, Hadramout, Yemen. The study enrolled TB patients from different districts of Hadramout Al-Sahel who had registered at the NTP center between January 1 and December 31, 2021. Results: A total of 127 new active TB cases were recruited, including 102 (80.3%) with pulmonary TB (PTB) and 25 (19.7%) with extra PTB (EPTB). The overall prevalence of TB disease in 2021 was 12.7 new TB cases per 100,000 population, while the median age of the study population was 38 years. The majority of cases (23.6%) belonged to the age group of 35–44 years. There were 85 (66.9%) males, and most patients (74; 58.3%) were identified in Al Mukalla City. EPTB was detected in 25 (19.7%) patients, with pleural effusion being the most frequent manifestation, found in 12 (48.0%) patients. All patients received 4-agent anti-TB therapies; 99 (77.9%) patients received anti-TB therapy for 6 months; 9 (7.1%) patients received anti-TB therapy for 9–12 months; 8 (6.3%) patients died during treatment; and 11 (8.7%) patients were lost during follow-up. The majority of patients (108; 85%) were cured on completion of treatment. Conclusion: The prevalence of TB in Hadramout Al -Sahel was 12.7 cases per 100,000 population. Males were affected more than females; the pleura was the most commonly affected extrapulmonary site; and 85% of cases were cured. The results indicated the need to support the Al Mukalla NTP center, by providing more resources for improved TB reporting and for conduct of surveillance to detect new TB cases among high risk groups. Health authorities are also urged to provide state hospitals with the equipment needed for TB diagnosis.
Background: In addition to the recent civil war in Yemen, the COVID-19 pandemic resulted in a collapse of the health system, a decline in vaccination coverage, and the spread of numerous outbreaks. In 2022, a measles outbreak impacted Al Dali governorate. This study aimed to describe the demographics of measles patients, measles risk factors, and disease outcomes in Al Dali Governorate, Yemen. Methods: All measles-infected children who sought medical attention at Al Tadhamon Hospital in Al Dali, Yemen, between February and December 2022 were included in this prospective and observational study. Results: During the study period, 154 parents gave their consent to enroll their children in this study; 88 (57.1%) were males, and 66 (42.9%) were females. The mean age of the children was 3.56±2.90 (0.3–12 years). More than half of the mothers (n=88, [57.1%]) were illiterate or had a basic educational level, while most of the fathers (n=126, [81.8%]) were well-educated. Nutritional status was normal in most children (n=146, [94.8%]), and all children were unvaccinated. Most children (n=152, [98.7]) came from areas having measles and most of them (n=130, [84.4]) were in contact with measles cases. Health facilities were close (<3 km) to many children (n=151 [98.1]), and house ventilation was good in 66.2% (n=102) of cases while crowdedness was found in 135 (87.7) cases. Family members were 7 or more in 90 (58.4) cases. Two children under the age of 5 years died because of the disease. Conclusion: Our study showed that the main risk factor for the recent measles outbreak in Al Dali governorate was lack of vaccination, as all involved children were unvaccinated. Routine immunization needs to be reinforced through health centers in different districts and community education about the dangers of the disease and the benefits of the vaccines should be enhanced to prevent outbreaks from recurring.
Kidney mass lesions are common and are often discovered accidentally. Renal cell carcinoma (RCC) represents approximately 5% of all cancers. Men have a two-fold higher likelihood of developing the disease and experience a higher mortality rate than females. The differences between the genders are attributed to individual variations, including hereditary factors, underlying medical conditions, genetics, lifestyle, hormonal factors, and others, such as hypertension and obesity. Renal tumors are usually asymptomatic; however, hematuria, dull aching flank pain, and lower abdomen pain can present symptoms. A tissue biopsy is typically unnecessary but may be required in certain cases. Men tend to exhibit larger and more severe tumors. Radiology tools application is helpful for early diagnosis and follow-up. Partial or radial nephrectomy is an effective curative therapy in localized renal masses. Nevertheless, immunotherapy, cryotherapy, and sometimes chemotherapy are used, especially in high-income nations. In this review, epidemiology, pathophysiology, risk factors, presentation, diagnosis, and kidney mass management will be reviewed and updated. Different keywords and phrases, such as kidney malignancy, renal cancer, epidemiology of kidney cancer, nephrectomy in kidney masses, and management of renal cell tumors, were used to search PubMed, EMBASE, Scopus, Google, and Google Scholar for new reviews and original articles and new comments with updates that were published between January 2019 and May 2025.
Recently, the definition of cardiorenal syndrome (CRS), a condition with a complicated pathogenesis, has been revised. Logically, CRS syndrome should be classified according to the initial organ that is injured, resulting in damage to another organ. Hence, there are only three main categories of CRS. Category one includes acute and chronic CRS. Category two involves renal-cardiac syndrome (RCS), which can be classified as acute or chronic. The third category represents secondary CRS, referred to as cardio-reno-cardiac syndrome (CRCS), which can be subdivided into acute and chronic CRCS. In this part of our series, we will discuss the epidemiology, pathophysiology, diagnosis, treatment, and prevention of acute CRS. We retrieved articles published on acute CRS using different keywords and phrases between January 2019 and June 2025 to achieve these goals.
Background: Glaucoma is a group of disorders that can lead to irreversible vision loss if untreated. It affects individuals across all ages, genders, and ethnicities, with intraocular pressure (IOP) being the only modifiable risk factor. Regional studies highlight variations in the prevalence of glaucoma subtypes, underscoring the need for population-specific data to guide effective prevention and treatment efforts. This study aimed to explore the clinical characteristics and patterns of glaucoma patients in a tertiary care setting in Bangladesh. Methods: This was a hospital-based cross-sectional study, conducted from January to December 2023 at the Glaucoma Department of Deep Eye Care Foundation. A total of 2,172 individuals aged 20 years and above were conveniently selected as the study population. After explaining the study objectives, written informed consent was obtained from all participants. Ethical approval was obtained from the institutional review board of the Deep Eye Care Foundation. Data analysis was performed using the Statistical Package for Social Sciences (SPSS), with a P-value of less than 0.05 considered statistically significant. Results: The study population predominantly consisted of middle-aged and older adults, with a slightly higher proportion of females than males. Most participants were housewives, followed by farmers. A majority resided in rural areas rather than urban, and only a negligible number reported a family history of glaucoma. More than half of the patients presented with reduced visual acuity. The average IOP was nearly similar in both eyes. Most cases showed bilateral involvement of glaucoma. The predominant types of glaucoma were primary angle-closure suspects (PACS) and primary open-angle glaucoma (POAG). The main treatment approaches included beta-blockers and laser peripheral iridotomy, while a notable proportion of patients were kept under observation. Conclusions: Bilateral involvement and reduced visual acuity were common, with PACS and POAG being the predominant subtypes. This study offers unique insights into the demographic and clinical profile of glaucoma in rural communities, emphasizing the need for communitybased screening, gender-sensitive eye care, and early detection to reduce visual disability.
Background: Cardiovascular diseases (CVDs) disproportionately affect conflict zones like Yemen, where diagnostic limitations persist. This meta-analysis evaluated the global prognostic utility of the red cell distribution width (RDW) and the neutrophil-to-lymphocyte ratio (NLR) as predictors of CVD and aimed to establish region-specific thresholds for low-resource settings. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines, we analyzed 75 prospective cohort studies (2014–2025) that included 201,604 adults from 142 countries. Random-effects models were used to pool hazard ratios (HRs) and the area under the curve (AUC). Results: NLR > 3.0 (HR, 2.2 [95% CI, 1.8–2.7]) independently predicted an elevated CVD risk (p < 0> 14% was associated with increased CVD risk in unadjusted analyses (HR, 2.3 [95% CI, 1.9–2.8]), this association became non-significant after adjusting for ferritin (HR, 1.02 [95% CI, 0.98–1.07]). This indicates that RDW primarily reflects iron status, emphasizing the need to measure ferritin before attributing high RDW to CVD risk. The combined RDW + NLR showed superior discriminative power (AUC, 0.82 vs. 0.71–0.74 for individual markers). Subgroup analyses revealed higher NLR cutoffs (>3.8) in HIV-endemic African populations (reflecting chronic immune activation). Sensitivity analyses revealed attenuated NLR effects in rural populations (HR, 1.9) and non-significant RDW-CVD associations when adjusting for ferritin (HR, 1.02), highlighting contextual limitations. Conclusions: While NLR stands as an independent CVD predictor, RDW > 14% must be interpreted with concurrent ferritin measurement. This is crucial to avoid misattributing CVD risk in malnutrition-endemic regions, such as Yemen, where an RDW > 15% is common. The RDW primarily reflects iron status and requires iron-status validation, especially in these high-malnutrition areas. However, caution is warranted when generalizing findings to rural settings where the CVD burden is rising fastest, given the underrepresentation of rural populations (only 16% of included studies). We strongly recommend standardized automated hematology analyzers (k > 0.85).
To the editor, On April 24, 2025, the World Health Organization (WHO) issued an urgent call to reinvigorate global action to end malaria, releasing updated guidelines that reflect both progress and persisting challenges in combating this deadly disease. [1] This renewed guidance arrives at a critical juncture: global malaria cases have plateaued, progress is faltering, and health systems in endemic regions face increasing strain from drug resistance, climate change, and funding shortfalls.