Access to and utilisation of antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia: a pilot cross-sectional survey.

OBJECTIVES: Identifying key barriers to accessing quality-assured and affordable antimicrobials among forcibly displaced persons in Uganda, Yemen and Colombia and investigating their (1) utilisation patterns of antibiotics, (2) knowledge about antimicrobial resistance (AMR) and (3) perception of the quality of antimicrobials received. DESIGN: Pilot cross-sectional survey. SETTING: Data were collected from five health facilities in the Kiryandongo refugee settlement (Bweyale, Uganda), three camps for internally displaced persons (IDPs) in the Dar Sad district (Aden, Yemen) and a district with a high population of Venezuelan migrants (Kennedy district, Bogotá, Colombia). Data collection took place between February and May 2021. The three countries were selected due to their high number of displaced people in their respective continents. PARTICIPANTS: South Sudanese refugees in Uganda, IDPs in Yemen and Venezuelan migrants in Colombia. OUTCOME MEASURE: The most common barriers to access to quality-assured and affordable antimicrobials. RESULTS: A total of 136 participants were enrolled in this study. Obtaining antimicrobials through informal pathways, either without a doctor's prescription or through family and friends, was common in Yemen (27/50, 54.0%) and Colombia (34/50, 68.0%). In Yemen and Uganda, respondents used antibiotics to treat (58/86, 67.4%) and prevent (39/86, 45.3%) a cold. Knowledge of AMR was generally low (24/136, 17.6%). Barriers to access included financial constraints in Colombia and Uganda, prescription requirements in Yemen and Colombia, and non-availability of drugs in Uganda and Yemen. CONCLUSION: Our multicentred research identified common barriers to accessing quality antimicrobials among refugees/IDPs/migrants and common use of informal pathways. The results suggest that knowledge gaps about AMR may lead to potential misuse of antimicrobials. Due to the study's small sample size and use of non-probability sampling, the results should be interpreted with caution, and larger-scale assessments on this topic are needed. Future interventions designed for similar humanitarian settings should consider the interlinked barriers identified.

The silence of the lambs: Child morbidity and mortality from malnutrition in Yemen.

More than 2.3 million children under the age of five in Yemen suffer from acute malnutrition. Approximately 450,000 are expected to suffer from severe acute malnutrition and may die if they do not receive urgent treatment. In this context, without security, stability, and better access for farmers to have the means to resume growing food, children and their families continue to sink deeper and deeper into hunger and malnutrition. As a result, malnourished children are more vulnerable to illnesses, including diarrhea, respiratory infections, and malaria, which are a major concern in Yemen. This situation is a vicious and often deadly cycle.

Urgent call to action: Child rights and the state of child morbidity and mortality in Yemen.

More than 2.3 million children under the age of five in Yemen suffer from acute malnutrition. Approximately 450,000 are expected to suffer from severe acute malnutrition and may die if they do not receive urgent treatment. In this context, without security, stability, and better access for farmers to have the means to resume growing food, children and their families continue to sink deeper and deeper into hunger and malnutrition.

Case-area targeted preventive interventions to interrupt cholera transmission: Current implementation practices and lessons learned.

BACKGROUND: Cholera is a major cause of mortality and morbidity in low-resource and humanitarian settings. It is transmitted by fecal-oral route, and the infection risk is higher to those living in and near cholera cases. Rapid identification of cholera cases and implementation of measures to prevent subsequent transmission around cases may be an efficient strategy to reduce the size and scale of cholera outbreaks. METHODOLOGY/PRINCIPLE FINDINGS: We investigated implementation of cholera case-area targeted interventions (CATIs) using systematic reviews and case studies. We identified 11 peer-reviewed and eight grey literature articles documenting CATIs and completed 30 key informant interviews in case studies in Democratic Republic of Congo, Haiti, Yemen, and Zimbabwe. We documented 15 outbreaks in 12 countries where CATIs were used. The team composition and the interventions varied, with water, sanitation, and hygiene interventions implemented more commonly than those of health. Alert systems triggering interventions were diverse ranging from suspected cholera cases to culture confirmed cases. Selection of high-risk households around the case household was inconsistent and ranged from only one case to approximately 100 surrounding households with different methods of selecting them. Coordination among actors and integration between sectors were consistently reported as challenging. Delays in sharing case information impeded rapid implementation of this approach, while evaluation of the effectiveness of interventions varied. CONCLUSIONS/SIGNIFICANCE: CATIs appear effective in reducing cholera outbreaks, but there is limited and context specific evidence of their effectiveness in reducing the incidence of cholera cases and lack of guidance for their consistent implementation. We propose to 1) use uniform cholera case definitions considering a local capacity to trigger alert; 2) evaluate the effectiveness of individual or sets of interventions to interrupt cholera, and establish a set of evidence-based interventions; 3) establish criteria to select high-risk households; and 4) improve coordination and data sharing amongst actors and facilitate integration among sectors to strengthen CATI approaches in cholera outbreaks.

Mind the gap: what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysis.

BACKGROUND: Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities. METHODS: Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010-2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package. RESULTS: Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education. CONCLUSIONS: The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.

A single polyploidization event at the origin of the tetraploid genome of Coffea arabica is responsible for the extremely low genetic variation in wild and cultivated germplasm.

The genome of the allotetraploid species Coffea arabica L. was sequenced to assemble independently the two component subgenomes (putatively deriving from C. canephora and C. eugenioides) and to perform a genome-wide analysis of the genetic diversity in cultivated coffee germplasm and in wild populations growing in the center of origin of the species. We assembled a total length of 1.536 Gbp, 444 Mb and 527 Mb of which were assigned to the canephora and eugenioides subgenomes, respectively, and predicted 46,562 gene models, 21,254 and 22,888 of which were assigned to the canephora and to the eugeniodes subgenome, respectively. Through a genome-wide SNP genotyping of 736 C. arabica accessions, we analyzed the genetic diversity in the species and its relationship with geographic distribution and historical records. We observed a weak population structure due to low-frequency derived alleles and highly negative values of Taijma's D, suggesting a recent and severe bottleneck, most likely resulting from a single event of polyploidization, not only for the cultivated germplasm but also for the entire species. This conclusion is strongly supported by forward simulations of mutation accumulation. However, PCA revealed a cline of genetic diversity reflecting a west-to-east geographical distribution from the center of origin in East Africa to the Arabian Peninsula. The extremely low levels of variation observed in the species, as a consequence of the polyploidization event, make the exploitation of diversity within the species for breeding purposes less interesting than in most crop species and stress the need for introgression of new variability from the diploid progenitors.

Relationship between cervical vertebral maturation and dental development in a sample of yemeni children and adolescents / Relación entre la maduración vertebral cervical y el desarrollo dental en una muestra de niños y adolescentes yemeníes

Objective: This study was conducted to investigate the relationship between dental development and cervical vertebral maturation stages in a group of Yemeni children and adolescents. Materials an Methods: The study included digital panoramic radiographs and lateral skull cephalograms obtained from 207 Yemeni subjects­122 females and 85 males aged between 8 to 18 years. Dental maturity was evaluated according to the method of Demirijian et al., calcification stages of the left mandibular canines, first and second premolars and second molars were assessed. Skeletal maturity was assessed by the cervical vertebral maturation (CVM) stages according to the method of Baccetti et al. Correlation between CVM and dental maturation was evaluated by Spearman rank-order correlation coefficient (SROCC). Results: CVM and dental calcification stages were highly correlated (p<0.001) in both genders, ranging from 0.686 to 0.873 for females and 0.787 to 0.871 for males. Calcification stages of the second molars showed the strongest correlation with CVM. Conclusion: Calcification stages of the second molar may be used as a reliable maturation indicator. Dental maturation may be applied to determine the skeletal maturity status of Yemeni children and adolescents.

Objetivo: Este estudio se realizó para investigar la relación entre el desarrollo dental y las etapas de maduración vertebral cervical en un grupo de niños y adolescentes yemeníes. Material y Métodos: El estudio incluyó radiografías panorámicas digitales y cefalogramas laterales del cráneo obtenidos de 207 sujetos yemeníes: 122 mujeres y 85 hombres de entre 8 y 18 años. La madurez dental se evaluó de acuerdo con el método de Demirijian et al. Se evaluaron las etapas de calcificación de los caninos mandibulares izquierdos, primer y segundo premolares y segundos molares. La madurez esquelética se evaluó mediante las etapas de maduración vertebral cervical (CVM) de acuerdo con el método de Baccetti et al. La correlación entre la CVM y la maduración dental se evaluó mediante el coeficiente de correlación de orden de rango de Spearman (SROCC). Resultado: Las etapas de CVM y calcificación dental estuvieron altamente correlacionadas (p<0.001) en ambos sexos, con un rango de 0.686 a 0.873 para las mujeres y 0.787 a 0.871 para los hombres. Las etapas de calcificación de los segundos molares mostraron la correlación más fuerte con CVM. Conclusión: las etapas de calcificación del segundo molar pueden usarse como un indicador de maduración confiable. La maduración dental puede aplicarse para determinar el estado de madurez esquelética de los niños y adolescentes yemeníes.

Association of Khat chewing, smoking, age and sex with periodontal status among Yemeni adults / Associação da mastigação de Khat, tabagismo, idade e gênero com a condição periodontal entre adultos iemenitas

Objective: Periodontal diseases are very common dental disease. Many risk factors may play significant role in the periodontal disease initiation and progression. This study was performed to evaluate the effects of khat chewing, smoking, age and gender on periodontal status among Yemeni adults. Material and Methods: This cross-sectional study was performed on 1231 patients attending the outpatient dental polyclinics of University of Science and Technology during the academic years 2017/2018. All completed sheets were collected throughout the year by the supervisors. Data cleaning, descriptive statistics, and inferential statistics were then performed. Results: Khat chewers were more frequent than non-chewers counterparts (60.7% vs. 39.3%). The prevalence of smoking was 25.5% (297 patients). Study results indicated that periodontitis is more associated with female gender and participants aged more than 35 years old. Results also showed that female and age older participants aged more than 35 years were significantly associated with gingival recession. Mean number of the teeth with gingival recession in male patients were higher than in females. Male gender and patients aged more than 35 years old were significantly associated with furcation involvement. Conclusion: The present study has shown females gender and age older than 35 seem to be risk factors of periodontal diseases. Males has more teeth affected by gingival recession and more furcation involvement (AU)

Objetivo: As doenças periodontais são patologias dentárias com alta prevalência. Diversos fatores de risco podem desempenhar papel significativo no início e progressão das doenças periodontais. Este estudo foi realizado para avaliar os efeitos da mastigação de khat, tabagismo, idade e gênero na condição periodontal de adultos iemenitas. Material e Métodos: Este estudo transversal foi realizado em 1231 pacientes atendidos nas policlínicas odontológicas ambulatoriais da Universidade de Ciência e Tecnologia durante os anos acadêmicos de 2017/2018 através de um questionário para coleta de dados préestabelecido. Todas os questionários preenchidos foram coletados ao longo do ano pelos supervisores. A apuração dos dados, estatística descritiva e estatística inferencial foram realizadas. Resultados: os mastigadores de Khat foram mais frequentes do que as não-mastigadores (60,7% vs. 39,3%). A prevalência de tabagismo foi de 25,5% (297 pacientes). Os resultados do estudo indicaram que a periodontite está mais associada ao gênero feminino e aos participantes com mais de 35 anos de idade. Os resultados também mostraram que participantes do gênero feminino e acima de 35 anos foram significativamente associadas à recessão gengival. O número médio de dentes com recessão gengival em pacientes do gênero masculino foi maior que no feminino. O gênero masculino e os pacientes com mais de 35 anos de idade foram significativamente associados ao envolvimento da furca. Conclusão: O presente estudo mostrou que o gênero feminino e a idade acima de 35 anos parecem ser fatores de risco para doenças periodontais. Pacientes do gênero masculino têm mais dentes afetados pela recessão gengival e mais envolvimento de furca.(AU)

The Reliability of Fishman and Nolla Methods in Prediction of Chronological Age of Yemeni Children / A confiabilidade dos métodos Fishman e Nolla na predição da idade cronológica de crianças iemenitas

Objective: This cross-sectional school based study aimed to assess the reliability of Fishman and Nolla methods in predicting the chronological age for Yemeni children. Material and Methods: Orthopantomographs and left handwrist radiographs were taken for 358 Yemeni children (193 boys and 165 girls) 8 - 16 years. Skeletal age estimated by Fishman method and dental age estimated by Nolla method were compared to chronological age using SPSS version 21, statistical significance was predetermined at P < 0.05 , using Intraclass Correlation CoefficientICC and Wilcoxon signed rank test. Results: The mean chronological, skeletal and dental ages were 12.00 ± 2.25 years, 12.39 ± 1.65 years and 11.32 ± 2.65 years, respectively. Intraclass correlation coefficient showed strong correlation between chronological age and skeletal and dental ages. Wilcoxon test showed Fishman method significantly underestimated the chronological age by 0.44 ± 1.26 years in boys and non-significantly underestimated the chronological age by 0.02 ± 1.08 years in girls. Nolla method significantly underestimated the chronological age by 0.59 ± 1.28 years in boys and 0.78 ± 1.21 years in girls. Conclusions: Chronological age of Yemeni children is highly correlated to skeletal age estimated by Fishman method and dental age estimated by Nolla method. However, the two methods underestimate the chronological age of Yemeni children.(AU)

Objetivo: Este estudo transversal de base escolar teve como objetivo avaliar a confiabilidade dos métodos Fishman e Nolla na predição da idade cronológica em crianças iemenitas. Material e Métodos: Foram realizadas ortopantomografias e radiografias do punho esquerdo em 358 crianças iemenitas (193 meninos e 165 meninas) de 8 a 16 anos. A idade esquelética estimada pelo método Fishman e a idade odontológica estimada pelo método Nolla foram comparadas com a idade cronológica pelo, utilizando-se o programa SPSS versão 21; a significância estatística foi predeterminada em P < 0,05, pelo coeficiente de correlação intraclasseICC e pelo teste de Wilcoxon. Resultados: As idades cronológica, esquelética e odontológica média foram de 12,00 ± 2,25 anos, 12,39 ± 1,65 anos e 11,32 ± 2,65 anos, respectivamente. O coeficiente de correlação intraclasse mostrou forte correlação entre idade cronológica e idade esquelética e dentária. O teste de Wilcoxon mostrou que o método Fishman subestimou significativamente a idade cronológica em 0,44 ± 1,26 anos nos meninos e não subestimou significativamente a idade cronológica em 0,02 ± 1,08 anos nas meninas. O método Nolla subestimou significativamente a idade cronológica em 0,59 ± 1,28 anos nos meninos e 0,78 ± 1,21 anos nas meninas. Conclusões: A idade cronológica de crianças iemenitas está altamente correlacionada à idade esquelética estimada pelo método Fishman e à idade dentária estimada pelo método Nolla. No entanto, os dois métodos subestimam a idade cronológica das crianças iemenitas.(AU)

The prevalence of tooth wear among a group of yemeni adults / La prevalencia del desgaste dental entre un grupo de adultos yemeníes

This study aimed at investigating tooth wear prevalence and determining the associated factors among a group of Yemeni adults. It is a preliminary cross-sectional and analytical investigation conducted on 600 participants aged 20­50 years. The participants were purposively selected from two main cities (Sana'a and Aden) with an equal sample size and divided equally by gender. For administering a questionnaire, interviews were conducted with all participants before clinically examining them. Using the Tooth Wear Index (TWI), tooth wear was assessed. Data were analyzed using the chi-square test to identify the relationship between tooth wear and associated factors., Tooth wear was prevalent among 78.67% of the participants; of which 64.83% were in anterior teeth, 63.83% in posterior teeth, 74% in maxillary teeth, and approximately 74.5% in mandibular teeth. It also was 100% prevalent in the 31-40 and 41-50 age groups, while it was 67.2% in the 20-30 age group. This showed that tooth wear prevalence was significantly higher in the two oldest groups than in the youngest group (p<0.001). Moreover, khat chewing, location, highly frequent consumption of foods and high frequency of acidic drinks consumption were critical indicators of tooth wear. Besides, a low education level, smoking and a low socio-economic status were associated with tooth wear. Finally, the study revealed that tooth wear is highly prevalent among adults in two Yemeni cities, and socio-behavioral risk indicators such as khat chewing and cigarette smoking have a significantly association with tooth wear.

Este estudio tuvo como objetivo investigar la prevalencia del desgaste dental y determinar los factores asociados en un grupo de adultos yemeníes. Es una investigación preliminar analítica y transversal que se lleva a cabo en 600 participantes de entre 20 y 50 años. Los participantes fueron seleccionados a propósito de dos ciudades principales (Sana'a y Aden) con un tamaño de muestra igual y divididos por igual por género. Para administrar un cuestionario, se realizaron entrevistas con todos los participantes antes de examinarlos clínicamente. Usando el Índice de Desgaste Dental, se evaluó el desgaste dental. Los datos se analizaron utilizando la prueba de chi-cuadrado para identificar la relación entre el desgaste dental y los factores asociados. El degaste dental tuvo una prevalencia del 78,67% de los participantes; de los cuales 64.83% en dientes anteriores, 63.83% en dientes posteriores, 74% en dientes maxilares y aproximadamente 74.5% en dientes mandibulares. Fue 100% prevalente en los grupos de edad 31-40 y 41-50, mientras que la prevalencia fue 67.2% en el grupo de edad 20-30. Esto demostró que la prevalencia del desgaste dental fue significativamente mayor en los dos grupos de personas mayores que en el grupo más joven (p<0.001). Además, mascar khat, la ubicación, el consumo muy frecuente de alimentos y la alta frecuencia de bebidas ácidas fueron indicadores críticos del desgaste dental. Además, el bajo nivel educativo, el tabaquismo y el bajo nivel socioeconómico se asociaron con el degaste dental. Finalmente, el estudio reveló que el desgaste dental es altamente prevalente entre los adultos en dos ciudades yemeníes, y los indicadores de riesgo socioconductual como la masticación de khat y el tabaquismo tienen una asociación significativa con el desgaste dental.

Prevalence of carotid artery calcification detected by digital panoramic radiographs in a sample of yemeni dental patients / Prevalencia de la calcificación de la arteria carótida detectada por radiografías panorámicas digitales en una muestra de pacientes dentales yemeníes

Background: Carotid artery calcification (CAC) is one of risk factors of cardiovascular disorders (CVDs). Digital panoramic radiographs can detect it. Aim of the study: This study aimed to determine the prevalence of CAC detected by digital panoramic radiographs in a sample of Yemeni dental patients. Materials and Methods: An observational and analytical cross-sectional study was used to investigate a convenience sample of 443 patients. These patients were interviewed face-to-face for their socio-demographic information and their medical background regarding CVDs and associated risk factors. The researchers for detection of CAC assessed the digital panoramic radiographs. Results: High income and middle-aged patients were risk factors of CVDs significantly associated with increased incidence of CAC (42 patients (9.5%) and 32 patients (7.2%), respectively). Patients with a previous medical consultation, previous medications and family history of CVDs revealed a significant higher prevalence of CAC (p=0.001). Conclusion: There was an increased prevalence of CAC detected on digital panoramic radiographs, as a risk factor of CVDs. CAC was more common in females than males.

Antecedentes: La calcificación de la arteria carótida (CAC) es uno de los factores de riesgo de enfermedades cardiovasculares (ECV). La CAC puede ser detectada por radiografías panorámicas digitales. Objetivo del estudio: Este estudio tuvo como objetivo determinar la prevalencia de CAC detectada por radiografías panorámicas digitales en una muestra de pacientes dentales yemeníes. Materiales y métodos: Se utilizó un estudio transversal observacional y analítico para investigar una muestra de conveniencia de 443 pacientes. Estos pacientes fueron entrevistados en persona para obtener su información sociodemográfica y sus antecedentes médicos con respecto a las ECV y los factores de riesgo asociados. Los investigadores evaluaron las radiografías panorámicas digitales para detectar CAC. Resultados: Los pacientes de ingresos altos y de mediana edad fueron factores de riesgo de ECV significativamente asociados con una mayor incidencia de CAC (42 pacientes (9,5%) y 32 pacientes (7,2%), respectivamente). Los pacientes con una consulta médica previa, medicamentos previos y antecedentes familiares de ECV revelaron una prevalencia significativamente mayor de CAC (p=0.001). Conclusión: Hubo una mayor prevalencia de CAC detectada en radiografías panorámicas digitales como factor de riesgo de ECV, y CAC fue más común en mujeres que en hombres.

Prevalence of impacted teeth among a sample of yemeni population and their association with sex and age / Prevalencia de dientes impactados entre una muestra de población yemení y su asociación con el sexo y la edad

Aim: the aim of the study was to assess the prevalence of impacted teeth and its association with sex and age among a sample of the Yemeni population. Materials and Methods: A cross sectional study design was employed. The study included 999 radiographical records of patients who had panoramic X- rays previously done. All radiographs were assessed for the number and type of impacted teeth, pathology-associated impaction, sex, age and location (mandible and/or maxilla). The collected data was analyzed using SPSS®version21 software. Results: The study sample comprised digital panoramic radiographs of Yemeni patients aged 17 to 54 years (mean 26.6 years). The present study found 542 patients (54.3%) presented with at least one impacted tooth. The 17 to 25 years age group of the study sample had the highest prevalence of tooth impaction (28.6%). Only 10 (1.0%) case presented pathologies associated with the impacted teeth. There was a significant difference in the number of male 203 (20.3%) and female 339 (33.9%) patients with impacted teeth (p=0.031). Impacted teeth occurred slightly more often in the mandible (42.8%) compared to the maxilla (42.4%). Conclusion: The prevalence of impacted teeth among a sample of Yemeni population was high. Third molars and canines were the most common impacted teeth. The prevalence of impacted teeth in females was higher than in males and it was higher in the mandible than in the maxilla, with the younger patients with a higher prevalence of impaction.

Objetivo: el objetivo del estudio fue evaluar la prevalencia de dientes impactados y su asociación con el sexo y la edad en una muestra de la población yemení. Material y Métodos: se empleó un diseño de estudio transversal. El estudio incluyó 999 registros radiográficos de pacientes con radiografías panorámicas realizadas previamente. Todas las radiografías fueron evaluadas en relación al número y tipo de dientes impactados, patología asociada a la impactación, sexo, edad y ubicación (mandíbula y/o maxilar). Los datos recopilados se analizaron utilizando el software SPSS® version 21. Resultados: La muestra del estudio comprendió radiografías panorámicas digitales de pacientes yemeníes entre 17 a 54 años (media 26,6 años). El presente estudio encontró que 542 pacientes (54,3%) presentaron al menos un diente impactado. El grupo de edad de 17 a 25 años de la muestra de estudio tuvo la mayor prevalencia de impactación dental (28,6%). Solo 10 casos (1,0%) presentaron patologías asociadas a los dientes impactados. Hubo una diferencia significativa en el número de pacientes masculinos 203 (20.3%) y femeninos 339 (33.9%) con dientes impactados (p=0.031). Los dientes impactados ocurrieron con un poco más de frecuencia en la mandíbula (42.8%) en comparación con el maxilar (42.4%). Conclusión: La prevalencia de dientes impactados entre una muestra de población yemení fue alta. Los terceros molares y caninos fueron los dientes más comúnmente impactados. La prevalencia de dientes impactados en las mujeres fue mayor que en los hombres y fue mayor en la mandíbula que en el maxilar, y los pacientes más jóvenes mostraron una mayor prevalencia de impactación.

Perception and confidence levels among dental students and interns in performing various endodontic procedures / Niveles de percepción y confianza entre estudiantes de odontología y pasantes en la realización de diversos procedimientos de endodoncia

Aim: The present study aimed to collect information from senior students and new interns enrolled at the College of Dentistry, University of Science and Technology (UST), regarding their confidence levels in performing endodontic treatments. Materials and Methods: Anonymous surveys were distributed to 40 senior students and 37 new interns at UST, in Sana'a, Yemen. They were asked to indicate their self-confidence level using a Likert scoring system ranging from 1 and 5. Mann-Whitney U test and chi-squared test were used to determine statistical significance between the studied groups. Results: 37.5% of students and 35.1% of interns rated endodontic practice as difficult. Only 55% of students found that the number of treated cases were satisfactory, similar to that reported by interns (56.8%). There were no statistically significant differences between both groups regarding self-confidence levels for most endodontic procedures (p<0.05). Placing of a rubber dam, followed by managing inter-appointment flare-ups were procedures in which both groups reported the lowest confidence. On the other hand, both groups felt the lowest confidence in the treatment of maxillary followed by mandibular molars. Statistically significant differences were reported between the two groups for performing root canal treatments (RCT) (p< 0.05). Self-confidence levels on the management of most different indications showed no statistically significant differences between both groups (p>0.05) with exception to the management of irreversible pulpitis, necrotic pulp, asymptomatic apical periodontitis, chronic abscess, and traumatic cases, in which significant differences were noticed (p<0.05). Immature apices, root resorption, endodontic-periodontal (EP) lesions, trauma, symptomatic apical periodontitis and acute abscess were ranked as the cases in which both groups reported the lowest confidence. Canal blockage and ledge formation were the main mishaps encountered during practice among students and interns. Conclusion: Students and interns displayed neutral confidence in performing endodontic treatments.

Objetivo: El presente estudio tuvo como objetivo recopilar información de estudiantes de último año y nuevos pasantes inscritos en la Facultad de Odontología, Universidad de Ciencia y Tecnología (UST), con respecto a sus niveles de confianza en la realización de tratamientos de endodoncia. Materiales y métodos: se distribuyeron encuestas anónimas a 40 estudiantes de último año y 37 nuevos pasantes en UST, en Sana'a, Yemen. Se les pidió que indicaran su nivel de confianza en sí mismos utilizando un sistema de puntuación Likert que oscilaba entre 1 y 5. Se utilizaron la prueba U de Mann-Whitney y la prueba de ji al cuadrado para determinar la significación estadística entre los grupos estudiados. Resultados: el 37.5% de los estudiantes y el 35.1% de los pasantes calificaron la práctica de endodoncia como difícil. Solo el 55% de los estudiantes encontró que el número de casos tratados fue satisfactorio, similar al reportado por los pasantes (56.8%). No hubo diferencias estadísticamente significativas entre ambos grupos con respecto a los niveles de autoconfianza para la mayoría de los procedimientos de endodoncia (p<0.05). La colocación de una presa de goma, seguida de la gestión de brotes entre citas, fueron procedimientos en los que ambos grupos informaron la menor confianza. Por otro lado, ambos grupos sintieron la menor confianza en el tratamiento del maxilar seguido de los molares mandibulares. Se informaron diferencias estadísticamente significativas entre los dos grupos para realizar tratamientos de conducto radicular (ECA) (p<0.05). Los niveles de autoconfianza en el manejo de la mayoría de las indicaciones diferentes no mostraron diferencias estadísticamente significativas entre ambos grupos (p>0.05) con excepción del manejo de pulpitis irreversible, pulpa necrótica, periodontitis apical asintomática, absceso crónico y casos traumáticos, en los cuales se notaron diferencias (p<0.05). Los ápices inmaduros, la reabsorción radicular, las lesiones endodóncicas-periodontales (EP), los traumatismos, la periodontitis apical sintomática y el absceso agudo se clasificaron como los casos en que ambos grupos informaron la menor confianza. El bloqueo del canal y la formación de repisas fueron los principales percances encontrados durante la práctica entre estudiantes y pasantes. Conclusión: los estudiantes y los pasantes mostraron una confianza neutral en la realización de tratamientos de endodoncia.

Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: a randomized controlled clinical trial

Aim: the present study aimed to assess the clinical efficacy of nanosilver (NS) mouthwash and compared with chlorhexidine (CHX) mouthwash for the treatment of plaque-induced gingivitis. materials and methods: sixty-two (28 males and 34 females) plaque-induced gingivitis patients were allocated into two groups and asked to rinse with 10ml of NS or CHX, immediately after brushing, for 1 min, in the morning and evening. the plaque, gingival, and papilla bleeding indices were taken at baseline, two weeks, and finally at four weeks for each patient. the statistical analysis between and within groups were performed using Mann-Whitney U-test and Wilcoxon signed rank test respectively. result: Intergroup comparison by Mann-Whitney U-test showed no statistically significant differences in the investigated groups at the baseline for all studied parameters. at 2 and 4 weeks follow up, the CHX group showed statistically significant lower plaque scores than the NS group (p<0.05). however, there is no statistically significant difference between NS and CHX groups for gingival and papilla bleeding scores (p>0.05). both groups showed statistically significant reductions in plaque, gingival and papilla bleeding scores after 2 weeks and 4 weeks of product use when compared to baseline (p<0.001). conclusion: both mouthwashes decreased plaque, gingival and papilla bleeding scores, however the reduction in plaque scores was higher for the CHX group compared to the NS group.

Management of temporomandibular joint ankylosis in yemeni children by metatarsal bone grafts

Aim: This study aimed to evaluate temporomandibular joint reconstruction in Yemeni children with metatarsal bone graft after release of ankylosis. Methodology: Ten patients ≤12 years of age, comprising eight unilateral and two bilaterally TMJ ankylosis, were selected for this study. These patients underwent reconstruction with 10 non-vascularized metatarsal grafts. The reconstructed joints were then followed for an average of 1 year. Measures of opening, symmetry, and clinical symptoms relating to the reconstructed joints were assessed. Results: Mean pre-operative interincisal aperture was 8.2mm, and immediate post-operative aperture 23.4mm. At the end of the follow-up period, acceptable results were achieved in 8 out of 10 cases, with adequate mouth opening of 35.6mm in 8 out of 10 patients and overall interincisal aperture of 30.3mm. Re-ankylosis occurred in two bilaterally-treated patients at the end of follow-up. Subjectively, 80 percent of the patients rated their function as satisfactory and were able to occlude and masticate without any difficulty. Conclusion: Reconstruction of TMJ after release of ankylosis utilizing metatarsal bone graft shows a satisfactory interincisal aperture in 80 percent of patients.

Profesores cubanos enseñando Medicina, en un país árabe, en inglés / Cuban professors, teaching Medicine, in an Arabic country, in English

Introducción: La colaboración médica cubana no se ha limitado al campo de la atención de salud, también ha incluido la formación de recursos humanos autóctonos, incluyendo la creación de Facultades de Medicina en el exterior. La Facultad de Medicina de la República Democrática de Yemen es un destacado ejemplo de esta actividad. Objetivo: describir algunas características y singularidades de este relevante hecho de la colaboración médica cubana. Material y Métodos: Se realizó un trabajo histórico descriptivo, a partir de materiales periodísticos, fotografías, el diario personal y otros documentos del archivo del autor. Desarrollo: La Facultad de Medicina de Adén fue creada en 1975 con la participación de profesores cubanos en calidad de colaboradores. Durante su segundo curso, esta Facultad recibió la visita del Comandante en Jefe, Fidel Castro Ruz, durante su estancia en la República Democrática de Yemen, en marzo de 1977. La prensa yemenita brindó amplia cobertura a la visita. Fidel tuvo palabras de estímulo y admiración por la realización de esta tarea de colaboración. Conclusiones: La constitución de la Facultad de Medicina en la República Democrática de Yemen, en 1975, constituyó un hito histórico relevante en el desarrollo de la colaboración médica cubana. La visita de Fidel Castro a la Facultad de Medicina en Adén en marzo de 1977 fue un estímulo de especial significación para los colaboradores cubanos(AU)

Introducción: Cuban medical collaboration has not been limited to the field of health care, it has also included the training of own human resources, including the creation of Medical Faculties in other countries. The Faculty of Medicine of the Democratic Republic of Yemen is a leading example of this activity. Objective: To describe some characteristics and singularities of this relevant historical event of the Cuban medical collaboration. Material and Methods: A descriptive historical research was done, based on journalistic materials, photographs, personal diary and other documents of the author's archives. Development: The Faculty of Medicine of Aden was created in 1975 with the participation of Cuban professors as collaborators. During its second course, this Faculty received the visit of Commander-in-Chief Fidel Castro Ruz during his stay in the Democratic Republic of Yemen in March of 1977. The Yemeni press provided a wide coverage to the visit. Fidel had words of encouragement and admiration for the accomplishment of this collaboration. Conclusions: The creation of the Faculty of Medicine in the Democratic Republic of Yemen in 1975 was an important historical milestone in the development of Cuban medical collaboration. Fidel Castro's visit to the Faculty of Medicine in Aden in March 1977 was a stimulus of special significance for Cuban collaborators.(AU)

Tongue lesions and anomalies in a sample of Yemeni dental patients: a cross-sectional study

Background: Tongue examination helps considerably in diagnosing the underlying health state of the patient, especially in the cases of chronic diseases. The aim of this study is to determine the prevalence and association of tongue lesions with risk factors among Yemeni dental patients. Materials and methods: An oral medicine specialist examined all 713 patients attending the dental polyclinics at the University of Sciences and Technology (Sana’a, Yemen). The examination sheet was designed to include information related to patient characteristics, medical history, dental history, habits, and tongue lesions. Results: The prevalence of tongue lesions among the examined participants was 76.5 percent. The prevalence rate was 83.4 percent for males and 69.2 percent for females. Fissured tongue was the most common condition. Logistic regression analysis indicated that older age (p<0.001), gender (p=0.007), khat chewing (p<0.001), and smoking (p=0.001) were associated with fissured tongue; gender (p<0.001), khat chewing (p<0.001), and smoking (p<0.001) were associated with hairy tongue; and older age (p<0.001), khat chewing (p=0.001), and smoking (p=.021) were associated with coated tongue. Conclusion: The prevalence of tongue lesions among this sample of Yemeni population was 76.5 percent; fissured tongue and hairy tongue were the most prevalent lesions. Khat chewing, smoking, and older age were the associated risk factors for many of studied lesions and anomalies.

Cross-sectional assessment of the periapical status as related to quality of root canal fillings and coronal restorations in a Yemeni population

Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sana’a, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.