Prevalence and risk factors for helicobacter pylori infection among Yemeni dyspeptic patients

Helicobacter pylori [H. pylori] is one of the world's most common human bacterial infections. Acquisition of H. pylori infection may be associated with chronic gastritis, peptic ulceration and gastric cancer. This study was aimed at investigating the prevalence of H. pylori infection among dyspeptic patients, any correlation with dyspeptic symptoms and endoscopic findings and, any socioeconomic and environmental risk factors. The study was conducted between September 1997 and October 1998 in one Endoscopy Unit, Sana'a city, Yemen. A total of 275 consecutive patients with chronic dyspepsia were enrolled in the study. Endoscopic examination was conducted, gastric biopsies were obtained from the antrum and corpus, and H. pylori infection was diagnosed at the time of endoscopy using the rapid urease test. The prevalence of H. pylori infection in our patients was 82.2% [95% confidence interval [CI] 78 to 87%]. Independent variables associated with infection were age >40 years [odds ration [OR]=2.2; 95% CI: 1.0-4.64; P=0.043]; the presence of >= 5 children under 14 years per household [OR=6.62; 95% CI: 2.245 to 19.5; P= 0.001]; and duodenal ulcer disease [OR=3.7; 95% CI: 1.38 to 10.0; P=0.009]. The prevalence of H. pylori infection in dyspeptic patients in Yemen seems to be high. Advancing age, 5 or more children per household and duodenal ulcer disease were found to be significantly associated with H. pylori infection

effects of chewing QAT leaves on psychotic patients

Chewing leaves of the Qat plant [Catha edulis] for their pleasurable central stimulant effect is a habit widespread in the Yemen and certain areas of East Africa. Their use is believed to Cause a variety of central nervous system [CNS] complaints /symptoms. We studied the effects of chewing Qat leaves on psychotic patients. 65 male psychiatric in-patients were recruited in this study. 40 of them were regular Qat chewers and 25 were rare chewers. Also, for purpose of comparison 50 age and weight matched healthy subjects 25 regular and 25 rare Qat chewers, as controls, were included in the study. They were interviewed using a structured questionnaire for assessing the effects of chewing Qat leaves. The study revealed that the prevalence of mood changes in the form of anxiety and/or depression, aggressive and / or hyperactivity behaviour, delusion symptoms and auditory hallucination were significantly higher [P<0.0l] among psychotic patients either regular or rare Qat chewers than those in regular and rare Qat chewing control subjects. This study confirms that Qat chewing can induce elevated mood, aggressive behaviour, delusions and auditory hallucination symptoms among psychotic patients who chew Qat leaves resulting in treatment difficulties. These effects are believed to be caused by the central effects of cathinone in Qat leaves, which is known to have amphetamine like effects

Familial clustering of type ll diabetes mellitus [dm] diagnosed under the age of 40 years in yemen: is it early-onset type ll dm or maturity-onset diabetes of the young?

Clinical presentation of type II diabetes mellitus [DM] has frequently been observed at an early age in developing countries, probably as a result of genetic, epidemiological and demographic factors. This study aimed to investigate the pattern of familial clustering of type II DM in patients who developed clinical diabetes before the age of 40 years. Patients and Method: The study involved family pedigrees, clinical assessments and laboratory investigations of 191 patients with type II DM, and 260 age-matched randomly selected non-diabetic controls. The prevalence of type II DM was found to be statistically higher among parents [P 0.0001], fullsiblings [P<0.0001], half-siblings [P<0.001], uncles [P<0.01] and aunts [P<0.001] of the index patients, as compared to the corresponding relatives of nondiabetic controls. The odds ratio of the family history index [FHI], in association with type II DM in probands who had no family history of diabetes [FHI=0.0], was significantly negative [OR=0.34; 95% CI 0.23, 0.52; P<0.0001]. At an FHI level of 0.5-1.0, there was a slight nonsignificant increase in odds ratio for diabetes [OR=1.53; 95% CI 0.95, 2.45; P=0.08]. A higher level of FHI [1.5] was associated with a significant increase in odds ratio for diabetes [OR=3.75; 95% CI 2.13, 6.64; P<0.0001]. The age-corrected relative risk of type II DM for the offspring of diabetic parents was found to be progressively increasing from a nonconsanguineous diabetic father [22%] or mother [26.5%], to nonconsanguineous conjugal diabetic parents [27%] and to the offspring of consanguineous single or conjugal diabetic parents [37.5%]. On the contrary, the age-corrected relative risk for the offspring of nonconsanguineous and consanguineous nondiabetic parents was characteristically lower [14% for each]. Maturityonset diabetes of the young [MODY] was suspected in 10 probands [5%], and early-onset type II DM in the offspring of conjugal diabetic parents in 16 probands [9%]. The remaining 165 probands [86%] were "unclassified" due to lack of specific classification criteria. The considerable familial clustering of type II DM diagnosed under the age of 40 years in this study population reflects the presence of a strong genetic component in its etiology. In addition, the development of early-onset type II DM was more likely associated with a consanguineous and/or conjugal diabetic parents and probably MODY subtype among a substantial number of patients. Epidemiological and demographic factors might have been implicated, especially in those with negative parental diabetic history

Demographic and clinical features of diabetes mellitus in 1095 yemeni patients

The ever-increasing incidence of diabetes mellitus is a cause for growing public health concern in both developed and developing countries. In this study, we aim to explore the special demographic and clinical features of diabetes, as seen in a large sample of Yemeni patients, and to compare these features with those reported in other countries. All patients referred to our diabetic clinic over a five-year period were investigated according to a standardized protocol. Data was collected and fed into a personal computer with a software statistical package for analysis. The relative frequencies of clinical classes of diabetes were 10.5% for BDD, 58.6% for non-obese NIDDM; 26.2% for obese NIDDM, and 4.7% for IGT. In the IDDM class, the age-specific relative frequency rate showed a higher and earlier onset peak frequency in females than in males. Among NIDDM class, about 31% of patients were diagnosed under the age of 45 years, and only 12% were first diagnosed after the age of 65 years. Most NIDDM patients came from social classes I and n [professionals and intermediate professionals] and most IDDM patients came from social class DIM [skilled manual]. A positive family history of diabetes among first-degree relatives of index patients was observed in 33.7% of IDDM patients, in 30% of non-obese NIDDM patients, in 39.2% of obese NIDDM patients and 32% of IGT patients. Female NIDDM patients had a significantly higher mean body mass index [BMI] than males [P<0.0001]. Hypertension was recognized in 24.2% of the diabetic population aged 20 to >65 years. Large vessel disease [LVD] was observed in 28% of patients, small vessel disease [SVD] in 45%, and peripheral neuropathy in 40.7%. Inadequate glycemic control was noticed during follow-up in the majority of patients. Diabetes mellitus in Yemen, especially NIDDM, is characterized by an earlier age at onset, and predominance of males and non-obese NIDM subclass. Other characteristics include moderate genetic susceptibility, inadequate glycemic control and high prevalence of chronic complications