DETERMINATION OF RIFAMPICIN MONO-RESISTANCE MYCOBACTERIUM TUBERCULOSIS IN THE NATIONAL TUBERCULOSIS CONTROL PROGRAMME IN SANA'A CITY-YEMEN: A SIGNIFICANT PHENOMENON IN WAR REGION WITH HIGH PREVALENCE TUBERCLOISIS

Objective: The current study was undertaken in Sana'a city, Yemen, which has one of the highest rates of Tuberculosis (TB) in the region. The aims of this retrospective study were determined the prevalence of true RIF's mono-resistance, using the gold standard of molecular assays comparing with culture based phenotypic drug susceptibility testing (DST), and determined the associated risk factors of contracting RF gene among Yemeni TB patients. Methods: Patient's data were collected in a predesigned questionnaire which included demographic information and the relevant risk factors associated with RIF. All sputum specimens received were routinely cultured, and, underwent phenotypic drug susceptibility testing. DNA sequences specific for MTB and RIF were detected by automated molecular test. Results: The total end treatment rate was 5.94% of the total cases (11/185).   MTB gene was positive for all cases which indicate more sensitive than sputum examination; 3.2% of total patients show RIF's genes positive. Higher rate of RIF with male (5.4%), and low in female patients (1.8%).  There was higher rate of RIF with age group 36-45 years (8.7%) and >15 years (7.1%). There was significant rate of RIF gene with after food drug taken (RIF=13.3%, with Odds ratio (OR)=6.4), and with DOTs program (RIF=10%, with OR=6.4). In addition, there was significant rate of RIF gene with one dose regimen (11.8%, OR=5.5). Conclusion: In conclusion, this study reveals the presence of RIF- M. tuberculosis in Sana’a, Yemen and most of them were observed among patients who default treatment. This is considered as a threat to TB control programme and it is recommended that strategies should be put in place in order to ensure patients’ compliance and monitoring of patients’ response to TB treatment.                       Peer Review History: Received 12 June 2019;   Revised 30 June; Accepted 8 July, Available online 15 July 2019 Academic Editor: Rola Jadallah, Arab American University, Palestine, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dr. Tanveer Ahmed Khan, Hajvery University, Lahore, Pakistan, [email protected] Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected] Similar Articles: THE RELATIONSHIP BETWEEN DIABETES MELLITUS AND TUBERCULOSIS IN REVIEW OF PREVALENCE, DIAGNOSTICS AND PREVENTIO

SURVEY OF SAFETY PRACTICES IN DIARRHEAL TREATMENT CENTERS: CHOLERA TREATMENT CENTERS IN YEMEN

Objectives:  Monitoring of Diarrheal treatment centers (DTCs) was conducted so as to assess the quality of care and help draw evidence-based decisions on the current and future support of DTCs and other cholera prevention interventions. Methods: This monitoring exercise was included 102 DTCs, data were collected by a trained team of 18 doctors, 18 nurses, and 2 supervisors during the month of June, 2019 to cover the center’s performance in the prior month i.e. May2019.  Specially designed forms were used for data collection applying mixed methods: direct observation, record review, direct and phone interviews with the staff and patients as well as discussions with the health offices and community leaders whenever feasible. Results: No more than 23% of DTCs have water for hand washing, showering and washing clothes at all times and in all important locations such as hand washers and toilets; and 76% have one toilet for every 50 patients, but only 57% of toilets are regularly disinfected. Hazardous practices ranged from 32 to 62% leading to cholera infection among 4 out of 10 health workers and 5 visitors of the DTCs. Around 27 % of the DTCs do not have a designated area to bury body excreta from severe cases; only 23% have an isolated area for the deceased. A high of 59% of designated staff are neither trained nor equipped to deal appropriately with dead bodies and only 39% of dead bodies are disinfected with chlorine solution 2%. Conclusions: The DTC network provides much-needed services over the width of the country. Lives are being saved on  a daily basis despite the ongoing conflict and other humanitarian interventions. However, despite the efforts made so far, there are remaining areas for the quality of the improvement, most importantly availing water and strengthening the infection control measures and preventions of hazardous practices.                        Peer Review History: Received 30 July 2020; Revised 15 August; Accepted 28 August, Available online 15 September 2020 Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 7.0/10 Average Peer review marks at publication stage: 8.0/10 Ali Awadallah Saeed, National University, Sudan, [email protected] Dr. Wadhah Hassan Edrees, Hajjah University, Yemen, [email protected] Similar Articles: EPIDEMICITY OF VIBRIO CHOLERA IN SANA’A CITY, YEMEN: PREVALENCE AND POTENTIAL DETERMINANTS &nbsp

BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

Objective: Biofilm formation by uropathogens on the surface of indwelling medical devices can inflict obstinate or recurring infection, thought-provoking antimicrobial therapy.  This study included 227 patients with indwelling urinary catheters and suffering from CAUTI. They were analyzed for biofilm formation and antibiogram susceptibility, 59.4% were males and 40.6% were females. Methods: Ensuing phenotypic identification of isolated bacteria, antibiotic sensitivity test was performed by modified Kirby–Bauer disc diffusion method following   the Clinical and Laboratory Standards Institute (CLSI 2015) guidelines; Biofilm-forming uropathogens were detected by the tissue culture plate (TCA) method. Results: The predominant uropathogen in catheter-associated UTIs (CAUTIs) was Escherichia coli 46.3%, followed by K. pneumoniae18.5%, P. aeruginosa 11.9%,7%, S. coagulase negative 5.7%, S. aureus 4.8%, Enterobacter spp. 4.4%, E. faecalis 1.3%.  The total rate of biofilm producer bacteria was 49.3% (21.1% high producers, 28.2% moderate producers). Prime biofilm producers were E. coli 60% with OR=8.6 (p=0.002), followed by K. pneumoniae 57.1% with OR=10.1 (p=0.002), and P. aeruginosa 37% with OR=6.6 (p=0.02). Gram-negative biofilm producers found 100%, 100%, 88.6%, 82.9%, 81.9%, 80.9%, and 72.4%, 40%, 33% resistant to ampicillin , amoxyclave, cotrimoxazole,  ceftraxone, nalidixic acid, ciprofloxacin, cefotaxime, nitrofurantoin and amikacin respectively. Conclusion: In conclusion, a high antimicrobial resistance was observed in biofilm producers than non-biofilm producers. Of recommended antimicrobial therapies for CAUTIs, ampicillin and amoxicillin-clavulanate were the least active antibiotics, whereas imipenem and amikacin were found as the most effectual for gram-negative biofilm producer. Likewise, penicillin and erythromycin were the least active antibiotics, whereas vancomycin, and rifampicin were found as the most effective antibiotic for Gram-positive biofilm producer.                                 Peer Review History: Received 10 December 2019;   Revised 26 December; Accepted 4 January, Available online 15 January 2020 Academic Editor: Rola Jadallah, Arab American University, Palestine, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Mujde Eryilmaz, Ankara University,Turkey, [email protected] Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] Dr. Ali Abdullah Al-yahawi, Al-Razi university, Department of Pharmacy, Yemen, [email protected] Similar Articles: EVALUATION OF ANTIBACTERIAL RESISTANCE OF BIOFILM FORMS OF AVIAN SALMONELLA GALLINARUM TO FLUOROQUINOLONES PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEMEN PSEUDOMONAS AERUGINOSA SKIN-NASOPHARYNGEAL COLONIZATION IN THE IN-PATIENTS: PREVALENCE, RISK FACTORS AND ANTIBIOTIC RESISTANCE IN TERTIARY HOSPITALS IN SANA'A CITY -YEMEN PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND RISK FACTORS OF MRSA ISOLATED FROM CLINICAL SPECIMENS AMONG MILITARY PATIENTS AT 48 MEDICAL COMPOUND IN SANA'A CITY-YEMEN PREVALENCE OF PSEUDOMONAS AERUGINOSA (P. AERUGINOSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEME

THE EFFECT OF NANOSILVER AND CHLORHEXIDINE MOUTHWASH ON ANAEROBIC PERIODONTAL PATHOGENS COUNTS

Objective: The necessitate for frequent application of Chlorhexidine (CHX), and other side effects has encouraged the search for option that are more suitable for patients as nanosilver mouthwash (NS). So the aim of this study was to determine the effects of a mouthwash made with nanosilver on dental plaque microbial counts and compare it with commercially available Chlorhexidine.    Methods: Sixty two plaque induced gingivitis patients were allocated into two groups and asked to rinse with 10 ml of NS and CHX, immediately after brushing, for 1 min, in the morning and evening. Sub gingival plaque microbial counts were taken at baseline, two weeks, and finally at four weeks for each patient. Subsequently, the samples were collected, transferred and cultured in blood agar in anaerobic media. The colonies were counted and expressed as CFUs. The statistical analysis between CFUs variables within groups was calculated and the variation significance was calculated by performed t-test.   Results: It is very obvious that the values of CFU decreased significantly (p<0.001) as the time of use nanosilver until reaching the highest value when the time of use was 4 weeks [70.3±47 to 32.4±24.6 (2 weeks), and 14.2±9.9 (4 weeks) with inhibition of growth rate after 2 weeks was 46% and after 4 weeks was 79.7%. The effect of commercially available CHX mouthwash was approximately similar to the effect of NS mouthwash used. Conclusion: In conclusion, both Group I and Group II showed similar effect on inhibition anaerobic periodontal pathogens counts and gingival health. There was significant inhibitory effect on microbial counts where NS mouth-wash had shown better results than CHX, but there was no significant difference between the nanosilver mouth wash and the Chlorhexidine mouthwash.                                                                                        Peer Review History: Received 12 September 2019;   Revised 2 November; Accepted 8 November, Available online 15 November 2019 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Mohamed Salama, Modern University for Technology & Information, Egypt, [email protected] Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] Similar Articles: EVALUATION OF CARBAPENEM USE AMONG PATIENTS AT INTENSIVE CARE UNIT (ICU) IN SANA'A, YEME

EXPLOSION OF HEPATITIS B AND C VIRUSES AMONG HEMODIALYSIS PATIENTS AS A RESULT OF HEMODIALYSIS CRISIS IN YEMEN

Objective: The United Nations considers the situation in Yemen to be the worst humanitarian crisis in the world. In the midst of this, the fastest-spreading viral infection among HD patients was recorded. Therefore, this cohort study based in HD unit was conducted in Dhamar Hospital to estimate the outbreak of hepatitis B and C viruses among dialysis patients during the dialysis crisis in Yemen. Methods: All the patients who continuous go through hemodialysis from January 2018 to December 2018 and they were free from HBV/HCV infections at the start of the study (January 2018) were included. Patients who were discontinued from dialysis before the end of the year due to death or relocation were excluded from the study. Patients were tested for anti-HCV antibodies and hepatitis B surface antigen (HBsAg) at study start (January 2018) then at the end of the follow up (December 2018). The individual’s data were collected in a pre-designed questionnaire including; demographic data of HD frequency, and laboratory results. Results: The study included 202 patients, 20 (9.9%), 18 (8.9%) and 6 (2.97%) were found to be infected with HCV, HBV and Co-HBV/HCV infection respectively. There was significant association between rise of HCV rate and younger patient age, and high frequency of dialysis.  Conclusion: In conclusion, the prevalence of HBV and HCV infection and HBV / HCV infection in haemodialysis patients in our surroundings one year after HD was extremely common and lead to disaster for HD patients. This catastrophe is due to the lack or limited availability of materials and tools for dialysis and laboratory materials for virus tests due to the unfair siege on Yemen from Saudi Arabia and the United Arab Emirates and the closure of Sana'a airport, which is the only entrance to medicines.    Peer Review History: Received 24 September 2019;   Revised 12 October; Accepted 1 November, Available online 15 November 2019 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dr. Mohammed Sadeg Abdullah Al-Awar, Physiology & Histopathology Queen Arwa University and Amran University, Yemen, [email protected] Dr. Heba-Tallah Ahmed  Mohamed Moustafa, Heliopolis University Cairo, Egypt, [email protected] Similar Articles: SERO-EPIDEMIOLOGICAL STUDY OF HEPATITIS B, C, HIV AND TREPONEMA PALLIDUM AMONG BLOOD DONORS IN HODEIDA CITY- YEMEN PREVALENCE OF HEPATITIS G VIRUS AMONG PATIENTS WITH CHRONIC LIVER DISEASE AND HEALTHY INDIVIDUALS, SANA'A CITY-YEMEN PREVALENCE AND GENOTYPING OF HEPATITIS C VIRUS IN HEMODIALYSIS PATIENTS AND EVALUATION OF HCV-CORE ANTIGEN TEST IN SCREENING PATIENTS FOR DIALYSIS IN SANA'A CITY, YEMEN PREVALENCE AND POTENTIAL RISK FACTORS OF HEPATITIS B VIRUS IN A SAMPLE OF CHILDREN IN TWO SELECTED AREAS IN YEME

DETECTION OF INFLUENZA VIRUSES AMONG HOSPITALIZED CASES SUFFERING FROM SEVERE ACUTE RESPIRATORY ILLNESS (SARI) IN SANA’A CITY, YEMEN

Objective: Influenza is a major cause of morbidity and mortality around the world. So national influenza surveillance have been important for understanding the epidemiology of influenza over time. The aims of this study were to determine the prevalence rate of influenza viruses among hospitalized patients with severe acute respiratory illness (SARI), identify circulating types and subtypes of influenza viruses among them, and determine the risk factors associated with SARI.Methods: A total of 320 hospitalized patients suffering from SARI at Al Joumhouri University hospital in Sana’a city were enrolled; and their age was ranged from < 1 year to ≥ 56 years. Both nasopharyngeal and oro-pharyngeal swabs were collected from each patient and tested by using rRT-PCR technique for the detection of influenza A, influenza B and subtypes of influenza A viruses (A/H1N1 (2009) and A/H3N2).Results: The crude prevalent rate of influenza viruses among SARI patients was 10.9%; the female rate was 12.4%, and the male rate was 9.9%.. The rate of Flu A in the total SARI cases was 5.9% and for Flu B was 5%. In addition 3.8% of SARI patients were suffering from influenza A/H3N2, 2.2% from influenza A/H1N1(2009) infections; and the mortality rate for influenza infections was 17.1%. Also, a high mortality rate was occurred in influenza infections in age groups 36-45 years and 6-15 years. Also, there was a significant association between flu infection; and 46-55 years group (OR=2.8), Winter time (OR=17.5), cardiac diseases (OR=9.1), and diabetic mellitus (OR=3.7).Conclusion: In conclusion: both influenza A and B were represented as a causative agents of SARI, and Influenza A/H3N2 was present subtype followed by A/H1N1(2009). The frequency of influenza viruses ascertain among SARI patients in Yemen highlights the need for health authorities to develop strategies to reduce morbidity among at-risk population in the course of vaccine recommendation.                           Peer Review History: Received 20 July 2019;   Revised 3 August; Accepted 8 September, Available online 15 September 2019 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 7.5/10 Average Peer review marks at publication stage: 9.5/10 Reviewer(s) detail: Dr. Nada Farrag, Misr International University, Egypt, [email protected] Dr. Nicola Micale, University of Messina, Italy,  [email protected]

SURVEY OF SAFETY PRACTICES IN DIARRHEAL TREATMENT CENTERS: CHOLERA TREATMENT CENTERS IN YEMEN

Objectives:  Monitoring of Diarrheal treatment centers (DTCs) was conducted so as to assess the quality of care and help draw evidence-based decisions on the current and future support of DTCs and other cholera prevention interventions. Methods: This monitoring exercise was included 102 DTCs, data were collected by a trained team of 18 doctors, 18 nurses, and 2 supervisors during the month of June, 2019 to cover the center’s performance in the prior month i.e. May2019.  Specially designed forms were used for data collection applying mixed methods: direct observation, record review, direct and phone interviews with the staff and patients as well as discussions with the health offices and community leaders whenever feasible. Results: No more than 23% of DTCs have water for hand washing, showering and washing clothes at all times and in all important locations such as hand washers and toilets; and 76% have one toilet for every 50 patients, but only 57% of toilets are regularly disinfected. Hazardous practices ranged from 32 to 62% leading to cholera infection among 4 out of 10 health workers and 5 visitors of the DTCs. Around 27 % of the DTCs do not have a designated area to bury body excreta from severe cases; only 23% have an isolated area for the deceased. A high of 59% of designated staff are neither trained nor equipped to deal appropriately with dead bodies and only 39% of dead bodies are disinfected with chlorine solution 2%. Conclusions: The DTC network provides much-needed services over the width of the country. Lives are being saved on  a daily basis despite the ongoing conflict and other humanitarian interventions. However, despite the efforts made so far, there are remaining areas for the quality of the improvement, most importantly availing water and strengthening the infection control measures and preventions of hazardous practices.                        Peer Review History: Received 30 June 2020; Revised 15 July; Accepted 28 August, Available online 15 September 2020 Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, [email protected] Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 7.0/10 Average Peer review marks at publication stage: 8.0/10 Ali Awadallah Saeed, National University, Sudan, [email protected] Dr. Wadhah Hassan Edrees, Hajjah University, Yemen, [email protected] Similar Articles: EPIDEMICITY OF VIBRIO CHOLERA IN SANA’A CITY, YEMEN: PREVALENCE AND POTENTIAL DETERMINANT