About Afghan Medical Journal: The Afghan Medical Journal (AMJ) is an official international open-access peer-reviewed journal, certified by the ministry of higher education, with ISSN 3007-0805 (Online) and ISSN 3007-0791 (Print) numbers, and functions under the oversight of an editorial board of the Kabul University of Medical Sciences (KUMS). KUMS is the first ever medical and higher education institute established in 1932 as a faculty of medicine, in the country with a vision to building healthy and prosperous society through imparting higher medical education and empowerment societies.

The printed version of the journal was established about 7 decades ago and has since published 194 serial issues providing cutting edge knowledge in the medicine and public health. The AMJ specifically encourages the faculty, practitioners and students to make the new knowledge, they obtained through robust research methods, available by publishing in the AMJ for national and global readership for optimal impact. The new knowledge disseminated through the journal informs policies and programs that improve the health and wellbeing of the humans. Online publication of the journal as well as indexing with global online databases will increase its readership and audience multifold and consequently its impact will substantially increase.

Articles


Prevalence of hanging deaths in forensic cases; Kabul city 2020-2022

Hasibullah Baha Nijrabi, Abdul Manan Paigham,

Abstract Introduction Hanging is defined as complete or partial suspension of the body by a ligature tied around the neck and force of constriction on the neck being applied by the weight of the body hanged. In general; hanging refers to a position in which a person hangs from the neck without any support. It can occur in a sitting, semi-sitting, or even fully reclined position. In addition to hard, semi-hard and soft ligatures, hanging can happen with tree branches, poles, car doors, etc. Depending on the type of ligature locations, hanging is divided into two categories, which can occur typically or atypically due to various factors (Alemi, Forensic Medicine, 2019). Objective of the Research The main purpose of this research is to obtain the prevalence of deaths caused by hanging, demographic characteristics and clinical symptoms of mechanical injuries in external examinations of deaths caused by hanging referred to the KFMSC during the years 2020-2022. Methods and Materials This study is designed as a descriptive or observational cross-sectional study. Results According to this study, out of a total of 3,895 cases of death during the years 2020, 2021 and 2022 that were referred to the Kabul Forensic Medicine Services Center, 171 cases (4.39%) were due to hanging. Among these 171 cases of death by gender, 112 cases (65.09%) were among women and 59 cases (34.91%) were observed among men. According to the age category, the majority of cases, especially 97 cases (56.72%) were among young people aged 18 to 40 years. Regarding the locations of the ligature knot in most cases, in 92 cases (53.80%) it was at the back of the neck. In addition, 90 cases (52.64%) were found without signs of mechanical and physical trauma. Final Conclusion The results of this study show that among the 171 deaths caused by hanging that were referred to the KFMSC during 2020, 2021 and 2022; the majority of cases were women and young people. That in most of the cases, the position of the ligature's knot is in the back of the neck, and no signs of Mechanical and physical trauma were observed in the majority of cases with external examinations. Keywords Prevalence, hanging-related fatalities, forensic medicine services center, study of documents

Prevalence of co-morbidities among fatal COVID-19 cases in Kabul, Afghanistan: A Cross-sectional study

Aminulhaq Sarwary, Mohamad Sediq Ysufzai, Ahmad Reshad Ghafori, Abduljalil Hassan, Ataullah Zarabi

Abstract Objective: This study explored the prevalence of co-morbidities among fatal COVID-19 cases admitted to the Afghan-Japan Communicable Diseases hospital in Kabul, Afghanistan. Methods: a descriptive cross-sectional study was carried out in Afghan-Japan Communicable Diseases Hospital, Kabul, Afghanistan. The data of fatal COVID-19 cases admitted to this hospital between 20 May and 20 June 2020 was retrospectively retrieved from the patients' documents in the hospital medical records department. Results: During the study period total of 50 Covid-19 patients died in Afghan-Japan Communicable Diseases Hospital whose diagnosis was confirmed by RT-PCR test. 33 (66%) were males, and 17 (34%) were females. Their mean age was 12.67± 57.6 years. Most patients were aged 50-60 years, and the least were aged 30-40 years. In terms of occupation, 16(32%) were housewives, 9(18%) were unemployed, 7(14%) were teachers, 5(10%) were government officials, 2(4%) were carpenters, 2(4%) were businessmen, 2(4%) were laborers, 1(2%) were doctor, 1(2%) were shopkeeper. 49(98%) were residents of Kabul, while 1(2%) was resident of other provinces. 5 patients (10%) had hypertension, 4(8%) had chronic renal failure, 1 (2%) had chronic obstructive pulmonary disease, and 38 patients (76%) had no co-morbidities. Conclusion: Most of the fatal COVID-19 cases in this study were men aged 50-60 years and residing in Kabul. Hypertension, chronic renal failure, and chronic obstructive pulmonary disease were the co-morbidities, respectively. Keywords: Co-morbidity, COVID-19, Afghan-Japan Hospital, Afghanistan

Objective: Assessment of the existence and severity of the adverse effects of Janssen COVID-19 vaccine among Kabul University of Medical Sciences students. Methods & Material: An interview- based, observational retrospective study was conducted to assess adverse effects of Janssen COVID-19 vaccine among Kabul University of Medical Sciences (KUMS) students from 13th to 29th March, 2022. After the administration of a single dose of the mentioned vaccine, a professional interviewer interviewed all the participants. Students were asked to report all the adverse effects they suffered within the first week of vaccination. Interrelation of the adverse effects was analyzed with the age and sex of the all the participants. The population had no history of previous COVID-19 vaccines. Result: The most common adverse effects of Janssen COVID-19 vaccine was pain at injection site. Most of the participants reported headache, fever and chills after taking single dose of Janssen Vaccine. The rare side effects of this vaccine were amnesia, dizziness, hand paralysis, hypotension and chest pain. Prevalence of the side effects was higher in age group <20 than age group ≥20. Those effects were mild to moderate in severity and there were no hospitalization reports. There was no case of severe adverse effect or Guillain–Barre syndrome (GBS). Adverse effects were more severe in participants with history of another COVID virus infection, SARS-CoV-2. Conclusion: The participants of this study reported that the adverse effects of Janssen COVID-19 vaccine were mild to moderate in severity and no case of severe adverse effects was reported. As the duration, the adverse effects were of short duration.

Background: Studies have shown that cancer is one of the main causes of death in most of the developed countries; and in the developing countries, cancer is the second leading cause of death. Objective: To investigate the prevalence of different types of cancers diagnosed in the oncology department of the referral Jamhoriat Hospital. Research Methodology: This is a retrospective quantitative cross-sectional study which was conducted using medical records of patients suffering from various types of cancers from the march 2022 to September 2023 in the specialized and referral Jamhoriat hospital in Kabul-Afghanistan. Results: Out of the 3001 patients who were included in the study, 62.2% were females and 37.8% were males. Most of them were between the age 39-57 years old. The most common cancers in females were breast cancer 20.7% and esophagus cancer 20.1% followed by stomach 8.1%, uterus and cervix 6.7%, gastro esophageal junction 6.6%, colorectal 6.5%, ovaries 4% ,liver 3.4%,sarcoma 2.9%, gallbladder 2.1% , kidney 1.8% ,non Hodgkin lymphoma 1.4%, Hodgkin lymphoma 1.3% ,skin melanoma 1.2% , lung 1.1% and urinary bladder 1.1%.The leading cancers in males were esophagus 26.5% followed by stomach 12.1%, colorectal 9.4%, gastro esophageal junction 8.5%, testicles 6%, liver 5.1%.%, sarcoma 4.1%, non Hodgkin lymphoma 2.8%, skin melanoma 2.7%, Hodgkin lymphoma 2.6%, lung 2%, gallbladder 1.6% , kidney 1.2% , and urinary bladder 1.1%.According to the ethnic of the patients most of them were Pashtuns 42.4% followed by Tajiks 35%, Hazara 10.3% and Uzbek 7.1% .Place of recidence of the patients mojrity of them were reside in central zone 38.8%, followed by north east 16.3%, south east 11.8%, north10.6%, east 9.3%, south 8.6% and west 4.6%. Conclusion: In current study the most common cancers in Afghans males were esophagus, stomach, colorectal, gastro esophageal junction, testicles and liver. And in Afghans females the most prevalent cancers were breast, esophagus, stomach, uterus and cervix, gastro esophageal junction, colorectal, ovaries and liver. Most of the patients were between 39-57 years old age categories. Further investigation is needed in future for finding the related factors.

Introduction: Bacterial meningitis is a bacterial infection that causes inflammation of the membranes that surround the brain and spinal cord. The aim of this study is to investigate the prevalence of bacterial meningitis from infectious (Antani) disease hospital in Kabul Afghanistan. Methods: This is a retrospective cross sectional study which used medical records of the diagnosed bacterial meningitis patients from Infectious (Antani) disease hospital between September 2021 to March 2022 in Kabul- Afghanistan. Results: From 331 diagnosed bacterial meningitis patients’ majority of them were female 69.8% followed by male 30.2%. Most of them 59.5% were between age 15-25 years old followed by 20.8% between 26-35 years old, 8.5% between 36-45 years old ,5.7% between 46-55 years old, 3.0% between 56-65 years old , 1.5% between 66-75 years old and 0.9% were between 76-90 years old. Majority of them resided in Kabul 35% followed by Ghazni 9.4%, Parwan 4.8% , Ghor 3.9% , Baghlan and Takhar 3.6% , Kapisa ,Logar,Wardak and Balkh 3.3%, Samangan and Kunduz 2.7% ,Bamyan and Faryab 2.4% , Sarpul 2.1% , Badakhshan and Paktika 1.8%,Paktya ,Zabul and Daikundi 1.5% ,Helmand 1.2%,Badghis and Khost 0.9% , Nangarhar 0.6%,Herat ,Nimruz , Laghman,Urozgan ,Kandahar ,Panjshir and Juzjan 0.3%. Conclusion: The current study is hospital based most of the bacterial meningitis patients were females followed by males and most of them were between 15-25 years old and majority of them were resided in Kabul. Further study is needed in future for better outcome.

Background: Hepatitis-B is a life-threatening disease, despite the availability of vaccines and drugs, this disease still remains a major human health problem worldwide specially in third world and low income countries such Afghanistan. Objective: To investigate the prevalence of hepatitis B from March 2023 to September 2023 in public and referral infectious disease (Antani) hospital in Kabul-Afghanistan. Research method: This is a retrospective cross sectional study using medical records of HBS positive patients from infectious disease (Antani) hospital. Results: Total of 36186 individuals visited hospital 217 were HBS positive with 0.59% prevalence. From 217 HBS positive patients: majority of the patients had chronic hepatitis b 63.6% followed by acute 36.4%, most of them were male 50.7% followed by female 49.3%, most of them were over 45 years olds 44.2%, most of them were married 82.9%, most of them were from provinces 52.1% followed by capital 47.9%. Most of the patients 89.9% had not family history of hepatitis b and only 10.1% of them had. Most of the patients 69.6% had weak economic status and 30.4% had good economic status. Conclusion: Most of the HBS positive patients were chronic, male 50.7% and female 49.3%, married, over 40 years old, low economic status, no family history of disease and residence in province 52.1% followed by capital 47.9%. Further investigation need to find its related factors and enhance knowledge of prevention HBV for all specially for married individuals.

Globally, around 2.5 million neonates die each year, and prematurity accounts for the main cause of such deaths. The majority cases of prematurity occur in Asian and African countries. Some factors may increase the risk of prematurity and are known as the associated factors of prematurity. Since there was a paucity of data regarding the prevalence and associated factors of prematurity in neonates admitted to the Neonatal Unit of Maiwand Teaching Hospital, such a study was conducted. Aims: To assess the prevalence and associated factors of prematurity in neonates admitted to the Neonatal Unit of Maiwand Teaching Hospital during 2021-2022. Method: This was an analytic cross-sectional study. SPSS software and appropriate statistical tests were used to analyze the data. Result: Totally, 121 neonates admitted to the Neonatal Unit of Maiwand Teaching Hospital were evaluated, of whom 61.2% were boys and 38.8% were girls. The mean gestational age of newborns was 35.4±3.3, while the mean maternal Body Mass Index (BMI) was 24.5±4. In newborn babies who were admitted, the prevalence of prematurity was found to be 48.8% (late preterm babies account for 24%) in this study. Maternal age less than 20 year was significantly associated with prematurity (AOR=4.8, P-value=0.027). Furthermore, there were statistically significant associations between maternal BMI less than 18.5 (AOR=9, P-value=0.047) and more than 30 (AOR=1.6, P-value=0.01) with prematurity. Conclusion: The prevalence of neonates with gestational ages of less than 37 weeks was higher in the Neonatal Unit, and more cases were late preterm. Maternal age less than 20 years, BMI less than 18.5 and more than 30 were significantly associated with prematurity.

PREVALENCE OF CO-MORBIDITIES AMONG FATAL COVID-19 CASES IN KABUL, AFGHANISTAN: A CROSS-SECTIONAL STUDY

Aminulhaq Sarwary, Mohamad Sediq Ysufzai, Ahmad Reshad Ghafori,Abduljalil Hassan,Ataullah Zarabi,

Coronavirus Disease (COVID-19) is an infectious illness caused by the novel coronavirus known as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study explored the prevalence of co-morbidities among fatal COVID-19 cases admitted to the Afghan-Japan Communicable Diseases hospital in Kabul, Afghanistan. Methods: a descriptive cross-sectional study was carried out in Afghan-Japan Communicable Diseases Hospital, Kabul, Afghanistan. The data of fatal COVID-19 cases admitted to this hospital between 20 May and 20 June 2020 was retrospectively retrieved from the patients' documents in the hospital medical records department. Results: During the study period total of 50 Covid-19 patients died in Afghan-Japan Communicable Diseases Hospital whose diagnosis was confirmed by RT-PCR test. 33 (66%) were males, and 17 (34%) were females. Their mean age was 12.67± 57.6 years. Most patients were aged 50-60 years, and the least were aged 30-40 years. In terms of occupation, 16(32%) were housewives, 9(18%) were unemployed, 7(14%) were teachers, 5(10%) were government officials, 2(4%) were carpenters, 2(4%) were businessmen, 2(4%) were laborers, 1(2%) were doctor, 1(2%) were shopkeeper. 49(98%) were residents of Kabul, while 1(2%) was resident of other provinces. 5 patients (10%) had hypertension, 4(8%) had chronic renal failure, 1 (2%) had chronic obstructive pulmonary disease, and 38 patients (76%) had no co-morbidities.

Background: Variability in the celiac trunk is frequent and should be taken into consideration when scheduling surgical operations or radiographic intervention, in order to minimize the possibility of unintentional damage to the blood vessels. The objective of this study was to estimate the prevalence of celiac trunk and identify various types of the existed variations using multi-detector computed tomographic angiography. Method: A cross-sectional study which was retrospective had been carried out. Images from the computed tomographic angiography were obtained between June 2017 and March 2018. Using a workstation, 3D reconstructions of the images were made and the normal and anatomical variations of the celiac trunk were examined. IBM SPSS statistic version 22 was utilized to calculate the results. Findings: Out of the 140 patients who were chosen, 23 were not included. With a male to female ratio of 65.8 to 34.2, the average age was 57.3 years. In 54 (46.2%) cases, anatomical variations of the celiac trunk were identified. In 21 cases (17.9%), the origin of the inferior phrenic artery from the celiac trunk was the most prevalent variation, followed by the celiac-colic trunk in 15 cases (12.8%). Nonetheless, some variations which were not included in Uflacker's classification were also seen in 31 (26.5%) of the cases. The association of the inferior phrenic artery with other Uflacker's types, the Buhler arc, the accessory hepatic artery from the celiac trunk, and the association of the celiac-colic trunk with the gastro-splenic and hepato-splenic trunks are among the variations which were identified.

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