Annals Of Saudi Medicine[JOURNAL]
Sun
200 papers
Comorbidity of attention deficit hyperactivity disorder in young adults who had major depressive disorder.
Yazıcı M, Puşuroğlu M
Ann Saudi Med · 2025 · PMID 40189855 · Full text
BACKGROUND: The comorbidity of Major Depressive Disorder (MDD) and Attention Deficit Hyperactivity Disorder (ADHD) in adults is well recognized. The role of ADHD in the etiology of MDD, as well as the overlap of genetic...
BACKGROUND: The comorbidity of Major Depressive Disorder (MDD) and Attention Deficit Hyperactivity Disorder (ADHD) in adults is well recognized. The role of ADHD in the etiology of MDD, as well as the overlap of genetic and environmental factors between these two disorders, is an area of research. ADHD symptoms are considered risk factors for MDD. OBJECTIVES: The study aimed to examine the relationship between MDD in young adults with history of ADHD. DESIGN: Retrospective and observational study. SETTINGS: Outpatient clinic of a tertiary hospital. PATIENTS AND METHODS: Data of young adults diagnosed with MDD, aged 18-25 years and seen between January 2017 and May 2023, were included. Individuals with comorbidities other than ADHD in adulthood were excluded from the study. The sociodemographic and clinical data of a total of 489 cases, as well as data on childhood psychiatric referrals, diagnoses, and treatment histories, were retrospectively examined. MAIN OUTCOME MEASURES: ADHD diagnosis history and clinical impact in adults diagnosed with MDD. SAMPLE SIZE: 489. RESULTS: A total of 489 cases (68.9% female) with a mean age of 21.14 years were included in the study. It was determined that 8% of the cases had ADHD in adulthood, 13.3% in childhood, and 31.9% had at least one mental health diagnosis during childhood. The rate of ADHD diagnosis was significantly higher in males than females in both adulthood and childhood. Additionally, the age of diagnosis of MDD was lower in individuals with ADHD diagnosis and/or those who have discontinued ADHD treatment. CONCLUSIONS: In young adults diagnosed with MDD, the comorbidity of ADHD should also be considered. It is important to acknowledge that ADHD is not just a childhood disorder but a lifelong disorder due to its negative consequences, and to develop appropriate strategies in this regard. LIMITATİONS: Retrospective observational design and the single-center setting, which may affect the generalizability of the findings.
Outcomes of patients in intensive care units according to COVID-19 status: analysis of 114 854 cases in Saudi Arabia.
Alzahrani S, Ennaceur SA, Arbaein T
Ann Saudi Med · 2025 · PMID 40189854 · Full text
BACKGROUND: The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly affected global health systems. Healthcare systems across the globe have been pushed to...
BACKGROUND: The COVID-19 pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly affected global health systems. Healthcare systems across the globe have been pushed to their limits, with intensive care units (ICUs) witnessing a sharp rise in admissions, putting a strain on resources and personnel. OBJECTIVES: Examine ICU health outcomes, including mortality, length of stay (LOS), and discharge rates, among COVID-19 and non-COVID-19 patients. DESIGN: Retrospective, cross-sectional study. SETTING: A national cross-sectional dataset provided by the Ministry of Health in Saudi Arabia. PATIENTS AND METHODS: All patients admitted to ICUs across Saudi Arabia between January 1, 2022, and December 31, 2022. Patients were classified as confirmed COVID-19 cases and non-COVID-19 cases. To evaluate the ICU outcomes, the study used multivariate regression models, adjusting for covariates including age, gender, region, citizenship, and comorbidity score. MAIN OUTCOME MEASURES: ICU outcomes including mortality, LOS and discharge rate. SAMPLE SIZE: 114 854 ICU patients. RESULTS: The study population consisted of 114 854 ICU patients across various demographic and clinical categories. Mortality was found to be higher in COVID-19 patients than non-COVID-19 patients, with COVID-19 patients showing a 7% increase in mortality (OR=1.07, 95% CI: 1.02-1.12). Also, COVID-19 patients had 78% higher odds of being discharged home than the non-COVID-19 group (OR=1.78, 95% CI: 1.71-1.84). Moreover, the average LOS in the ICU was significantly shorter for COVID-19 patients than non-COVID-19 patients by 6% on average (Coefficient=-0.06, 95% CI: -0.07 to -0.03). CONCLUSION: Significant differences were seen in ICU outcomes between patients with and without COVID-19, including mortality rates, discharge rates, and LOS. COVID-19 patients exhibited higher mortality rate and discharge rate, and shorter ICU LOS than those without COVID-19. LIMITATIONS: The data used in this study has missing critical information such as laboratory results, socioeconomic variables, and hospitalization characteristics.
Association between human herpesviruses and head and neck squamous cell carcinoma: a molecular perspective.
Gürler M, Gōkcan MK, Yüksel S … +1 more , Karahan ZC
Ann Saudi Med · 2025 · PMID 40189853 · Full text
BACKGROUND: Head and neck cancer (HNC) is the seventh most common malignant tumor. Herpesviruses are a significant risk factor in the multifactorial pathogenesis of HNC. OBJECTIVES: This study aimed to investigate the as...
BACKGROUND: Head and neck cancer (HNC) is the seventh most common malignant tumor. Herpesviruses are a significant risk factor in the multifactorial pathogenesis of HNC. OBJECTIVES: This study aimed to investigate the association between herpesviruses and the development of head and neck squamous cell carcinoma (HN-SCC). DESIGN: Experimental study. SETTING: A university hospital in Turkey. PATIENTS AND METHODS: Pathological archive tissue samples of 500 patients were included in the study. These samples were categorized into two groups: those diagnosed with HN-SCC (n=300, malignant group [MG]) and those diagnosed with benign head and neck lesions (n=200, benign group [BG]). The presence of herpesvirus in samples was detected using polymerase chain reaction. MAIN OUTCOME MEASURES: Association of herpesviruses in the development of head and neck cancer. SAMPLE SIZE: 500 patients. RESULTS: HHV-1, -2, -7, and -8 were not detected in any samples. In the malignant group (MG), EBV-DNA was detected in 1 patient (0.3%) and HHV-6 DNA in 2 patients (0.6%), while in the benign group (BG), VZV-DNA was detected in 1 patient (0.5%), EBV-DNA in 3 patients (1.5%), CMV-DNA in 5 patients (2.5%), and HHV-6 DNA in 3 patients (1.5%). While no significant difference was found between the groups for VZV, EBV, and HHV-6, a statistically significant difference was found in favor of the benign group for CMV. CONCLUSION: Although herpesvirus seroprevalence is relatively high in the population, the lack of viral genome in tissue samples indicates that other factors might be prominent in developing HN-SCC. LIMITATION: The storage conditions of the sample used (paraffinized sample) may have negatively affected the detection frequency of HHVs.
High-dose statins for the prevention of recurrent ischemic stroke: a systematic review and meta-analysis of randomized controlled trials.
Shahid MS, Bourgleh MS, Alharfi A … +5 more , Albariqi S, Albalawi L, Alohali R, Albaqami T, Bourgleh MS
Ann Saudi Med · 2025 · PMID 40189852 · Full text
INTRODUCTION: Ischemic stroke (IS) is a leading cause of disability and mortality, with fatal outcomes increased with recurrent strokes. This systematic review and meta-analysis of randomized controlled trials (RCTs) eva...
INTRODUCTION: Ischemic stroke (IS) is a leading cause of disability and mortality, with fatal outcomes increased with recurrent strokes. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the safety and efficacy of high-dose statins for secondary IS prevention. METHODS: This review was regestered on PROSPERO (registration number: CRD42024574088). Cochrane methodology was followed in this review and comprehensively searched PubMed, Embase, Cochrane Library and clinicaltrial.gov, to include all RCTs conducted from 2004 to 2024, comparing high-dose statins (simvastatin ≥40 mg, atorvastatin ≥40 mg, and rosuvastatin ≥20 mg) with low-dose statins, placebo, or standard care. Outcomes of this review were recurrent IS reduction and adverse events reported in RCTs. RESULTS: Nine RCTs involving 5,503 patients, with male patients ranging from 25.8% to 81.6% were included. Compared to controls, high-dose statins did not significantly reduce risks for secondary IS (OR 0.78, 95% CI [0.61, 1.00], =.05) and hemorrhagic stroke (OR 0.85, 95% CI [0.56, 1.29], =.45). Furthermore, no differences were observed in mortality rates and adverse events between groups. CONCLUSION: Treatment with high dose statins didn't reduce the risk of stroke recurrence or improve mortality, though further research is needed.
Electrocardiogram screening for school children: a cross-sectional, population-based study.
Alakhfash AA, Al Mesned A, Al-Manea W … +2 more , Al Qwaee A, Al-Hassnan ZN
Ann Saudi Med · 2025 · PMID 40189851 · Full text
BACKGROUND: Identification of life-threatening arrhythmogenic disorders, which may present during infancy, childhood, or later stages, enables the early initiation of effective preventive therapies. Electrocardiogram (EC...
BACKGROUND: Identification of life-threatening arrhythmogenic disorders, which may present during infancy, childhood, or later stages, enables the early initiation of effective preventive therapies. Electrocardiogram (ECG) screening may detect conditions that elevate risk of sudden cardiac death (SCD) at an early stage. OBJECTIVES: This study aims to assess the prevalence, clinical significance, and characteristics of ECG abnormalities in a large population of schoolchildren. It also aims to determine whether ECGs performed during childhood can aid in the early detection of conditions associated with the risk of SCD. DESIGN: Population-based cross-sectional study. SETTING: A multicenter study conducted at King Faisal Specialist Hospital & Research Centre (KFSHRC) in Riyadh and Prince Sultan Cardiac Center-Qassim (PSCC-Q), Qassim, Saudi Arabia. METHODS: The study analyzed 12-lead ECGs performed on elementary school students 6-15 years old in Buraidah, Qassim region, Saudi Arabia. ECGs were recorded and interpreted following international standards. Children with abnormal ECG results were referred for full pediatric cardiology evaluation. MAIN OUTCOME MEASURES: Prevalence of normal and abnormal ECG findings, including long QT intervals. SAMPLE SIZE: 14 403 students. RESULTS: During the study period, ECGs were performed on 14 403 students (53.8% females). The mean age was 9.5±1.9 years, and the mean weight was 32.1±16.1 kg. Abnormal ECGs were identified in 468 students (3.3%), 271 of whom had complete clinical evaluation, including repeat ECG and echocardiography. The most common ECG abnormality was a prolonged QTc interval. The overall prevalence of abnormal ECG findings ranged from 0.7% to 2.04%, with long QTc intervals (460 msec or more) found in 0.4% to 1.6% of students. CONCLUSIONS: Long QTc intervals (460 msec or more) were the most common ECG abnormality in school children, with an estimated prevalence of 0.4% to 1.6%. This study may serve as a model for large-scale, community-based, 12-lead ECG screening programs for children. LIMITATIONS: Causality cannot be derived given the design, the potential for false positive and false-negative results, and the lack of genetic studies for children with prolonged QT intervals.
Endometrial thickness as a predictive value of ectopic pregnancy in in-vitro fertilization/intracytoplasmic sperm injection cycles: a case-control study.
Alsadhan HF, Aljahdali GL, Alfaraj SS … +7 more , Masud N, Almutlaq M, Alwasel L, Alfaraj LH, Abualburak S, Alrabieaa H, Alsalman F
Ann Saudi Med · 2025 · PMID 39929793 · Full text
BACKGROUND: The incidence rate of ectopic pregnancy (EP) with assisted reproductive technology (ART) has been reported to be higher than that of spontaneous pregnancy. Endometrial thickness (EMT) is considered an indepen...
BACKGROUND: The incidence rate of ectopic pregnancy (EP) with assisted reproductive technology (ART) has been reported to be higher than that of spontaneous pregnancy. Endometrial thickness (EMT) is considered an independent risk factor. OBJECTIVES: Evaluation of endometrial thickness as a predictor of ectopic pregnancy in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. DESIGN: Case-control study. SETTING: Women's Health Specialist Hospital, formerly known as King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia. PATIENTS AND METHODS: This study was a 1:2 matched case-control study that enrolled 24 ectopic pregnancy patients and 50 matched intrauterine pregnancy patients. They were matched on maternal age, the presence of tubal factor, and parity. The estimated sample size for patients with ectopic pregnancy was 25-30, whereas that for controls was estimated to be 60 patients. The sampling technique was a purposive (nonprobability). MAIN OUTCOME MEASURES: Endometrial thickness after IVF/ICSI is a predictor of ectopic pregnancy. SAMPLE: 79 patients. RESULTS: Multivariate logistic regression analysis was performed to analyze EP predictors, and a receiver operating characteristic (ROC) curve was used to evaluate the predictors of EP. After adjustment for other factors in the logistic regression model, we found that the tubular factor increased the risk of EP by 7.6 times, whereas the ovarian factor significantly decreased EP by 85%. Other factors, including EMT, did not significantly affect the probability of developing ectopic pregnancy. CONCLUSIONS: EMT was not predictive nor protective of EP in women who underwent ART cycles. Nevertheless, the presence of tubular factors has strong predictive value, whereas ovarian factors have significant protective value against EP. LIMITATIONS: The study design affects the generalizability and level of evidence provided. The small sample size and single-center inclusion had an impact on the results and statistical tests used.
The therapeutic effect of leucogen in treating alcoholic liver cirrhosis with thrombocytopenia or leukopenia.
Su M, He M, Yang WC … +7 more , Wang J, Guo C, Fu YM, Chun-Wang, Li S, Ji D, Chen HY
Ann Saudi Med · 2025 · PMID 39929792 · Full text
BACKGROUND: Thrombocytopenia and leukopenia are common complications of alcoholic liver cirrhosis (ALC) and are associated with an increased risk of bleeding, infection and mortality. OBJECTIVES: Evaluate the effectivene...
BACKGROUND: Thrombocytopenia and leukopenia are common complications of alcoholic liver cirrhosis (ALC) and are associated with an increased risk of bleeding, infection and mortality. OBJECTIVES: Evaluate the effectiveness and safety of leucogen, a cysteine derivative that increases platelet (PLT) and white blood cell (WBC) counts in ALC patients. DESIGN: Retrospective. SETTING: Department of hepatology, general hospital. PATIENTS AND METHODS: Patients with ALC who had thrombocytopenia and/or leukopenia were enrolled between 2022 and 2023 and were divided into two groups based on their treatment: the leucogen group (20 mg, three times per day) and the non-leucogen group. MAIN OUTCOME MEASURES: The primary endpoint was an increase in PLT or WBC of ≥5% from baseline. SAMPLE SIZE: 413 patients (320 patients in the final analysis). RESULTS: In this retrospective study, 320 patients were analyzed post-propensity score matching: 160 patients each in the leucogen and non-leucogen groups. Following 3 months of treatment, the leucogen group experienced a median increase in PLT levels of 1.0×10/L versus a decrease of 3.0×10/L in the non-leucogen group (=.003), and a median increase in WBC counts of 0.1×10/L compared to a decrease of 0.1×10/L (=.006). The changes in ALT, AST, and TBIL levels were not significantly different between groups. A higher proportion of patients in the leucogen group experienced increases in both PLT (46.9% vs. 32.5%, =.012) and WBC counts (50.0% vs. 36.2%, =.018), and 28.1% of patients in the leucogen group had increases in both parameters, compared to 15.6% in the non-leucogen group (=.01). The leucogen group also demonstrated greater increases in PLT (OR 1.833; =.009) and WBC counts (OR 1.759; =.013) compared to the non-leucogen group. The safety profile of leucogen was favorable, with no significant adverse events reported. Leucogen was particularly beneficial for patients younger than 60 years and those with lower baseline ALT and AST levels, showing significant improvements in both PLT and WBC counts in these subgroups. CONCLUSIONS: Leucogen effectively increased PLT and WBC counts in patients with ALC, showing a favorable safety profile. LIMITATIONS: Retrospective study.
Timing of discharge of pediatric patients post cardiac catheterization.
Alakhfash AA, Al Mesned AA, Al Qwaiee AM … +2 more , Kolko N, Alnakhli Z
Ann Saudi Med · 2025 · PMID 39929791 · Full text
BACKGROUND: Same-day discharge after cardiac catheterization may be safe for some patients. This study aimed to review our experience with same-day discharge after pediatric cardiac catheterization following the implemen...
BACKGROUND: Same-day discharge after cardiac catheterization may be safe for some patients. This study aimed to review our experience with same-day discharge after pediatric cardiac catheterization following the implementation of a fast-track protocol. OBJECTIVES: Evaluate the feasibility of same-day discharge after pediatric cardiac catheterization and identify risk factors for prolonged hospital stay. DESIGN: Retrospective review. SETTING: Pediatric cardiology department. PATIENTS AND METHODS: Data from patients who underwent cardiac catheterization were recorded over 17 months, from January 2022 to May 2023, focusing on pediatric cardiac catheterization procedures, including demographics, clinical, echocardiographic, catheterization data, and outcomes. Criteria were set to determine the possibility of same-day discharge post-cardiac catheterization. MAIN OUTCOME MEASURES: The primary outcome was the length of hospital stay post-cardiac catheterization. Secondary outcomes included identifying risk factors for prolonged hospital stay (more than 12 hours) and any associated complications. SAMPLE SIZE: 300 patients. RESULTS: Of the 300 patients, 201 (67%) were discharged on the same day (with less than 12 hours' hospital stay), and 57 patients (19%) stayed overnight. The median length of stay (LOS) after pediatric cardiac catheterization was 8.7 hours (25th percentile: 7.5 hours, 75th percentile: 23.8 hours). No complications were reported in patients discharged on the same day. The majority of procedures were interventional cardiac catheterizations (242 cases, 80.7%), with most patients (166 cases, 55.3%) discharged on the same day of the procedure. The most common age group was between 3 to 6 months (114 patients, 38%). Regression analysis revealed that cardiac catheterization in neonates and infants less than 3 months old, more complex interventions such as patent ductus arteriosus stenting and right ventricular outflow tract stenting, interventions in the aortic valve, and the occurrence of complications were associated with prolonged hospital stay. CONCLUSION: Same-day discharge following catheterization is feasible for the majority of pediatric patients and can contribute to reduced healthcare costs and improved patient satisfaction. We developed a fast-track protocol for assessing the timing of discharge after pediatric cardiac catheterization, outlining potential indications and contraindications for same-day discharge. Factors associated with prolonged hospital stays include interventions in the neonatal period and procedure-related complications. Careful patient selection and monitoring impleare essential to ensure optimal outcomes. LIMITATIONS: The retrospective nature of the study and the single-center experience may limit the generalizability of the findings.
Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia.
Alayed T, Alansary A, Al-Nahdi M … +6 more , Alotaibi A, Alhuthil R, Al Abdulsalam M, Aljofan F, Alturki A, Alofisan T
Ann Saudi Med · 2025 · PMID 39929790 · Full text
BACKGROUND: Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate. OBJECTIVES: Investigate AKI incidence, outcomes, and mortality-related risk factors am...
BACKGROUND: Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate. OBJECTIVES: Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children. DESIGN: Retrospective cohort. SETTING: A PICU. PATIENTS AND METHODS: The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre. MAIN OUTCOMES MEASURES: AKI incidence, outcomes, and mortality-related risk factors. SAMPLE SIZE: 111 records of patients with AKI. RESULTS: Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16-120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (=.042) and inotropic support (=.001) as significant predictors of mortality. CONCLUSION: These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted. LIMITATIONS: Retrospective study single-center nature.
Nontraumatic headaches in the emergency department: identifying clinical associations and predictive warning signs of intracranial pathologies.
Alghamdi AM, Alghamdi AM, Allarakia YF … +5 more , Alghamdi AS, Alrashid AS, Alotaibi AM, Addas R, Lary AI
Ann Saudi Med · 2025 · PMID 39929789 · Full text
BACKGROUND: Although headaches are common, only 3-21% are estimated to be secondary, with their causes ranging from non-alarming to life-threatening conditions. OBJECTIVES: Evaluate the associated factors and predictive...
BACKGROUND: Although headaches are common, only 3-21% are estimated to be secondary, with their causes ranging from non-alarming to life-threatening conditions. OBJECTIVES: Evaluate the associated factors and predictive warning signs of intracranial pathologies in patients presenting with nontraumatic headaches to the emergency document (ED). DESIGN: Retrospective chart review. SETTINGS: Medical center in Jeddah. PATIENTS AND METHODS: Data were collected from all patients who presented to the ED with nontraumatic headaches and underwent brain computed tomography (CT) scans from September 2021 to September 2022. MAIN OUTCOME MEASURES: The associated factors and predictive warning signs of intracranial pathologies. SAMPLE SIZE: 387. RESULTS: Sixty-seven (17.31%) patients had intracranial pathologies. The median (IQR) age of all patients was 49 (23) years and females constituted 61.8%. Patients with intracranial pathologies were significantly more likely to have severe headaches (59.7% vs. 33.7%, <.001), to have compressing or sharp headaches (16.4% vs. 6.2%, P=.003), to have constant headaches (16.4% vs. 7.8%, =.003), to be on chemo-therapy or radiotherapy (10.5% vs. 2.8%, =.004), and to be smokers (13.4% vs. 6.2%, =.042) than the other group. Multiple logistic regression of headache warning signs revealed that significant changes or progression in pattern, frequency, or severity of headache (OR: 3.2, CI: 1.5-6.6, =.001), motor deficits, including abnormal reflexes (OR: 2.9, CI: 1.2-6.9, =.011), personality changes, confusion, memory impairment, drowsiness, slurred speech or loss of consciousness (OR: 2.6, CI: 1.4-5.0, =.002), and sudden onset of headache (OR: 1.9, CI: 1.0-3.6, =.046) were predictive of intracranial pathologies. CONCLUSIONS: Our findings suggest that these four headache warning signs can help physicians predict intracranial pathologies and subsequently decide which patients should undergo brain imaging in non-traumatic headache cases. LIMITATIONS: Single-center study and retrospective design.
Evaluation of intra-abdominal injuries in patients referred to the emergency department as a result of traffic accidents.
Yılmaz AM, Kalıntaş E, Yılmaz HEK
Ann Saudi Med · 2025 · PMID 39929788 · Full text
BACKGROUND: Traffic accidents are one of the most important reasons that increase the workload of emergency services all over the world. Especially in developing countries, this problem is difficult to solve due to rapid...
BACKGROUND: Traffic accidents are one of the most important reasons that increase the workload of emergency services all over the world. Especially in developing countries, this problem is difficult to solve due to rapid population growth. OBJECTIVE: The aim of this study was to evaluate the causes of mortality and morbidity, the organs affected by the injury, and the prognosis of the patients who are referred to the emergency department as a result of traffic accidents and underwent abdominal imaging. DESIGN: Retrospective, cross-sectional study. SETTING: A state hospital in Turkey. PATIENTS AND METHODS: 1014 patients admitted to Gaziantep Abdulkadir Yüksel State Hospital between 15 July 2022 to 15 July 2023 due to traffic accidents and examined for abdominal trauma were retrospectively evaluated. MAIN OUTCOME MEASURES: Evaluation of patients admitted due to traffic accidents and examined for abdominal trauma. SAMPLE SIZE: 1014 patients. RESULTS: The mean age of the patients was 25.88 years, 79.6% were male, 67.3% were admitted to the hospital by ambulance, 47.4% were admitted as a result of a vehicular traffic accident, 34.3% were admitted as a result of a non-vehicular traffic accident, 18.2% were admitted as a result of a motorcycle accident and 36.4% were drivers, 35.3% were pedestrians and 28.3% were passengers. Intra-abdominal organ injuries were detected in 3.2% of all patients, including urinary system in 1%, hepatobiliary system in 0.9% and spleen in 0.8%. It was determined that 13% of the patients had life-threatening injuries and 40.2% had injuries that could not be treated with simple medical intervention. CONCLUSION: It was determined that 21% of the patients admitted to the emergency department as a result of traffic accidents required hospitalization or resulted in death. Prevention of traffic accidents, which especially threaten the young population, is of great importance both in reducing the workload in the emergency department and in minimizing labor and financial losses. LIMITATIONS: Since the study was based on retrospective file review, files with missing information were not included in the study.
Impact of renin angiotensin system inhibitors on survival of patients with metastatic non-small cell lung cancer.
Sever N, Yunusov E, Çelebi A … +12 more , Yaşar A, Majidova N, Kocaaslan E, Erel P, Ağyol Y, Güren AK, Işık S, Arıkan R, Ercelep Ö, Köstek O, Bayoğlu İV, Sarıc M
Ann Saudi Med · 2025 · PMID 39929787 · Full text
BACKGROUND: We aimed to explore the correlation between anti-hypertensive treatment and survival rates in patients with metastatic non-small cell lung cancer (mNSCLC). OBJECTIVE: In this study, we analyzed the correlatio...
BACKGROUND: We aimed to explore the correlation between anti-hypertensive treatment and survival rates in patients with metastatic non-small cell lung cancer (mNSCLC). OBJECTIVE: In this study, we analyzed the correlation between antihypertensive treatment and survival in 300 patients with mNSCLC. DESIGN: Retrospective. SETTINGS: Medical faculty hospital. PATIENTS AND METHODS: We investigated the relationship between antihypertensive treatment and survival in 300 patients who were diagnosed with mNSCLC. We also examined the relationship between histological type, performance status, gender, age and type of antihypertensive medication used and survival. MAIN OUTCOMES AND MEASURES: Survival difference between mNSCLC patients with and without antihypertensive treatment. SAMPLE SIZE: 300 patients with mNSCLC. RESULTS: Among patients receiving concomitant antihypertensive treatment, 107 (35.7%) were prescribed angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB), 64 (21.3%) beta-blockers and 36 (11%) calcium channel blockers. The study found that the overall survival rates for all patients at 36 and 60 months were 11.5% and 7%, respectively. However, the ACEi/ARB group had higher survival rates at 18.1% and 12% for 36 and 60 months, respectively, compared to the non-ACEi/ARB group with rates of 8.7% and 5% (<.05). CONCLUSION: These results strongly suggest that renin-angiotension system (RAS) inhibitors hold great promise as potential adjunctive therapies for mNSCLC due to their significant inhibitory effects on cell proliferation, angiogenesis and tumor progression. LIMITATIONS: Retrospective and non-randomized nature. Additionally, the retrospective analysis did not allow for verification of the duration or regularity of drug use, which made it infeasible to examine dose-response relationships with reliability.
The association of metabolic positron emission tomography/computed tomography parameters with survival in small cell lung cancer.
Türk MA, Kömürcüoğlu B, Agüloğlu N … +4 more , Çiftçi TD, Fidan M, Çolak S, Batum Ö
Ann Saudi Med · 2025 · PMID 39929786 · Full text
BACKGROUND: Small cell lung cancer (SCLC) is a lung malignancy with a poor prognosis and metastases at the time of diagnosis. There is limited experience using positron emission tomography/computed tomography (PET/CT) fo...
BACKGROUND: Small cell lung cancer (SCLC) is a lung malignancy with a poor prognosis and metastases at the time of diagnosis. There is limited experience using positron emission tomography/computed tomography (PET/CT) for SCLC diagnosis, staging, and follow-up. OBJECTIVE: Investigate the survival effect of primary tumor standardized uptake value max (SUVmax), SUV mean, metabolic tumor volume (MTV), total lesion glucose (TLG), bone marrow SUV (BM), and bone marrow to liver ratio (BLR) in SCLC. DESIGN: Retrospective. SETTING: Single center in Turkey. PATIENTS AND METHODS: Patients who were cyto/histologically diagnosed with SCLC and had PET/CT simultaneous with the diagnosis were included in the study. MAIN OUTCOME MEASURES: The effect of PET/CT parameters on overall survival (OS) and progression-free survival (PFS). SAMPLE SIZE: 304. RESULTS: The 5-year OS median value was 14.62 months, and the 5-year PFS was 13.01 months. In Kaplan-Meier analysis, SUVmax, MTV, and TLG were statistically significant variables in OS (=.03; <.001; <.001, respectively). MTV and TLG were significant in PFS (<.001; =.0003, respectively). In the multivariate analysis, MTV was an independent PET/CT parameter associated with OS (=.003), stage of disease (=.012), SUVmax (=.003), MTV (=.016), and TLG (=.005) were significant variables in PFS. CONCLUSION: In our study, MTV was an independent parameter that can be used to predict survival in SCLC. Considering the effect of MTV, a metabolic PET/CT parameter on survival, it can be recommended for clinical use as a standard measure of evaluation in PET/CT reports, just like SUVmax. LIMITATIONS: The first limitation was the single-center and retrospective design of the study. Due to the retrospective design of the study, weight loss, performance status, and smoking history could not be obtained from every patient. Second, inaccurate registration of PET and CT images due to patient respiratory movements may affect measurements.
Feasibility, safety, and outcome of fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia at a low case-load center: one center's experience.
Alshanafey S, Kurdi WI, Tulbah M … +7 more , Khan RM, Al Sahan N, Al Mugbel M, Al-Hazzani F, Almutairi G, Jebreel A, Al-Nemer M
Ann Saudi Med · 2024 · PMID 39651926 · Full text
BACKGROUND: Antenatal fetoscopic endoluminal tracheal occlusion (FETO) has been introduced as an effective intervention to improve the outcome of severe congenital diaphragmatic hernia (CDH). OBJECTIVE: We report our ear...
BACKGROUND: Antenatal fetoscopic endoluminal tracheal occlusion (FETO) has been introduced as an effective intervention to improve the outcome of severe congenital diaphragmatic hernia (CDH). OBJECTIVE: We report our early experience with FETO. DESIGN: A retrospective chart review of case series. SETTING: Tertiary health care center. PATIENTS AND METHODS: 18-45 years old, with single fetuses diagnosed with left severe CDH (lung-head ratio <1 measured between 27-29 weeks of gestational age (GA) and liver up or observed/expected lung-to-head ratio <25%, normal echocardiogram and karyotype were included. FETO was performed between 28-30 weeks of gestation and removed after 4-6 weeks or at birth during an ex utero intrapartum treatment (EXIT) procedure. MAIN OUTCOME MEASURES: FETO represents a viable option for severe type of CDH fetuses with reasonable outcomes. FETO performance in low volume centers may be feasible with reasonable outcomes. Good outcome of postnatal care with no potential antenatal complications may affect FETO adoption in some societies. SAMPLE SIZE: 5. RESULTS: 14 pregnant women were referred for assessment and only 7 met the inclusion criteria. Two were excluded initially (late referral and spouse refusal) and a 3rd excluded later due to failure of FETO due to faulty balloons. The median age of the mothers was 28 years and the gestational age was 29 weeks. Median observed/expected lung-to-head ratio was 23%. Among patients who had successful FETO, one had the balloon removed fetoscopically 4 weeks after insertion and one was removed 8 weeks after insertion during an elective EXIT procedure and both have survived. The other two had premature labor after 1 and 5 weeks after FETO and balloon removed during an emergency EXIT procedures, and both died within 24 hours of birth. CONCLUSION: FETO represents a viable option for severe type of CDH fetuses with reasonable outcome. FETO performance in a low volume centers may be feasible with reasonable outcomes. Good outcome of postnatal care with no potential antenatal complications may affect FETO adoption in some societies. LIMITATIONS: Retrospective nature of the study may imply inaccuracy, but we believe data from electronic medical records is highly accurate.
Analysis of recurrence of risk factors after transcatheter bronchial artery embolization for hemoptysis.
Dong Y, An J
Ann Saudi Med · 2024 · PMID 39651925 · Full text
BACKGROUND: As a proven and preferred technique for hemoptysis, bronchial artery embolization (BAE) cannot avoid the possibility of postoperative recurrence; however, few studies have examined the causes of hemoptysis re...
BACKGROUND: As a proven and preferred technique for hemoptysis, bronchial artery embolization (BAE) cannot avoid the possibility of postoperative recurrence; however, few studies have examined the causes of hemoptysis recurrence after BAE. OBJECTIVES: Identify the risk factors for hemoptysis recurrence after BAE treatment. DESIGN: Retrospective. SETTING: Tertiary training and research hospital. PATIENTS AND METHODS: A retrospective analysis was conducted on 406 patients with hemoptysis, 55 patients who developed with recurrent postembolization hemoptysis, covering the period from January 2011 to January 2021. Single factor analysis and multiple factor logistic regression were used to analyze high-risk factors for hemoptysis recurrence. MAIN OUTCOME MEASURES: The incidence and risk factors for recurrence hemoptysis associated with transcatheter BAE. SAMPLE SIZE: 406 patients. RESULTS: Multivariate logistic regression analysis showed that preoperative computed tomography angiography (CTA) (odds ratio [OR]: 0.052, 95% CI: 0.012-0.225), tumor-related hemoptysis (OR: 20.753, 95% CI: 6.778-63.545), pleural thickening (OR: 3.168, 95% CI: 1.081-9.286), and bilateral lung lesions (OR: 8.442, 95% CI: 2.449-29.101) had a statistically significant impact on the recurrence of hemoptysis after BAE. CONCLUSIONS: Preoperative CTA serves as a protective factor against hemoptysis recurrence, whereas tumor-related hemoptysis, pleural thickening, and bilateral lung diseases are significant risk factors for hemoptysis recurrence following interventional therapy. LIMITATIONS: This was a retrospective analysis of a single center with a small sample, which may have a certain degree of recall bias when collecting data, thus, reducing the reliability of the results.
Application of digital slide scanning in external quality assessment program on intestinal parasites.
Nguyen VT, Huynh PTD, Nguyen PTB … +4 more , Tran DN, Nguyen VT, Ngo DQ, Le CV
Ann Saudi Med · 2024 · PMID 39651924 · Full text
BACKGROUND: Intestinal parasitic infections remain prevalent in Viet Nam. Therefore, ensuring quality assurance in intestinal parasite testing is crucial for screening laboratories. The challenges associated with liquid...
BACKGROUND: Intestinal parasitic infections remain prevalent in Viet Nam. Therefore, ensuring quality assurance in intestinal parasite testing is crucial for screening laboratories. The challenges associated with liquid or glass slide samples necessitate the exploration of digital slide applications, which can offer numerous benefits to program suppliers and participants. OBJECTIVES: Compare the true and concordance rates of digital and glass slides for diagnosis. DESIGN: Experimental research design. MATERIALS AND METHODS: In total, 30 medical professionals from 30 hospitals participated in the trial. The sets of slides encompassed a range of densities, including negative and coinfected slides. Seven types of glass slides were selected for scanning and digital slide production. MAIN OUTCOME MEASURES: The primary outcomes were true and concordance variables. Secondary outcomes included time sample sending and time completion. The digital slides were uploaded to a secure website for participant access while glass slides were sent individually by mail. Data collection involved participants analyzing specimens and reporting their results using a scoring method based on parasite detection and identification accuracy. SAMPLE SIZE: 210 glass and digital slide-reading results each. RESULTS: The mean true rate between original and glass slides diagnosis was 97.6% (range 90.0%-100%), and it slightly increased to 98.1% (range 90.0%-100%) when using digital slides. The average concordance diagnosis rate between glass and digital slides was 99.5%. Importantly, there were no differences in the diagnostic results between glass and digital slides. The findings revealed that the use of digital slides reduced the total time required by approximately 1.1 days compared with that of glass slides. CONCLUSION: Altogether, the application of digital slides in the external quality assessment program for intestinal parasites offers convenience for users through online platforms and saves operational time process. LIMITATIONS: The small sample size in this experimental study limited the statistical significance of the comparisons.
Discharge against medical advice in pediatrics: a 10-year retrospective analysis in a tertiary care center.
Albalawi M, Sadler K, Abudari G … +5 more , Alhuthil RT, Alyami HH, Alharbi AH, Badran RH, Malhmar AO
Ann Saudi Med · 2024 · PMID 39651923 · Full text
BACKGROUND: There is still limited data on Discharge Against Medical Advice (DAMA) in the pediatric population. Most research comes from low-and middle-income countries, where the financial burden associated with medical...
BACKGROUND: There is still limited data on Discharge Against Medical Advice (DAMA) in the pediatric population. Most research comes from low-and middle-income countries, where the financial burden associated with medical care is often an important reason to leave a healthcare facility prematurely. Discharge against medical advice in the children's population is considered a significant issue that may lead to an increased risk of morbidity and mortality. OBJECTIVES: Describe the characteristics and predictors of DAMA in children over ten years in in Riyadh, Saudi Arabia. DESIGN: Retrospective. SETTING: Tertiary care center. PATIENTS AND METHODS: This study included all patients aged <14 years who had DAMA during all admissions between 1 January 2012, and 31 December 2022. MAIN OUTCOME MEASURES: Data was retrieved from medical records and included 1) sociodemographic data, 2) medical history and clinical characteristics, 3) utilization of services during the admission leading to DAMA, and 4) interventions provided to prevent departure. SAMPLE SIZE: 355 DAMA episodes. RESULTS: Males accounted for 45.4%, and the average age was 4.4 years. The overall DAMA prevalence of was 0.4%. At baseline, 277 children (78%) had at least a chronic illness or severe baseline condition; 59% had a potential life-limiting or life-threatening condition. Reasons for DAMA included disagreement about the treatment plan (14.9%), social reasons (12.6%), and perception that the child's condition improved (5.6%). An increased risk of DAMA recurrence was associated with pre-existing severe or chronic medical conditions (OR: 8.2, =.004) and a discharge during the treatment phase (OR: 1.9, =.040). CONCLUSIONS: Despite inconsistent documentation, preventive measures included the involvement of healthcare providers, social services, and patient relations. The study highlights the need for standardized protocols and improved documentation practices to effectively address discharge against medical advice. LIMITATIONS: Needs to moderate documentation quality of DAMA episodes. The study was limited to a single center, which may affect the generalizability. Children might also have presented to receive care in another facility post-DAMA.
Prospective evaluation of serum and peritoneal fluid markers as indicators of postoperative complications in patients with enteric anastomosis.
Kasalović M, Odalović B, Mihajlović L … +5 more , Jakovljević S, Elek Z, Igrutinović G, Anđelković M, Pajčin M
Ann Saudi Med · 2024 · PMID 39651922 · Full text
BACKGROUND: Postoperative complications of colorectal cancer surgery contribute to increased morbidity and mortality in patients. OBJECTIVES: Investigate the role of biochemical markers in serum and peritoneal fluid in t...
BACKGROUND: Postoperative complications of colorectal cancer surgery contribute to increased morbidity and mortality in patients. OBJECTIVES: Investigate the role of biochemical markers in serum and peritoneal fluid in the development of postoperative complications in patients with enteral anastomosis. DESIGN: Prospective. SETTING: University hospitals. PATIENTS AND METHODS: The studied population consisted of patients who underwent surgical treatment with created anastomosis or Hartmann's resection from April 2022 to April 2024, conducted at the Clinical-Hospital Center Kosovska Mitrovica and the University Clinical Center Kragujevac. Spearman's correlation coefficient (r) was used to test associations between categorical variables. MAIN OUTCOME MEASURES: Lactate, albumin, lactate dehydrogenase, and IgA antibodies were monitored as predictors of anastomotic dehiscence and general postoperative complications. SAMPLE SIZE: 52. RESULTS: The concentration of lactate in the drain fluid on the third postoperative day was statistically significantly higher in patients who did not develop anastomotic dehiscence (=.006). The concentration of IgA antibodies in the drain fluid on the third and fifth days post-surgery showed a moderate negative correlation with lactate concentration (r=-.670, =.012; r=-.577, =.039), repectively. There was a significantly higher concentration of albumin in the drain fluid on the third day post-surgery in patients who developed dehiscence (=.040), and on the seventh day post-surgery in those who did not develop dehiscence (=.001). The concentration of LDH on the third day in the drain fluid after surgery was statistically significantly higher in patients who did not develop dehiscence (=.020). There was a statistically significant difference in lactate concentration in the drain fluid on the third (<.001) and fifth days (=.041) post-surgery, as well as in albumin concentration on the third day post-surgery (=.024) with respect to the development of general postoperative complications. CONCLUSION: This study revealed significant differences in the concentrations of lactate, albumin, and LDH in the drain fluid on the third and fifth days post-surgery with respect to the development of complications. These results suggest that monitoring these markers may help in the early identification of patients at risk of complications such as dehiscence. LIMITATIONS: Limited literature on specific aspects of this study, including the absence of a control group, small sample size, and two-center study.
Efficacy and safety of semaglutide: real-world tertiary care experience from Saudi Arabia.
Butt MI, Alkhalifah KM, Riazuddin M … +6 more , Almuammar SM, Almuammar SM, Alhifthi GA, Ahmed FW, Al Hashim SM, Waheed N
Ann Saudi Med · 2024 · PMID 39651921 · Full text
BACKGROUND: Semaglutide, a glucagon-like peptide-1, is an effective antidiabetic drug promoting weight loss and providing cardiovascular protection. The original trials did not include participants from Saudi Arabia; hen...
BACKGROUND: Semaglutide, a glucagon-like peptide-1, is an effective antidiabetic drug promoting weight loss and providing cardiovascular protection. The original trials did not include participants from Saudi Arabia; hence, the study's findings are expected to be useful. OBJECTIVES: Explore the efficacy, safety, and favorable effects of once-weekly subcutaneous semaglutide (1 mg) in patients with type 2 diabetes and those who received it as an off-license prescription without having diabetes. DESIGN: Retrospective review of medical records. SETTING: Department of medicine at our institution. PATIENTS AND METHODS: This retrospective observational study evaluated patients receiving the glucagon-like peptide-1 analog semaglutide, with the trade name Ozempic. The weight, height, body mass index, blood pressure, and laboratory data, including serum creatinine and hemoglobin A1c (HbA1c) levels and urine albumin/creatinine ratio, were recorded. Moreover, any history of medical comorbidities, such as cardiovascular diseases, cerebrovascular diseases, and heart failure, was documented before and after drug administration. MAIN OUTCOME MEASURES: Glycemic and weight loss efficacy. SAMPLE SIZE: 1007 patients. RESULTS: The median age of the patients was 57.0 years, comprising 60.28% females. Among them, 955 and 442 patients received the medication for at least 3 and 6 months, respectively. Our results show a 4.4% weight loss and 0.4% improvement in HBA1c in patients with diabetes. Similar results were observed in the patients without diabetes in terms of weight along with a significant decrease in diastolic blood pressure. Our results also show stability in the serum creatinine and urine albumin creatinine ratio. The drug was equally effective in males and females. CONCLUSION: Treatment with once-weekly subcutaneous semaglutide (1 mg) led to clinically significant weight loss and improved HbA1c level and cardiometabolic risk factors such as blood pressure. LIMITATIONS: Retrospective design.
Advanced trauma life support training outcomes in Saudi Arabia: a four-year multicenter analysis of influential characteristics and factors (2019-2023).
Aldarsouni FG, Alkhulaiwi H, Alruwaite H … +3 more , Alsubaie S, Abdulkareem F, Alsuabie N
Ann Saudi Med · 2024 · PMID 39651920 · Full text
BACKGROUND: The prevalence of trauma necessitates effective training for healthcare providers in Saudi Arabia. The Advanced Trauma Life Support (ATLS) program is pivotal, yet localized success rate data are lacking. OBJE...
BACKGROUND: The prevalence of trauma necessitates effective training for healthcare providers in Saudi Arabia. The Advanced Trauma Life Support (ATLS) program is pivotal, yet localized success rate data are lacking. OBJECTIVES: Determine the failure rate and identify factors influencing ATLS course success rates among physicianss in Saudi Arabia. DESIGN: A retrospective cohort. SETTING: Two major accredited ATLS training centers in Riyadh. PATIENTS AND METHODS: Participants who completed ATLS training at the Trauma Courses Office at the Ministry of National Guard Health Affairs from January 2019 to December 2020, and at the Clinical Skills and Simulation Center at King Saud University Medical City from December 2020 through January 2023. Particpitants were grouped as interns and all physicians other than interns, for the purpose of analysis. MAIN OUTCOME MEASURES: Success and failure rates were the primary outcomes, with failure identified as a score of less than 75% or below standard performance in the practical session. SAMPLE SIZE: 603. RESULTS: The overall failure rate for the ATLS courses was 36.6%. Analysis revealed age, pre-test scores, and attendance at a refresher course as significant predictors of success. Specifically, general practitioners and OMFS specialists had a higher odds of failing, while general surgeons and trauma-related specialties consultants were more likely to succeed. CONCLUSION: ATLS course failure is notably high, with specific specialties and levels demonstrating increased risk. Results indicate a need for tailored pre-course preparation and an extension of the course duration for less experienced participants to improve proficiency, especially for at-risk groups. LIMITATIONS: Retrospective design and other variables, such as emotional status, level of instructors, and level of motivation.
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