Samargandy SA, Khedher YZ, Alzahrani GA
… +5 more, Nahhas HT, Alshaikh MA, Samargandy S, Alzahrani KA, Ghoneim AH
Saudi Med J
· 2025 Oct · PMID 41087065
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OBJECTIVES: To evaluate the added diagnostic value of ultrasonographic risk levels to cytological diagnoses in nodules with Bethesda III and IV cytology. METHODS: This retrospective study was conducted in Jeddah, Saudi A...OBJECTIVES: To evaluate the added diagnostic value of ultrasonographic risk levels to cytological diagnoses in nodules with Bethesda III and IV cytology. METHODS: This retrospective study was conducted in Jeddah, Saudi Arabia, and involved analyzing thyroid nodules from patients who underwent thyroidectomy between 2016 and 2023. We focused on pathology, US risk stratification based on the 2015 American Thyroid Association (ATA) guidelines, and fine-needle aspiration cytology (FNAC) using the Bethesda system. We calculated malignancy rates for each ultrasound (US) and FNAC category, with the indeterminate cytology groups defined as follicular lesions of undetermined significance (FLUS) and follicular neoplasms (FN). RESULTS: In 290 patients, malignancy rates in the high-risk US group were 72%. In patients with FLUS, the malignancy rate was 36.9%, while in those with FN, it was 50%. For FLUS and FN, high-risk US features showed a sensitivity of 47%, a specificity of 81%, and a kappa of 29%. Combining FLUS with high-risk US features improved sensitivity to 50%, specificity to 80%, and kappa to 32%. CONCLUSION: For indeterminate thyroid cytology, US features can guide decision-making, supporting surgery in patients with high-risk US findings rather than follow-up or repeat FNAC.
Saudi Med J
· 2025 Oct · PMID 41087063
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OBJECTIVE: To evaluate and provide evidence on drugs investigated in completed phase IV clinical trials for adult non-small cell lung carcinoma (NSCLC) therapy, primarily focusing on treatment objectives and adverse effe...OBJECTIVE: To evaluate and provide evidence on drugs investigated in completed phase IV clinical trials for adult non-small cell lung carcinoma (NSCLC) therapy, primarily focusing on treatment objectives and adverse effects. METHODS: Clinical research studies from January 2020 to January 2025 were systematically reviewed using the "ClinicalTrials.gov" database. The inclusion criteria focused on publicly available, relevant, and completed Phase IV studies limited to "Clinicaltrials.gov", while those not meeting these specifications were excluded. As of 3 January 2025, a total of 7,541 Phase IV clinical trials were available on "ClinicalTrials.gov", of which 121 were related to NSCLC. RESULTS: Six of these clinical studies met the requirements for inclusion in the current investigation. The pharmacological agents investigated in these Phase IV trials were dacomitinib, lorlatinib, durvalumab, osimertinib, and a combination of rivaroxban and sotorasib. Treatment options for NSCLC remain limited due to its complex nature and frequent co-occurrence with other respiratory infections. CONCLUSION: The studies reviewed reported high rates of adverse events, alongside reduced subjective outcomes and faster response periods. This warrants for continuous research to develop safer and more efficient therapy methods for NSCLC patients..
Saudi Med J
· 2025 Oct · PMID 41087062
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OBJECTIVES: To identify the primary risk factors contributing to stroke incidents and deaths, analyzing the trends and changes in regional stroke statistics between 1990 and 2021 in the Gulf Cooperation Council (GCC) cou...OBJECTIVES: To identify the primary risk factors contributing to stroke incidents and deaths, analyzing the trends and changes in regional stroke statistics between 1990 and 2021 in the Gulf Cooperation Council (GCC) countries. METHODS: This longitudinal time trend study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from June to August 2024. The data were recorded from the Institute for Health Metrics and Evaluation (IHME) and the Global Burden of Diseases (GBD) datasets. The incidence, mortality, and disability-adjusted life year (DALY) rates of stroke in the GCC countries, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE), and their association with environmental pollution, dietary, and metabolic risk factors were documented from 1990 to 2021. RESULTS: From 1990 to 2021, the GCC countries exhibited varied trends in stroke incidence, mortality and DALYs. The UAE had the highest stroke incidence rate in 2021 (106.01 per 100,000). The mortality rates due to stroke decreased in the GCC, except in Kuwait, where they increased by 14.4%. DALYs decreased in GCC countries, with the highest decline in Qatar (56%). Qatar experienced a 59.9% decrease in death rates and a 53.4% reduction in DALYs for hypertension. CONCLUSION: In GCC countries, hypertension, air pollution, and dietary factors are dominant risk factors for stroke, stroke-related deaths, and DALY rates. The UAE had the highest stroke incidence rate in 2021. However, mortality rates decreased in all GCC countries except Kuwait.
Jamjoom M, Alharbi M, Malibari WM
… +6 more, Alshehri W, Aalem MA, Althubaity WD, Alalshaikh NK, Toonsi MA, Boker FA
Saudi Med J
· 2025 Oct · PMID 41087060
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OBJECTIVES: To assess the impact of Acute Coronary Syndrome (ACS) on quality of life (QoL) among patients at King Abdulaziz Medical City in Western Jeddah. Acute Coronary Syndrome significantly affect patients' QoL. Many...OBJECTIVES: To assess the impact of Acute Coronary Syndrome (ACS) on quality of life (QoL) among patients at King Abdulaziz Medical City in Western Jeddah. Acute Coronary Syndrome significantly affect patients' QoL. Many individuals experience challenges post-ACS. While previous research has identified baseline QoL, access to specialized care, and assessment tools as important factors influencing recovery, limited studies have examined how baseline QoL affects long-term outcomes. METHODS: This hybrid cross-sectional study included ACS patients treated at King Abdulaziz Medical City. A sample size of 268 was calculated using RAOSOFT. A culturally tailored questionnaire, derived from the SF-36, was developed, validated, and administered through phone interviews. Data was analyzed using SPSS, applying descriptive statistics. Statistical significance was set at <0.05. RESULTS: A total of 311 patients participated. The mean QoL score was 9.7 (±3.4). Age was found to be a statistically significant predictor of QoL classification (=0.001), with an odds ratio of 1.04. However, there is an inverse correlation between the quality-of-life score and age and years since diagnosis. CONCLUSION: The ACS negatively affects social participation, religious practices, fasting during Ramadan, and willingness to return to work. Higher age was associated with better improvement in QoL after ACS. Additionally, we found a weak but significant invers correlation between age and QoL, and longer time since diagnosis and QoL.
Saudi Med J
· 2025 Oct · PMID 41087059
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OBJECTIVES: To investigate how the Qassim Health Cluster (QHC) implemented population health management (PHM) in tandem with the goals of Saudi Vision 2030 and to pinpoint the main issues and lessons gained from this imp...OBJECTIVES: To investigate how the Qassim Health Cluster (QHC) implemented population health management (PHM) in tandem with the goals of Saudi Vision 2030 and to pinpoint the main issues and lessons gained from this implementation. METHODS: This research used a descriptive population study design and was conducted between November and December 2024. We collected data using a mixed-method approach, gathering qualitative data from 11 PHM implementers and secondary quantitative data from 102,946 healthcare service users. RESULTS: Qassim Health Cluster's PHM implementation team established a regional 5-year strategic plan to follow the national PHM framework, utilizing data-based decision-making to implement the strategy. The major challenges identified include the lack of availability of relevant comprehensive PHM policy documents and guidelines, ineffective and delayed technical support, and resistance to change among stakeholders. Lobbying and effective communication were 2 useful strategies for PHM implementation. CONCLUSION: In the coming decades, the QHC's PHM implementation will drastically shift healthcare practices toward a more sustainable healthcare system that aligns with Vision 2030. To guarantee the successful operation of PHM in the QHC and other health clusters, more advocacy for institutional support, technical assistance, adequate funding, and sponsorship is required.
Saudi Med J
· 2025 Sep · PMID 40897426
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OBJECTIVES: To analyze the trends, histopathological characteristics, and demographic distribution of genitourinary (GU) tumors at a major academic center in Jeddah, Saudi Arabia, over a 16-year period (2007-2023). METHO...OBJECTIVES: To analyze the trends, histopathological characteristics, and demographic distribution of genitourinary (GU) tumors at a major academic center in Jeddah, Saudi Arabia, over a 16-year period (2007-2023). METHODS: A retrospective review of electronic medical records was conducted, including all histologically confirmed cases of GU tumors. Data on patient demographics, tumor type, and histopathological findings were extracted and analyzed using descriptive and inferential statistical methods. RESULTS: A total of 1,791 GU tumor cases were identified. Bladder cancer was the most prevalent (42%), followed by prostate cancer (21%) and renal cell carcinoma (21%). Testicular and ureteral tumors were less common, with scrotal and penile malignancies being rare (<1%). The mean age at diagnosis varied significantly, with prostate and bladder cancers occurring predominantly in older patients, while testicular tumors were diagnosed at a younger age. A significant rise in kidney and bladder cancer diagnoses was observed, potentially linked to improved screening and environmental factors. CONCLUSION: This study provides valuable insights into the epidemiological trends of GU tumors in Saudi Arabia, emphasizing the need for early detection and targeted screening. Further research is needed to explore contributing factors and optimize treatment approaches.
Mashali MH, Abdelmohsen GA, Baamer AS
… +16 more, Elhudairy MS, Alkhushi NA, Bahaidarah SA, Abdelsalam MH, Elakaby AR, Maghrabi KA, Azhar AS, Zaher ZF, Al Ata JA, Al-Radi OO, Jamjoom AA, Shihata MS, Elmahrouk AF, Dohain AM, Baamer FA, Bekheet SA
Saudi Med J
· 2025 Sep · PMID 40897425
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OBJECTIVES: To assess the surgical outcomes of atrioventricular septal defect associated with Tetralogy of Fallot (AVSD)-TOF repair performed at 2 specialized cardiac centers. METHODS: From May 2012 to December 2024, 20...OBJECTIVES: To assess the surgical outcomes of atrioventricular septal defect associated with Tetralogy of Fallot (AVSD)-TOF repair performed at 2 specialized cardiac centers. METHODS: From May 2012 to December 2024, 20 patients diagnosed with AVSD-TOF who underwent surgical repair were included. RESULTS: The median age at the time of surgical repair was 13 months, with a median weight of 8.2 kg (IQR: 6.2-11.5 kg). Biventricular repair was successfully performed in 18 patients (90%), while one and half ventricular repair was required in 2 patients (10%). Before definitive repair, palliative procedures, including bidirectional Glenn shunts, were carried out in 2 patients (10%), and right ventricular outflow tract (RVOT) stenting in another 2 patients (10%). Postoperative complications included a third-degree heart block requiring pacemaker implantation in 10% and chylothorax in 15%. The median duration of chest drains was 10 days. In 40% of patients, reintervention was required, involving catheter-based procedures and redo surgeries for residual lesions. Despite these complexities, overall survival was 90%, with all patients surviving to hospital discharge. CONCLUSION: Biventricular repair of AVSD-TOF is feasible and offers favorable early survival. However, the complexity of the condition, frequent reinterventions, and residual lesions highlight the need for individualized surgical/interventional planning and long-term follow-up.
Radhwi OO, Raslan OM, Almoshary MA
… +1 more, Mansory EM
Saudi Med J
· 2025 Sep · PMID 40897424
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OBJECTIVES: This study investigates the prevalence of iron deficiency anemia (IDA) in Saudi Arabia, analyzing variations by gender, age, and geographical region. METHODS: An observational, cross-sectional analysis was co...OBJECTIVES: This study investigates the prevalence of iron deficiency anemia (IDA) in Saudi Arabia, analyzing variations by gender, age, and geographical region. METHODS: An observational, cross-sectional analysis was conducted from January 2014 to February 2024 using data from Al Borg laboratories, including ferritin levels, demographics, and routine hematological results. RESULTS: The study included 420,956 individuals, with 73% being female and 94% over 15 years old. The IDA was found in 19.8% of patients, Non-Anemic Iron Deficiency (NAID) in 23.7%, and other anemias in 9.6%. Females represented 93% of those with IDA and NAID. All patients under 12 were anemic, with 45% having IDA. Among the elderly (65+), 29% had iron deficiency. Prevalence varied geographically, from 28% in Al-Jouf to 42% in Makkah, with female rates reaching 69%. CONCLUSION: The study reveals a high prevalence of IDA and NAID across Saudi Arabia, particularly among females. It underscores the need for targeted interventions to address this public health issue.
Thalapalliyil K, Bobby Z, Dorairajan G
… +1 more, Toi PC
Saudi Med J
· 2025 Sep · PMID 40897421
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OBJECTIVES: To explore whether uniform supplementation causes iron overload among a cohort of South Indian non-anemic pregnant women with diabetes-in-pregnancy (DIP). METHODS: The study took place between May 2022 and Ma...OBJECTIVES: To explore whether uniform supplementation causes iron overload among a cohort of South Indian non-anemic pregnant women with diabetes-in-pregnancy (DIP). METHODS: The study took place between May 2022 and May 2024 and consisted of 120 participants from 2 groups: healthy pregnant women (HP) and pregnant women with DIP. Levels of Hb and the serum indices of iron homeostasis-iron, unsaturated iron-binding capacity, total iron-binding capacity, transferrin saturation, ferritin, hepcidin, soluble transferrin receptor (sTfR), and sTfR index, were estimated. The levels of high-sensitivity C-reactive protein, indices of oxidative stress, malondialdehyde, total antioxidant status (TAS), and oxidative stress index (OSI; ratio of MDA/TAS), and inflammatory markers, interleukin-10 (IL-10) and interleukin-18 (IL-18), were also estimated. The perinatal outcomes between the 2 groups were compared. RESULTS: The serum iron and ferritin levels were lower, and HbA1c levels were higher in the DIP than in HP. The indices of iron homeostasis and Hb were comparable between the 2 groups. While the levels of OSI were higher in the DIP, the pro-inflammatory markers were comparable between the 2 groups. The perinatal outcome of DIP was inferior in comparison to HP. CONCLUSION: The current uniform daily oral iron supplementation dose in non-anemic South Indian women with DIP did not show evidence of iron overload in our cohort, contrary to expectations.
Saudi Med J
· 2025 Sep · PMID 40897419
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OBJECTIVES: To measure the pressure exerted on the base of the tongue during endotracheal intubation using a standard pediatric model. METHODS: The study was conducted in October-November 2022 at Hacettepe University Fac...OBJECTIVES: To measure the pressure exerted on the base of the tongue during endotracheal intubation using a standard pediatric model. METHODS: The study was conducted in October-November 2022 at Hacettepe University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Turkey. Anesthesiology residents performed intubations with Glidescope-LoPro-T2, Storz-C-MAC-paediatric-D-blade, and standard-Macintosh-1-blade on the same pediatric intubation model. The force exerted on the base of the tongue was measured during intubation using a force sensor. The duration and success of intubation, Cormack-Lehane-grade, and the force exerted on the oropharyngeal tissues were recorded. RESULTS: A total of 156 intubations were performed by 52 residents. The force exerted with the Storz-C-MAC-pediatric-D-blade was significantly lower when the Cormack-Lehane view was acquired and during the insertion of the endotracheal tube as compared to that exerted with the Glidescope-LoPro-T2 and direct laryngoscopy with Macintosh-1-blade. Longer intubation time was associated with higher force application regardless of blade type. CONCLUSION: Videolaryngoscopy improved glottic view even in the same manikin as compared to direct laryngoscopy. Significantly lower forces were measured with the C-MAC-D-blade as compared to the other blades. Further studies on real patients are required to determine what amount of force exerted on the oropharyngeal tissue is clinically meaningful and thus avoid complications.
Yılmaz A, Kaymaz T, Yakar B
… +3 more, Gömleksiz M, Önalan E, Gürsu MF
Saudi Med J
· 2025 Sep · PMID 40897418
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OBJECTIVES: To investigate serum levels of growth differentiation factor 15 (GDF-15), inflammatory biomarkers, and betatrophin in individuals with diabetes mellitus, both with and without complications. METHODS: A cross-...OBJECTIVES: To investigate serum levels of growth differentiation factor 15 (GDF-15), inflammatory biomarkers, and betatrophin in individuals with diabetes mellitus, both with and without complications. METHODS: A cross-sectional analysis was conducted involving patients with diabetes. Participants were categorized into 3 groups: Group 1 (30 healthy individuals without diabetes), Group 2 (30 diabetic patients without complications), and Group 3 (30 diabetic patients with complications). Blood samples were collected to assess standard biochemical parameters, as well as plasma concentrations of betatrophin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and GDF-15. All serum biomarkers were quantified using enzyme-linked immunosorbent assay (ELISA) techniques. RESULTS: Median GDF-15 concentrations were 486.96 pg/mL (range: 172.2-1272.0) in the control group, 843.9 pg/mL (range: 458.3-1393.3) in diabetics without complications, and 1794.3 pg/mL (range: 741.6-4449.5) in those with complications. The GDF-15 levels were significantly elevated in diabetic patients compared to healthy controls (<0.001), and markedly higher in patients with complications than those without (<0.001). Additionally, TNF-α, IL-6, and betatrophin levels were significantly increased in diabetic individuals relative to the control group (all <0.001). CONCLUSION: Serum GDF-15 levels are elevated in diabetic patients compared to non-diabetic controls and are further increased in those with complications. These findings suggest that GDF-15 may serve as a potential biomarker for diabetes severity and complication risk.
Saudi Med J
· 2025 Sep · PMID 40897416
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OBJECTIVES: To evaluate current mammogram screening rates and identify barriers and facilitators for mammogram uptake among Saudi women. METHODS: This systematic review was conducted in accordance with the PRISMA framewo...OBJECTIVES: To evaluate current mammogram screening rates and identify barriers and facilitators for mammogram uptake among Saudi women. METHODS: This systematic review was conducted in accordance with the PRISMA framework, beginning with a database search performed by 2 researchers using PubMed, PsycINFO, CINAHL Plus, and Google Scholar for pertinent studies published between 2000 and 2024. Qualitative and quantitative studies were included if they: a) were conducted in Saudi Arabia among Saudi women, b) explored factors associated with mammogram uptake among Saudi women, and c) were peer-reviewed. The socioecological model was used to thematically synthesize the results. RESULTS: A total of 39 studies were included in this review. Nine studies revealed low adherence to annual or biannual mammogram screenings among Saudi women. The socioecological model was utilized to categorize the factors that influenced Saudi women's uptake of mammograms, divided into: a) individual factors, including breast cancer and mammogram knowledge, demographic characteristics, health beliefs, fear, pain, and embarrassment; b) interpersonal factors, including male family members, health care providers, and competing priorities; and c) social factors, including health behaviors related to secondary health screenings, and the health care system. CONCLUSION: To improve adherence to mammogram screening among Saudi women, it is recommended to design interventions that target factors at each level of the socioecological model. Understanding how each factor functions as a barrier or facilitator will enable more effective and tailored strategies that address these factors within their respective socioecological levels..
AlOtaibi AS, AlShamlan NA, AlSubki LA
… +8 more, Altuwaigri LO, Awan SA, Farooq D, Saydo BA, Farhan HF, Samhan LM, Yaseen LM, Awartani KA
Saudi Med J
· 2025 Sep · PMID 40897415
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OBJECTIVES: To estimate the prevalence of anxiety and depression symptoms in females awaiting preimplantation genetic diagnosis (PGD) as well as investigate their associated factors. METHODS: This cross-sectional study i...OBJECTIVES: To estimate the prevalence of anxiety and depression symptoms in females awaiting preimplantation genetic diagnosis (PGD) as well as investigate their associated factors. METHODS: This cross-sectional study included 289 female patients awaiting PGD at a large tertiary hospital in Saudi Arabia. A structured questionnaire was used to collect information on patient characteristics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and data on PGD. Independent factors associated with anxiety and depression were identified using multivariable analysis. RESULTS: The prevalence of anxiety was 13.5% and that of depressive symptoms was 12.1%. Odds of anxiety were higher among females with a Master's degree (adjusted OR: 14.9, 95% CI: 3.1-72.4, <0.01), those with a psychiatric disorder (adjusted OR: 3.4, 95% CI: 1.2-9.8, =0.02), and with 3 or more children with congenital issues (adjusted OR: 6.6, 95% CI: 1.3-33.1, =0.02). However, for depression, no significant predictors were observed. CONCLUSION: Anxiety and depression are prevalent problems among females awaiting PGD. This promotes periodic mental health assessments of individuals on the waiting list, especially those at risk, and early referrals to women's mental health services. Furthermore, these findings may be useful for family physicians and experts in women's health who wish to better understand this problem, particularly in Arab countries.