Saudi Medical Journal[JOURNAL]
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200 papers
National Heart Center Perfusion Guidelines.
Khouqeer FA, Albaradei AS, Jamjoom AA … +13 more , Jabbad HH, Iskander KA, Zainalabdeen OM, Alheraish YA, Alanazi EM, Alhumiany AF, Buraiki ASA, Rana MW, Jelaldin MI, ZainAldeen ZA, Zamzami BA, Aujan BSA, Elsherbeny AMG
Saudi Med J · 2026 Feb · PMID 42239921 · Full text
OBJECTIVES: To establish the first national standards and guidelines for best practice in perfusion for patients undergoing cardiothoracic surgery in Saudi Arabia. Cardiopulmonary bypass (CPB) enables complex cardiac sur...
OBJECTIVES: To establish the first national standards and guidelines for best practice in perfusion for patients undergoing cardiothoracic surgery in Saudi Arabia. Cardiopulmonary bypass (CPB) enables complex cardiac surgeries; however, it poses risks of potential complications. METHODS: We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop these guidelines and assess the certainty of evidence through a collaborative process. A panel of 16 Cardiovascu- lar perfusion experts across Saudi Arabia formulated 22 key clinical questions relevant to local practice. PubMed, Scopus, and Embase databases were searched for each question to identify relevant systematic reviews, randomized controlled trials (RCTs), non-randomized trials, post hoc analyses, and pooled analyses published from 2010 to 2024. The guideline panel voted for every question using the GRADEpro system, requiring a minimum consensus of 70% for approval. RESULTS: A total of 16 conditional recommendations and 6 good practice statements were finally approved, categorized into 5 key domains. Of these, 4 addressed guidelines, protocols, and general practices; 2 focused on surgical techniques; 8 covered heart-lung machine hardware; 3 centered on cardioplegia and Priming Solutions; and 5 emphasized monitoring and perioperative management. Six statements were based on expert opinion due to insufficient supporting evidence. Using a standardized pre-bypass checklist to enhance safety and implementing perioperative glycemic management to control glucose levels and reduce complications were strongly recommended by the panel. Conditional recommendations focus on pump selection, biocompatible oxygenators, and continuous cerebral oxygenation monitoring. Anticoagulation, myocardial protection, and transfusion management were also highlighted. CONCLUSION: These Saudi guidelines provide evidence-based recommendations to enhance the care of patients undergoing cardiac surgery with CPB, offering clear guidance for clinicians to achieve optimal outcomes. Nevertheless, future locally relevant research and regular updates are essential to bridge existing evidence gaps.
Bleeding Avoidance Strategies in Patients with Atrial Fibrillation.
Landi A, Valgimigli M
Saudi Med J · 2026 Feb · PMID 42239920 · Full text
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Bridging Diagnosis and Prevention: The Impact of CCTA on CAD Risk Management - A Retrospective Single-Center Study.
Jumani AI, Rashwan GA, Ibrahim HO … +4 more , Aldhaheri JS, Almohdar SM, Hassan H, Alfakih KM
Saudi Med J · 2026 Feb · PMID 42239919 · Full text
OBJECTIVE: To assess the clinical utility of coronary computed tomographic angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with stable chest pain at Zayed Military Hospital, focusing on its im...
OBJECTIVE: To assess the clinical utility of coronary computed tomographic angiography (CCTA) for diagnosing coronary artery disease (CAD) in patients with stable chest pain at Zayed Military Hospital, focusing on its impact on management and preventive strategies. BACKGROUND: Chest pain is a common presenting symptom in hospitals. Coronary computed tomographic angiography offers an accurate, non-invasive method for diagnosing CAD in patients with low to intermediate pre-test probability. METHODS: A retrospective review of all 417 patients who underwent CCTA from January to December 2024 was conducted. Demographics, calcium scores, CAD findings, comorbidities, and subsequent management, including invasive coronary angiography and pharmacological interventions, were analyzed. RESULTS: Among the 417 patients (mean age 43.8 years; 90.8% male), 77% had normal coronary arteries, and 23% showed varying degrees of CAD. Of those with moderate to severe CAD (n = 40), 33 underwent invasive angiography, with 63% requiring percutaneous intervention. A zero-calcium score was found in 66%, with only 0.7% showing severe CAD. Hypertension and diabetes were linked to higher CAD severity. Statins were prescribed to 85% of those with mild CAD and universally to those with more advanced disease. CONCLUSION: CCTA is a valuable first-line diagnostic tool for stable chest pain, offering high negative predictive value and facilitating targeted preventive strategies for CAD.
A Bibliometric Analysis of the Most Influential and Impactful Plastic Surgery Publications From Saudi Arabia.
Mortada H, Alnufaei A, Aljuaid AT … +5 more , Hubail ZAA, Alanazi WN, Jasaniah AS, Ramzi SA, Arkoubi AY
Saudi Med J · 2026 Feb · PMID 42239918 · Full text
OBJECTIVE: To analyze the most cited plastic surgery articles from Saudi Arabia, focusing on publication trends, leading contributors, collaboration patterns, and thematic areas. METHODS: We conducted a bibliometric anal...
OBJECTIVE: To analyze the most cited plastic surgery articles from Saudi Arabia, focusing on publication trends, leading contributors, collaboration patterns, and thematic areas. METHODS: We conducted a bibliometric analysis using the Web of Science Core Collection (1990-2025). Keywords covering plastic surgery subfields were combined with geographic identifiers ("Saudi Arabia," "KSA," "Kingdom of Saudi Arabia") using Boolean operators. Only English-language original and review articles were included. Citation metrics, authorship networks, and keyword co-occurrence were analyzed with VOSviewer and the bibliometrix R package. RESULTS: We identified 1,013 Saudi-affiliated plastic surgery publications, receiving 7,929 citations. The top 100 most-cited articles averaged 39.3 citations (range: 19-283). King Saud University was the leading institution, contributing 59 articles. Dr. Mohammad M. Al-Qattan was the most prolific author, with first authorship on 52 publications. Hand surgery dominated the thematic spectrum (36%), followed by peripheral nerve (14%) and aesthetic surgery (12%). International collaboration occurred in 21 articles (22.8%), mainly with the United States and Canada. Nearly half of the studies (49%) were Level IV evidence. CONCLUSION: Saudi Arabia has achieved a notable presence in plastic surgery literature, especially in hand and peripheral nerve surgery. However, the concentration of authorship and reliance on lower-level evidence highlight the need for broader collaboration, prospective study designs, and greater methodological rigor to strengthen future contributions.
Risk Factors and Outcomes of Acute Kidney Injury in Children With Congenital Heart Disease Following Cardiac Surgery.
Zaher ZF, Shalaby MA, Alhasan KA … +10 more , Ghazi MA, Mustafa GA, Bamashmos YS, Alimamah MA, Sandokji IA, Alsharief AN, Bahassan AM, Albanna AS, Safdar OY, Kari JA
Saudi Med J · 2026 Feb · PMID 42239917 · Full text
OBJECTIVES: To investigate the incidence and risk factors for Acute kidney injury (AKI) following cardiac surgery in children with congenital heart diseases, and to identify modifiable factors that remain insufficiently...
OBJECTIVES: To investigate the incidence and risk factors for Acute kidney injury (AKI) following cardiac surgery in children with congenital heart diseases, and to identify modifiable factors that remain insufficiently studied. Acute kidney injury is common after cardiac surgery for children with congenital heart disease (CHD). Children with AKI are known to have complicated hospital courses, including their need for kidney replacement therapy, and have increased mortality. METHODS: We conducted a retrospective analysis of children admitted to the pediatric cardiac intensive care unit (PCICU) at King Abdulaziz University Hospital over 7 years (2014-2021), using the Kidney Disease Improving Global Outcome (KDIGO) definitions and stages of AKI. RESULTS: The cohort included a total of 628 children who had cardiac surgery for congenital heart disease, of whom 186 (29.6%) developed AKI. Children with AKI had significant difference than children without AKI in the following factors: (preoperative characteristics) age younger than one year, advanced score in risk adjustment for congenital heart surgery scores (RACHS-1 score), existing renal anomalies, hypoalbuminemia, and needed cardiac catheterization, (intraoperative factors) longer median cardiopulmonary bypass and aorta cross-clamping durations, had cardiac arrest and required ECMO and respiratory support. The most predictive variables for AKI development in these children were RACHS-1 score, cardiopulmonary bypass duration, cardiac catheter insertion, and presence of renal anomalies. CONCLUSIONS: This study provides valuable insights into the risk factors for AKI development in children with CHD following their cardiac surgery. These factors should be addressed in this patient population to reduce the risk of AKI and its following complications.
Anatomical Distribution and Extent of Carotid Plaque in Early Inflammatory Polyarthritis.
Almutairi FF
Saudi Med J · 2026 Feb · PMID 42239916 · Full text
OBJECTIVE: To compare the extent and anatomical distribution of carotid atherosclerotic plaques in the carotid artery segments between patients with early Inflammatory Polyarthritis (IP) and age- and sex-matched controls...
OBJECTIVE: To compare the extent and anatomical distribution of carotid atherosclerotic plaques in the carotid artery segments between patients with early Inflammatory Polyarthritis (IP) and age- and sex-matched controls, and to assess associated cardiovascular and disease-specific risk factors. METHODS: This retrospective study was conducted at King Abdulaziz University Hospital (June 2022 to April 2023), 349 patients (70% female; age 50.74 years; 41.81-58.34) and 115 matched controls (66% female; age 52.28 years; 42.29-58.42) underwent carotid ultrasound examination. Associations between plaques and cardiovascular were assessed. RESULTS: Plaques were significantly more common among patients than controls (46.1% vs. 27.8%, = 0.0006), particularly in the carotid bulb (34.7% vs. 20.0%, = 0.0032) and ICA (17.2% vs. 7.8%, = 0.0144). Bilateral plaques were significantly more common among patients than controls (19.5% vs. 9.6%, = 0.014). Among the traditional cardiovascular risk factors, age, hypertension, smoking, and prior CVD were significantly associated with plaques in the carotid bulb and ICA, whereas disease activity (DAS28) and the levels of C-reactive protein (CRP) and rheumatoid factor were not. CONCLUSION: Patients with early IP have a higher prevalence and wider anatomical distribution of carotid plaques than matched controls, with the carotid bulb and ICA the most frequently affected sites. These findings highlight the need for early cardiovascular screening in patients with IP, focusing on high-risk anatomical sites.
Bridging the Evidence Gap: A Retrospective Lens on Survival and Treatment Patterns in Older Patients With Colorectal Cancer.
Tashkandi EM
Saudi Med J · 2026 Feb · PMID 42239915 · Full text
OBJECTIVES: To advise evidence-based strategies and healthcare policies to optimize the management of older adults with colorectal cancer (CRC) in the region. Older adults are disproportionately affected by CRC but are u...
OBJECTIVES: To advise evidence-based strategies and healthcare policies to optimize the management of older adults with colorectal cancer (CRC) in the region. Older adults are disproportionately affected by CRC but are underrepresented in clinical trials. Hence, real-world data are crucial in guiding treatment in this population. METHODS: We conducted a retrospective cohort study involving patients aged ≥65 years diagnosed with CRC between 2015 and 2021 at King Abdullah Medical City, Makkah, Saudi Arabia. Clinical data, treatment patterns, and survival outcomes were analyzed. RESULTS: Among 256 patients (mean age 74.7; 61.7% male), 75% had an Eastern Cooperative Oncology Group performance status of ≥2, and 31.2% presented with metastatic disease. Curative surgery was performed in 66.4% of patients, and 37.9% received adjuvant chemotherapy. Among patients experiencing metastatic disease, only 36% of patients received first-line therapy, and this proportion declined to 2% by fourth-line therapy. The median overall survival was 42 months, with a 5-year survival rate of 45%. Adjuvant chemotherapy (hazard ratio [HR] = 0.20; = 0.001) and curative surgery were associated with improved survival, whereas late-stage disease (HR = 4.22; = 0.003) predicted poorer outcomes. Age, sex, and body mass index were not significant predictors of survival. CONCLUSIONS: Despite functional limitations, older patients benefit from standard therapies. These findings support function-based decision-making and routine integration of geriatric assessments into clinical care to improve outcomes in older patients with CRC.
The Effect of Motivational Interviewing on Glycemic Control Among Saudi Persons with Type 2 Diabetes: A Feasibility Study.
Al-Slail FY, Jumah IMB, Abdelfadil KO … +4 more , Fadl SM, Almutairy AO, Alanazi AF, Kheir OO
Saudi Med J · 2026 Feb · PMID 42239914 · Full text
OBJECTIVES: To assess the feasibility of integrating a motivational interviewing approach with a comprehensive diabetes care program in Saudi primary care clinics. Approximately 23.1% of the adult Saudi population is dia...
OBJECTIVES: To assess the feasibility of integrating a motivational interviewing approach with a comprehensive diabetes care program in Saudi primary care clinics. Approximately 23.1% of the adult Saudi population is diabetic, yet only 22.5% of these diabetic individuals maintain adequate glycemic control as defined by Hemoglobin A1c (HbA1c) levels <7%. METHODS: This quasi-experimental study employed pre- and post-evaluation methods to compare HbA1c levels among persons with uncontrolled diabetes before and after implementing a motivational interviewing (MI) and comprehensive care program. Adults with type 2 DM were included. The MI approach was used to educate and motivate the patients. Starting from November 2023, all included patients were followed up for six months with the assessment of the HbA1c, blood pressure, and body mass index at each visit. Furthermore, a multivariate logistic regression was performed to determine variables that predict good glycemic control. RESULTS: Overall, 187 participants were included in the final analysis. The HbA1c was significantly reduced from 9.9% (baseline) to 8.9% (3 months), then 8.3% (6 months). A multivariate logistic regression showed that baseline HbA1c interpretation and baseline diastolic blood pressure were the only predictors of poor glycemic control. CONCLUSION: MI represents a valuable component of diabetes care, with the potential to improve clinical and psychological outcomes for patients. However, additional research is required to validate these findings.
White Islands in a Sea of Red.
Alessa DS, Alghubaywi FA, Al-Khenaizan S
Saudi Med J · 2026 Feb · PMID 42239913 · Full text
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Evaluating Diagnostic Capability of Computed Tomography and Role of Bronchoscopy in Admitted Cases With Pulmonary Diseases.
Waheed KB, Ahmed Z, Mahmood A … +7 more , Masoudi JH, Alanazi AOZ, Almubireek AM, Bilal Z, Alshehri RA, Mahasneh MH, Arulanantham ZJ
Saudi Med J · 2026 Feb · PMID 42239912 · Full text
OBJECTIVE: To evaluate AU: Please specify the corresponding author name. capability of CT scan in diagnosing pulmonary diseases, identifying malignancy, and role of bronchoscopy in confirming or changing imaging diagnosi...
OBJECTIVE: To evaluate AU: Please specify the corresponding author name. capability of CT scan in diagnosing pulmonary diseases, identifying malignancy, and role of bronchoscopy in confirming or changing imaging diagnosis. METHOD: A retrospective record-based cross-sectional study was performed evaluating data of all consecutive adult patients who had CT and bronchoscopies performed in a period of 2 years (between Jan. 2023 to Jan. 2025). Demographic, clinical symptoms, CT chest and bronchoscopy findings were recorded. Final diagnoses were based on clinical (improvement with time or resolution of symptoms with specific antimicrobial drugs), laboratory (bronchoalveolar lavage and biopsy, blood or sputum cultures) and imaging guided biopsies (where performed). Patients without imaging or bronchoscopy data were excluded. Data was collected on SPSS version 22. A 2×2 contingency table was used to determine diagnostic capability of CT in identifying malignancy. Also, multivariate analysis (for certain variables), receiver operating characteristic (ROC) curve and area under curve (AUC) were acquired. RESULTS: Of 97 patients, majority were males (n = 64, 66%) with mean age of 54.4 (range, 13-93, Std deviation- 18). Cough with other symptoms (CO; n = 43) and hemoptysis (H; n = 25) constituted most clinical presentations. More than half of patients (50/97) were smokers. Benign findings were mostly recorded (n = 78, 80%) and that too were mainly infections (69/78). A changed diagnosis was made on bronchoscopy in 18 cases. Sensitivity, specificity, and accuracy of CT in diagnosing malignancy was calculated as 75% (Confidence Interval/ CI, 50.90-91.34), 95% (87.23-98.57), and 91% (CI, 83.12-95.67) respectively, with a high performance (AUC, 0.753). CONCLUSION: Computed tomography of the chest is highly useful for identifying pulmonary lesions however bronchoscopy remains essential for definitive diagnosis in a notable proportion of cases.
Healthcare Practitioners' Satisfaction with Ministry of Health Electronic Programs in Primary Healthcare Centers in Abha: A Comprehensive Analysis.
Alasmari BA, AlSaleh MM, Saeed A … +8 more , Aseri MY, Albraik MA, Assiri NM, AlAsiri KA, Alrashadi MA, Alqasem MY, Faya FA, Alahmari MD
Saudi Med J · 2026 Feb · PMID 42239911 · Full text
OBJECTIVE: This study assessed the satisfaction of health care providers with MOH electronic programs in Abha primary care centers and identified key drivers of user satisfaction. METHODS: Cross sectional survey of 152 p...
OBJECTIVE: This study assessed the satisfaction of health care providers with MOH electronic programs in Abha primary care centers and identified key drivers of user satisfaction. METHODS: Cross sectional survey of 152 physicians 48.7, nurses 27.0, allied health staff 21.1 and lab technicians 3.3 from May to July 2025. Participants had to be using MOH electronic systems daily. Descriptive stats and Spearman correlations examine links between satisfaction and system features. RESULTS: Among 152 respondents 98.7 used at least one MOH program daily.Raqim was most used 89.5. Overall, 11.2 were very satisfied, 44.1 satisfied, 28.3 neutral, and 16.4 dissatisfied. Significant drivers were system efficiency 53.3 rated efficient, technical support quality 48.7 satisfied, and ease of use 67.1 easy very easy. 55.9 reported frequent technical problems, 61.8 cited system downtime, and 53.3 lacked adequate training. CONCLUSION: While MOH electronic programs are widely adopted, performance, interface usability, technical support, and training need to improve. Addressing system reliability, boosting support, and strengthening user training are key to reaping benefits of digital health transformation in Saudi Arabia s healthcare sector.
Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, and Emerging Interventions for Prevention and Management.
Baali FH
Saudi Med J · 2026 Feb · PMID 42239910 · Full text
Childhood obesity, characterized by excessive accumulation of body fat that adversely affects health, is a global public health challenge. It affects approximately 8.2% of children and adolescents globally and contribute...
Childhood obesity, characterized by excessive accumulation of body fat that adversely affects health, is a global public health challenge. It affects approximately 8.2% of children and adolescents globally and contributes significantly to the burden of chronic diseases in later life. Obese children are at increased risk of developing metabolic disorder cluster, type 2 diabetes (T2D), coronary artery disease (CAD), and psychosocial complications. Increasing prevalence of childhood obesity imposes substantial economic costs and highlights the urgent need for effective prevention and management strategies. The causes of childhood obesity are multifactorial including genetic predispositions, environmental influences, dietary habits, and physical inactivity. Early intervention focusing on lifestyle modifications remains the cornerstone of treatment; however, pharmacological and surgical options are considered in severe cases. This paper provides an overview of the latest evidence regarding the prevalence, causes, and potential solutions for childhood obesity, emphasizing its critical role in preventing chronic diseases.
Risk Factors, Clinical Manifestations, and Treatment Outcomes of Primary Bone Sarcomas.
Alyami AH, Alkhotani MA, Alsiraihi AA … +5 more , Bukhari MM, Alqurashi AS, Alghamdi AM, Kurdi AR, Khawaji BA
Saudi Med J · 2026 Feb · PMID 42239909 · Full text
OBJECTIVE: To investigate the risk factors, clinical manifestations, and treatment outcomes in patients with Primary Bone Sarcomas (PBS). METHODS: This retrospective study included all patients with PBS treated between J...
OBJECTIVE: To investigate the risk factors, clinical manifestations, and treatment outcomes in patients with Primary Bone Sarcomas (PBS). METHODS: This retrospective study included all patients with PBS treated between June 2016 and December 2023 at King Abdulaziz Medical City, excluding patients with incomplete data, presence of other malignancies, diagnosis at autopsy, or unknown metastasis. Data were analyzed using SPSS software version 27. A p-value of less than 0.05 was considered statistically significant. Log Rank test was used for survival analysis. RESULTS: The study included 127 patients. Common past medical history included diabetes (7%), hypertension (5.5%), and metastasis at presentation (15%). Joint pain (76%) and bone swelling (75%) were common clinical presentations. The median overall survival was 5 years, with a 42% mortality rate. The presence of diabetes, hypertension, high Charlson score, high histological grading, and metastasis were more common among patients with osteosarcoma than other types ( < 0.05). Significant predictors of mortality included older age (HR: 1.03, = 0.009), metastasis at presentation (HR: 8.19, = 0.042), and metastasis (HR: 2.92, = 0.010). Male gender (HR: 0.47, = 0.020) had a lower risk of mortality. CONCLUSION: This study highlights the significant burden of PBS in Saudi Arabia. Key risk factors such as age and metastasis at diagnosis significantly impact survival, underscoring the necessity for improved surveillance and follow-up strategies. Further research is needed to develop effective, risk-stratified treatment to improve outcomes for patients.
Prevalence of BRCA1 and BRCA2 Germline Mutations in Western Saudi Patients with Epithelial Tubo-Ovarian Carcinoma.
Mehros W, Aldaheri F, Alqarni A … +5 more , Aljehani S, Alnamlah A, Althubaiti A, Huneef S, Jifree H
Saudi Med J · 2026 May · PMID 42239567 · Full text
OBJECTIVE: Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. gene mutations are associated with ovarian cancer, younger age at presentation, strong family...
OBJECTIVE: Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. gene mutations are associated with ovarian cancer, younger age at presentation, strong family history of EOC, and multiple malignancies in a single patient. This study calculated the rate of -positive EOC and compared -mutated vs non-mutated EOC cases. METHODS: This retrospective cohort study, conducted at Princess Noura Oncology Center between May 2016 and December 2023, explored outcomes in -positive EOC patients. The inclusion criteria covered all EOC cases. A total of 70 patients were selected. RESULTS: Of the 70 patients, 27 (38.6%) exhibited gene mutations. -positive patients demonstrated significant associations with familial history of cancer ( < 0.001) and lower diabetes mellitus rates ( = 0.02). However, our findings revealed no significant differences in treatments, prognosis, or outcomes between -positive and -negative patients. Subgroup analyses of different mutation types yielded no significant differences. Intriguingly, we found no significant variations in recurrence rates, comorbid cancers, or therapy duration between -positive and -negative cases (p > 0.01). Contrary to previous studies, we identified no differences in prognosis and survival rates between the cohorts. CONCLUSION: We identified gene mutations in 38.6% of our patients. Most comparisons revealed no significant differences between -positive and -negative patients, highlighting the need for additional studies to determine the prognostic and clinical value of gene testing in EOC.
Reliability and Validity of the Arabic Version of the NOSE-Perf Scale.
Alfallaj RM, BinGhaith AI, Alyoussef MY … +4 more , Alsaleh AS, Alsaleh SA, AlQahtani AA, Alroqi AS
Saudi Med J · 2026 May · PMID 42239566 · Full text
OBJECTIVES: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation-perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf...
OBJECTIVES: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation-perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. METHODS: Conducted between May 2024 and June 2025, the study included 100 participants-20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, and the intraclass correlation coefficient (ICC) was utilized to verify test-retest reliability. Discriminative validity was evaluated by comparing score differences, while concurrent validity was analyzed through correlations with the NOSE and SNOT-22 scales. RESULTS: Strong correlations were observed between the NOSE-Perf and the established NOSE (r = 0.920, < 0.001) and SNOT-22 (r = 0.885, < 0.001) measures, confirming the scale's concurrent validity. Discriminative validity was evident: NOSE-Perf scores were significantly higher in cases (29.8 ± 9.48) than controls (5.76 ± 8.10, < 0.001; AUC = 0.856). NOSE scores also differed (cases: 68.1 ± 26.1; controls: 9.44 ± 21.9; < 0.001; AUC = 0.931). SNOT-22 scores were 57.1 ± 24.2 in cases and 18.0 ± 18.4 in controls ( < 0.001; AUC = 0.32). CONCLUSION: The Arabic adaptation of the NOSE-Perf questionnaire exhibited reliability and validity as a tool for assessing subjective symptoms among individuals experiencing septal perforation.
Comparison of Clinical Outcome of Mushroom Poisonings with and without Specific Treatment: .
Deveci K, Baykan N, Kus B … +3 more , Ünlü F, Salt Ö, Koyuncu S
Saudi Med J · 2026 May · PMID 42239565 · Full text
OBJECTIVES: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our ce...
OBJECTIVES: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. METHODS: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. RESULTS: The median age of the 425 patients admitted was 51 years (34-63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% (n = 93) moderate, 7.3% (n = 31) severe, and 0.5% (n = 2) fatal. Patients who received specific antidote treatment had a statistically significantly higher morbidity rate than those who did not (48.6% vs. 22.9%, < 0.01). In the subgroup analysis, hepatotoxicity was more common (35.8% vs. 8.8%, < 0.01), whereas there was no significant difference in other organ failure. CONCLUSION: Mushroom poisoning is an uncommon type of poisoning that varies seasonally. The integrity of treatment may have been lost because of intermittent visits. We recommend careful evaluation of the patients and rapid initiation of specific possible antidote therapies, in addition to basic supportive treatment (fluid resuscitation, activated charcoal, and so on).
Mental Health in Relation to Parental Absence: .
Barry M, Alyahyawi A, Sabbagh HJ
Saudi Med J · 2026 May · PMID 42239564 · Full text
OBJECTIVE: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that co...
OBJECTIVE: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. METHODS: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. RESULTS: Findings indicate that orphaned children demonstrated higher levels of aggressive behavior (1 study: = 0.05), depression (2 studies: <0.001 and <0.001), and PTSD symptoms (1 study: <0.001). Anxiety was also higher among orphans (3 studies: = 0.038, = 0.006 and <0.001). Orphans also had poorer psychological well-being (1 study: <0.001), greater somatic symptoms (1 study: <0.001), and higher social dysfunction (1 study: <0.001). There were no statistically significant differences in resilience (1 study: = 0.16), self-efficacy (1 study: = 0.58), or internalizing and externalizing problems (1 study: = 0.64). Meta-analysis of studies evaluating depression yielded non-significant increased standardized mean differences (SMD) of 0.77 ( = 0.10). While the meta-analysis of studies evaluating anxiety showed a significant increased SMD of 0.68 ( = 0.02) among children with parental absence. CONCLUSION: Orphaned children may exhibit elevated levels of depression, anxiety, aggression, and poorer psychological well-being compared to their non-orphaned peers. However, they also possess internal strengths such as resilience and self-efficacy. These findings should be interpreted with caution due to the limited number of studies and the high degree of heterogeneity across studies and cultural contexts.
Emerging Nanotherapy Applications in Cancer Treatment: .
Mahallawi WH
Saudi Med J · 2026 May · PMID 42239563 · Full text
This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial i...
This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically "cold" tumors to "hot" responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence shows promising safety profiles with predominantly mild-to-moderate adverse events across multiple Phase I-III trials. While nanotherapy represents a paradigm shift in precision oncology, addressing manufacturing reproducibility, long-term safety, and regulatory harmonization remains essential for full clinical translation.
The Nephroprotective Effects of Dulaglutide in Patients with Type 2 Diabetes and Chronic Kidney Disease: .
Jamal MH, Alzahrani HA, Bakhshwin DM … +4 more , Ghamri RA, Binzomah FS, Jamal WH, Abulfaraj MW
Saudi Med J · 2026 May · PMID 42239562 · Full text
OBJECTIVE: This study aimed to evaluate the effectiveness and safety of dulaglutide in individuals with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). METHODS: This retrospective cohort study included...
OBJECTIVE: This study aimed to evaluate the effectiveness and safety of dulaglutide in individuals with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). METHODS: This retrospective cohort study included 212 patients with CKD (stages 1-4) and T2DM treated with once-weekly dulaglutide (1.5 mg) for either 12 or 24 months at three tertiary care centers in Saudi Arabia from January 2021 to December 2023. Safety was assessed based on the presence of adverse events. Efficacy was measured using the changes in estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), and body mass index (BMI). Changes in efficacy outcomes were assessed using paired t-tests. RESULTS: Baseline HbA1c was 9.1% (±1.8%), BMI was 33.0 (±6.4) kg/m, and eGFR was 68.2 (±28.5) mL/min/1.73 m. At 12 and 24 months, HbA1c decreased by 1.2% (95% confidence interval [CI]: 1.0-1.4, < 0.001) and BMI by 1.1 kg/m (95% CI: 0.9-1.3, < 0.001). Further, eGFR remained stable at 12 months (change: $-$0.1, 95% CI: $-$2.2 to 2.0, = 0.937) but increased by 2.8 mL/min/1.73 m (95% CI: 0.3-5.3, = 0.029) at 24 months, particularly in stage 3 CKD ( = 0.041). By multivariable regression analysis, with adjustment for concomitant medications, dulaglutide was associated with a significant increase in eGFR increase at 24 months (adjusted mean change: 2.6 mL/min/1.73 m, 95% CI: 0.2-5.0, = 0.034). Patients aged <60 years ( = 0.049) and with HbA1c of ≤9.0% ( = 0.002) demonstrated greater eGFR increases. Adverse events occurred in 31.6% of patients, mainly nausea (10.8%), vomiting (8.0%), and diarrhea (10.8%). CONCLUSION: Dulaglutide was associated with a modest increase in eGFR and improved glycemic control in patients with T2DM and CKD, particularly among younger individuals with moderate-stage CKD. The treatment demonstrated an acceptable safety profile.
Erratum to "The Association between Inflammatory Bowel Disease and Ischemic Heart Disease: A Retrospective Cohort Study" [Saudi Medical Journal 2025 Oct; 46(10):1174-1181].
Mosli MH, Alsulami DM, Alghamdi YK … +7 more , Badahdah AS, Alhibshi AH, Alamri TM, Alkhattabi MS, Alzahrani KT, Alsufyani HA, Saadah OI
Saudi Med J · 2026 May · PMID 42239561 · Full text
[This corrects the article DOI: 10.15537/smj.2025.46.10.20250181.].
[This corrects the article DOI: 10.15537/smj.2025.46.10.20250181.].
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