Albakr RB, Alrowie F, Sandokji IA
… +7 more, Alshammari OA, Mitwalli HA, AlSudais H, Albacker AB, Temsah MH, Mitwalli AH, Alhasan KA
Saudi Med J
· 2025 Dec · PMID 41402075
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OBJECTIVES: To conduct a community-wide screening of the Saudi population for chronic kidney disease risk factors. METHODS: This study utilized a non-selective, exploratory point-of-care screening approach involving 215...OBJECTIVES: To conduct a community-wide screening of the Saudi population for chronic kidney disease risk factors. METHODS: This study utilized a non-selective, exploratory point-of-care screening approach involving 215 participants in Riyadh, Saudi Arabia, during a kidney disease awareness campaign for World Kidney Day in March 2022. Participants were randomly selected, and their estimated glomerular filtration rates (eGFRs) were measured to assess kidney function. RESULTS: The findings revealed that 4% of participants had eGFRs less than 60 mL/min/1.73 m², 34% had eGFRs between 60 and 90 mL/min/1.73 m², and the rest had eGFRs over 90 mL/min/1.73 m². Key risk factors for lower eGFRs included older age, overweight or obesity, and a history of hypertension or diabetes. CONCLUSION: The study indicates that community-based screening programs using point-of-care testing can effectively detect kidney diseases early, facilitating prompt health monitoring and interventions. Further research is necessary to enhance screening criteria for estimating eGFRs in similar settings.
Saudi Med J
· 2025 Dec · PMID 41402071
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OBJECTIVES: To provide details on patient satisfaction with the Saudi healthcare system and patient characteristics associated with satisfaction levels using nationally representative survey data. METHODS: A cross-sectio...OBJECTIVES: To provide details on patient satisfaction with the Saudi healthcare system and patient characteristics associated with satisfaction levels using nationally representative survey data. METHODS: A cross-sectional secondary analysis was conducted using the Kingdom of Saudi Arabia World Health Survey (KSAWHS 2019) data, which collected information on demographics, health status, chronic conditions, and access to and use of healthcare services among Saudi adults aged ≥15 years. Descriptive statistics and logistics regression analyses were performed to identify significant predictors of satisfaction with Saudi healthcare services. RESULTS: Between April and July 2019, 8,912 individuals completed the KSAWHS 2019 individual questionnaire. Out of them 3,929 participants received healthcare services in the last 12 months, were aged ≥15 years, submitted completed records, and were included in this study. The majority of study participants (89.4%) were satisfied with the Saudi healthcare system. Age, marital status, language, health status, presence of chronic conditions, and number of primary healthcare centers per region were significantly and positively associated with patient satisfaction, while gender, type of clinic last visited, and number of hospitals per region were significantly and negatively associated with patient satisfaction. CONCLUSION: Patient satisfaction with healthcare systems is an important assessment metric for overall system performance. Regular measurement of patient satisfaction and characteristics associated with levels of satisfaction can provide meaningful feedback for health policymakers and administrators to develop interventions to improve system performance.
Saudi Med J
· 2025 Dec · PMID 41402070
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OBJECTIVES: To establish a ferroptosis-related colorectal cancer (CRC) diagnostic model by integrating machine learning and gene expression analysis. Tumorigenesis is strongly linked to ferroptosis, an iron-mediated kind...OBJECTIVES: To establish a ferroptosis-related colorectal cancer (CRC) diagnostic model by integrating machine learning and gene expression analysis. Tumorigenesis is strongly linked to ferroptosis, an iron-mediated kind of cell death. The dismal prognosis of CRC, a severely malignant gastrointestinal cancer, accentuates the demand for effective diagnostic biomarkers. METHODS: The study was performed between January 2024 and 2025. The GEO database provided 2 openly searchable gene expression profiles (GSE9348 and GSE21510) from CRC as well as non-tumor tissues. Genes that were expressed differently in tumor and healthy tissues were found using the GSE9348 dataset. Distinct genetic biological functions were identified through functional enrichment analysis. SVM-RFE and LASSO regression models helped identify potential genetic markers associated with CRC. RESULTS: GSE9348 dataset analysis helped identify 27 differentially expressed ferroptosis-related genes. KEGG analysis suggested that these genes are primarily related to inflammatory responses, NF-κB signaling, and regulation of the interleukin family. Based on this model, CHMP2A, CYCS, HMGB1, IL18, IL1B, and GZMA were selected as potential diagnostic markers, and a novel diagnostic model was constructed. Its predictive value was examined using receiver operating characteristic analysis. We validated the expression changes of model genes using PCR assays along with a validation set (comprising TCGA and GSE21510 datasets). CONCLUSION: These outcomes provide an efficient ferroptosis-related gene-based diagnostic model for CRC. Nevertheless, before its use in real-time settings, more clinical studies are required to confirm its diagnostic value.
Saudi Med J
· 2025 Dec · PMID 41402069
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OBJECTIVES: Phenylketonuria (PKU) is associated with detrimental impacts on factors contributing to the etiology of obesity, and metabolism disorders. Therefore, we hypothesized that physicians and dietitians demonstrate...OBJECTIVES: Phenylketonuria (PKU) is associated with detrimental impacts on factors contributing to the etiology of obesity, and metabolism disorders. Therefore, we hypothesized that physicians and dietitians demonstrate a sufficient level of nutritional knowledge of the PKU type diet. The aim of this study is to assess understanding of the PKU diet in relation to current guidelines among dietitians and metabolic physicians in Saudi Arabia. METHODS: This study involved 238 participants, primarily Saudi and non-Saudi dietitians and metabolic physicians working in Saudi Arabia, who asked to complete an electronic questionnaire assessing their nutritional knowledge of the PKU diet. The questionnaire evaluated participants' knowledge across three PKU diet domains, their opinions on diet and patient body composition and their understanding of the 'traffic light system' of food categorization. RESULTS: A total of 181 participants completed the questionnaire. The assessment of knowledge revealed a correct score of 46%; that is, more than half of the participants scored below 50%. While the most correctly answered question concerned the importance of adhering to the PKU diet among patients with PKU (93% answered correctly), the least correctly answered question (6% answered correctly) required participants to recognize that female PKU patients have more pronounced differences in body composition. More than that 85% of the study participants agreed that PKU patients have difficulty complying with the PKU diet. There was varied familiarity with the 'traffic light system' of food item categorization. Key concerns for poor dietary compliance included social and financial challenges, alongside the diet's unpalatability. CONCLUSION: Dietitians and metabolic physicians demonstrate a moderate level of understanding regarding the nutritional management of patients with PKU, establishing the need for enhanced educational focus for both groups.
AlHumedi H, Al-Dorzi HM, Aldawood A
… +19 more, Almatroud A, Aldawsari M, Banu Khan H, Burrows V, Alanazi SA, Naidv B, January E, Al Zayer S, Yeni Z, Marhoun S, Khoutani H, Maghrabi S, AlZighaibi S, Rabeeah F, Alanazi S, Alghamdi H, Aleem Atassi A, Alkathaami A, Arabi YM
Saudi Med J
· 2025 Nov · PMID 41224352
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OBJECTIVES: To describe the utilization of the My Visit application for video calls between patients admitted to intensive care units (ICUs) and their families during the .COVID-19 pandemic as an alternative to hospital...OBJECTIVES: To describe the utilization of the My Visit application for video calls between patients admitted to intensive care units (ICUs) and their families during the .COVID-19 pandemic as an alternative to hospital visits. METHODS: The My Visit (Zeyareti) application was launched in 2 National Guard Health Affairs hospitals in Riyadh, Saudi Arabia, in response to the COVID-19 pandemic in March 2020 and extended to all ICUs in August 2020. It allowed patients to communicate with their families using dedicated screens. This retrospective study was conducted using an automated satisfaction survey between September 2020 and September 2023. RESULTS: Over 37 months, 25,655 video calls were conducted in COVID-19 and non-COVID-19 ICUs, particularly during the pandemic's peaks. A total of 1,329 family members responded to the satisfaction survey, and 893 respondents identified their relationship with patients. Parents represented 58%, siblings 18%, children 15%, and spouses 7% of respondents. Most were very satisfied with the ease of registration/login (85.1%), the timing of virtual visits (76.4%), consideration for patient privacy (80.5%), staff cooperation (76%), and the hospital's video call initiative (80.4%). Feedback included 546 comments appreciating the staff and 233 remarks suggesting improvements. CONCLUSION: During the COVID-19 pandemic, video calls between ICU patients and their family members were frequently conducted. Parents made up the majority of callers, and video calls were associated with high family satisfaction.
Demircan G, Berk S, Karayilan D
… +7 more, Ozgur BT, Ketenci S, Elbegi I, Karpuz V, Yavuz M, Midi A, Akin D
Saudi Med J
· 2025 Nov · PMID 41224351
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OBJECTIVES: To study the different cellular death mechanisms between viral cirrhosis and alcoholic cirrhosis. The research investigated autophagy and apoptosis mechanisms in hepatitis B virus (HBV), hepatitis C virus (HC...OBJECTIVES: To study the different cellular death mechanisms between viral cirrhosis and alcoholic cirrhosis. The research investigated autophagy and apoptosis mechanisms in hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol-induced cirrhosis. METHODS: The research team analyzed biopsy samples from the liver which were obtained at Florence Nightingale Hospitals, Istanbul, Turkey. The experimental protocols were performed between February 2021 and February 2023. The study included 19 HBV, 15 HCV, 13 alcohol-related cirrhosis patients and 6 normal liver tissues. Beclin-1, Caspase-3, Bcl-2 and LC3 expressions were evaluated by immunohistochemistry. RESULTS: Staining intensity as well as extent underwent evaluation through H-score methodology. The expression levels of Beclin-1 (control: 0.7±0.3, HBV: 6.0±1.4, HCV: 5.1±1.3, alcohol: 4.8±1.2), caspase-3 (control: 0.4±0.2, HBV: 6.0±1.4, HCV: 5.1±1.2, alcohol: 5.5±1.3) and Bcl-2 (control: 0.3±0.2, HBV: 5.5±1.2, HCV: 4.8±1.1, alcohol: 4.6±1.1) were significantly higher than those of the control group (<0.001). LC3 expression revealed no between-group differences. A positive association for Beclin-1 with Caspase-3 (r=0.582) alongside negative association for Bcl-2 with Caspase-3 (r=-0.608) was documented. CONCLUSION: Our findings suggest that both autophagic and apoptotic pathways are active in the pathogenesis of cirrhosis. Similar cell death mechanisms were found to be involved in viral and alcoholic cirrhosis, but these pathways were more prominently activated in viral cirrhosis.
Almutadares MN, Gazzaz NM, Alyahyawi NY
… +7 more, Alrayes NM, Mazi EA, Mansouri FF, Hothan KA, Hamadallah HA, Bukhari EM, Mazi AA
Saudi Med J
· 2025 Nov · PMID 41224350
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OBJECTIVES: To assess the long-term effects and mortality rates associated with GH therapy in patients with Prader-Willi Syndrome (PWS). Prader-Willi Syndrome is a rare genetic disease characterized by growth hormone (GH...OBJECTIVES: To assess the long-term effects and mortality rates associated with GH therapy in patients with Prader-Willi Syndrome (PWS). Prader-Willi Syndrome is a rare genetic disease characterized by growth hormone (GH) deficiency among other endocrine disorders. METHODS: A systematic literature search was carried out on 4 databases including PubMed, Scopus, Web of Science, and Cochrane databases. The search was based on two keywords: "Growth hormone" AND "Prader-Willi Syndrome". Outcome data included height-standard deviation score (SDS), weight SDS, body mass index (BMI)-SDS, insulin like growth factor 1 (IGF1), mortality, low density lipoprotein (LDL)-cholesterol, and blood glucose. RESULTS: A total of 41 studies were included, of which 30 were involved in the meta-analysis. Following treatment with GH, height-SDS showed a significant increase compared to baseline in two timeline subgroups (≤2 years and >2 years), with a mean difference (MD) of 1.05 (95% CI: 0.92-1.18, <0.00001) and 1.53 (95% CI: 1.23-1.82, <0.00001), respectively. Patients on GH experienced a more pronounced increase in height-SDS compared to those who have not received GH. This was further associated with a lower BMI-SDS among GH-treated patients compared to their counterparts, with an MD of -1.02 (95% CI: -1.76 to -0.28, =0.007; I²=84%, =0.0003). Additionally, IGF1-SDS showed a marked increase after GH. Other metabolic effects include significant increase in LDL and blood glucose levels after GH treatment. The mortality rate in PWS patients undergoing GH treatment is estimated at 1.5% (95% CI: 0.8-2.2%), with causes including respiratory issues, cardiac arrest, infections, accidents, and gastrointestinal complications. CONCLUSION: GH therapy in PWS significantly improves height and IGF-1 SDS, while relatively decreasing BMI compared to no-GH, indicative of lean mass growth and healthy development. Nonetheless, GH therapy requires careful metabolic monitoring due to its mixed effects on cholesterol and glucose levels..
Khamees H, Gulati A, Vatsa A
… +2 more, Aldosari M, Hoque E
Saudi Med J
· 2025 Nov · PMID 41224349
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OBJECTIVES: To provide an accurate estimate of autism spectrum disorder (ASD) prevalence among children in the Kingdom of Saudi Arabia (KSA) by benchmarking against international and regional data, addressing the limitat...OBJECTIVES: To provide an accurate estimate of autism spectrum disorder (ASD) prevalence among children in the Kingdom of Saudi Arabia (KSA) by benchmarking against international and regional data, addressing the limitations of the currently reported prevalence rate of 0.6%. METHODS: We conducted a comparative benchmarking analysis using ASD prevalence data from countries with advanced monitoring systems (United Kingdom, United States, Denmark, South Korea, Italy, Singapore) and regional comparators (United Arab Emirates, Qatar, Jordan). We assessed differences in healthcare infrastructure, diagnostic frameworks, and screening intensity, and reviewed recent KSA-based studies. Methodological limitations such as underreporting, cultural stigma, and diagnostic inconsistencies were also considered. RESULTS: The official General Authority for Statistics estimate of 0.6% underrepresents the actual prevalence of ASD in KSA. International benchmarks suggest higher prevalence, with the UK at 1.8%, the US at 3.2%, and South Korea at 2.6%. Regional studies in Qatar and the UAE show rates of 1.1% and 0.6%, respectively. KSA-specific studies report prevalence ranging from 1.3% (systematic review and meta-analysis across 24,000 children) to 2.5% (hospital-based screening in Riyadh). Integrating these findings, we estimate that the realistic prevalence in KSA lies between 1.7% and 1.8%. CONCLUSION: The prevalence of ASD among children in KSA is substantially higher than the official estimate of 0.6%. A calibrated range of 1.7% to 1.8% better reflects the true prevalence and provides a foundation for evidence-based public health planning, early screening initiatives, and resource allocation for autism services in KSA.
Saudi Med J
· 2025 Nov · PMID 41224346
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OBJECTIVES: To examine the relationships between the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) in myringosclerosis after ventilation tu...OBJECTIVES: To examine the relationships between the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) in myringosclerosis after ventilation tube insertion (VTI). METHODS: We conducted this descriptive case-control study between March 2022 and September 2024. A total of 75 children aged 6 to 12 years with a history of VTI were enrolled. Myringosclerosis+ (n=43) included children with myringosclerosis, while Myringosclerosis- (n=32) included children without myringosclerosis. Preoperative values for NLR, PLR, and SII were collected by hematological testing and calculations. Demographic factors, prognostic risk factors and discrimination power of parameters were determined by statistical methods. RESULTS: Compared to the myringosclerosis-, the myringosclerosis+ had significantly higher NLR, PLR, and SII values (=0.00, =0.04, and =0.01, respectively). Receiver operating characteristic (ROC) curve area of NLR is 0,76 (95% CI: 0.65-0.87, =0.00). Area under curve of SII is 0,62 (95%CI: 0.57-0.81, =0.01). Neutrophil-to-lymphocyte ratio affects myringosclerosis development at 1.34 with sensitivity=0.63, specificity=0.78. Neutrophil-to-lymphocyte ratio(NLR) and systemic immune inflammation index(SII) show myringosclerosis development at different powers of predictivity. The ROC area of NLR is highest of all parameters but is moderately predictive (<0.80). It is slight for SII. The NLR may be a marker of prediction of myringosclerosis OR=0.182 (95%CI:0.067-0.496). CONCLUSION: Neutrophil-to-lymphocyte ratio and SII are systemic inflammatory prognostic markers in myringosclerosis, and elevated NLR values are a predictor of myringosclerosis with modest affect. Other parameters should be sought in myringosclerosis development.
AlFraih Y, AlDaffaa M, AlSuhaibany T
… +2 more, AlShehri A, AlTokhais T
Saudi Med J
· 2025 Nov · PMID 41224344
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OBJECTIVES: To present our institutional experience with pediatric morgagni hernia (MH) emphasizing the presentation, diagnostic workup, surgical techniques, and follow-up. METHODS: A retrospective chart review of patien...OBJECTIVES: To present our institutional experience with pediatric morgagni hernia (MH) emphasizing the presentation, diagnostic workup, surgical techniques, and follow-up. METHODS: A retrospective chart review of patients diagnosed with MH who underwent surgical repair from May 2014 to May 2024. Data points collected included demographic, clinical, and follow up information. We analyzed the data using basic thematic analysis. For categorical variables, we employed counts and percentages. Statistical analysis performed using the Mann-Whitney U test. RESULTS: Nine patients underwent MH repair. Respiratory symptoms were the most common, affecting 66% of patients. All patients received chest radiography, while 5 required computed tomography imaging. Three (33%) patients underwent laparotomy, 5 (55%) underwent laparoscopic repair, and 1 (11%) underwent thoracotomy repair. The laparotomy group required significantly more days in the Intensive Care Unit (ICU) (=0.037), more days on mechanical ventilation (=0.020), and more days on IV narcotics (=0.20). The laparotomy group experienced longer durations of NPO status and overall hospital stay. One (11%) patient experienced MH recurrence. CONCLUSION: Laparoscopic repair offers superior outcomes, such as fewer days in the ICU and on mechanical ventilation, reduced intravenous narcotic use, shorter NPO durations, and an overall shorter hospital stay. When feasible and safe, laparoscopic repair should be considered the preferred method for pediatric MH.
Saudi Med J
· 2025 Nov · PMID 41224342
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Thyroid disorders encompass a variety of autoimmune conditions such as Graves' disease, Hashimoto's thyroiditis, as well as several types of thyroid cancer. Recent advancements in next-generation sequencing methodologies...Thyroid disorders encompass a variety of autoimmune conditions such as Graves' disease, Hashimoto's thyroiditis, as well as several types of thyroid cancer. Recent advancements in next-generation sequencing methodologies have elucidated significant genetic mutations, which include , , , and more, which are associated with thyroid cancers and autoimmune disorders. BRAF V600E mutation as an indicator of prognosis in papillary thyroid carcinoma or the identification of genetic markers clarifies treatment strategies. Similarly, polymorphisms in immune regulatory genes such as , particularly when combined with , are linked to higher risk to autoimmune thyroid diseases. Molecular analysis plays a central role in achieving high diagnostic precision. Emerging molecular profiles offer further insight into the complex nature of these multifactorial conditions. This review highlights the impact of genetic and molecular research on diagnosis and management, highlighting the importance of these approaches for precision medicine in thyroid disorders.
Saudi Med J
· 2025 Nov · PMID 41224340
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OBJECTIVES: To evaluate unplanned reoperation (URO) as a quality indicator and identify its rate and associated risk factors at our institution. Parental satisfaction and patient safety are crucial, necessitating an inve...OBJECTIVES: To evaluate unplanned reoperation (URO) as a quality indicator and identify its rate and associated risk factors at our institution. Parental satisfaction and patient safety are crucial, necessitating an investigation into the factors influencing unplanned return to the operating room rates. Understanding the reasons behind UROs and how to prevent them is vital for improving surgical services. METHODS: This study employs a retrospective cohort design to analyze existing patient data from King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia. It aims to evaluate clinical endpoints and factors associated with unplanned reoperations, which are defined as any secondary surgery occurring within 30 days of the initial procedure due to complications. RESULTS: From February 2015 to August 2023, a total of 2551 patients underwent 2963 abdominal surgeries. Among these, 75 (2.94%) patients required re-surgeries, resulting in a total of 179 surgeries. Regression analysis revealed that females had 2.1 times higher odds of requiring a reoperation compared to males (CI: 0.8-5.1, =0.04). Furthermore, patients with a history of previous abdominal surgeries had 2.7 times greater odds of requiring reoperation (CI: 1.05-6.9, =0.038). Other demographic variables did not demonstrate significant associations. CONCLUSION: Monitoring URO rates is essential for enhancing pediatric surgical practices, improving preoperative counseling, and optimizing resource allocation.