Aljabab SA, Aldehaim MA, AlHussain HA
… +7 more, Bahadur YA, Alomary IS, Al Othman MO, Alghamdi MA, Alghamdi AS, Alayed YM, Balbaid AA
Saudi Med J
· 2025 Nov · PMID 41224339
·
Full text
OBJECTIVES: To update the national guidelines for proton therapy to reflect the evolving literature. The Saudi Particle Therapy Centre is making efforts to establish proton therapy services in the Kingdom of Saudi Arabia...OBJECTIVES: To update the national guidelines for proton therapy to reflect the evolving literature. The Saudi Particle Therapy Centre is making efforts to establish proton therapy services in the Kingdom of Saudi Arabia. METHODS: The Saudi Particle Therapy Center collaborated with the Saudi Association of Radiation Oncology to formulate a panel of radiation oncologists with proton therapy experience to refine and update our previous publication. The recommendation level was based on the overall evidence using a 4-grade scale following the World Health Organization quality of evidence recommendations. These updates focus on summarizing the literature and the level of recommendation for each disease site. The Panel identified key clinical questions to ensure that the guidelines were evidence-based, followed by a comprehensive literature review of PubMed, EMBASE, and other academic databases. RESULTS: The Panel reported that the body of evidence favored proton therapy for specific indications, including ocular tumors, skull and spine tumors, oropharyngeal cancer, hepatocellular carcinoma, specific genetic syndromes and mutations, pediatric rhabdomyosarcoma, pediatric central nervous system malignancies, tumors of the paranasal sinuses/nasal cavity, and for re-irradiation of all sites when curative treatment was intended. In addition, proton therapy may be considered at other sites when photon therapy exceeds the acceptable dose constraints for critical structures. CONCLUSION: The Panel did not recommend the routine use of proton therapy for all cancers. Each case should be assessed individually following a multidisciplinary review and expert consultation while accounting for financial, logistical, and patient-specific factors.
Obeidat FN, Nafi' DM, Suleiman AN
… +6 more, Al-Hyasat HA, Alhadidi LA, Budair NH, AbuShawer OJ, Al Kloub RG, Al Hyasat SA
Saudi Med J
· 2025 Nov · PMID 41224338
·
Full text
OBJECTIVES: To investigate the incidence and nature of unusual histopathological findings in appendectomy specimens and assess their impact on post-appendectomy management. METHODS: A retrospective study was conducted on...OBJECTIVES: To investigate the incidence and nature of unusual histopathological findings in appendectomy specimens and assess their impact on post-appendectomy management. METHODS: A retrospective study was conducted on patients who underwent appendectomies at Jordan University Hospital between January 2015 and December 2024. It included patients with presumed diagnoses of acute appendicitis or those who underwent incidental appendectomies during other surgical procedures. Pathology reports with complete data and slides showing unusual findings were retrieved from the archives of the histopathology laboratory of the hospital. Statistical Package for the Social Sciences was used for statistical analysis. RESULTS: Of the 2,275 patients, unusual histopathological findings were identified in 171 (7.5%). These findings included fibrous obliteration (2%), serositis (1.2%), fecalith impaction (1.1%), low-grade appendiceal mucinous neoplasms (1%), mucinous adenocarcinoma (0.4%), Enterobius vermicularis infection (0.4%), well-differentiated neuroendocrine tumors (0.3%), mucosal hyperplasia (0.3%), endometriosis (0.3%), colon carcinomas involving the appendix (0.2%), high-grade appendiceal mucinous neoplasms (0.1%), diverticulosis (0.1%), ischemic changes (0.1%) and a sessile serrated polyp (0.0%). CONCLUSION: Although acute appendicitis remained the primary diagnosis, appendectomy specimens revealed various incidental pathologies. Notably, mucinous neoplasms were more frequent than well-differentiated neuroendocrine tumors.
Ömeroğlu E, Serden Ay A, Günler T
… +2 more, Küçükosmanoğlu İ, Kozacıoğlu S
Saudi Med J
· 2025 Nov · PMID 41224336
·
Full text
OBJECTIVES: To investigate the association of β-galactoside α2-6 sialyltransferase 1 (ST6GAL1) expression with hormone receptor (HR), human epidermal growth factor receptor 2 (HER2), and other clinicopathological paramet...OBJECTIVES: To investigate the association of β-galactoside α2-6 sialyltransferase 1 (ST6GAL1) expression with hormone receptor (HR), human epidermal growth factor receptor 2 (HER2), and other clinicopathological parameters, including histological grade, stage, lymphovascular invasion, perineural invasion, and survival in breast carcinomas (BCs). METHODS: This study included 85 patients who had undergone surgery for breast cancer (BC). The associations of HR, HER2 status, and histopathologic tumor characteristics with immunohistochemical expression of ST6GAL1 were analyzed. RESULTS: The majority (48 [56.5%]) of patients were in the T2 stage, and no association was seen between staging and ST6GAL1 (<0.05). Further, 44 (54.2%) patients were HR positive, and most of them exhibited high ST6GAL1 levels (=0.001), whereas 44 (51.8%) were HER2 negative, and most of them demonstrated low ST6GAL1 levels (=0.007). Ki-67 of ≥20% was observed in 55 (64.7%) and <20% in 30 (35.3%) patients. Most of those with high Ki-67 demonstrated low-grade STLGAL1 expression; however, no correlation was detected between the two values (=0.378). High and low ST6GAL1 expressions were observed in 39 (45.9%) and 46 (54.1%) cases, respectively. CONCLUSION: This research is one of the first studies to use ST6GAL1 in preoperative biopsies of patients not scheduled for neoadjuvant treatment. This study revealed highly significant associations of ST6GAL1 expression with HR, HER2, and molecular subtyping. Future studies are recommended to clarify the possible role of ST6GAL1 in resistance to HR and HER2-targeted and other chemotherapeutic agents in BCs.
Saudi Med J
· 2025 Nov · PMID 41224335
·
Full text
OBJECTIVES: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in communication, social interaction, and behavior. This study aimed to explore the factors influencing the clinic...OBJECTIVES: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in communication, social interaction, and behavior. This study aimed to explore the factors influencing the clinical presentation of children with ASD in Saudi Arabia, focusing on demographic, medical, and environmental determinants. METHODS: A multi-center, cross-sectional study was conducted in Saudi Arabia, enrolling 104 children diagnosed with ASD. Data were collected via structured parent interviews and analyzed to examine the relationships between demographic characteristics, therapy participation, self-care abilities, and clinical symptoms. RESULTS: Male children were more likely to exhibit hyperactivity compared to females (=0.037). Age was significantly associated with delayed speech (=0.003), aggression (=0.034), attention deficits (=0.006), sleeping problems (=0.001), and anxiety (=0.007). Self-care abilities - such as bathroom independence and dressing - improved significantly with age (<0.05). Therapy participation varied with 49% receiving speech therapy, 44.2% engaged in behavioral therapy and 5.8% currently undergoing physiotherapy. Approximately, 34.6% had received occupational therapy for less than one year. CONCLUSION: The clinical presentation of ASD in Saudi Arabia is influenced by demographic and environmental factors, highlighting the need for early diagnosis and individualized interventions. The findings underscore the importance of improving therapy access and parental support to address persistent challenges, such as hyperactivity, learning difficulties, and limited self-care skills.
Saudi Med J
· 2025 Nov · PMID 41224334
·
Full text
OBJECTIVES: To promote healthy habits among pharmacy students through curriculum-embedded challenges. Student well-being is a growing concern in Saudi pharmacy education, with high rates of stress and poor health behavio...OBJECTIVES: To promote healthy habits among pharmacy students through curriculum-embedded challenges. Student well-being is a growing concern in Saudi pharmacy education, with high rates of stress and poor health behaviors reported among students. Traditional interventions often fall short in bridging the gap between awareness and action. METHODS: A quasi-experimental design was conducted from September to December 2024 at Taibah University. Four month-long challenges targeting smartphone use, physical activity, sleep, and gratitude were integrated into a required hospital pharmacy course. The intervention was grounded in behavioral economics principles (salience and inertia) and delivered via Blackboard LMS with minimal extrinsic incentives. A reflective survey assessed participation, motivations, baseline behaviors, and post-intervention intentions. RESULTS: Of 198 enrolled students, 155 (78.3%) engaged in at least one challenge. Participation was highest in the smartphone challenge (64.1%) and lowest in the gratitude challenge (28.8%). Key motivators included extra credit and interest in the challenging outcomes. A large majority (89.7%-98.7%) reported intentions to sustain the positive behaviors post-intervention, particularly among those who had not previously adopted them. Intrinsic motivation, such as the desire for personal well-being, showed a significant positive correlation with the intention to continue. CONCLUSION: Embedding nudge-based challenges into pharmacy curricula is a feasible and culturally responsive strategy for enhancing student well-being. Further research should evaluate long-term impacts and scalability across educational settings.
Saudi Med J
· 2025 Nov · PMID 41224333
·
Full text
OBJECTIVES: To assess the prognostic significance of Borrmann classification subtypes in patients with stage 2-3 gastric cancer who underwent surgical treatment. METHODS: A retrospective review of 96 gastric cancer patie...OBJECTIVES: To assess the prognostic significance of Borrmann classification subtypes in patients with stage 2-3 gastric cancer who underwent surgical treatment. METHODS: A retrospective review of 96 gastric cancer patients treated at Van Yüzüncü Yıl University Medical Faculty Hospital from 2008 to 2024 was conducted. Patients were included if they were aged >18 year (yr), had undergone surgery without neoadjuvant therapy, had no distant metastases, and had a postoperative pathological stage of 2-3. Demographic and clinicopathological data were documented, and median overall survival (OS) was analyzed according to the Borrmann classification. RESULTS: The median age of the 96 patients was 66 yr, and 36.4% were female. Total gastrectomy was performed in 45.8% of cases. According to the Borrmann classification, type 2 tumors (49%) were the most common. The tumor was most frequently located in the antrum and pylorus (45.8%), and adenocarcinoma was the predominant histopathological type (77.1%). Recurrence was observed in 63.5% of cases. The median OS was 54.66 months, with survival rates of 74.8% at 2 yr and 48.7% at 5 yr. Among Borrmann subtypes, type 1 tumors had the highest median OS (110.1 months) (=0.787). CONCLUSION: Although patients with Borrmann type 1 tumors had the highest OS rate, no significant prognostic differences were observed across the four Borrmann subtypes.
Salih MM, Abdullah Alotaibi S, Al Talhi AM
… +3 more, Hassan MA, Bhaket KM, Bakhsh NA
Saudi Med J
· 2025 Nov · PMID 41224332
·
Full text
OBJECTIVES: To classify serous effusions using the ISRSFC and assess malignancy risk across diagnostic categories, considering patient demographics and clinical features. Serous fluid cytopathology is a minimally invasiv...OBJECTIVES: To classify serous effusions using the ISRSFC and assess malignancy risk across diagnostic categories, considering patient demographics and clinical features. Serous fluid cytopathology is a minimally invasive, cost-effective method for diagnosing benign and malignant conditions. The International System for Reporting Serous Fluid Cytopathology (ISRSFC) standardizes reporting, yet data from Saudi Arabia are limited. METHODS: A prospective observational study was conducted from October 2023 to June 2024. Serous fluid samples (peritoneal, pleural, pericardial) were stained with the Papanicolaou method and evaluated microscopically. RESULTS: Among 153 effusions, peritoneal (60.7%) was most common. Patients aged 41-66 comprised the largest group (41.2%). Cytologically, 36% were negative for malignancy, 19% atypia of undetermined significance (AUS), and 18.3% malignant. Risk of malignancy by ISRSFC category was: nondiagnostic (3.2%), negative for malignancy (5.4%), AUS (6.8%), suspicious for malignancy (52.7%), malignant (100%). Significant associations were found with clinical and demographic factors. CONCLUSION: The ISRSFC effectively classifies effusions and stratifies malignancy risk. Peritoneal effusion was most frequent, highlighting cytology's diagnostic value and the need for further regional studies.
Almatham KI, Almudaiheem HY, Alhazzani WA
… +9 more, Alotaibi HF, Alobaili SS, Tawhari MH, Alsifri SN, Albakr RB, Alomi MN, Alenzi KA, Al-Omari BA, Al-Jedai AH
Saudi Med J
· 2025 Oct · PMID 41087076
·
Full text
OBJECTIVES: To develop evidence-based national guidelines incorporating recent advancements in clinical research and therapeutic strategies for the management of patients with diabetic kidney disease (DKD) in the Kingdom...OBJECTIVES: To develop evidence-based national guidelines incorporating recent advancements in clinical research and therapeutic strategies for the management of patients with diabetic kidney disease (DKD) in the Kingdom of Saudi Arabia (KSA). METHODS: We developed the guidelines using the GRADE methodology and a multidisciplinary expert panel comprising nephrologists, endocrinologists, clinical pharmacists, and methodologists across KSA. We conducted a systematic literature review of studies published between 2014-2024. The evidence certainty was evaluated across 5 domains using GRADEpro and categorized into 4 levels: "high", "moderate", "low", and "very low". Recommendations were formulated based on the benefit-risk ratio, evidence quality, and expert consensus, with a minimum agreement threshold of 70%. RESULTS: We established 39 evidence-based recommendations addressing key aspects of DKD management, including monitoring and treatment. Among the 39 recommendations, 6 focus on lifestyle interventions, 7 address glucose-lowering therapies, one discusses glycemic monitoring and targets, 8 address DKD evaluation and risk assessment, 7 emphasize comprehensive management approaches, and 10 discuss DKD pharmacological management. Two recommendations related to the comprehensive management of DKD were based on expert opinions owing to a lack of supporting evidence. CONCLUSION: These Saudi national guidelines offer an evidence-based approach for managing DKD in adults with DM and provide a comprehensive framework for monitoring and treatment. Nevertheless, further local research and data collection are warranted to refine and enhance the guidelines' effectiveness.
Shi A, Chen J, He X
… +6 more, Chen C, Sun M, Li W, Xu W, Yang W, Han X
Saudi Med J
· 2025 Oct · PMID 41087074
·
Full text
OBJECTIVES: To identify risk factors for moderate-to-severe pain during intraosseous infusion (IOI) in non-cardiac arrest patients in the emergency department (ED). Secondary aims include evaluating pain trajectory acros...OBJECTIVES: To identify risk factors for moderate-to-severe pain during intraosseous infusion (IOI) in non-cardiac arrest patients in the emergency department (ED). Secondary aims include evaluating pain trajectory across procedural stages and assessing the efficacy of a personalized pain management strategy. METHODS: This mixed-methods study analyzed 220 ED patients undergoing IOI (150 retrospective, 70 prospective). The prospective cohort was randomized to standard care (n=35) or personalized pain management (n=35). Pain was quantified using the numeric rating scale (NRS) and critical-care pain observation tool (CPOT). RESULTS: During puncture, 35.33% (53/150) reported no/mild pain. Pain severity peaked during flushing, with 73.33% (110/150) experiencing moderate/severe pain. At 15-minute infusion, this decreased to 57.33% (86). Univariate analysis identified gender and BMI as pain-associated factors (<0.05). Multivariate analysis confirmed female gender (OR=13.468) and low BMI (OR=7.250) as independent risk factors (<0.05). Compared to the control group, the personalized strategy group demonstrated significantly lower pain scores during puncture, flushing, and early infusion, with reduced analgesic requirements in the first 2 stages. No between-group differences occurred in puncture success or complication rates. CONCLUSION: Intraosseous infusion flushing induces the most severe pain, particularly among females and low-BMI patients. Personalized, stage-targeted analgesia significantly improves pain control without compromising safety, supporting its integration into emergency IOI protocols.
Alanazi MH, Alrabiah AA, Algosaibi EA
… +5 more, Alzahrani NH, Alanazi MA, Aldhafeeri MM, Albrahim HA, Mobrad AM
Saudi Med J
· 2025 Oct · PMID 41087073
·
Full text
OBJECTIVES: To evaluate the utility of point-of-care ultrasound (POCUS) devices in prehospital care in Saudi Arabia. Furthermore, the impact of POCUS training on paramedics' knowledge, confidence in use, and attitudes to...OBJECTIVES: To evaluate the utility of point-of-care ultrasound (POCUS) devices in prehospital care in Saudi Arabia. Furthermore, the impact of POCUS training on paramedics' knowledge, confidence in use, and attitudes toward POCUS devices was assessed. METHODS: Thirty-seven paramedics who were engaged in providing prehospital emergency care were selected. A quasi-experimental pre-test and post-test study was conducted between February 5 and March 20, 2025. Participants underwent a comprehensive POCUS training involving theoretical lectures, hands-on sessions, and simulation-based exercises. RESULTS: A significant improvement in overall POCUS knowledge, confidence in use, and diagnostic accuracy were noted on the post-test survey. Pre-test knowledge scores averaged 2.57 on a 5-point scale, whereas post-test scores exceeded 4 in all assessed categories. Confidence in using POCUS devices improved from a mean of 1.51 (not confident) to 3.51 (moderately confident). Training influenced attitudes, as 97% of participants recommended POCUS in Emergency Medical Services (EMS) practice. CONCLUSION: Point-of-care ultrasound training can influence diagnostic abilities. The implementation of POCUS devices in the prehospital setting can improve clinical decision-making, ultimately leading to improvement in patients' outcomes.
Saudi Med J
· 2025 Oct · PMID 41087071
·
Full text
OBJECTIVES: To evaluate the association between Inflammatory bowel disease (IBD) and Ischemic heart disease (IHD). METHODS: A retrospective cohort analysis included patients with and without IBD seen at the outpatient ga...OBJECTIVES: To evaluate the association between Inflammatory bowel disease (IBD) and Ischemic heart disease (IHD). METHODS: A retrospective cohort analysis included patients with and without IBD seen at the outpatient gastroenterology clinic of a large tertiary care hospital between January 2015 and October 2022. The primary outcome was the association between IBD and IHD, and the secondary outcome was predictors of IHD in patients with IBD. RESULTS: The study included 400 patients; 291 were IBD patients, and 109 had other non-inflammatory GI disorders. The IBD group displayed significantly lower rates of hyperlipidemia (8.6% vs. 30.3%, <0.001), diabetes mellitus (DM) (10% vs. 24.8%, <0.001), and hypertension (11.7% vs. 32.1%, <0.001) compared to the non-IBD group. Only 2.7% (n=8) of IBD patients developed IHD. Logistic regression analysis did not demonstrate a significant association between IBD and IHD (=0.932). Among classical risk factors, only hypertension (OR: 26.2, 95% CI: 2.14-661, =0.016) and hyperlipidemia (OR: 10.5, 95% CI: 1.32-132, =0.0405) significantly increased the risk of developing IHD among patients with IBD. CONCLUSION: In this cohort, there is no increased risk of developing IHD in patients with IBD compared to non-IBD patients.
Almehmadi MM, Alharbi FA, Shawush AK
… +4 more, Allahyani MA, Abdulaziz OA, Alhazmi AS, Aghamdi AA
Saudi Med J
· 2025 Oct · PMID 41087070
·
Full text
OBJECTIVES: To explore the prevalence of respiratory tract infections (RTIs) in Taif via molecular diagnosis method, to enhance the clinical decision making and the need for vaccination strategies. METHODS: A 5864 partic...OBJECTIVES: To explore the prevalence of respiratory tract infections (RTIs) in Taif via molecular diagnosis method, to enhance the clinical decision making and the need for vaccination strategies. METHODS: A 5864 participants were enrolled in this study, all from Taif city. Samples were collected via nasal swab, throat swab, or sputum sample. The duration of the study were 24 months from January 2023 to December 2024. Samples were transported in viral transport medium. Then processed using GeneXpert system. Fluorescent probes detected viral RNA and reported as detected or not detected. Chi-square test was applied for statistical analysis purposes. RESULTS: A total of 228 (3.9%) detected viral RTIs. FLU A was the most common (71.07%), followed by FLU B (17.11%), SARS-CoV-2 (5.75%), and RSV (3.5%). Few cases of H1N1 were detected. The most common affected age group were pre-school, and family medicine ward was highest. Viral RTIs co-infection was detected. CONCLUSION: Our study highlighted the impact of RTIs, especially influenza as the leading cause. Pre-school age group was mostly affected due to their developing immune system. The high burden of RTIs management was on the primary care ward, family medicine handled the highest percentage of cases. RTIs have caused several pandemics in the recent year, and developing in vaccination and diagnostic tools can enhance the efficacy and improving the patient's management, which can relief the burden on health care system.
Saudi Med J
· 2025 Oct · PMID 41087069
·
Full text
OBJECTIVES: To assess awareness of diabetes complications and knowledge of hypoglycemia. METHODS: This cross-sectional study was conducted in a tertiary hospital between December 2022 and November 2023. The participants...OBJECTIVES: To assess awareness of diabetes complications and knowledge of hypoglycemia. METHODS: This cross-sectional study was conducted in a tertiary hospital between December 2022 and November 2023. The participants were 362 adult patients with diabetes selected using systematic random sampling. Data were collected through structured interviews using a validated questionnaire that included sections on socio-demographic characteristics, diabetes history, and knowledge of hypoglycemia and awareness about diabetes complications. Descriptive statistics and one-way ANOVA were used for data analysis. RESULTS: The majority of participants were female (71.3%), and 227 (62.7%) had been diabetic for more than 10 years. Approximately 37% are taking a combination of antidiabetic medications. Hypoglycemia reported in 218 (60.2%) and hypoglycemic coma reported in 37 (17.1%). Overall, 81.1% had good knowledge of hypoglycemia, and 91.4% had good awareness of diabetes complications. Better knowledge was associated with higher education, insulin treatment and other combination therapies, and previous experience with hypoglycemia. Patients with type 1 diabetes or a long duration of diabetes were more aware of diabetes complications. CONCLUSIONS: Patients with diabetes had a high degree of knowledge and awareness, but hypoglycemia was still a prevalent issue. Neuroglycopenic symptoms and long-term consequences are insufficiently recognized. Teaching and coaching can help prevent hypoglycemia.
Aljawadi MH, Alonazi KF, Alsultan IM
… +3 more, Kalagi NA, Alrasheed MA, Alhammad AM
Saudi Med J
· 2025 Oct · PMID 41087066
·
Full text
OBJECTIVES: To evaluate clinical trials involving pharmaceutical agents conducted in Saudi Arabia and registered on ClinicalTrials.gov. Since the early 2000s, Saudi Arabia has expanded its involvement in clinical researc...OBJECTIVES: To evaluate clinical trials involving pharmaceutical agents conducted in Saudi Arabia and registered on ClinicalTrials.gov. Since the early 2000s, Saudi Arabia has expanded its involvement in clinical research. Recognizing the importance of clinical trials, we aimed to analyze the clinical trial landscape in the Kingdom to identify well-covered areas and potential gaps. METHODS: In this descriptive cross-sectional study, ClinicalTrials.gov was used as the primary source to collect data regarding pharmacological and biological interventions conducted in Saudi Arabia between 2002 and June 2025. RESULTS: A total of 474 pharmaceutical studies were included. Of these, 52.95% were completed, indicating moderate research activity but suggesting room for growth compared to global benchmarks. Among completed trials, 38.64% had their results published on ClinicalTrials.gov. Overall, 223 sponsors were identified: 23.32% were international pharmaceutical companies and 24.22% were Saudi sponsors, of which 77.78% were governmental and 22.22% private. Additionally, 239 studies were funded by international companies. Oncology (23.21%) was the most represented medical field, followed by infectious diseases (12.87%). CONCLUSION: Saudi Arabia witnessed an increase in registered clinical trials between 2002 and June 2025, with strong contributions from both international and Saudi sponsors, particularly the governmental sector. However, only one-fifth of completed trials had results published on ClinicalTrials.gov, highlighting the need for greater transparency and dissemination of findings.