Saudi Journal of Medicine & Medical Sciences最新文献

Objective: To perform a bibliometric analysis of the scientific production related to intestinal microbiota and bariatric surgery between January 2016 and December 2022.

Materials and methods: A bibliographic search was performed in the Scopus database to identify published papers. Free and controlled terms (MeSH and Emtree) were used. The information collected was analyzed with SciVal.

Results: A total of 518 published papers were included in the analysis. Carel Le Roux was the author with the highest scientific production; however, Edi Prifti had the highest impact. French National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale) was the institution with the highest number of published articles. Six of the 10 institutions with the highest production were in France, yet the United States had the highest volume of scientific production in this research topic. Most papers were published in first quartile journals. Articles with international collaboration had the highest impact. There is a sustained increase in the number of publications since 2019.

Conclusions: The study found that the vast majority of research on gut microbiota changes following bariatric surgery are conducted in the United States and European countries. In addition, the sustained increase in production coupled with the articles being published in high-quality journals and having good citation impact are indictors of the current interest in this research field.

Background: Cardiovascular diseases (CVDs) are a prominent cause of mortality in prostate cancer patients. However, it has been reported that patients with preexisting CVDs are at greater risk. Literature on the magnitude of this problem in Saudi Arabia is lacking.

Objectives: To measure the prevalence of prostate cancer patients with preexisting CVDs in our population and to elucidate the possible risk factors of new cardiovascular events (CVEs) in patients who received androgen deprivation therapy (ADT).

Materials and methods: This retrospective study included all patients newly diagnosed with prostate cancer at a tertiary hospital in the Eastern Province of Saudi Arabia from October 2008 to January 2019. The prevalence of preexisting cardiovascular diseases in these patients were determined. In addition, the incidence of new CVEs after initiating ADT was determined along with the risk factors for the same.

Results: The prevalence of preexisting CVD in our cohort was 16%. About 6% of the patients who received ADT had CVEs after a median follow-up of 39 months (IQR: 11-49 months). In the univariate analysis, hyperlipidemia (P = 0.002), stroke (P = 0.001), peripheral vascular disease (P = <0.001), cardiac patients with stents (P = <0.001), and cardiac patients without stent (P = <0.001) were significant risk factors of new CVEs after initiating ADT. However, in the multivariate regression analysis, only history of stroke and CVD (with or without stent) were found to be significant risk factors of new CVEs after initiating ADT (P = 0.01).

Conclusion: About one-fifth of the prostate cancer patients had preexisting CVDs. This study also found that luteinizing hormone-releasing hormone agonist could be a risk factor for new CVEs.

Background: Signet-ring cell colorectal carcinoma (SRCC) is an extremely aggressive yet uncommon histologic subtype of colorectal cancer (CRC) with an unknown etiology. There is a stark difference in the prevalence of signet cancers between Western countries and the Indian subcontinent; however, India itself is a vast and diverse country with variable cancer incidence.

Objective: To study the spatial epidemiology of SRCC in India for identifying regions with high prevalence.

Methods: This retrospective study included all patients diagnosed with colorectal adenocarcinoma at Tata Memorial Hospital, the largest colorectal cancer referral unit in India, between January 2020 and December 2022. Geocoding based on the location of the residence was done to map the incidences. Comparisons were performed between the proportion of signet cell and non-signet colorectal cancers.

Results: A total of 4100 patients with colon or rectal adenocarcinomas were included, of which signet cell histology was found in 624 (15%) patients. SRCC accounted for the highest proportions of CRCs in the Central (19%) and Northern (19%) regions, and the lowest in the North-Eastern (10%) and Western (12%) regions of India (P < 0.001), with non-overlapping confidence intervals. Compared with patients with non-signet CRCs, those with SRCC more commonly had colon cancers (22% vs. 17%; P = 0.003) and belonged to a lower socioeconomic background (67% vs. 59%; P < 0.001).

Conclusions: This study found that SRCCs accounted for a significant proportion of CRC cases in India, but there was no substantial disparity in distribution across regions.

Background: Students' satisfaction surveys are valuable tools for assessing and improving the quality of education being imparted. Limited data are available from Saudi Arabia regarding students experience at halfway through an undergraduate dental program.

Objective: To determine students' perception of their halfway experience on various attributes of the quality of dental education programs in public dental schools across Saudi Arabia.

Methods: This exploratory study included all students from four major public universities who had completed their third year of undergraduate dental education during the academic year 2022-23. A previously validated, self-administered, 23-item Students Experience Survey was modified and used to collect data regarding the following five factors: course characteristics, infrastructure and facilities, learning resources, instructor characteristics, and program efficacy.

Results: The questionnaire was administered to 296 students, of which 252 (85.1%) responded. Overall, 84% of the students had a positive experience regarding the quality of the dental education programs. Females reported significantly higher positive experiences than males (mean score: 4.36 vs. 4.21, respectively; P = 0.042). Course characteristics (P = 0.041), instructors' characteristics (P = 0.002), and program efficacy (P = 0.009) were significant predictors of students' overall experience.

Conclusion: This study found that the majority of students had a positive halfway experience with the quality of dental education programs offered in Saudi Arabia. The significant predictors of satisfaction identified in this study can be useful for policymakers to further improve satisfaction levels.

Background: Social stigma is a major problem among patients with multiple sclerosis (MS), which can affect their quality of life. There is limited research from Saudi Arabia on the anticipated stigma among patients with MS.

Objectives: To determine the levels of anticipated stigma and its predictors in patients with MS in Saudi Arabia.

Methods: This cross-sectional study included adult patients with MS across Saudi Arabia. Sociodemographic and medical information, including age, gender, marital status, educational level, duration of disease, number of MS episodes in the past 12 months, previous diagnosis of mental illness, and performing activities of daily living without assistance, were collected. Anticipated stigma was measured using an Arabic version of the Chronic Illness Anticipated Stigma Scale.

Results: A total of 222 patients with MS were included. Moderate to severe anticipated stigma was found among 70.4% of the patients. The highest anticipated stigma mean score was from work colleagues (2.96/5). Predictors of stigma were age (P = 0.049), gender (P = 0.016), marital status (P = 0.015), education level (P = 0.003), number of MS episodes in the previous year (P < 0.001), and previous diagnosis of a mental disorder (P = 0.001).

Conclusions: The findings of this study indicate the need for developing programs that reduce the anticipated stigma among patients with MS in Saudi Arabia.

Ischemic stroke is a considerable public health hazard and a significant cause of disability and mortality in Saudi Arabia. Primary prevention strategies in the country are currently limited. With the health sector transformation program that depends on the principles of value-based care and applying the new model of care in disease prevention, aggressive and serious steps for primary stroke prevention are expected to be implemented. This article reviews primordial and primary prevention of ischemic stroke in Saudi Arabia and suggests a combination approach and framework for implementation. We provide a pragmatic solution to implement primordial and primary stroke prevention in Saudi Arabia and specify the roles of the government, health professionals, policymakers, and the entire population. Currently, there are several key priorities for primordial and primary stroke prevention in Saudi Arabia that should target people at different levels of risk. These include an emphasis on a comprehensive approach that includes both individual and population-based strategies and establishing partnerships across health-care providers to share responsibility for developing and implementing both strategies. This is an urgent call for action to initiate different strategies suggested by experts for primary stroke prevention in Saudi Arabia.

Background: Hepatotoxicity caused by CCL₄ is well known. Geraniol (GNL) has high antioxidant effect that can induces liver regeneration. However, the protective effect of GNL effect on CCL₄-induced hepatorenal toxicity in pregnant mice has not yet been studied.

Objective: To investigate whether GNL could protect against oxidative stress induced by CCL₄ via the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway, which is regulated by phosphatidylinositol 3 kinase/protein kinase B (PI3K/AKT), and has been found to have protective effects on renal and hepatic tissues.

Materials and methods: Forty-eight female albino mice weighing 25-30 g were randomly allocated to 4 groups: Group I served as a control; Group II received a toxicity-inducing single dose of 15 μL of CCL₄ on the 4^th day after mating; Group III received 40 mg/kg GNL + CCL₄ (with GNL from the 1^st day of assimilation to delivery); and Group IV received GNL alone from the 1^st day of assimilation to the end of the delivery period. GNL was evaluated for its protective effects on hepatotoxicity in CCL₄-treated pregnant mice. Litter size, weight, survival rate, and resorption were recorded. In addition, H & E staining was done for liver and kidney pathology as well as biochemical markers and oxidative markers malondialdehyde, superoxide dismutase, and catalase were analyzed.

Results: CCL₄ significantly reduced survival rate and increased resorption after exposure. Alanine transaminase and aspartate aminotransferase concentrations in the serum, tissue MDA, blood urea nitrogen, and creatinine were increased after CCL₄ exposure. GNL improved enzyme and antioxidant levels and prevented CCL₄-induced hepatic injury in mice. Caspase-3 cleavage was decreased by GNL, which increased PI3K, phosphorylated AKT, Nrf2, and B-cell lymphoma 2.

Conclusion: GNL demonstrates a protective effect against CCl4-induced hepatorenal toxicity, mediated through the activation of the PI3K/AKT signaling pathway and the upregulation of Nrf2. These findings highlight the potential therapeutic implications of GNL in mitigating oxidative stress and inflammation in liver and kidney tissues.

The concept of health span is an emerging topic in recent years, with a truly palpable relevance to public health. With ageing comes a loss of skeletal muscle mass, strength, and performance, which is termed as sarcopenia. Sarcopenia is a major public health concern and poses a challenge to health-care systems. Modifiable lifestyle factors may be linked to the course of sarcopenia progression. Many countries developed diagnostic tools to accurately detect sarcopenia for its prevention, delay, or treatment. However, to date, there is no sufficient information regarding the status of sarcopenia in Saudi Arabia. The review aims to discuss sarcopenia and relevant updates in research and literature, the association with modifiable lifestyle factors, the implications of sarcopenia in a rapidly developing country such as Saudi Arabia, and the current state and need for research in Saudi Arabia in this domain along with future directions in combating this disease.

Background: The 2013 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommends statin treatment for all adult kidney transplant recipients (KTRs), except those aged <30 years of age and without prior cardiovascular risk factors (CVRF), but does not specify on-treatment low-density lipoprotein cholesterol (LDL) target levels. The 2018 American Heart Association (AHA) guidelines addressed the management of hyperlipidemia in the general population based on an individualized approach of the CVRF with a specific on-treatment LDL target.

Objective: To analyze dyslipidemia management according to the recommendations of the KDIGO and AHA guidelines.

Methods: This retrospective study included all KTRs who underwent transplantation between January 2017 and May 2020 at King Abdulaziz Medical Center, Riyadh, Saudi Arabia. The rate of statins prescription in general, rate of statins prescription among KTRs per their CVRF, and rate of achieving the proposed LDL goals, as defined by the AHA, were analyzed.

Results: A total of 287 KTRs were included. Of the 214 (74.6%) patients aged ≥30 years, 80% received a statin. Statins were prescribed in 93% and 96% of KTRs with diabetes or coronary artery disease, respectively. In patients aged ≥30 years, LDL targets, per AHA guidelines, were achieved in 62% with a target of 2.6 mmol/l, and in 19% with a target of 1.8 mmol/l. Statin therapy resulted in non-significant changes in the mean LDL values from baseline to 12 months after transplantation (P = 0.607), even when only patients prescribed statin after transplantation were included (P = 0.34).

Conclusion: By applying the KDIGO guidelines, a high rate of statin prescriptions was achieved among KTRs with multiple CVRF and KTRs in general. However, a significant proportion of these KTRs did not achieve the LDL targets proposed by the AHA guidelines, suggesting that higher-intensity statins would be required to achieve these targets.