Saudi Medical Journal最新文献

Objectives: To validate the diagnostic performance of the iSelfie Heart Health tool compared to standard-of-care devices, focusing on accuracy, reliability, and classification capabilities.

Methods: Vital sign measurements from 579 participants were analyzed using the iSelfie tool in calibrated and non-calibrated modes. Further analyses applied the Association for the Advancement of Medical Instrumentation (AAMI) standards and criteria for cuff-based blood pressure (BP) devices. Primary endpoints included mean absolute error (MAE) and cumulative error percentages for all vital parameters. Binary and multi-class classification analyses evaluated the device's performance to categorize hypertension grades.

Results: In calibrated mode, the iSelfie tool demonstrated high accuracy, with MAE of 4.42 beats per minute (BPM) for heart rate (HR), 8.94 mmHg for systolic BP (SBP), 7.50 mmHg for diastolic BP (DBP), and 1.16% for oxygen saturation (SaO2). When applying AAMI criteria, MAE was reduced to 4.35 BPM for HR, 5.29 mmHg for SBP, and 3.60 mmHg for DBP. Binary classification analysis to distinguish normotensive from hypertensive states yielded 84.4% sensitivity and 84.7% specificity in calibrated mode after applying AAMI criteria. Multi-class classification accuracy was highest for normotensive cases (Grade 0), with limited representation for higher grades.

Conclusion: The iSelfie Heart Health tool demonstrated strong performance in measuring HR and SaO2, with improved BP accuracy following calibration and application of AAMI criteria, highlighting its clinical potential as a contactless, user-friendly tool for cardiovascular health monitoring and screening.

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.

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.

Objectives: To confirm a preoperative scoring system devised by the Modified Randhawa Model.

Methods: This retrospective study was performed in the period between October 2017 to October 2023 on every patients hospitalized for elective laparoscopic cholecystectomy in the Surgery Department, National Guard Hospital in Riyadh, Saudi Arabia. A preoperative scoring system, devised using the Modified Randhawa Model, was applied to each patient retrospectively. The preoperative score was compared to the intraoperative degree of difficulty.

Results: The history of previous biliary inflammation, the impacted stone, the palpable gall bladder, the more gall bladder wall thickness, the higher body mass index and older ages were significantly associated with more difficult surgeries and more operative time. The preoperative scoring system devised by the Modified Randhawa Model is valid.

Conclusion: The study found that the Modified Randhawa Model scoring system is valid, effective and reliable predictor of LC difficulty in Saudi Arabia.

Objectives: To characterize the clinical and genetic spectrum of genodermatoses in Southwestern Saudi Arabia, the present study examines the impact of consanguinity on this particular population, and proposes a tailored premarital genetic screening protocol.

Methods: A retrospective cross-sectional study of 32 patients diagnosed with genodermatoses during the study period at a tertiary hospital (King Khalid Hospital, Najran) were included. Genetic screening was performed for patients with suspected genodermatoses based on clinical findings, using whole-exome sequencing (WES), specifically employing next-generation sequencing (NGS) technology. Clinical and genetic analysis data were extracted from medical records.

Results: Among 32 patients diagnosed with genodermatoses, the majority were aged 1-10 years (50%), male (56.3%), and Saudi nationals (87.5%). Autosomal dominant inheritance was most prevalent (56.3%), followed by autosomal recessive and X-linked patterns (each 15.6%). Consanguinity was observed in 71.9% of cases, predominantly first-degree (53.1%). Twenty distinct genodermatoses were identified, with Ichthyosis Vulgaris being the most frequent (15.6%). Consanguinity showed a strong association with genodermatosis subtype (adjusted p=0.002176; Cramér's V=0.942), while inheritance patterns were significantly linked to genodermatosis subtype (adjusted p=0.0000053512; Cramér's V=1.000), but not to age, sex, or nationality. Most patients (90.6%) survived with complications.

Conclusion: Consanguinity contributes to a higher burden of autosomal dominant genodermatoses in Southwestern Saudi Arabia. Implementation of a premarital targeted genetic screening, integrated with culturally sensitive counseling and feasibility considerations, may reduce disease incidence and associated healthcare costs.