Saudi Medical Journal最新文献

Splanchnic artery aneurysms, particularly those involving the left gastric artery, are infrequent occurrences and often lack noticeable symptoms, but their rupture involves a significant risk of mortality. We present a case involving an unruptured left gastric artery aneurysm (LGAA) that extended into the right hemithorax. This case report outlines the categorization, clinical manifestations, and diagnostic challenges associated with such aneurysms. Our findings could offer valuable insights for clinicians and radiologists when adopting a systematic approach for the early detection and management of LGAA.

Objectives: To review the outcomes of the cochlear implantation program at King Abdallah Medical Center (KAMC) in Makkah from its launch in 2018 to 2023, focusing on patient demographics, procedural details, and complications.

Methods: A retrospective analysis was conducted on 133 patients who underwent cochlear implantation (CI) at KAMC between May 2018 and June 2023. Data collected included demographics, hearing loss types, anatomical findings from imaging, types of CI devices, procedural challenges, and complications.

Results: The average age of the patients was 9 years (108 months) with 56.4% males and 96.2% Saudi nationals. Most patients (50.4%) were from Makkah, and 19.5% had a family history of hearing loss. Med-El implants were used in 63.9% of cases, and 37.6% had simultaneous bilateral implants. Intraoperative complications occurred in 7 (5.3%) patients, while 11 (8.3%) patients experienced postoperative complications. Follow-up adherence was high at 94%, with 18.8% of patients using telehealth services for monitoring.

Conclusion: The CI program at KAMC has demonstrated to be a safe and effective approach for treating severe-to-profound hearing loss. Minor complications were observed, and follow-up adherence was strong. The study emphasizes the importance of ongoing accreditation and support for the program to ensure its success in hearing rehabilitation.

Objectives: To ascertain the prevalence of depressive symptoms and identify related risk factors among adolescents.

Methods: A cross-sectional survey was carried out using an online questionnaire completed by 1,413 adolescents from Central Java and Yogyakarta Provinces، Indonesia. The validated Indonesian version of the Children's Depression Inventory (CDI) was used to evaluate depressive symptoms.

Results: Symptoms of depression were identified in 28.5% of participants. Multivariate analysis revealed important risk factors, including female gender (OR 3.962, 95% CI 2.684-5.849), having mother who is a housewife (OR 4.155, 95% CI 1.424-12.126) or works in labor/farming/self-employment (OR 3.665, 95% CI 1.216-11.051), residing with a biological father (OR 5.386, 95% CI 1.458-19.894) or non-parental guardians (OR 1.826, 95% CI 1.059-3.146), and lack of siblings (OR 1.459, 95% CI 1.057-2.013). Behavioral factors such as abnormal sleep duration (<6 hours or >8 hours per night, OR 3.750, 95% CI 2.833-4.964), smoking (OR 4.272, 95% CI 2.110-8.649), frequent consumption of sugary beverages (>3 times/week, OR 2.472, 95% CI 1.623-3.765), and chronic illnesses requiring regular medication (OR 2.057, 95% CI 1.177-3.595) were also strongly linked to depressive symptoms.

Conclusion: This study reveals the increased prevalence of depressive symptoms in adolescents and highlights the complex interplay of demographic, behavioral, and social determinants. Findings emphasize the necessity for targeted, evidence-based interventions to enhance adolescent mental health.

Objectives: To identify genetic polymorphisms in factor I fibrinogen (rs6050) and factor XI plasma thromboplastin (rs4253417) in Saudi women with recurrent spontaneous miscarriage (RSM). Furthermore, to compare the levels of clotting factors in the blood of patients and healthy controls.

Methods: The current study was conducted at the King Khalid University Hospital in Riyadh, Saudi Arabia, from September 2022 to June 2023. The study involved 100 Saudi women, 50 pregnant and 50 non-pregnant individuals, who experienced RSM. Furthermore, 100 healthy Saudi women, including 50 pregnant and 50 non-pregnant individuals, were also included as controls. TaqMan genotyping assays were used to determine single nucleotide polymorphisms in the promoter regions of the factor I and XI genes.

Results: A significant correlation was found between the Factor I fibrinogen genotype (rs6050 C/T) and RSM in non-pregnant Saudi women. However, no significant correlation was observed between the Factor XI polymorphism (rs4253417 C/T) and RSM.

Conclusion: We demonstrated a significant correlation between genetic polymorphisms in factor I fibrinogen in certain genes studied and RSM. This association could be attributed to changes in fibrinogen levels, which impact the coagulation process and lead to an increase in thrombotic events, which are recognized as risk factors for miscarriage. Notably, variations in the other genes examined did not exhibit any association with the risk of RSM.

Objectives: To provide insights into the real-world usage of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) among individuals with type 2 diabetes (T2D) from Bahrain, Kuwait, and Qatar who either had established atherosclerotic cardiovascular disease (eASCVD) or were at high risk of developing ASCVD.

Methods: This study of 1062 adults diagnosed with T2D from Bahrain, Kuwait, and Qatar is a sub-analysis within the Prevalence and Clinical Management of Atherosclerotic Cardiovascular Diseases in Patients with Type 2 Diabetes across Countries in the Middle East and Africa (PACT-MEA) study, a noninterventional, cross-sectional study. Participants were recruited from 13 primary or secondary care facilities between March and August 2022. Medical records of participants were reviewed to extract relevant data, including demographic characteristics, eASCVD status, ASCVD risk and glucose-lowering treatment. Appropriate descriptive and inferential statistical tests were performed.

Results: Among T2D participants with eASCVD, a significantly higher proportion (41.3%) received SGLT2i compared to GLP-1RA (10.5%, p<0.001). There were notable variations in GLP-1RA/SGLT2i utilization across countries (p<0.001): being lowest in Bahrain (2.3%/18.0%), 26.9%/58.2% in Kuwait and 10.5%/67.1% in Qatar. The use of both medications was significantly higher in individuals with body mass index (BMI) ≥30 kg/m² (p<0.05).

Conclusion: Despite these cardioprotective agents being recommended by guidelines, the study findings suggest a suboptimal use of GLP-1RA and SGLT2i in a real-world setting.

Objectives: To study is to establish the OM-6 scores in Saudi children with OME and subjectively assess the change in QoL following VT insertion. The Otitis Media 6 (OM-6) questionnaire is a widely used measure of the quality of life (QoL) in children with otitis media with effusion (OME). Myringotomy with ventilation tube (VT) insertion is indicated when OME persists with clinically documented hearing impairment.

Methods: The present study is a prospective cohort study investigating the QoL of children with OME using a validated OM-6 questionnaire. The caregivers of 100 children were subjected to the questionnaire preoperatively from January 2023 to December 2023. All included patients underwent bilateral myringotomy and VT insertion with adenoidectomy under general anaesthesia. Caregivers were asked to complete the OM-6 questionnaire three months postoperatively to assess the change in QoL.

Results: A total of 100 children were enrolled in this study. The average OM-6 score was 16 before surgery and reduced to 7 after surgery. There is a statistically significant reduction in the score after the surgery (p<0.001). While considering the OM-6 score separately, the Wilcoxon signed rank test shows that, there is statistically significant reduction in the average score of all the variables except caregiver concern, which remained the same pre and post-surgery (p<0.001).

Conclusion: The QoL of children with OME measured by OM-6 questionnaire significantly improved following VT insertion.

Objectives: To evaluate whether hypothyroidism is a risk factor for transient ischemic attack (TIA).

Methods: We systematically searched Embase, PubMed, Cochrane, Vipers database, China Biomedical Literature Database, Wanfang Data, and China National Knowledge Infrastructure for studies assessing the association between hypothyroidism and TIA (publication cut-off in May 2024). Two researchers independently extracted the data based on inclusion and exclusion criteria. Meta-analysis was carried out using Review Manager 5.3 software.

Results: A total of 7 studies (combined n=190248) were included. Hypothyroidism showed a significant association with TIA (risk ratio [RR]=1.43 [95% confidence interval [CI]: [1.29-1.57]). The association was significant in clinical hypothyroidism (RR=1.45 [95% CI: [1.31-1.62]) but not evident in subclinical hypothyroidism (RR=1.20 [95% CI: [0.90-1.61]). Sensitivity analysis confirmed the stability and reliability of the results from the 7 studies (Begg's test z=1.2, p<0.01). No significant publication bias was detected in the meta-analysis.

Conclusion: Hypothyroidism, particularly clinical hypothyroidism, may be an independent risk factor for TIA.PROSPERO No. ID: CRD42024552608.