Saudi Medical Journal最新文献

Objectives: To report and describe the characteristics and outcomes of patients with advanced atrioventricular block (AVB) in Saudi Arabia.

Methods: We included consecutive patients who underwent pacemaker implantation at King Khaled University Hospital, Riyadh, Saudi Arabia, for advanced AVB, which was defined as second degree type 2 AVB, third degree AVB, and symptomatic atrial fibrillation with slow ventricular response. The variable "young patient" was defined as age of 60 or less, based on guidelines recommending cardiac sarcoidosis (CS) evaluation at this age or younger.

Results: Among 100 patients (median age: 71 males, 51%), 29 (29%) were young patients. Most patients had at least one comorbidity including hypertension, diabetes, or dyslipidemia (81%). Young patients constituted 26.6% (n=21/79) of idiopathic AVB cases and only 23.8% (n=8/21) underwent CS evaluation (8/21).

Conclusion: A significant proportion of AVB occurs in young patients. Yet, CS is often not ruled out. Future studies should define the yield of CS evaluation in the Saudi population when international consensus documents are followed.

Objectives: To analyze the existing literature on the prevalence of psychological symptoms in healthcare workers (HCWs) in Saudi Arabia during the COVID-19 pandemic. The review will evaluate the assessment methods used for measuring the prevalence of psychological symptoms and critically review the literature's findings concerning psychological support for HCWs.

Methods: All articles were selected from the PubMed database and reviewed for potential inclusion in March 2023. The articles were screened following the preferred reporting items for systematic reviews and meta-analyses protocol. Assessment of the quality and risk of bias in the included studies was guided using the prevalence critical appraisal tool criteria.

Results: We identified 7 articles that investigated the prevalence of psychological symptoms among HCWs in Saudi Arabia during the COVID-19 pandemic. We determined the studies' characteristics and classified and explained various themes. These themes included the prevalence of psychological symptoms found in HCWs, the study designs, the tools used to assess psychological symptoms in HCWs, and the potential impact of the studies on the mental health challenges faced by HCWs due to COVID-19. We also examined the quality and risk of bias in the included studies.

Conclusion: This review's findings provide valuable insights into the psychological symptoms experienced by HCWs during the pandemic. To ensure the consistency of the results, it is essential to reevaluate the prevalence of these symptoms and use a culturally sensitive approach to translating the measures. This review lays the groundwork for future research on psychological symptoms and the interpretation of measurement outcomes.PROSPERO No. ID: CRD42024479813.

Objectives: To evaluate the role of sonography in revealing and characterizing liver transplant complications based on gray scale and color Doppler, describe the normal Doppler findings, and discuss the significance of distinguishing normal transient changes in the spectral waveform from findings that may suggests ominous complications.

Methods: We carried out a retrospective cross-sectional study at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. The medical records and imaging studies of a total of 122 candidates who underwent transplantation between January 2016 to February 2022 were reviewed.

Results: Our results showed that most patients were males with the most frequent age group being those between 54-71 years. Hepatitis B virus and hepatic cellular carcinoma were the most common indications for transplants. A total of 95 patients received a graft from a living related donor. Regarding complications, biliary issues (including leaks and ducts dilation) were the second most frequent complication after collections. Vascular complications represented 7.4% of all complications and was the leading cause of death in 4.8% of cases. Among all vascular issues encountered during liver transplant, portal vein thrombosis was the most predominant. In respect to Doppler findings, portal vein velocities and resistive index of hepatic artery had re-averaged within 7-10 post-operative days in most patients.

Conclusion: Ultrasound plays crucial role in the post-operative management of compilations, facilitating early detection, which is substantial for the graft survival.

Objectives: To review the epidemiology of elderly trauma at the Kind Saud Medical City (KSMC), Riyadh, Saudi Arabia, and carry out risk-adjusted analyses to benchmark outcomes with the Alfred Hospital, Melbourne, Australia, the largest Australasian trauma service.

Methods: This retrospective study included records of injured patients (≥65 years) from the hospital trauma registries during 2022. Demographic and injury data were extracted. Risk-adjusted endpoints were: inpatient mortality and length of stay, analysed using logistic and median regression.

Results: A total of 193 elderly patients were registered on the KSMC registry and 1233 elderly patients were registered on the Alfred Hospital registry. Kind Saud Medical City saw proportionally less major trauma (injury severity score of >12, 24.4% vs. 44.2%, p<0.001) and less females (31.1% vs 44.4%, p<0.001). The modal injury group was low level falls in both centres (≈60%). Discharge destination was different, particularly for patients discharged home (86.5% vs. 56%) or to a rehabilitation facility (0.5% vs. 28.2%). The risk-adjusted length of stay was 4.5 days less at the Alfred Hospital (95% CI: [3.25-5.77] days, p<0.001). The odds of in-hospital death were not significantly different (OR=0.72, 95% CI: [0.36-1.47], p=0.37).

Conclusion: Despite the different settings, low level falls were the major cause of injury in older patients. A longer length of stay in the acute hospital was identified for KSMC, however, this may be partly explained by discharge destination practices in the 2 countries.

Objectives: To assess argyrophilic nucleolar organizer regions (AgNORs) in 60 patients with primary breast carcinoma and evaluated their association with clinical prognostic parameters of breast cancer.

Methods: Argyrophilic nucleolar organizer regions were stained in paraffin sections of the tissues using Ploton's silver method. For each sample, the number of AgNORs within the nuclei of 100 tumor cells was counted. The average number of AgNORs per nucleus was calculated, and the results were expressed as mean.

Results: The number of AgNORs was significantly higher in breast invasive ductal carcinoma (6.6) compared to benign breast tumors (fewer than 2.0). However, differences in AgNOR counts across different age groups were not statistically significant.

Conclusion: This study suggests that AgNOR counts could be used as a potential procedure for estimating proliferation characteristics in histopathological sections of benign and malignant breast lesions. Argyrophilic nucleolar organizer region counts may also be valuable for identifying high-risk patients and indicating tumor aggressiveness. A larger study with an increased sample size that incorporates both AgNOR numbers and Ki67 scores for assessing cell kinetics is needed to confirm our findings.

Objectives: To highlight the importance of neglected Entamoeba histolytica (E. histolytica) infections in the geriatric age group, which is an increasing proportion of the world's population.

Methods: This study was carried out between January 2022 and December 2023 at Van Yüzüncü Yıl University, Faculty of Medicine, Parasitology Laboratory, Van, Turkey. The study included 96 geriatric patients with diarrhea (geriatric group). Two different control groups (CGs) were also included in the study, comprising 92 patients aged 18-64 years with diarrhea as CG1 and 50 geriatric individuals without diarrhea and other gastrointestinal complaints as CG2. Samples were analysed macroscopically and then evaluated by microscopic, enzyme-linked immunoassay, and polymerase chain reaction.

Results: This study detected E. histolytica in 31.3% of the geriatric group and 14.1% of the patients in CG1 (p=0.004). Entamoeba histolytica positivity was not detected in CG2. According to the multiple correspondence analysis, there was a close association between E. histolytica positivity and bloody diarrhea and mucous diarrhea in the geriatric patients. It was also determined that E. histolytica can cause abdominal pain, abdominal distension, and epigastric tenderness in geriatric patients.

Conclusion: Both the risk of E. histolytica infection and the pathogenicity of the infection increase in geriatric individuals. Therefore, it was concluded that amoebiasis is a serious health problem in the geriatric population and should not be neglected.

Objectives: To explore the quality of life (QoL) of patients with systemic lupus erythematosus (SLE) and the factors affecting it.

Methods: In this cross-sectional study, 269 patients diagnosed with SLE from multiple centers across different regions of Saudi Arabia were included. We used the LupusPRO1.8 QoL assessment tool. Additionally, comprehensive data regarding patient demographics, disease features, and associated comorbidities were collected for analysis.

Results: The overall mean QoL score was 57.71±11.97, with the median value (interquartile range [IQR]) of 56.82 (48.62-66.65). The mean health-related QoL (HRQoL) score was 57.09±18.81, with the median (IQR) of 55.63 (44.04-70.19). Among HRQoL domains, the emotional health domain had the lowest score (44.67±30.00, median: 41.7 [16.7-66.7]). The second and third lowest scores were for fatigue (46.24±29.18, median: 43.8 [25-68.8]) and pain (48.65±30.38, median: 50 [25-71.9]). Regarding non-HRQoL, the mean score was 58.32±15.52 and median (IQR) score was 58.85 (48.18-70.83). The desires-goals domain had the lowest score (45.79±31.41), with the median value of 43.8 (21.9-68.8). The presence of comorbidities was the only factor affecting the QoL of patients with SLE.

Conclusion: Our findings indicate that patients with SLE have worse overall QoL, which includes both HRQoL and non-HRQoL domains. Furthermore, the presence of comorbidities was the only factor that influenced the QoL of lupus patients.