Saudi Medical Journal最新文献

Objectives: To investigate the relationship between breast arterial calcifications (BAC) detected on mammography and coronary artery calcifications (CAC) identified on chest CT in Saudi women, focusing on prevalence, age-specific patterns, and cardiovascular risk factors.

Methods: This cross-sectional study was conducted at a tertiary center in Saudi Arabia using data from hospital electronic medical records of 60 women aged 40-88 years who underwent mammography and chest CT, within the same year during the time period from January 2021 to December 2022. Data on demographics, cardiovascular risk factors, and imaging findings were collected. The association between BAC and CAC was analyzed using chi-square tests and binary logistic regression.

Results: The BAC was detected in 33.3% of the participants, while CAC was present in 21.7%. A significant association was observed between the presence of BAC and CAC (p=0.015), with 40.0% of BAC-positive patients showing CAC, compared to only 12.5% of BAC-negative patients. Age was a significant predictor of both BAC and CAC, particularly in the 60-69 age group (p=0.031). Traditional risk factors such as hypertension and diabetes did not show significant predictive value for CAC or BAC.

Conclusion: The findings highlight the potential utility of BAC as a non-invasive marker for CAC, particularly in older women. Routine reporting of BAC on mammography could enhance cardiovascular risk stratification in clinical practice.

Objectives: To explore whether uniform supplementation causes iron overload among a cohort of South Indian non-anemic pregnant women with diabetes-in-pregnancy (DIP).

Methods: The study took place between May 2022 and May 2024 and consisted of 120 participants from 2 groups: healthy pregnant women (HP) and pregnant women with DIP. Levels of Hb and the serum indices of iron homeostasis-iron, unsaturated iron-binding capacity, total iron-binding capacity, transferrin saturation, ferritin, hepcidin, soluble transferrin receptor (sTfR), and sTfR index, were estimated. The levels of high-sensitivity C-reactive protein, indices of oxidative stress, malondialdehyde, total antioxidant status (TAS), and oxidative stress index (OSI; ratio of MDA/TAS), and inflammatory markers, interleukin-10 (IL-10) and interleukin-18 (IL-18), were also estimated. The perinatal outcomes between the 2 groups were compared.

Results: The serum iron and ferritin levels were lower, and HbA1c levels were higher in the DIP than in HP. The indices of iron homeostasis and Hb were comparable between the 2 groups. While the levels of OSI were higher in the DIP, the pro-inflammatory markers were comparable between the 2 groups. The perinatal outcome of DIP was inferior in comparison to HP.

Conclusion: The current uniform daily oral iron supplementation dose in non-anemic South Indian women with DIP did not show evidence of iron overload in our cohort, contrary to expectations.

Objectives: To systematically review physical therapy interventions for stroke survivors in Arab countries and summarize the clinical and demographic characteristics, types and intensities of interventions, outcomes assessed, and adverse events.

Methods: We conducted a systematic search of Google Scholar, ISI web of science, Scopus, Medline/PubMed, and ProQuest databasesfrom inception to 2025. Studies were eligible if they evaluated physical therapy interventions for stroke rehabilitation in Arab countries and reported clinical outcomes. We included randomized controlled trials, cohort studies, and case-control studies. Study selection followed PRISMA guidelines.

Results: Five studies met the inclusion criteria. Interventions included neuromuscular electrical stimulation (NMES), radial extracorporeal shock wave therapy (rESWT), constraint-induced movement therapy (CIMT), and robotic-assisted therapy. NMES improved gait and lower limb function; CIMT and robotic-assisted therapy enhanced upper limb motor recovery; rESWT reduced spasticity and increased grip strength. Variability in methodologies, short durations, and limited accessibility were common limitations.

Conclusion: Although physical therapy interventions show beneficial outcomes for stroke rehabilitation in Arab countries, the evidence base is limited due to the small number of reported studies. There is a clear need for more high-quality research, including multicenter and longitudinal studies, to establish standardized, accessible, and culturally relevant rehabilitation practices across the region.PROSPERO No.: CRD420251007974.

Objectives: To measure the pressure exerted on the base of the tongue during endotracheal intubation using a standard pediatric model.

Methods: The study was conducted in October-November 2022 at Hacettepe University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Turkey. Anesthesiology residents performed intubations with Glidescope^®-LoPro-T2, Storz^®-C-MAC-paediatric-D-blade, and standard-Macintosh-1-blade on the same pediatric intubation model. The force exerted on the base of the tongue was measured during intubation using a force sensor. The duration and success of intubation, Cormack-Lehane-grade, and the force exerted on the oropharyngeal tissues were recorded.

Results: A total of 156 intubations were performed by 52 residents. The force exerted with the Storz^®-C-MAC-pediatric-D-blade was significantly lower when the Cormack-Lehane view was acquired and during the insertion of the endotracheal tube as compared to that exerted with the Glidescope^®-LoPro-T2 and direct laryngoscopy with Macintosh-1-blade. Longer intubation time was associated with higher force application regardless of blade type.

Conclusion: Videolaryngoscopy improved glottic view even in the same manikin as compared to direct laryngoscopy. Significantly lower forces were measured with the C-MAC-D-blade as compared to the other blades. Further studies on real patients are required to determine what amount of force exerted on the oropharyngeal tissue is clinically meaningful and thus avoid complications.

Objectives: To evaluate whether there is any relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio(PLO), systemic immune -inflammation (SII) level and HALP score and the location of involvement, surface width, burn degree in pediatric burn patients to investigate the effect on prognosis.

Methods: After obtaining institutional ethical committee approval, a retrospective analysis was conducted on 192 pediatric cases (under 18 years old) treated for burns in our hospital from December 2018 to December 2023. Hemoglobin, leukocyte, neutrophil, platelet and albumin levels. Simultaneously NLR, PLR, SII and HALP scores were calculated.

Results: Post-hoc test results revealed that the NLR values in the first-degree burn group were significantly lower than those in the second-degree burn group and the group with combined first- and second-degree burns (p=0.001, p=0.027). Similarly, the SII values in the first-degree burn group were significantly lower than those in the second-degree burn group and the combined burn group (p=0.001, p=0.004). The HALP score values in the combined burn group were significantly lower than those in the first-degree burn group (p=0.031). No significant differences were observed between other groups (p>0.05).

Conclusion: These parameters are derived from routinely collected blood tests, making them cost-effective, easily accessible, and practical for patients. Therefore, they could be useful as biomarkers for predicting prognosis in pediatric burned patients.

Objectives: To assess the surgical outcomes of atrioventricular septal defect associated with Tetralogy of Fallot (AVSD)-TOF repair performed at 2 specialized cardiac centers.

Methods: From May 2012 to December 2024, 20 patients diagnosed with AVSD-TOF who underwent surgical repair were included.

Results: The median age at the time of surgical repair was 13 months, with a median weight of 8.2 kg (IQR: 6.2-11.5 kg). Biventricular repair was successfully performed in 18 patients (90%), while one and half ventricular repair was required in 2 patients (10%). Before definitive repair, palliative procedures, including bidirectional Glenn shunts, were carried out in 2 patients (10%), and right ventricular outflow tract (RVOT) stenting in another 2 patients (10%). Postoperative complications included a third-degree heart block requiring pacemaker implantation in 10% and chylothorax in 15%. The median duration of chest drains was 10 days. In 40% of patients, reintervention was required, involving catheter-based procedures and redo surgeries for residual lesions. Despite these complexities, overall survival was 90%, with all patients surviving to hospital discharge.

Conclusion: Biventricular repair of AVSD-TOF is feasible and offers favorable early survival. However, the complexity of the condition, frequent reinterventions, and residual lesions highlight the need for individualized surgical/interventional planning and long-term follow-up.