Saudi Medical Journal最新文献

Objective: Medical students frequently attend lectures without prior review of the related literature when preparing for examinations. It raises the question of whether studying the material in advance could enhance their learning outcomes during lectures.

Methods: A total of 102 medical students from a Saudi Arabian university took part in this research. Participants were assigned to one of 2 cohorts: one read a 4-page passage before a 15-minute lecture, while the other attended the lecture before reading the passage. Knowledge acquisition was measured using a test that assessed their ability to recall concepts administered 3 times-prior to the session, post reading, and after attending the lecture. This design allowed for a comparison of the effects of each sequence of learning activities.

Results: This study revealed that the combined approach produced notably greater attainment than lecture alone (p < 0.001). When the order was compared, reading prior to the lecture yielded notably better results (p < 0.05) than lecture followed by reading.

Conclusion: In contrast to the usual approach among medical students, preparing by reading before attending lectures leads to improved learning performance.

Objectives: Celiac disease (CD) is a prevalent autoimmune disorder triggered by gluten consumption, leading to an immune response that damages the small intestine. Research shows a link between CD and autoimmune thyroid disorders (AITD). This study seeks to determine the prevalence of AITD among adult and pediatric patients with CD in the primary care setting in Riyadh, Saudi Arabia.

Methods: A retrospective cross-sectional study reviewed electronic health records of individuals diagnosed with CD from January 2016 to December 2023 at King Faisal Specialist Hospital and Research Centre. Collected data encompassed patient demographics, diagnostic approaches, thyroid function assessments, thyroid autoantibody profiles, and therapeutic interventions. Statistical analyses were conducted using SPSS, with statistical significance defined at a p < 0.05.

Results: Out of 408 individuals diagnosed with CD, 76 (29.6%) adults and 24 (15.9%) pediatric patients were found to have thyroid-related disorders. Among those with thyroid conditions, AITD was identified in 34.2% of adults and 37.5% of children, with Hashimoto's thyroiditis emerging as the most prevalent subtype. The majority of cases were diagnosed through blood and thyroid antibody testing. Adult patients were significantly more likely to receive thyroid medication than pediatric patients (p = 0.01). Additionally, nonadherence to a gluten-free diet was common across both age groups.

Conclusion: CD patients in Saudi Arabia are at high risk of AITD, especially hypothyroidism, necessitating regular thyroid screenings to support integrated care and early diagnosis.

Objectives: To develop an evidence-based clinical guideline for the prevention and management of cardiovascular diseases (CVDs) in Saudi Arabia, tailored to local epidemiology and healthcare needs.

Methods: A multidisciplinary task force comprising cardiologists, public health specialists, and epidemiologists from different healthcare sectors in Saudi Arabia developed the guideline. Evidence synthesis was based on a comprehensive literature review and adaptation of international guidelines, particularly the 2021 European Society of Cardiology recommendations, contextualized to the Saudi setting.

Results: The guideline provides recommendations for both primary and secondary CVD prevention. Primary prevention emphasizes risk assessment incorporating genetic, lifestyle, and clinical factors, as well as lipid and glucose profiling. Lifestyle modifications, including dietary changes, smoking cessation, physical activity, weight management, and psychosocial support, are prioritized. Pharmacologic therapy targets lipid levels, blood pressure, and glycemic control, tailored to individual risk categories. For secondary prevention, strategies include post-event risk stratification, comorbidity management (diabetes, hypertension, chronic kidney disease), and optimization of pharmacologic therapy for coronary artery disease, heart failure, cerebrovascular disease, and peripheral artery disease. Lifestyle interventions, supervised cardiac rehabilitation, and routine follow-up for complication monitoring and treatment adjustment are integral components.

Conclusion: This guideline presents an updated, evidence-based framework specifically designed for the Saudi population, underscoring prevention, lifestyle modification, and optimized pharmacologic management to address the rising burden of CVDs.

Colorectal cancer has become a major public health concern in Saudi Arabia. It is the most prevalent cancer among men and the third most prevalent among women. Although screening for people aged 45-75 is recommended by national recommendations, screening uptake is still below 10%, and less than 1% of older persons have a colonoscopy. With regional differences that vary from age-standardized rates of 3.2 per 100,000 in Jouf to 21.8 per 100,000 in Riyadh among men, approximately 29% of cases are detected at late stages. Therefore, we assessed the epidemiological, social, and health-related systemic structures preventing effective colorectal cancer screening in the region. Important barriers to colorectal cancer screening include a lack of public knowledge, cultural taboos, healthcare system constraints, and gaps in physician knowledge. Although some initiatives, such as fecal immunochemical testing, appear promising, screening rates remain exceptionally low. Furthermore, the alarming increase in early onset colorectal cancer in individuals aged <50 years underscores the need to screen high-risk individuals at younger ages. This review highlights the pressing necessity for a nationwide colorectal cancer screening initiative, which should encompass the creation of a national registry, focused public education campaigns to overcome cultural obstacles, mobile screening units for rural regions, and the incorporation of artificial intelligence (AI)-assisted diagnostics to enhance the existing 5-year survival rates of 44-52%.

Objective: To investigate the demographic and clinical profiles of patients presenting with amphetamine-related emergencies at a tertiary hospital in Riyadh, Saudi Arabia. Amphetamine use is an escalating public health issue linked to a rise in emergency department (ED) visits.

Methods: This retrospective study encompasses 14 years and focuses on individuals diagnosed with amphetamine-related toxicity.

Results: Among the 659 cases studied, a predominant 96% were male, with over half (52%) aged between 19 and 30 years. Most patients (91%) were Saudi nationals. The leading cause of presentation was trauma, accounting for 24% of cases. This was followed by altered mental status (14%), seizures (10%), and acute intoxication (6%). Cardiovascular issues, such as chest pain, were noted in 6% of cases. ED stays varied in duration: 35% of patients remained in the ED for 4 to 8 h, while 28% stayed for more than 12 h. Weekend presentations made up 40% of the total cases, with a notably higher proportion of male patients presenting on weekends (99%) than on weekdays (95%). No significant differences were detected between visits during salary weeks compared to non-salary weeks.

Conclusion: Amphetamine-related ED visits primarily involve young adult males, with trauma as the most common presenting complaint. The incidence of these visits did not differ significantly between salary and non-salary periods.

Sickle cell disease (SCD) is a genetic disorder that affects millions of individuals worldwide. Chronic anemia, hemolysis and vasculopathy are the most common symptoms that arise from hemoglobin (Hb) polymerization, which is the primary event of SCD. The above process can lead to erythrocyte sickling. Therapeutic options for SCD remain limited, and novel therapies are still being evaluated for their effectiveness in particular populations. Sphingosine-1-phosphate (S1P), a significant bioactive sphingolipid, acts as a potent signal mediator, modulating several cellular functions. The potential role of erythrocyte-S1P in enhancing SCD severity has been previously reported by multiple studies. Therefore, the present review article aimed to summarize the effects of S1P on the progression of SCD and provide strategies to modulate this process. More specifically, it focused on erythrocyte-S1P as a potential target for reducing the complications associated with SCD, thus paving the way for the development of novel therapeutic strategies for SCD.

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.