Saudi Medical Journal最新文献

Objectives: To estimate the prevalence of hyperlipidemia in patients with psoriatic arthritis (PsA) in Riyadh, Saudi Arabia, and to investigate the relationship between PsA and hyperlipidemia.

Methods: This retrospective study examined medical records of PsA patients from January 2010 to May 2023 at 2 medical centers in Riyadh. Patients over 18 years old with a lipid profile were included. Hyperlipidemia cases were determined using Adult Treatment Panel III (ATP III) guidelines and European Association of Preventive Cardiology definitions based on lipid profile results.

Results: A total of 141 patients were included in the analysis. The prevalence of hyperlipidemia in patients with PsA was 40.7% at diagnosis, and 28.7% at the last visit. The prevalence of hyperlipidemia was significantly higher in males than females (56% versus [vs] 29.4%, p<0.005). While not statistically significant, among patients who received a biologic disease-modifying antirheumatic drugs (bDMARD), 31.6% had hyperlipidemia at the last visit, compared to 20% of those who did not receive it (p=0.317). Among patients who received conventional disease-modifying antirheumatic drugs (cDMARD), 30% had hyperlipidemia at the last visit, compared to 25.8% of those who did not it (p=0.813). The prevalence rates of hyperlipidemia at the first visit and the last visit were found to be statistically significant among patients who have comorbidities other than PsA (7.6 vs. 17.3%, p=0.004).

Conclusion: The study results are comparable to those of other studies showing no significant effect of PsA on the lipid profile. The prevalence of hyperlipidemia in PsA patients appears similar to that of the general population in Saudi Arabia, based on indirect comparison.

Objectives: To evaluate the safety and feasibility of the cable-transmitted, magnetically controlled capsule endoscopy (CT-MCCE) system for examining the esophagus and stomach.

Methods: A pilot study was carried out at the endoscopy facility of Peking University First Hospital; 30 volunteers were enrolled between September and November 2022. All participants were instructed to swallow the CT-MCCE capsule. An external magnetic robot arm was utilized to manipulate the capsule endoscope with string-facilitated control of the endoscope. This study assessed gastric preparation, safety, maneuverability, and mucosal visualization.

Results: The participants exhibited favorable reactions to the gastric preparation and examination, with no reported adverse effects, and the average duration of the gastric examination was 29.5±6.63 minutes. The gastric cavity cleanliness assessment revealed a good rating in 25 participants (83.3%) and a moderate rating in 5 participants (11.8%). TheCT-MCCE demonstrated good maneuverability in all 30 subjects (100%).The analysis of visualization indicated that more than 75% of the gastric mucosa was discerned in 79.4% of the participants (27 individuals), whereas 50% to 75% was visualized in 20.6% of the participants (7 individuals).

Conclusion: This study substantiates the feasibility and safety of employing magnetically controlled capsule endoscopy with cable transmission for the evaluation of human stomach and esophagus.

Objectives: To systematically review evidence on the prevalence of the JAK2V617F (JAK2) mutation and polycythemia vera (PV) among all blood donors, focusing on those with elevated hematocrit. Although blood donors are generally healthy, considering a preclinical stage of myeloproliferative neoplasm, especially in those with polycythemia, is crucial. Evidence on managing these donors is limited.

Methods: We performed a literature search using EMBASE and MEDLINE from inception until August 2023, including studies on the prevalence of JAK2 mutation or PV among blood donors. Eligible studies examined blood donors in hospital or community settings, had a sample size of at least 20 donors, and reported the prevalence of the JAK2 mutation or PV. We assessed bias, extracted data, and used a random effects model meta-analysis to estimate pooled prevalence and 95% confidence intervals. Subgroup analysis differentiated donors with normal hematocrit from those with polycythemia. Heterogeneity was assessed using I2 statistics.

Results: Our review included eleven studies in total. Of those, ten studies examined the presence of a JAK-2 mutation in 1,999 blood donors. The overall proportion of JAK2 mutations was 3% (95% CI 0.60 - 6.9, I2 90.21%). Subgroup analysis revealed a prevalence of 4.7% (95% CI 2.1 - 8.0, I2 0.00%) among repeat donors with polycythemia and 2.3% (95% CI 0.0 - 7.7, I2 0.00%) among healthy ones. Only 3 (309 donors) studies reported PV prevalence, precluding a meta-analysis.

Conclusion: The prevalence of the JAK2 mutation among blood donors is similar to the general population's but slightly higher among repeat donors with elevated hematocrit. Further research is necessary to establish definitive upper hemoglobin limits for donor deferral.PROSPERO No.: CRD42023456878.

Objectives: To assess the accuracy of ChatGPT-4 Omni (GPT-4o) in biomedical statistics. The recent novel inauguration of Artificial Intelligence ChatGPT-Omni (GPT-4o), has emerged with the potential to analyze sophisticated and extensive data sets, challenging the expertise of statisticians using traditional statistical tools for data analysis.

Methods: This study was performed in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, in May 2024. Three datasets in a raw Excel file format were imported onto Statistical Package for the Social Sciences (SPSS) version 29 for data analysis. Based on this analysis, a script of 9 questions was prepared to command GPT-4 Omni, which was used for data analysis for all 3 datasets on Omni. The score and the time were recorded for each result and verified after being compared to the original analysis results performed on SPSS.

Results: GPT-4 Omni scored 73 (85.88%) out of 85 points for all 3 datasets. All datasets took a total of 38.43 minutes to be fully analyzed. Individually, Omni scored 21/25 (84%) for the small dataset in 487.4 seconds, 20/25 (80%) for the middle dataset in 747.02 seconds and 32/35 (91.42%) for the large dataset in 1071 seconds. GPT-4 Omni produced accurate graphs and charts.

Conclusion: ChatGPT-4 Omni scored better over 80% in all 3 statistical datasets in a short period. GPT-4 Omni also produced accurate graphs and charts as commanded however it required explicit commands with clear instructions to avoid errors and omission of results to achieve appropriate results in biomedical data analysis.

Objectives: To investigate the numbers of natural killer (NK) cells, CD56+ T-cells and CD56- T cells, and the levels ofCD16 in healthy individuals seropositive for herpes simplex virus Type 1 (HSV-1). Specifically, it seeks to measure the levels of these cells to learn about the possible immunological significance during HSV-1 seropositive status.

Methods: This study employed a cross-sectional research design to examine the levels of CD56+ T-cells and CD16+ among individuals seropositive for herpes simplex virus type 1 (HSV-1) in Taif city. A total of 112 participants were enrolled, with HSV-1 serostatus determined via ELISA, and cellular evaluation conducted using flow cytometry. The study was performed between January 2023 to July 2023.

Results: Our study found 36% HSV-1 seropositivity, contrasting with higher rates in Saudi Arabia. No significant age or gender differences were observed. HSV-1 seropositive individuals showed elevated dim CD56 NK cells and CD56+ T-cells, aligning with prior research on lymphocyte infiltration during HSV-1 activation. Further investigation is warranted for CD56- T-cells and bright NK cells.

Conclusion: HSV-1 seropositive individuals showed elevated dim CD56 NK cells and CD56+ T-cells, consistent with lymphocyte activities during viral activation. CD16 expression on CD56+ T-cells suggests their involvement in viral defence, emphasizing the need for further investigation into immune responses against HSV-1.

Objectives: To determine the seroprevalence of Varicella Zoster virus (VZV) immunoglobulin (Ig)G and IgM antibodies among hemodialysis patients (HDP). Additionally, the presence of VZV viral DNA has been investigated for possible reactivation status.

Methods: Sera from 265 individuals were collected and tested. The study was carried out from November 2023 to February 2024. Enzyme linked immunosorbent assay was accomplished to determine the VZV IgG and IgM antibody levels. The viral DNA was tested by qPCR.

Results: We found a significantly higher proportion of Host defense peptides (HDP) have positive antibody levels compared to healthy controls (HC) (92.0% of HDP have positive immune responses compared to 79.1% of HC, p=0.005). Patients with both hypertension and diabetes showed lower VZV seropositivity (25.6%) than those without (74.4%). Only 3 HDP had positive IgG and IgM levels (1.9%, n=3), while 14 patients (100%) had negative IgG and IgM levels. Additionally, all IgM-positive patients appeared to have detectable viral DNA of the VZV.

Conclusion: In conclusion, significantly higher VZV seroprevalence and antibody levels in HDP indicate greater viral exposure than HC. Screening of hemodialysis (HD) to VZV serologically or at the molecular level is most important to avoid the consequences of viral reactivation, especially in those with asymptomatic HDP.

Objectives: To identify the clinical and histological features of MF that can assist in distinguishing MF from MF-mimicking cases. Although mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma, clinicopathological correlations are required to establish an accurate diagnosis, which are currently lacking.

Methods: This retrospective observational study evaluated the clinical presentations, characteristics, and histological features of 56 patients with suspected MF who presented to our clinic between January 2018 and August 2022. Immunohistochemistry was performed, and the loss of CD5 and CD7 T-cells and T-cell receptor rearrangement was evaluated.

Results: Overall, 34 patients were diagnosed with MF, whereas 22 were not. Clinical erythroderma, poikiloderma, and nodular presentations were more commonly associated with a histological diagnosis of MF than macular presentations. Erythema and pruritus were significantly more common in MF cases than in MF-mimicking cases (p<0.05). Epidermotropism and parakeratosis were the key histological features for diagnosing MF. Additionally, Pautrier's microabscesses correlated with the clinical presentation of plaques in MF. Loss of CD7 expression on the T-cell surface was observed even in early-stage MF cases.

Conclusion: Our proposed diagnostic features are statistically valid and, along with those previously reported, can aid in identifying and distinguishing MF cases from MF-mimicking cases.

Objectives: To explore the global epidemiological trends in the prevalence and mortality due to mpox in various regions worldwide.

Methods: In this cross-sectional study the data about mpox outbreak were recorded by the "World Health Organization, Centers for Disease Control and Prevention, and GSAID" from August 2023 to August 2024, analyzing the epidemiological trends from different countries worldwide.

Results: The total number of mpox cases has reached 99,518 (95,196 cases from 115 countries that have not historically reported mpox; and 4,322 cases from 07 states that have traditionally reported mpox), from a total of 122 countries. The top 10 countries with the greatest number of mpox cases include the United States (33,435) followed by Brazil (11212), Spain (8084), France (4272), Colombia (4249), Mexico (4124), United Kingdom (3952), Peru (3875), Germany (3857), and Democratic Republic of Congo (3104). America has the highest number of cases (63,145) accounting for 63% of total cases globally, followed by Europe (27,194). Democratic Republic of Congo faces the highest increase in cases within a single year, with the infectious rate in the region up by 160%, alongside a higher risk of mortality.

Conclusion: Mpox cases have rapidly spread worldwide, reaching 99,518 cases across 122 countries, and being declared a "Public Health Emergency of International Concern" by the WHO. Healthcare authorities must take timely measures to control this outbreak since the world cannot afford the global burden of it being another potential pandemic.