Saudi Medical Journal最新文献

Objectives: To investigate the association of β-galactoside α2-6 sialyltransferase 1 (ST6GAL1) expression with hormone receptor (HR), human epidermal growth factor receptor 2 (HER2), and other clinicopathological parameters, including histological grade, stage, lymphovascular invasion, perineural invasion, and survival in breast carcinomas (BCs).

Methods: This study included 85 patients who had undergone surgery for breast cancer (BC). The associations of HR, HER2 status, and histopathologic tumor characteristics with immunohistochemical expression of ST6GAL1 were analyzed.

Results: The majority (48 [56.5%]) of patients were in the T2 stage, and no association was seen between staging and ST6GAL1 (p<0.05). Further, 44 (54.2%) patients were HR positive, and most of them exhibited high ST6GAL1 levels (p=0.001), whereas 44 (51.8%) were HER2 negative, and most of them demonstrated low ST6GAL1 levels (p=0.007). Ki-67 of ≥20% was observed in 55 (64.7%) and <20% in 30 (35.3%) patients. Most of those with high Ki-67 demonstrated low-grade STLGAL1 expression; however, no correlation was detected between the two values (p=0.378). High and low ST6GAL1 expressions were observed in 39 (45.9%) and 46 (54.1%) cases, respectively.

Conclusion: This research is one of the first studies to use ST6GAL1 in preoperative biopsies of patients not scheduled for neoadjuvant treatment. This study revealed highly significant associations of ST6GAL1 expression with HR, HER2, and molecular subtyping. Future studies are recommended to clarify the possible role of ST6GAL1 in resistance to HR and HER2-targeted and other chemotherapeutic agents in BCs.

Objectives: To promote healthy habits among pharmacy students through curriculum-embedded challenges. Student well-being is a growing concern in Saudi pharmacy education, with high rates of stress and poor health behaviors reported among students. Traditional interventions often fall short in bridging the gap between awareness and action.

Methods: A quasi-experimental design was conducted from September to December 2024 at Taibah University. Four month-long challenges targeting smartphone use, physical activity, sleep, and gratitude were integrated into a required hospital pharmacy course. The intervention was grounded in behavioral economics principles (salience and inertia) and delivered via Blackboard LMS with minimal extrinsic incentives. A reflective survey assessed participation, motivations, baseline behaviors, and post-intervention intentions.

Results: Of 198 enrolled students, 155 (78.3%) engaged in at least one challenge. Participation was highest in the smartphone challenge (64.1%) and lowest in the gratitude challenge (28.8%). Key motivators included extra credit and interest in the challenging outcomes. A large majority (89.7%-98.7%) reported intentions to sustain the positive behaviors post-intervention, particularly among those who had not previously adopted them. Intrinsic motivation, such as the desire for personal well-being, showed a significant positive correlation with the intention to continue.

Conclusion: Embedding nudge-based challenges into pharmacy curricula is a feasible and culturally responsive strategy for enhancing student well-being. Further research should evaluate long-term impacts and scalability across educational settings.

Objectives: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in communication, social interaction, and behavior. This study aimed to explore the factors influencing the clinical presentation of children with ASD in Saudi Arabia, focusing on demographic, medical, and environmental determinants.

Methods: A multi-center, cross-sectional study was conducted in Saudi Arabia, enrolling 104 children diagnosed with ASD. Data were collected via structured parent interviews and analyzed to examine the relationships between demographic characteristics, therapy participation, self-care abilities, and clinical symptoms.

Results: Male children were more likely to exhibit hyperactivity compared to females (p=0.037). Age was significantly associated with delayed speech (p=0.003), aggression (p=0.034), attention deficits (p=0.006), sleeping problems (p=0.001), and anxiety (p=0.007). Self-care abilities - such as bathroom independence and dressing - improved significantly with age (p<0.05). Therapy participation varied with 49% receiving speech therapy, 44.2% engaged in behavioral therapy and 5.8% currently undergoing physiotherapy. Approximately, 34.6% had received occupational therapy for less than one year.

Conclusion: The clinical presentation of ASD in Saudi Arabia is influenced by demographic and environmental factors, highlighting the need for early diagnosis and individualized interventions. The findings underscore the importance of improving therapy access and parental support to address persistent challenges, such as hyperactivity, learning difficulties, and limited self-care skills.

Objectives: To examine the relationships between the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) in myringosclerosis after ventilation tube insertion (VTI).

Methods: We conducted this descriptive case-control study between March 2022 and September 2024. A total of 75 children aged 6 to 12 years with a history of VTI were enrolled. Myringosclerosis+ (n=43) included children with myringosclerosis, while Myringosclerosis- (n=32) included children without myringosclerosis. Preoperative values for NLR, PLR, and SII were collected by hematological testing and calculations. Demographic factors, prognostic risk factors and discrimination power of parameters were determined by statistical methods.

Results: Compared to the myringosclerosis-, the myringosclerosis+ had significantly higher NLR, PLR, and SII values (p=0.00, p=0.04, and p=0.01, respectively). Receiver operating characteristic (ROC) curve area of NLR is 0,76 (95% CI: 0.65-0.87, p=0.00). Area under curve of SII is 0,62 (95%CI: 0.57-0.81, p=0.01). Neutrophil-to-lymphocyte ratio affects myringosclerosis development at 1.34 with sensitivity=0.63, specificity=0.78. Neutrophil-to-lymphocyte ratio(NLR) and systemic immune inflammation index(SII) show myringosclerosis development at different powers of predictivity. The ROC area of NLR is highest of all parameters but is moderately predictive (<0.80). It is slight for SII. The NLR may be a marker of prediction of myringosclerosis OR=0.182 (95%CI:0.067-0.496).

Conclusion: Neutrophil-to-lymphocyte ratio and SII are systemic inflammatory prognostic markers in myringosclerosis, and elevated NLR values are a predictor of myringosclerosis with modest affect. Other parameters should be sought in myringosclerosis development.

Objectives: To study the different cellular death mechanisms between viral cirrhosis and alcoholic cirrhosis. The research investigated autophagy and apoptosis mechanisms in hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol-induced cirrhosis.

Methods: The research team analyzed biopsy samples from the liver which were obtained at Florence Nightingale Hospitals, Istanbul, Turkey. The experimental protocols were performed between February 2021 and February 2023. The study included 19 HBV, 15 HCV, 13 alcohol-related cirrhosis patients and 6 normal liver tissues. Beclin-1, Caspase-3, Bcl-2 and LC3 expressions were evaluated by immunohistochemistry.

Results: Staining intensity as well as extent underwent evaluation through H-score methodology. The expression levels of Beclin-1 (control: 0.7±0.3, HBV: 6.0±1.4, HCV: 5.1±1.3, alcohol: 4.8±1.2), caspase-3 (control: 0.4±0.2, HBV: 6.0±1.4, HCV: 5.1±1.2, alcohol: 5.5±1.3) and Bcl-2 (control: 0.3±0.2, HBV: 5.5±1.2, HCV: 4.8±1.1, alcohol: 4.6±1.1) were significantly higher than those of the control group (p<0.001). LC3 expression revealed no between-group differences. A positive association for Beclin-1 with Caspase-3 (r=0.582) alongside negative association for Bcl-2 with Caspase-3 (r=-0.608) was documented.

Conclusion: Our findings suggest that both autophagic and apoptotic pathways are active in the pathogenesis of cirrhosis. Similar cell death mechanisms were found to be involved in viral and alcoholic cirrhosis, but these pathways were more prominently activated in viral cirrhosis.

Objectives: To present our institutional experience with pediatric morgagni hernia (MH) emphasizing the presentation, diagnostic workup, surgical techniques, and follow-up.

Methods: A retrospective chart review of patients diagnosed with MH who underwent surgical repair from May 2014 to May 2024. Data points collected included demographic, clinical, and follow up information. We analyzed the data using basic thematic analysis. For categorical variables, we employed counts and percentages. Statistical analysis performed using the Mann-Whitney U test.

Results: Nine patients underwent MH repair. Respiratory symptoms were the most common, affecting 66% of patients. All patients received chest radiography, while 5 required computed tomography imaging. Three (33%) patients underwent laparotomy, 5 (55%) underwent laparoscopic repair, and 1 (11%) underwent thoracotomy repair. The laparotomy group required significantly more days in the Intensive Care Unit (ICU) (p=0.037), more days on mechanical ventilation (p=0.020), and more days on IV narcotics (p=0.20). The laparotomy group experienced longer durations of NPO status and overall hospital stay. One (11%) patient experienced MH recurrence.

Conclusion: Laparoscopic repair offers superior outcomes, such as fewer days in the ICU and on mechanical ventilation, reduced intravenous narcotic use, shorter NPO durations, and an overall shorter hospital stay. When feasible and safe, laparoscopic repair should be considered the preferred method for pediatric MH.