Saudi Medical Journal最新文献

Objectives: To evaluate the clinical relevance of Integrated Pulmonary Index (IPI) monitoring during transbronchial needle aspiration (EBUS-TBNA) under sedation and determine whether it reduces hypoxic events compared to standard monitoring.

Methods: This prospective observational research was carried out at Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey, between July 2022 and July 2023. A total of 50 patients, aged 18-80 years with American Society of Anesthesiologists scores of I-III, undergoing EBUS-TBNA with deep sedation for diagnostic purposes were included. The IPI values were measured at 6 time points: baseline, induction, 3, 5, 10 minutes, and at the end of the procedure. Patients were categorized based on whether their IPI scores were above 7 (group 1) or below 7 (group 2).

Results: A total of 43 patients completed the study. Group 1 had higher end-tidal carbon dioxide and respiratory rate at multiple time points, including induction and at 3, 5, and 10 minutes post-induction (p<0.05). Group 2 experienced a higher rate of apnea at these times (p<0.05). Those with lower IPI scores (namely, IPI=3 and IPI=4) showed significantly higher apnea rates, while those with higher scores (namely, IPI=7 and IPI=8) were less likely to have apneic episodes.

Conclusion: The IPI monitoring during EBUS-TBNA under sedation demonstrated improved detection of apnea episodes and enhanced respiratory safety compared to standard monitoring techniques. Additional research involving more varied populations is necessary to confirm these results.

Objectives: To analyze the diagnostic and prognostic potential of the BOLA gene family in kidney renal clear cell carcinoma (KIRC).

Methods: This study is an observational study. The whole study was carried out at Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia from January to November 2023. As it involves in silico and in vitro methods, ethical consent was not required. Various in silico and molecular experimental techniques were employed in this study.

Results: Significant up-regulation and hypomethylation of BOLA1, BOLA2, and BOLA3 were observed across 12 KIRC cell lines. Retrospective analysis of the cancer genome atlas program (TCGA)-KIRC cohorts confirmed hypomethylation of these genes in KIRC tissues. The cBioPortal analysis showed minimal genetic alterations, with amplification being the most common. Kaplan-Meier plotter data revealed that high BOLA1, BOLA2, and BOLA3 expression correlated with shorter overall survival and relapse-free survival in KIRC. Tumor-immune system interactions database analysis linked BOLA1 expression to immune and molecular subtypes. Gene silencing of BOLA1, BOLA2, and BOLA3 in 786-0 cells reduced cell growth and proliferation, enhancing wound healing capacity.

Conclusion: BOLA genes may serve as diagnostic and prognostic markers in KIRC, offering insights into therapeutic targets and disease progression.

Objectives: To highlight the complications associated with the products and practice of healers "Ferraga" who treat young children using traditional Moroccan pharmacopoeia.

Methods: This is a retrospective analysis of cases of products and practice of "Ferraga" intoxication in young children reported to the Moroccan Poison Control and Pharmacovigilance Center (MPCPC), Rabat, Morocco, from 2010-2020.

Results: During the study period, 24 cases of products and practice of "Ferraga" poisoning were reported to MPCPC, Rabat, Morocco. The average age of the patients was 2.48 years. The oral route was noted in 21 cases. The vast majority of patients (23 cases) exhibited symptoms upon admission, predominantly of digestive (16 cases), respiratory (3 cases), and neurological (4 cases). However, 29.16% of patients presented with both digestive and respiratory symptoms, 20.83% had digestive and neurological symptoms, and 4 cases manifested all 3 types of symptoms. The outcome was positive in 18 patients and fatal in 2 infants.

Conclusion: Products and practice of "Ferraga" poisoning in children remains a major health problem. It is crucial to implement a strategy to combat this type of practice in order to reduce the prevalence of such poisoning.

Objectives: To assess the prevalence of burnout among emergency and surgical residents and explore the associated factors.

Methods: This study was carried out at King Faisal University, Al Hofuf, Saudi Arabia, through the period from January to march 2024. A cross-sectional survey design was employed, utilizing the Maslach burnout inventory-human services survey and the resilience scale-14 to measure burnout and resilience. The survey included demographic information, health-related questions, and specific burnout-related items. Descriptive statistics, frequency distributions, and inferential analyses were carried out to explore the relationships between burnout, demographic factors, and resilience.

Results: The study revealed a diverse representation across demographic factors, with variations in burnout prevalence. Approximately 63% of participants reported experiencing burnout, with high levels of emotional exhaustion (55%) and depersonalization (28%). Resilience levels varied across different demographic characteristics. Significant associations were found between burnout and factors such as gender, marital status, having children, specialty, length of experience, and enrollment in postgraduate programs.

Conclusion: The findings underscore the urgent need for targeted interventions to address burnout in healthcare professionals. The nuanced relationships between burnout, resilience, and demographic factors highlight the importance of tailored strategies to mitigate burnout effectively. Addressing burnout is crucial not only for the well-being of healthcare professionals but also for maintaining high-quality patient care.

Objectives: To review the types of upper limb congenital differences in patients seen in a tertiary hospital in Jordan and to evaluate the effectiveness of the Oberg-Manske-Tonkin (OMT) system.

Methods: The medical charts and the X-rays of 222 patients with upper limb congenital differences were reviewed. All these cases were categorized using the OMT classification system.

Results: A careful review of the medical charts identified 222 patients with 295 upper extremity anomalies. The prevalence was 45/10000 patients. The mean age of the patients was 6.18±5.5 years, with a higher prevalence in males 54.1%. most cases were malformations 176 (79%) and of these the radial polydactyly was the most common (18.5%). A total of 28 cases of dysplasia were identified. A total of 15 (6.7%) patients were diagnosed with syndromes, of which Poland syndrome showed the highest frequency at 2.3% of the total. The least presentation was for the deformation anomalies (1.4%).

Conclusion: The malformation category constituted most of the congenital upper extremity difference in this study. Radial polydactyly was the most common in this category. Considering the regional differences, the need for a well-established healthcare infrastructure is a vital step toward managing and improving the outcomes of these patients.

Objectives: To correlate breast imaging-reporting and data system (BI-RADS) category 4 lesions with histopathology results to assess the accuracy of subcategorization.

Methods: A retrospective study was carried out from September 2021 to June 2022. A total of 247 breast lesions were reviewed categorized as BI-RADS 4 using ultrasound (US) and digital mammography. Feature analysis of the lesions were obtained using BI-RADS terminology and assigned to subcategories (4A, 4B, and 4C). Pathological analysis was carried out on tissue obtained through US-guided core biopsy. A p-value of <0.05 was considered significant.

Results: Of the 247 lesions, 135 were categorized as subcategory 4A, 68 as 4B, and 44 as 4C. Overall, 41 (16.6%) had malignant lesions, while 206 (83.4%) had benign lesions. The mean age of the patients with benign versus malignant lesions was (43.18±14.02 vs. 51.24±14.15 years; p<0.001). Mean size of benign versus malignant lesions was (1.93±1.65 vs. 3.82±3.89 cm; p<0.001). Findings were compared with histopathology, and the positive predictive value fell within the reference range for subcategories 4C (>70%). High reliability was observed between the 2 readers, with a weighted Cohen's Kappa value of 0.79 (0.73-0.85). Significant disagreements in the assignment of features on radiological lesion characterization were observed between the 2 readers regarding lesion density, shape, echo pattern, vascularity, and borders.

Conclusion: The results of this study contribute to the existing body of knowledge, emphasizing the need for standardized guidelines for the characterization of BI-RADS 4 subcategories and improved diagnostic accuracy in the management of breast lesions.

Objectives: To explore the prevalence of dense breast tissue among screened postmenopausal women and identify the factors influencing breast density in this population.

Methods: A retrospective analysis of data from postmenopausal women screened for breast cancer in Jeddah, Saudi Arabia, between April 2017 and June 2021 was carried out. Breast density was subjectively assessed, and influencing factors were retrieved from the hospital information system. Proportions were used for descriptive analysis, and binary logistic regression was used to identify the determinants of dense breast tissue.

Results: Only 12.7% of the postmenopausal women had dense breast tissue. Non-Saudi women (odds ratio [OR]=1.95, 95% confidence interval [CI]: [1.07-3.54], p=0.02) and those who did not breastfeed (OR=2.75, 95% CI: [1.33-5.53], p=0.006) had a greater likelihood of having dense breast tissue. Women who had never been pregnant (nulliparous) were 4 times more likely to have dense breast tissue than those who had been pregnant (parous; p<0.001). Additionally, women with fewer children had a higher chance of dense breast tissue (OR=2.58, 95% CI: [1.23-5.40], p=0.01).

Conclusion: The prevalence of dense breast tissue among screened postmenopausal women was low. However, certain factors increase the risk of having dense tissue in this population, including not being Saudi Arabian, never having breastfed, being nulliparous, and having fewer children.