Saudi Medical Journal最新文献

Objectives: To report the development and administration of the Saudi pediatric speech intelligibility (SPSI) test.

Methods: This study was carried out at King Abdullah Ear Specialist Center, King Saud University, Riyadh, Saudi Arabia, between 2021 and 2023. A pilot study was carried out in 5 regions of Saudi Arabia including 100 normal hearing children aged 7-11 years old, with 20 children from each region. The final test materials were voice-recorded by a native Saudi radio announcer, and a software-based application for administering the SPSI was developed.

Results: During the pilot study, minor adjustments were carried out to the test for more clarity. The developed SPSI software is an android-based application that includes features like automatic result calculation, data saving, and individual user accounts for examiners to review results. The SPSI test comprises 4-word cards and 2 sentence cards, each with 5 pictures, and operates in 3 modes: quiet, background noise, and competing sentences.

Conclusion: The SPSI test has been developed in an android-based software using the Saudi local dialects. It can facilitate comprehensive and accurate assessment of speech intelligibility, particularly in children with hearing impairments.

Objectives: To investigate the role of systemic immune-inflammation index (SII) in the diagnosis and severity of intrahepatic cholestasis of pregnancy (ICP).

Methods: This case-control research involved 173 pregnant women with ICP and 266 gestational age-related healthy pregnant women as the control group. Criteria for diagnosing ICP were acceptance of increased serum total bile acid (TBA) levels (≥10 μmol/L). The mild ICP group (n=109) had TBA levels ranging between 10-39 µmol/l, while the severe ICP group (n=64) had a minimum TBA level above 40 µmol/l. Sociodemographic data, laboratory results, and SII values were compared between groups. Cut-off values were calculated to predict ICP. The SII was calculated as the platelet count × neutrophil count/lymphocyte count.

Results: The leukocyte and neutrophil counts were lower (p<0.01), and the monocyte count was higher (p=0.026) in the severe ICP group compared to the controls. The platelet-to-lymphocyte ratio (PLR) was higher in mild ICP groups than in controls (p<0.01). The optimum PRL cut-off value was 126.2238, with a sensitivity of 57.2% and specificity of 57.1%.

Conclusion: Elevated SII values support the evidence for the inflammatory properties of ICP but do not aid in diagnosing and determining its severity. Platelet-to-lymphocyte ratio may be a useful marker in determining ICP.

Objectives: To review the clinical and radiological correlation of the central nervous system manifestations of tuberous sclerosis complex (TSC).

Methods: All patients under the age of 18 years with TSC seen at the Department of Pediatrics, Sidra Medicine, Doha, Qatar, between January 2003 and February 2021 were included in this retrospective study. Severity of epilepsy was determined using the early childhood epilepsy severity score (E-CHESS) tool.

Results: The study sample included 38 patients (50% male), 8 (21%) of whom were native to Qatar. The median age at diagnosis was 4 (range: 0-72) months. A family history of TSC was present in 10 (26%) cases, while 33 (86%) patients had a TSC2 gene mutation. Common presentations included seizures (79%), rhabdomyoma (26%), and developmental delay (13%). On MRI scans, cortical tubers were seen in all patients, subependymal nodules in 37 (97%), and subependymal giant cell astrocytoma was diagnosed in 8 (21%) cases. A total of 30 children developed epilepsy, 9 of whom had favorable and 21 had unfavorable E-CHESS scores, and 6 required pharmaceutical management. A total of 13 children were diagnosed with autistic spectrum disorder and 12 with attention deficit hyperactivity disorder.

Conclusion: Multidisciplinary management and further research is needed to optimize the care and quality of life of TSC affected individuals and their families.

Objectives: To investigate the cognitive performance of Saudi children and adolescents with type 1 diabetes mellitus (T1DM) compared to matched control groups.

Methods: A total of 64 participants (32 T1DM patients and 32 control), matched with age, gender, ethnicity, education, and body mass index were recruited. Cognitive functions were investigated using a highly reliable and valid "Cambridge neuropsychological test automated battery". The attention switching task (AST) and choice reaction time (CRT) test were carried out to evaluate the cognitive functions.

Results: The cognitive test parameters AST mean correct latency, AST mean correct latency (congruent), AST mean correct latency (incongruent), and CRT mean correct latency were significantly delayed in the T1DM group compared to their control group (p<0.0001). Moreover, the control group did significantly better on the cognitive test parameters AST and CRT than the T1DM children and adolescents with hemoglobin A1c (HbA1C) ≥8% group (p<0.01).

Conclusion: The findings demonstrate a delay in cognitive performance among children and adolescents with T1DM. Importantly, elevated HbA1C levels and duration of disease were associated with reduced cognitive functions. The present study findings highlight the importance of stringent glycemic management in children and adolescents with T1DM. The findings can support physicians and policymakers not only to prevent microvascular complications but also to mitigate potential cognitive deficits among children and adolescents with T1DM.

Objectives: To report and describe the characteristics and outcomes of patients with advanced atrioventricular block (AVB) in Saudi Arabia.

Methods: We included consecutive patients who underwent pacemaker implantation at King Khaled University Hospital, Riyadh, Saudi Arabia, for advanced AVB, which was defined as second degree type 2 AVB, third degree AVB, and symptomatic atrial fibrillation with slow ventricular response. The variable "young patient" was defined as age of 60 or less, based on guidelines recommending cardiac sarcoidosis (CS) evaluation at this age or younger.

Results: Among 100 patients (median age: 71 males, 51%), 29 (29%) were young patients. Most patients had at least one comorbidity including hypertension, diabetes, or dyslipidemia (81%). Young patients constituted 26.6% (n=21/79) of idiopathic AVB cases and only 23.8% (n=8/21) underwent CS evaluation (8/21).

Conclusion: A significant proportion of AVB occurs in young patients. Yet, CS is often not ruled out. Future studies should define the yield of CS evaluation in the Saudi population when international consensus documents are followed.

Objectives: To analyze the existing literature on the prevalence of psychological symptoms in healthcare workers (HCWs) in Saudi Arabia during the COVID-19 pandemic. The review will evaluate the assessment methods used for measuring the prevalence of psychological symptoms and critically review the literature's findings concerning psychological support for HCWs.

Methods: All articles were selected from the PubMed database and reviewed for potential inclusion in March 2023. The articles were screened following the preferred reporting items for systematic reviews and meta-analyses protocol. Assessment of the quality and risk of bias in the included studies was guided using the prevalence critical appraisal tool criteria.

Results: We identified 7 articles that investigated the prevalence of psychological symptoms among HCWs in Saudi Arabia during the COVID-19 pandemic. We determined the studies' characteristics and classified and explained various themes. These themes included the prevalence of psychological symptoms found in HCWs, the study designs, the tools used to assess psychological symptoms in HCWs, and the potential impact of the studies on the mental health challenges faced by HCWs due to COVID-19. We also examined the quality and risk of bias in the included studies.

Conclusion: This review's findings provide valuable insights into the psychological symptoms experienced by HCWs during the pandemic. To ensure the consistency of the results, it is essential to reevaluate the prevalence of these symptoms and use a culturally sensitive approach to translating the measures. This review lays the groundwork for future research on psychological symptoms and the interpretation of measurement outcomes.PROSPERO No. ID: CRD42024479813.

Objectives: To evaluate the role of sonography in revealing and characterizing liver transplant complications based on gray scale and color Doppler, describe the normal Doppler findings, and discuss the significance of distinguishing normal transient changes in the spectral waveform from findings that may suggests ominous complications.

Methods: We carried out a retrospective cross-sectional study at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. The medical records and imaging studies of a total of 122 candidates who underwent transplantation between January 2016 to February 2022 were reviewed.

Results: Our results showed that most patients were males with the most frequent age group being those between 54-71 years. Hepatitis B virus and hepatic cellular carcinoma were the most common indications for transplants. A total of 95 patients received a graft from a living related donor. Regarding complications, biliary issues (including leaks and ducts dilation) were the second most frequent complication after collections. Vascular complications represented 7.4% of all complications and was the leading cause of death in 4.8% of cases. Among all vascular issues encountered during liver transplant, portal vein thrombosis was the most predominant. In respect to Doppler findings, portal vein velocities and resistive index of hepatic artery had re-averaged within 7-10 post-operative days in most patients.

Conclusion: Ultrasound plays crucial role in the post-operative management of compilations, facilitating early detection, which is substantial for the graft survival.

Objectives: To review the epidemiology of elderly trauma at the Kind Saud Medical City (KSMC), Riyadh, Saudi Arabia, and carry out risk-adjusted analyses to benchmark outcomes with the Alfred Hospital, Melbourne, Australia, the largest Australasian trauma service.

Methods: This retrospective study included records of injured patients (≥65 years) from the hospital trauma registries during 2022. Demographic and injury data were extracted. Risk-adjusted endpoints were: inpatient mortality and length of stay, analysed using logistic and median regression.

Results: A total of 193 elderly patients were registered on the KSMC registry and 1233 elderly patients were registered on the Alfred Hospital registry. Kind Saud Medical City saw proportionally less major trauma (injury severity score of >12, 24.4% vs. 44.2%, p<0.001) and less females (31.1% vs 44.4%, p<0.001). The modal injury group was low level falls in both centres (≈60%). Discharge destination was different, particularly for patients discharged home (86.5% vs. 56%) or to a rehabilitation facility (0.5% vs. 28.2%). The risk-adjusted length of stay was 4.5 days less at the Alfred Hospital (95% CI: [3.25-5.77] days, p<0.001). The odds of in-hospital death were not significantly different (OR=0.72, 95% CI: [0.36-1.47], p=0.37).

Conclusion: Despite the different settings, low level falls were the major cause of injury in older patients. A longer length of stay in the acute hospital was identified for KSMC, however, this may be partly explained by discharge destination practices in the 2 countries.