Saudi Medical Journal最新文献

Objectives: To identify the primary risk factors contributing to stroke incidents and deaths, analyzing the trends and changes in regional stroke statistics between 1990 and 2021 in the Gulf Cooperation Council (GCC) countries.

Methods: This longitudinal time trend study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from June to August 2024. The data were recorded from the Institute for Health Metrics and Evaluation (IHME) and the Global Burden of Diseases (GBD) datasets. The incidence, mortality, and disability-adjusted life year (DALY) rates of stroke in the GCC countries, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE), and their association with environmental pollution, dietary, and metabolic risk factors were documented from 1990 to 2021.

Results: From 1990 to 2021, the GCC countries exhibited varied trends in stroke incidence, mortality and DALYs. The UAE had the highest stroke incidence rate in 2021 (106.01 per 100,000). The mortality rates due to stroke decreased in the GCC, except in Kuwait, where they increased by 14.4%. DALYs decreased in GCC countries, with the highest decline in Qatar (56%). Qatar experienced a 59.9% decrease in death rates and a 53.4% reduction in DALYs for hypertension.

Conclusion: In GCC countries, hypertension, air pollution, and dietary factors are dominant risk factors for stroke, stroke-related deaths, and DALY rates. The UAE had the highest stroke incidence rate in 2021. However, mortality rates decreased in all GCC countries except Kuwait.

Objectives: To assess the impact of Acute Coronary Syndrome (ACS) on quality of life (QoL) among patients at King Abdulaziz Medical City in Western Jeddah. Acute Coronary Syndrome significantly affect patients' QoL. Many individuals experience challenges post-ACS. While previous research has identified baseline QoL, access to specialized care, and assessment tools as important factors influencing recovery, limited studies have examined how baseline QoL affects long-term outcomes.

Methods: This hybrid cross-sectional study included ACS patients treated at King Abdulaziz Medical City. A sample size of 268 was calculated using RAOSOFT. A culturally tailored questionnaire, derived from the SF-36, was developed, validated, and administered through phone interviews. Data was analyzed using SPSS, applying descriptive statistics. Statistical significance was set at p<0.05.

Results: A total of 311 patients participated. The mean QoL score was 9.7 (±3.4). Age was found to be a statistically significant predictor of QoL classification (p=0.001), with an odds ratio of 1.04. However, there is an inverse correlation between the quality-of-life score and age and years since diagnosis.

Conclusion: The ACS negatively affects social participation, religious practices, fasting during Ramadan, and willingness to return to work. Higher age was associated with better improvement in QoL after ACS. Additionally, we found a weak but significant invers correlation between age and QoL, and longer time since diagnosis and QoL.

Objective: To evaluate and provide evidence on drugs investigated in completed phase IV clinical trials for adult non-small cell lung carcinoma (NSCLC) therapy, primarily focusing on treatment objectives and adverse effects.

Methods: Clinical research studies from January 2020 to January 2025 were systematically reviewed using the "ClinicalTrials.gov" database. The inclusion criteria focused on publicly available, relevant, and completed Phase IV studies limited to "Clinicaltrials.gov", while those not meeting these specifications were excluded. As of 3 January 2025, a total of 7,541 Phase IV clinical trials were available on "ClinicalTrials.gov", of which 121 were related to NSCLC.

Results: Six of these clinical studies met the requirements for inclusion in the current investigation. The pharmacological agents investigated in these Phase IV trials were dacomitinib, lorlatinib, durvalumab, osimertinib, and a combination of rivaroxban and sotorasib. Treatment options for NSCLC remain limited due to its complex nature and frequent co-occurrence with other respiratory infections.

Conclusion: The studies reviewed reported high rates of adverse events, alongside reduced subjective outcomes and faster response periods. This warrants for continuous research to develop safer and more efficient therapy methods for NSCLC patients.PROSPERO No.: CRD420251038011.

Objectives: To evaluate the association between Inflammatory bowel disease (IBD) and Ischemic heart disease (IHD).

Methods: A retrospective cohort analysis included patients with and without IBD seen at the outpatient gastroenterology clinic of a large tertiary care hospital between January 2015 and October 2022. The primary outcome was the association between IBD and IHD, and the secondary outcome was predictors of IHD in patients with IBD.

Results: The study included 400 patients; 291 were IBD patients, and 109 had other non-inflammatory GI disorders. The IBD group displayed significantly lower rates of hyperlipidemia (8.6% vs. 30.3%, p<0.001), diabetes mellitus (DM) (10% vs. 24.8%, p<0.001), and hypertension (11.7% vs. 32.1%, p<0.001) compared to the non-IBD group. Only 2.7% (n=8) of IBD patients developed IHD. Logistic regression analysis did not demonstrate a significant association between IBD and IHD (p=0.932). Among classical risk factors, only hypertension (OR: 26.2, 95% CI: 2.14-661, p=0.016) and hyperlipidemia (OR: 10.5, 95% CI: 1.32-132, p=0.0405) significantly increased the risk of developing IHD among patients with IBD.

Conclusion: In this cohort, there is no increased risk of developing IHD in patients with IBD compared to non-IBD patients.

Objectives: To explore the prevalence of respiratory tract infections (RTIs) in Taif via molecular diagnosis method, to enhance the clinical decision making and the need for vaccination strategies.

Methods: A 5864 participants were enrolled in this study, all from Taif city. Samples were collected via nasal swab, throat swab, or sputum sample. The duration of the study were 24 months from January 2023 to December 2024. Samples were transported in viral transport medium. Then processed using GeneXpert system. Fluorescent probes detected viral RNA and reported as detected or not detected. Chi-square test was applied for statistical analysis purposes.

Results: A total of 228 (3.9%) detected viral RTIs. FLU A was the most common (71.07%), followed by FLU B (17.11%), SARS-CoV-2 (5.75%), and RSV (3.5%). Few cases of H1N1 were detected. The most common affected age group were pre-school, and family medicine ward was highest. Viral RTIs co-infection was detected.

Conclusion: Our study highlighted the impact of RTIs, especially influenza as the leading cause. Pre-school age group was mostly affected due to their developing immune system. The high burden of RTIs management was on the primary care ward, family medicine handled the highest percentage of cases. RTIs have caused several pandemics in the recent year, and developing in vaccination and diagnostic tools can enhance the efficacy and improving the patient's management, which can relief the burden on health care system.