Saudi Medical Journal最新文献

Objectives: To assess awareness of diabetes complications and knowledge of hypoglycemia.

Methods: This cross-sectional study was conducted in a tertiary hospital between December 2022 and November 2023. The participants were 362 adult patients with diabetes selected using systematic random sampling. Data were collected through structured interviews using a validated questionnaire that included sections on socio-demographic characteristics, diabetes history, and knowledge of hypoglycemia and awareness about diabetes complications. Descriptive statistics and one-way ANOVA were used for data analysis.

Results: The majority of participants were female (71.3%), and 227 (62.7%) had been diabetic for more than 10 years. Approximately 37% are taking a combination of antidiabetic medications. Hypoglycemia reported in 218 (60.2%) and hypoglycemic coma reported in 37 (17.1%). Overall, 81.1% had good knowledge of hypoglycemia, and 91.4% had good awareness of diabetes complications. Better knowledge was associated with higher education, insulin treatment and other combination therapies, and previous experience with hypoglycemia. Patients with type 1 diabetes or a long duration of diabetes were more aware of diabetes complications.

Conclusions: Patients with diabetes had a high degree of knowledge and awareness, but hypoglycemia was still a prevalent issue. Neuroglycopenic symptoms and long-term consequences are insufficiently recognized. Teaching and coaching can help prevent hypoglycemia.

Objectives: To evaluate the added diagnostic value of ultrasonographic risk levels to cytological diagnoses in nodules with Bethesda III and IV cytology.

Methods: This retrospective study was conducted in Jeddah, Saudi Arabia, and involved analyzing thyroid nodules from patients who underwent thyroidectomy between 2016 and 2023. We focused on pathology, US risk stratification based on the 2015 American Thyroid Association (ATA) guidelines, and fine-needle aspiration cytology (FNAC) using the Bethesda system. We calculated malignancy rates for each ultrasound (US) and FNAC category, with the indeterminate cytology groups defined as follicular lesions of undetermined significance (FLUS) and follicular neoplasms (FN).

Results: In 290 patients, malignancy rates in the high-risk US group were 72%. In patients with FLUS, the malignancy rate was 36.9%, while in those with FN, it was 50%. For FLUS and FN, high-risk US features showed a sensitivity of 47%, a specificity of 81%, and a kappa of 29%. Combining FLUS with high-risk US features improved sensitivity to 50%, specificity to 80%, and kappa to 32%.

Conclusion: For indeterminate thyroid cytology, US features can guide decision-making, supporting surgery in patients with high-risk US findings rather than follow-up or repeat FNAC.

Objectives: To evaluate current mammogram screening rates and identify barriers and facilitators for mammogram uptake among Saudi women.

Methods: This systematic review was conducted in accordance with the PRISMA framework, beginning with a database search performed by 2 researchers using PubMed, PsycINFO, CINAHL Plus, and Google Scholar for pertinent studies published between 2000 and 2024. Qualitative and quantitative studies were included if they: a) were conducted in Saudi Arabia among Saudi women, b) explored factors associated with mammogram uptake among Saudi women, and c) were peer-reviewed. The socioecological model was used to thematically synthesize the results.

Results: A total of 39 studies were included in this review. Nine studies revealed low adherence to annual or biannual mammogram screenings among Saudi women. The socioecological model was utilized to categorize the factors that influenced Saudi women's uptake of mammograms, divided into: a) individual factors, including breast cancer and mammogram knowledge, demographic characteristics, health beliefs, fear, pain, and embarrassment; b) interpersonal factors, including male family members, health care providers, and competing priorities; and c) social factors, including health behaviors related to secondary health screenings, and the health care system.

Conclusion: To improve adherence to mammogram screening among Saudi women, it is recommended to design interventions that target factors at each level of the socioecological model. Understanding how each factor functions as a barrier or facilitator will enable more effective and tailored strategies that address these factors within their respective socioecological levels.PROSPERO No. ID: CRD628485.

Objectives: To examine the distribution of human papillomavirus (HPV) genotypes, regional trends, and cytological abnormalities in Saudi Arabia. The findings aim to inform effective cervical cancer prevention strategies. High-risk HPV infections is the leading cause of cervical cancer.

Methods: A retrospective, national laboratory-based study was conducted between 2016 and 2024, analyzing 9,096 medical records. Of these patients, 6,005 underwent co-testing of HPV DNA and cytology-based screening, and 3,091 underwent only cytology-based screening. The HPV genotype distribution, temporal trends, and geographic variations were evaluated.

Results: The HPV positivity rate was 13.84%, with HPV-16 accounting for 25.11% and HPV-18 for 7.55% of cases, while 67.34% of the infections were due to other high-risk strains. The HPV positivity peaked in the 30-39 age group (44.9%) and increased from 5.62% in 2016 to 13.33% in 2024. Jeddah (33.7%) and Riyadh (32.25%) had the highest HPV positivity rates. Among the evaluated cytology samples, 13.41% had precancerous lesions, and 0.64% had cancerous lesions. Notably, 19.37% of HPV-positive cases had normal cytological profiles, reinforcing the importance of co-testing HPV DNA and cytology tests.

Conclusion: This study reveals significant age and regional disparities in HPV prevalence in Saudi Arabia, with a predominance of non-16/18 genotypes. Broad vaccine coverage, genotype surveillance, and regionally adapted screening strategies are essential to reduce cervical cancer burden.

Objectives: To analyze the trends, histopathological characteristics, and demographic distribution of genitourinary (GU) tumors at a major academic center in Jeddah, Saudi Arabia, over a 16-year period (2007-2023).

Methods: A retrospective review of electronic medical records was conducted, including all histologically confirmed cases of GU tumors. Data on patient demographics, tumor type, and histopathological findings were extracted and analyzed using descriptive and inferential statistical methods.

Results: A total of 1,791 GU tumor cases were identified. Bladder cancer was the most prevalent (42%), followed by prostate cancer (21%) and renal cell carcinoma (21%). Testicular and ureteral tumors were less common, with scrotal and penile malignancies being rare (<1%). The mean age at diagnosis varied significantly, with prostate and bladder cancers occurring predominantly in older patients, while testicular tumors were diagnosed at a younger age. A significant rise in kidney and bladder cancer diagnoses was observed, potentially linked to improved screening and environmental factors.

Conclusion: This study provides valuable insights into the epidemiological trends of GU tumors in Saudi Arabia, emphasizing the need for early detection and targeted screening. Further research is needed to explore contributing factors and optimize treatment approaches.

Objectives: This study investigates the prevalence of iron deficiency anemia (IDA) in Saudi Arabia, analyzing variations by gender, age, and geographical region.

Methods: An observational, cross-sectional analysis was conducted from January 2014 to February 2024 using data from Al Borg laboratories, including ferritin levels, demographics, and routine hematological results.

Results: The study included 420,956 individuals, with 73% being female and 94% over 15 years old. The IDA was found in 19.8% of patients, Non-Anemic Iron Deficiency (NAID) in 23.7%, and other anemias in 9.6%. Females represented 93% of those with IDA and NAID. All patients under 12 were anemic, with 45% having IDA. Among the elderly (65+), 29% had iron deficiency. Prevalence varied geographically, from 28% in Al-Jouf to 42% in Makkah, with female rates reaching 69%.

Conclusion: The study reveals a high prevalence of IDA and NAID across Saudi Arabia, particularly among females. It underscores the need for targeted interventions to address this public health issue.

Objectives: To estimate the prevalence of anxiety and depression symptoms in females awaiting preimplantation genetic diagnosis (PGD) as well as investigate their associated factors.

Methods: This cross-sectional study included 289 female patients awaiting PGD at a large tertiary hospital in Saudi Arabia. A structured questionnaire was used to collect information on patient characteristics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and data on PGD. Independent factors associated with anxiety and depression were identified using multivariable analysis.

Results: The prevalence of anxiety was 13.5% and that of depressive symptoms was 12.1%. Odds of anxiety were higher among females with a Master's degree (adjusted OR: 14.9, 95% CI: 3.1-72.4, p<0.01), those with a psychiatric disorder (adjusted OR: 3.4, 95% CI: 1.2-9.8, p=0.02), and with 3 or more children with congenital issues (adjusted OR: 6.6, 95% CI: 1.3-33.1, p=0.02). However, for depression, no significant predictors were observed.

Conclusion: Anxiety and depression are prevalent problems among females awaiting PGD. This promotes periodic mental health assessments of individuals on the waiting list, especially those at risk, and early referrals to women's mental health services. Furthermore, these findings may be useful for family physicians and experts in women's health who wish to better understand this problem, particularly in Arab countries.