Saudi Medical Journal最新文献

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.

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.