Saudi Medical Journal最新文献

Objectives: To examine the relation between liver fibrosis and chronic kidney disease (CKD) in metabolic-associated fatty liver disease (MAFLD) patients and its risk factors.

Methods: The current study was carried out at Tanta University Hospital, Tanta, Egypt, from May 2021 to January 2023 and included 84 MAFLD patients with CKD and 80 MAFLD patients without CKD. All participants had been examined by abdominal ultrasonography and transient elastography with controlled attenuation parameter.

Results: Chronic kidney disease patients exhibited a greater incidence of fibrosis compared to patients without CKD (75.6% vs. 24.4%). Logistic analysis demonstrated that the presence of multiple health conditions, such as MAFLD, diabetes mellitus, hypertension, and cardiovascular disease, were individually linked to CKD. Gender and body mass index were not independent factors related to CKD. Additionally, factors such as age, hyperuricemia, hypertriglyceridemia, hypercholesterolemia, hypoalbuminemia, hyperbilirubinemia, and viral hepatitis, apart from MAFLD comorbidities, were independently linked to CKD.

Conclusion: Chronic kidney disease may represent a potential risk influence for liver fibrosis development in MAFLD patients.

Objectives: To identify potential diagnostic markers for small cell lung cancer (SCLC) and investigate the correlation with immune cell infiltration.

Methods: GSE149507 and GSE6044 were used as the training group, while GSE108055 served as validation group A and GSE73160 served as validation group B. Differentially expressed genes (DEGs) were identified and analyzed for functional enrichment. Machine learning (ML) was used to identify candidate diagnostic genes for SCLC. The area under the receiver operating characteristic curves was applied to assess diagnostic efficacy. Immune cell infiltration analyses were carried out.

Results: There were 181 DEGs identified. The gene ontology analysis showed that DEGs were enriched in 455 functional annotations, some of which were associated with immunity. The kyoto encyclopedia of genes and genomes analysis revealed that there were 9 signaling pathways enriched. The disease ontology analysis indicated that DEGs were related to 116 diseases. The gene set enrichment analysis results displayed multiple items closely related to immunity. ZWINT and NRCAM were screened using ML and further validated as diagnostic genes. Significant differences were observed in SCLC with normal lung tissue samples among immune cell infiltration characteristics. Strong associations were found between the diagnostic genes and immune cell infiltration.

Conclusion: This study identified 2 diagnostic genes, ZWINT and NRCAM, that were related to immune cell infiltration by integrating bioinformatics analysis and ML algorithms. These genes could serve as potential diagnostic biomarkers and provide possible molecular targets for immunotherapy in SCLC.

Objectives: To identify biomarkers that can discriminated small cell lung cancer (SCLC) from non-SCLC (NSCLC), and explore their association with the prognosis of SCLC under chemoradiotherapy.

Methods: The GSE40275 dataset was used to identify potential targets in SCLC. There were 196 patients of lung cancer (LC) in cohort 1 of this study. MTHFD1 levels in tissues were determined by immunohistochemistry assay in cohort 1. Lung cancer patients who were all underwent local chemoradiotherapy (CRT) were included in cohort 2, and the association of MTHFD1 levels with CRT treatment outcome were determined in cohort 2. Cell experiments were used to determine the function of MTHFD1 on the radio-sensitivity of SCLC and NSCLC cells.

Results: The MTHFD1 levels in LC tissues were increased, and could discriminate SCLC from both lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD). Small cell lung cancer patients with MTHFD1 high phenotype had a poorer prognosis after CRT treatment, whereas no significant correlation was found between MTHFD1 levels and prognosis in LUSC and LUAD group. Cell experiments demonstrated that overexpression of MTHFD1 increases radio-resistance in both SCLC and NSCLC in vitro.

Conclusion: MTHFD1 expressions might be a novel specifically prognostic biomarker for SCLC and the CRT treatment outcome.

Immune thrombocytopenia (ITP) is an autoimmune disorder marked by low platelet counts that puts patients at risk for spontaneous bleeding. A rare trigger for ITP is iron repletion, which has only been reported in a few cases. In this article, we present a unique case of a 54-year-old male with a history of recurrent ITP who experienced rapid thrombocytopenia following iron repletion with ferrous gluconate. Discontinuation of ferrous medications resulted in platelet counts returning to the normal baseline. Following more than 30 years of the patient's clinical timeline, this case demonstrates the chronic nature of ITP and the complexity of its causes. Further studies are needed to determine the prevalence of iron repletion-induced thrombocytopenia and its underlying mechanisms.

Objectives: To estimate the prevalence of electronic device usage and its association with mental health status among preschool children aged 3-6 years.

Methods: A cross-sectional study was conducted among preschool children aged 3-6 years in kindergartens in Makkah city in 2023-2024, using an electronic questionnaire. An Arabic version of the Strengths and Difficulties Questionnaire was used to assess mental health.

Results: We recruited a total of 399 children. The prevalence of electronic device usage was 91.5%. The number of hours spent using electronic devices ranged from 0 to 12 hour (h)/day, with a mean of 3.1 h/day. We found a significant positive correlation between the number of hours spent using electronic devices and emotional problems (r=0.200, p<0.001), conduct problems (r=0.149, p=0.003), hyperactivity (r=0.279, p<0.001), peer problems (r=0.104, p=0.038), and total difficulty scores (r=0.263, p<0.001). We also found a significant negative correlation between the number of hours spent using electronic devices and the prosocial score (r= -0.128, p=0.011), and most of the included children had scores within the "close to average" category across all scales of mental health status.

Conclusion: There was a high prevalence of electronic device usage among preschool children, which exceeded the recommended time limit. A significant correlation was observed between electronic device use and mental health scores. Further longitudinal studies are required to understand the nature of this association and its implications for child development.

Pulmonary agenesis is a very rare congenital abnormality that can be missed in a routine radiographic examination, which delays diagnosis until adulthood. It can be associated with other congenital malformations, such as valvular heart disease and gastrointestinal organ abnormalities. Computed tomography (CT) is a useful modality for its better delineation of pulmonary and vascular structures. The reported case here is for an adult male who presented with dextroposition of the heart and was found to have a unilobed right lung associated with polysplenia. This has not been previously reported in the literature.

Autosomal dominant hyper immunoglobulin E (IgE) syndrome is a rare inborn error of immunity that affects approximately one in a million individuals worldwide. It presents with various symptoms owing to multisystem involvement (immunological and non-immunological). Recurrent infections (mainly in the skin and lungs) are common presentations. A 5-year-old Middle Eastern boy presented with symptoms suggestive of obstructive uropathy secondary to multiple large pelviabdominal abscesses and acute kidney injury with hyperkalemia that necessitated admission to the intensive care unit. Upon further investigation, the patient's genetic test (whole exome sequencing) demonstrated a heterozygous missense variant in the STAT3 gene. The patient completely recovered and did not require further admission after initiating prophylactic antibiotics. Although deep-seated infections are uncommon in STAT3 hyper IgE syndrome, skin and lung infections are most commonly observed. Multiple deep collections can occur and require prompt intervention and aggressive treatment.

Objectives: To investigate the incidence rate, clinical characteristics across different age groups, antimicrobial susceptibility, and outcomes of Elizabethkingia meningoseptica (E. meningoseptica) infections.

Methods: A retrospective analysis was carried out to include 66 cases with confirmed E. meningoseptica cultures from sterile samples between January 2014 and June 2022 at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia.

Results: A total of 66 cases were identified, with an incidence rate of 0.3 per 1000 admissions. Most cases were hospital-acquired (80.3%), primarily in critical care areas. All patients had underlying diseases, with respiratory (40.9%) and cardiovascular (39.4%) diseases being the most common. Minocycline showed the highest susceptibility (96.0%), followed by trimethoprim/sulfamethoxazole (77.0%), whereas tobramycin and colistin were fully resistant. The in-hospital mortality rate was 34.8%, whereas the 28-day mortality rate was 22.7%. Clinical characteristics across age groups showed a higher prevalence of cardiovascular disease in pediatrics than in adults, whereas exposure to mechanical ventilation, immunosuppressive therapy, previous infection, anemia, and in-hospital mortality were reported more frequently in adults (p<0.05).

Conclusion: Our study provides valuable insights into E. meningoseptica infection in Saudi Arabia, emphasizing the importance of robust infection control measures. Incidence and mortality rates align with global trends. Variations in clinical characteristics across age groups highlight the importance of tailored treatments based on patient demographics and underlying comorbidities.

Objectives: To evaluate the nutritional quality and microbial contamination of raw camel milk sourced from street vendors and compare it with milk obtained from farms, with a particular emphasis on pathogenic organisms.

Methods: Twenty samples were systematically collected from street vendors and farms between July 2022 and February 2023 and analyzed at King Fahad Medical Research Centre and the Pharmacy College, King Abdulaziz University, Jeddah, Saudi Arabia. The microbial analysis employed culture-dependent techniques for colony-forming unit analysis and isolation of microbial colonies from milk samples. Microbial identification utilized advanced methods, including VITEK-MS equipment and the MALDI-TOF technique. The chemical composition was analysed through enzyme-linked immunosorbent assays.

Results: The findings revealed significant differences in microbial loads, with milk sourced from street vendors exhibiting considerably higher microbial counts than farm-sourced milk, including pathogenic species like Staphylococcus aureus and Escherichia coli. The results indicated that camel milk from street vendors possessed a higher level of microbial contamination, suggesting potential health risks associated with its purchase and consumption from these sources.

Conclusion: This study highlights the urgent need for stringent food safety practices in handling, selling, and distributing camel milk to reduce microbial risks to safe levels, thereby mitigating potential health hazards.

Objectives: To analyze the fertility rate trends in the GCC countries and their association with socioeconomic factors so that policymakers may use the study findings for future healthcare plans.

Methods: Total population, crude death rate, life expectancy, literacy rate, human development index (HDI), female employment, unemployment rate, urbanisation, gross domestic product (GDP) per capita and inflation were chosen as possible predictors of TFR trends. The data were collected for the Global Burden of Disease 2021 study and other official databases such as the World Bank, the United Nations Development Program and Our World in Data for the 6 Gulf Cooperation Council (GCC) countries. Mean with standard deviation and percentage change was calculated to assess trends of TFR and all other variables from 1980-2021.

Results: The fertility rate declined in all 6 countries in 2021 compared to 1980. The highest decline was found in the United Arab Emirates (75.5%), while the lowest was in Kuwait (60.9%). From 1980-2021, total population, life expectancy, HDI, literacy rate, GDP, urbanisation, and female labor force increased in all GCC countries. The total population, life expectancy, urbanisation, female labor force, GDP and HDI were negatively and significantly correlated with TFR (p<0.01). The literacy rate showed a negative and significant correlation with TFR in Bahrain, Kuwait, Saudi Arabia, and Qatar.

Conclusion: The TFR is declining in GCC countries. The plausible causes include the inclination towards postponement of marriages and excessive costs of living. These trends and associations need to be evaluated by policymakers so that they identify priority areas for interventions, allocate resources and formulate developmental plans accordingly to ensure strategic progress of the region.