Annals of Saudi Medicine最新文献

{"title":"Trends in colorectal cancer in Iraq over two decades: incidence, mortality, topography and morphology.","authors":"Salih Ibrahem,&nbsp;Hussien Ahmed,&nbsp;Suhair Zangana","doi":"10.5144/0256-4947.2022.252","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.252","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is mainly a disease of the elderly in the Western world, but its characteristics are changing globally. Iraq does not have a well established CRC screening program. Understanding trends of CRC incidence, fatality and the clinical features of CRC patients is vital to the design of effective public health measures; public awareness, screening, diagnosis and treatment strategies to meet the future demands.</p><p><strong>Objectives: </strong>Determine trends in demography, incidence proportion, mortality, topography (primary tumor site) and morphology (histology) over two decades.</p><p><strong>Design: </strong>Registry-based study SETTING: Iraqi National Cancer Registry (INCR) database PATIENTS AND METHODS: We collected and analyzed data from CRC patients obtained from the INCR to calculate incidence and mortality proportion per 100 000 population for the period from 2000 to 2019. In addition to estimation, data were examined by anatomic location and morphological type.</p><p><strong>Main outcome measures: </strong>Change in the incidence and mortality proportion, topography and morphology of CRC over 20 years.</p><p><strong>Sample size: </strong>20 880 CRC patients ranging in age from 14-80 years.</p><p><strong>Results: </strong>The overall (males and females) CRC incidence proportion (CIP) increased from 2.28 to 6.18 per 100 000 population in 2000 and 2019, respectively, with an annual percentage change (APC) of 5.11%. The incidence proportion (IP) of CRC in patients from 20 to <50 years rose from 1.46 in 2000 to 4.36 per 100 000 population in 2019, which is an APC of 5.6%. The IP in patients older than 50 years rose from 12.7 to 40.59 per 100 000 population in 2000 and 2019, respectively, with an APC of 5.98%. The percentage of all CRC cases to all total malignancies in Iraq grew from 3.69% in 2000 to 6.5% in 2019. The CRC mortality proportion increased from 1.25 to 1.77 per 100 000 populations in 2010 and 2019, respectively, reflecting an APC of 3.54%. Anatomically, colon (C18) tumor represented 59.2% and 65.7% in 2000 and 2019, respectively. Rectal (C20) tumors were 37.2% in 2000 down to 31.4% in 2019, while rectosigmoid junction tumor (C19) were 3.6% in 2000 dropping to 2% in 2019.</p><p><strong>Conclusions: </strong>CRC in Iraq is still a disease of the elderly and is rising in incidence and mortality in all age groups. This necessitates reconsidering health policy regarding CRC; public awareness, screening and management strategies to accommodate for these alarming changes.</p><p><strong>Limitations: </strong>Data about stages, grades and molecular characterisations are not available in the INCR.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"252-261"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/04/0256-4947.2022.252.PMC9357297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40686130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum vitamin D levels and age in patients with epilepsy: a retrospective study from an epilepsy center in Saudi Arabia.","authors":"Hussam Mohammed Alhaidari,&nbsp;Fawzi Babtain,&nbsp;Khalid Alqadi,&nbsp;Abdulrahman Bouges,&nbsp;Saleh Baeesa,&nbsp;Youssef A Al-Said","doi":"10.5144/0256-4947.2022.262","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.262","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency has been linked to various medical conditions such as bone loss, decreased mineralization, endocrine disorders, and central nervous system disorders, including epilepsy. Vitamin D deficiency is prevalent among patients with epilepsy (PWE). However, the specific association between vitamin D levels and age in PWE is unclear.</p><p><strong>Objectives: </strong>Identify the relation between vitamin D level and age in PWE and evaluate factors that may play a role in seizure control.</p><p><strong>Design: </strong>Retrospective analytical medical record review SETTING: Outpatient epilepsy research clinic in Saudi Arabia PATIENTS AND METHODS: Between November 2016 and April 2020, we selected eligible PWE aged older than 14 years whose vita-min D levels were recorded at least once after reviewing 1550 patient electronic files. We analyzed data on serum vitamin D level by age and other factors, vitamin D supplement use, seizure classification, and conducted a multivariate logistic regression to assess associations with seizure control.</p><p><strong>Main outcome measures: </strong>Relationships between vitamin D levels and age and factors that might affect seizure control.</p><p><strong>Sample size: </strong>524 patients RESULTS: The prevalence of low serum vitamin D levels was high (86.8%). The median vitamin D level in all patients was low (38 nmol/L), and was lower in young PWE than in adult PWE (<i>P</i><.01). Only 146 patients received vitamin D supplements. High vitamin D levels were associated with a 40% seizure reduction.</p><p><strong>Conclusion: </strong>Vitamin D deficiency is underestimated in PWE in Saudi Arabia, and is more prevalent among young adults and patients on polytherapy than in other PWE. Patients with high vitamin D levels had good seizure control compared with those with low levels. The effect of vitamin D supplements on seizure control should be further investigated in randomized control trials.</p><p><strong>Limitations: </strong>Retrospective study and no categorization by presence of supplementation.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 4","pages":"262-268"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/33/0256-4947.2022.262.PMC9357294.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9225580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of nutritional risk status assessment tools in predicting 30-day survival in critically ill COVID-19 pneumonia patients.","authors":"Umut Sabri Kasapoglu,&nbsp;Abdullah Gok,&nbsp;Leman Acun Delen,&nbsp;Ayse Belin Ozer","doi":"10.5144/0256-4947.2022.236","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.236","url":null,"abstract":"<p><strong>Background: </strong>Few clinical studies have addressed nutritional risk assessment in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU).</p><p><strong>Objectives: </strong>Assess the nutritional risk status of the critically ill COVID-19 pneumonia patients admitted to the ICU, and compare the nutritional risk screening tools.</p><p><strong>Design: </strong>Medical record review SETTING: Tertiary critical care unit PATIENTS AND METHODS: We included adult (age >18 years) PCR-confirmed critically ill COVID-19 pneumonia cases admitted to the ICU between August 2020 and September 2021. Scoring systems were used to assess COVID-19 severity and nutritional status (mNUTRIC: modified Nutrition Risk in Critically Ill, NRS2002: Nutritional Risk Screening 2002). The 30-day mortality prediction performance of nutritional scores and survival comparisons between clinical and demographic factors were assessed.</p><p><strong>Main outcome measures: </strong>Compare the nutrition risk tools SAMPLE SIZE: 281 patients with a mean (SD) age of 64.3 (13.3) years; 143 (50.8%) were 65 years and older.</p><p><strong>Results: </strong>The mean mNUTRIC score of the cases was 3.81 (1.66) and the mean NRS-2002 score was 3.21 (0.84.), and 101 (35.9%) were at high risk of malnutrition according to the mNUTRIC score and 229 (81.4%) according to the NRS 2002 score. In cases at high risk of malnutrition by the mNUTRIC score there was a greater need for invasive mechanical ventilation, vasopressors, and renal replacement therapy (<i>P</i><.001 for all comparisons). The mNUTRIC score was superior to the NRS-2002 score in estimating 30-day mortality. In patients who died within 30 days, the mNUTRIC score and NRS-2002 score on the day of hospitalization were significantly higher (<i>P</i><.001), and the proportion of patients with NRS-2002 score ≥3 and mNUTRIC score ≥5 was significantly higher in the non-surviving group (<i>P</i><.001). In addition, patients with a high risk of malnutrition had a shorter survival time. The mNUTRIC score was an independent and important prognostic factor for 30-day mortality, and patients with an mNUTRIC score ≥5 had a 6.26-fold risk for 30-day mortality in the multivariate Cox regression.</p><p><strong>Conclusion: </strong>One third of critical COVID-19 pneumonia cases hospitalized in the ICU due to acute respiratory failure have a high risk of malnutrition, and a high mNUTRIC score is associated with increased mortality.</p><p><strong>Limitations: </strong>Single center retrospective study.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"236-245"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/71/0256-4947.2022.236.PMC9357296.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40685671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman.","authors":"Rafie Alhassan,&nbsp;Noor Al Busaidi,&nbsp;Abdul Hakeem Al Rawahi,&nbsp;Hilal Al Musalhi,&nbsp;Ali Al Muqbali,&nbsp;Prakash Shanmugam,&nbsp;Fatma Ali Ramadhan","doi":"10.5144/0256-4947.2022.246","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.246","url":null,"abstract":"<p><strong>Background: </strong>Fine needle aspiration cytology (FNAC) of the thyroid has been a reliable and cost-effective method for diagnosing thyroid disorders. Since FNAC results are usually operator dependent, there is a compelling need to explore FNAC accuracy among Omanis.</p><p><strong>Objective: </strong>Describe cytological features of FNAC and assess FNAC accuracy compared to the postsurgical histopathology report.</p><p><strong>Design: </strong>Retrospective diagnostic accuracy study SETTING: Tertiary care center.</p><p><strong>Patients and methods: </strong>Our study included adult Omani adult patients with thyroid nodules who underwent FNAC from 2014 to 2017 and had final pathology results for patients who underwent thyroid surgery. The results were classified according to the UK Royal college of Pathologists 'Thy' categories. Accuracy of FNAC was calculated by determining false and true positive and negative results based on histopathology findings.</p><p><strong>Main outcome measures: </strong>FNAC accuracy (sensitivity and specificity) compared to the postsurgical histopathology.</p><p><strong>Sample size: </strong>867 patients with 1359 ultrasound guided FNACs of thyroid nodule; 137 underwent surgery.</p><p><strong>Results: </strong>The mean age of the 867 patients was 43.7 (13.3) years, with a median of 42 years, and 87.8% were females. Out of 1359 FNACs, 1001 (73.7%) were benign (Thy2), 119 (8.8%) were atypia of undetermined significance or follicular lesion of undetermined significance (Thy3a), 31 (2.3%) were follicular neoplasm or suspicious for a follicular neoplasm (Thy3f), 52 (3.8%) were suspicious for malignancy (Thy4), 55 (4%) were malignant (Thy5), 101 (7.4%) as Unsatisfactory (Thy1). Only 137 patients underwent thyroid surgery, and the FNAC reports were compared with their final histopathology reports. The sensitivity, specificity and total accuracy of FNAC were 80.2%, 98.9% and 89.9%, respectively. The positive and negative predictive values of FNAC were 98.6% and 84.3%, respectively.</p><p><strong>Conclusion: </strong>Our study findings confirmed that FNAC of the thyroid is a sensitive, specific, and accurate initial tool for the diagnosis of thyroid lesions. Most of the FNACs were benign with a very low malignancy rate. Due to the minimal chance of false negative results and the slow-growing nature of thyroid malignancy, it is important that patients with benign FNAC should have periodic clinical and radiological follow-up.</p><p><strong>Limitations: </strong>Retrospective design and single-center study, and thyroid nodule size unavailable.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"246-251"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/92/0256-4947.2022.246.PMC9357295.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40685669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome after single dose of ChAdOx1 vaccine against SARS-CoV-2 infection at 16 weeks post-vaccination among healthy adults in Saudi Arabia.","authors":"Ahlam Alghamdi,&nbsp;Nasser Alsanea,&nbsp;Mohammed Alraey,&nbsp;Mercy Joseph,&nbsp;Mohammed Aboud,&nbsp;Thamer Almangour,&nbsp;Wasaef Alharbi,&nbsp;Hind Alhumidan,&nbsp;Abdalrhman Alanizi,&nbsp;Ahmed Al-Jedai","doi":"10.5144/0256-4947.2022.223","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.223","url":null,"abstract":"<p><strong>Background: </strong>The rate of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination among young and healthy participants remains unclear in Saudi Arabia.</p><p><strong>Objectives: </strong>Assess the rate of subsequent infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination in a sample of healthy and young participants.</p><p><strong>Design: </strong>Cross-sectional study SETTING: Academic teaching hospital in Riyadh, Saudi Arabia SUBJECTS AND METHODS: Healthy participants 18-50 years of age, who received one dose of ChAdOx1 vaccine and had no history of SARS CoV-2 infection were recruited, and blood samples were obtained 16 weeks after vaccination to assess immunogenicity using a commercially available kit.</p><p><strong>Main outcome measures: </strong>The rate of SARS-CoV-2 infection within 16 weeks post-vaccination.</p><p><strong>Sample size: </strong>385 participants with median (IQR) age of 34 (29-38) years.</p><p><strong>Results: </strong>Eleven (2.8%) participants acquired polymerase chain reaction (PCR)-confirmed infection within 16 weeks after a single dose of ChAdOx1 vaccine (mean [SD] 42.5 [28] days post-vaccination). No hospital or intensive care unit admissions occurred among the subjects in this sample. Females were significantly over-represented in PCR-confirmed cases of SARS-CoV-2 infection, with 10 of 11 infections occurring in females (<i>P</i>=.006). Antibody response against anti-spike IgG were detectable in 92.7% of subjects at 16 weeks' post-vaccination. The median anti-spike IgG level after vaccination was 273.1 (IQR 107-1052 AU/mL). However, the anti-nucleocapsid IgG antibody demonstrated a sensitivity of only 20%.</p><p><strong>Conclusion: </strong>A single dose of ChAdOx1 vaccine in healthy and young individuals was associated with a low, single-digit rate of PCR-confirmed infection, most of which were mild.</p><p><strong>Limitations: </strong>Small sample size and single-center.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"223-228"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/55/0256-4947.2022.223.PMC9357300.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40686128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman.","authors":"Abdullah M Al Alawi,&nbsp;Ikhlas Al Busaidi,&nbsp;Emaad Al Shibli,&nbsp;Al-Reem Al-Senaidi,&nbsp;Shahd Al Manwari,&nbsp;Ibtisam Al Busaidi,&nbsp;Fatema Muhanna,&nbsp;Ahmed Al Qassabi","doi":"10.5144/0256-4947.2022.269","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.269","url":null,"abstract":"<p><strong>Background: </strong>Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.</p><p><strong>Objectives: </strong>Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.</p><p><strong>Design: </strong>Retrospective and survival analysis SETTING: Inpatient unit at a tertiary care referral hospital.</p><p><strong>Patients and methods: </strong>All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.</p><p><strong>Main outcome measures: </strong>Functional dependency and factors associated with mortality.</p><p><strong>Sample size and characteristics: </strong>110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.</p><p><strong>Results: </strong>Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.</p><p><strong>Conclusions: </strong>Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.</p><p><strong>Limitations: </strong>Retrospective at single center.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"269-275"},"PeriodicalIF":1.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/c3/0256-4947.2022.269.PMC9357299.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40685670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of patients with COVID-19 and inflammatory rheumatic diseases receiving biological/targeted therapy","authors":"Ö. Pehlivan, Tutku Aydin","doi":"10.5144/0256-4947.2022.155","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.155","url":null,"abstract":"BACKGROUND: Anti-cytokine treatments are used in the treatment of severe COVID-19. Other studies have shown statistical significance with TNF inhibitors but not with other biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD). OBJECTIVES: Compare the rate of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection and the course and incidence of COVID-19 infection in patients who received b/tsDMARD with control patients. DESIGN: Analytical cross-sectional SETTINGS: Tertiary care hospital PATIENTS AND METHODS: All patients who applied to the rheumatology outpatient clinic between June 2020-March 2021 and received b/tsDMARD were included in the study. All patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis who applied to the rheumatology outpatient clinic in the three months before March 2021 and did not receive b/tsDMARD were included as the control group. History of COVID-19 infection and treatments were recorded. Multivariate analysis was performed to assess factors associated with use of tumor necrosis factor (TNF) inhibitors and differences between specific biologic drugs. MAIN OUTCOME MEASURES: Rate of COVID-19 disease among patients using biological/targeted synthetic therapy and non-biological/targeted synthetic therapy. COVID-19 clinical outcomes (hospitalization, intensive care admission, mechanical ventilation and death). SAMPLE SIZE: 553 in total; 341 received b/tsDMARD, 212 in the control group that did not receive b/tsDMARD. RESULTS: One hundred patients (18%) had been infected with SARS-COV-2. The difference in SARS-COV-2 infection between b/tsDMARD and the control was statistically significant (13, 2% vs. 25, 9%, respectively) (P<.001). The hospital stays were longer in the controls (P<.001). Multinomial regression analysis revealed that COVID-19 negative patients were more likely to use tumor necrosis factor (TNF) inhibitors (OR: 2, 911; 95% CI: 1.727-4.908; P<.001) compared to COVID-19 positive participants. Multinomial logistic regression analysis indicated that non-hospitalized patients were more likely to use TNF inhibitors (OR: 11, 006; 95% CI: 3.447-35.138; P<.001) and there was no significant difference between b/tsDMARDs other than TNF inhibitors in frequency of hospitalization. CONCLUSIONS: Patients who were medicated with b/tsDMARD were less likely to be infected with COVID-19 and be hospitalized due to the infection. We have found that this effect was particularly dependent on the use of TNF inhibitors. LIMITATIONS: Conducted in a single center and unable to provide a homogeneous study population. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"155 - 164"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42655326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological pattern of endometrial biopsies in patients with abnormal uterine bleeding in a tertiary referral hospital in Jordan","authors":"E. Alshdaifat, Sami Saif El-Deen Al-Horani, M. Al-Sous, S. Al-Horani, Fernas Emile Sahawneh, A. Sindiani","doi":"10.5144/0256-4947.2022.204","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.204","url":null,"abstract":"BACKGROUND: Abnormal uterine bleeding (AUB) is a symptom that deviates from the normal menstrual cycle. AUB is characterized by changes in the frequency, volume, and duration of the menstrual flow. The etiology of AUB, which varies with age, may be attributed to both structural and non-structural causes. OBJECTIVES: Determine the histopathological pattern of endometrial biopsies in patients with AUB across different age and parity groups who have undergone dilation and curettage (D&C), along with the discrepancy between D&C and histopathological findings after hysterectomy. DESIGN: Retrospective chart review SETTING: Tertiary referral hospital PATIENTS AND METHODS: We collected data on all patients diagnosed with AUB between January 2015 and December 2020. Histopathological findings of all D&C endometrial biopsy samples were examined after being categorized by age and parity groups. Sensitivity, specificity, positive predictive value, and NPV were calculated to evaluate the diagnostic accuracy of D&C. MAIN OUTCOME MEASURES: Histopathological pattern of D&C endometrial biopsies by age and parity groups. SAMPLE SIZE: 3233 patients. RESULTS: Most patients were in the 18-39 year age group, with normal cyclical findings being the most common histopathological finding. Malignant lesions were observed in 42 patients with a majority being older than 50 years. In 13.3% (42/316) of patients, D&C failed to detect intrauterine disorder that was found on hysterectomy. The overall accuracy of D&C in determining the existence of normal versus pathological findings was 75.60%, the sensitivity was 72.90%, the specificity was 77.90%, the positive predictive value was 73.86% and the NPV was 77.05% in our patients. CONCLUSION: Normal cyclic changes account for the highest proportion of histopathological findings. However, hyperplasia and malignancies are important causes of perimenopausal and postmenopausal bleeding. While the use of D&C as a sampling tool for AUB cases remains questionable, the use of D&C in diagnosing premalignant and malignant cases is highly effective. LIMITATIONS: Single-center, retrospective design, incomplete medical records, and inter-rater reliability could not be determined. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"204 - 213"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49098111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal anesthesia versus combined sciatic nerve/lumbar plexus nerve block in elderly patients undergoing total hip arthroplasty: a retrospective study.","authors":"Mustafa Kaçmaz,&nbsp;Zeynep Yuksel Turhan","doi":"10.5144/0256-4947.2022.174","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.174","url":null,"abstract":"<p><strong>Background: </strong>The most important cause of mortality due to long bone fractures in the elderly patients are femoral fractures that require total hip arthroplasty (THA). THA surgeries may cause severe postoperative pain, long hospital stays, a need for transfusion and mortality.</p><p><strong>Objective: </strong>Compare outcomes of spinal anesthesia (SA) versus combined sciatic nerve/lumbar plexus block (CSLPB).</p><p><strong>Design: </strong>Retrospective cohort trıal.</p><p><strong>Setting: </strong>University hospital in Turkey.</p><p><strong>Patients and methods: </strong>We selected patients from the electronic medical records by date of surgery (most recent first) and compared demographic and pre- and postoperative clinical characteristics including the amount of opioid use within the first 48 postoperative hours, 30-day mortality rates, length of hospital stay, intraoperative oxygen saturation (SpO₂) and mean arterial pressure (MAP) values, duration of the surgery, and blood transfusion need.</p><p><strong>Main outcome measure: </strong>Opioid use within the first 48 postoperative hours.</p><p><strong>Sample size: </strong>204, 102 patients in each group with overall median (IQR) age of 82 (10.2) years.</p><p><strong>Results: </strong>There was no significant difference between the groups in terms of the amount of opioid use within the postoperative 48 hours, 30-day mortality rates, intensive care need, duration of the surgery, blood transfusion need, and length of hospital stay. While the intraoperative SpO₂ value was lower in the CSLPB group (<i>P</i>=.03), MAP values were lower in the SA group (<i>P</i>=.046). Preoperative American Society of Anesthesiology score (ASA) scores (<i>P</i>=.039) and the number of comorbidities were higher in the CSLPB group.</p><p><strong>Conclusion: </strong>We prefer CSLPB used with standardized sedation protocols for anesthesia in THA surgery in elderly patients.</p><p><strong>Limitations: </strong>Retrospective design and single-centered.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":" ","pages":"174-180"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/7c/0256-4947.2022.174.PMC9167455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40406836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematologic reference intervals for healthy adult Saudis in Riyadh","authors":"Salwa Bakr, A. Alfattani, R. Al-Nounou, N. Bakshi, H. Khogeer, Maha Alharbi, Nasser Almousa, Waleed S. Alomaim, Amelita M Aguilos, May Almashary, T. Owaidah","doi":"10.5144/0256-4947.2022.191","DOIUrl":"https://doi.org/10.5144/0256-4947.2022.191","url":null,"abstract":"BACKGROUND: Laboratory hematological tests are widely used in clinical practice to assess health and disease conditions. Reference ranges provided by laboratory reports are considered the most authoritative medical tools to assist in the decision-making phase. International standards institutes recommend that reference ranges be established for each region. OBJECTIVES: Provide reference values of routine hematological parameters in Saudi adults according to age and gender. DESIGN: Cross-sectional SETTING: Central province of Saudi Arabia. PATIENTS AND METHODS: Apparently healthy Saudi adults were subjected to laboratory testing of routine hematological parameters (full blood count, hemostatic profile, and serum hematinics), after completing a detailed health medical questionnaire. MAIN OUTCOME MEASURES: Hematological reference values based on the local population. SAMPLE SIZE AND CHARACTERISTICS: 637 after screening 827 potentially healthy Saudi adults with ages ranging from 15 to 65 years. RESULTS: The reference values of routine hematological parameters for the full population and by gender are presented with 90% CI as the lower and upper limits. Reference ranges mostly differed from universal established ranges shown in textbooks. CONCLUSION: The reference ranges of routine hematologic parameters for accurate assessment and appropriate management will help improve the routine clinical care of the adult Saudi population. LIMITATIONS: Difficulty in assessing health status of participants, who could have subclinical illnesses not reflected in the evaluated blood measurement. Lack of ability to eliminate individuals who might be carriers for haemoglobinopathies. Studies with larger sample sizes from different areas of the country are required to achieve a more accurate representation of the whole Saudi population. CONFLICT OF INTEREST: None.","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"42 1","pages":"191 - 203"},"PeriodicalIF":1.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48200710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}