Annals of Saudi medicine最新文献

{"title":"Impact of the COVID-19 pandemic on the diagnosis, tumor characteristics, and survival outcomes of colorectal cancer: a retrospective cohort study.","authors":"Enver Yarikkaya, Merve Cin, Sena Ecin-Demezoglu, Beste Noyan-Mod, Mert Mahsuni Sevinc, Yakup Bozkaya, Nevra Dursun-Kepkep","doi":"10.5144/0256-4947.2025.169","DOIUrl":"10.5144/0256-4947.2025.169","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease (COVID-19) pandemic has significantly disrupted healthcare systems, delaying the diagnosis and treatment of various diseases, including colorectal cancer (CRC).</p><p><strong>Objectives: </strong>To determine differences in patient demographics, clinical and histopathological characteristics, and survival rates in patients diagnosed with CRC before and during the first year of the pandemic.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary-care center.</p><p><strong>Patients and methods: </strong>We included 284 patients newly diagnosed with CRC, stratified into two cohorts: those diagnosed one year before and during the first year of the pandemic. Patient demographics, tumor characteristics (diameter, location, histological type, grade, multifocality, invasion depth, lymphovascular and perineural invasion, number of metastatic lymph nodes, tumor budding, and deposits), and clinical factors (operability, presence of distant metastases, and survival status) were evaluated.</p><p><strong>Main outcome measures: </strong>Tumor stage at diagnosis, histopathological aggressiveness, and overall survival rates.</p><p><strong>Sample size: </strong>284 patients.</p><p><strong>Results: </strong>Patients diagnosed during the pandemic had a significantly higher incidence of distant metastasis (14.8% vs. 5.1%, <i>P</i>=.005), a greater proportion of pT4b stage tumors (12.9% vs. 0.6%, <i>P</i><.001), and a higher prevalence of rectosigmoid tumors (41.4% vs. 24.4%, <i>P</i>=.002). Additionally, tumor budding (63.6% vs. 47.3%, <i>P</i>=.014) and perineural invasion (35.2% vs. 24.5%, <i>P</i>=.053) were more common in the pandemic cohort. During the pandemic, significant shifts occurred in treatment modalities (<i>P</i>=.005), with increased utilization of neoadjuvant chemotherapy (18.8% vs. 11.5%), radiotherapy (22.7% vs. 12.2%), and palliative treatments (14.9% vs. 5.1%). Survival analysis showed no differences in survival rates between groups across all time points, including at three-year follow-up (<i>P</i>>.05).</p><p><strong>Conclusions: </strong>The COVID-19 pandemic has led to increased metastasis and advanced tumor rates in CRC cases, possibly owing to diagnostic delays. Although survival outcomes were similar between the periods, delayed effects on prognosis may manifest, necessitating long-term follow-up.</p><p><strong>Limitations: </strong>Retrospective design, single-center study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"169-176"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo surgery for persistent hyperinsulinemic hypoglycemia of infancy in the age of laparoscopic pancreatectomy.","authors":"Saud Alshanafey, Sarah Saud Almanea","doi":"10.5144/0256-4947.2025.165","DOIUrl":"10.5144/0256-4947.2025.165","url":null,"abstract":"<p><strong>Background: </strong>Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is a rare disease but the most common cause of persistent neonatal hypoglycemia, often requiring early pancreatectomy. In cases of persistent/relapsed hypoglycemia, redo surgery may be necessary.</p><p><strong>Objectives: </strong>We report our experience with the redo of laparoscopic pancreatectomy at a tertiary healthcare center.</p><p><strong>Design: </strong>Single-center, retrospective study.</p><p><strong>Setting: </strong>Tertiary health care center.</p><p><strong>Patients and methods: </strong>We conducted a retrospective review of the patients who underwent redo laparoscopic pancreatectomy between March 2004 and April 2021. Demographic, clinical, and follow-up data were collected and analyzed. Descriptive data were generated.</p><p><strong>Main outcome measures: </strong>Feasibility and safety of the procedure. Success in controlling the PHHI.</p><p><strong>Sample size: </strong>82 patients.</p><p><strong>Results: </strong>We managed 82 patients with PHHI by pancreatectomy, 11 of whom (6 boys and 5 girls) required redo procedures to control hypoglycemia, with 2 needing 2 redo procedures. The mean age during the redo procedure was 21 months. The redo procedures were performed at a mean duration of 15.5 months after the primary pancreatectomy. All patients exhibited the histologically diffuse type. The mean follow-up was 7 years. All cases were managed successfully after the redo procedures. Six patients were on medical treatment, 4 developed diabetes mellitus, and 1 became euglycemic). Two patients developed severe pancreatitis postoperatively, 1 required drainage of the infected collection and 1 developed thrombosis of the inferior vena cava, which was managed with anticoagulation medication.</p><p><strong>Conclusions: </strong>Redo laparoscopic pancreatectomy is feasible, safe, and effective option for managing persistent or recurrent hypoglycemia after primary pancreatectomy in diffuse PHHI. Sufficient experience with laparoscopic pancreatectomy is required for redo surgeries.</p><p><strong>Limitations: </strong>Retrospective design of the study may introduce bias.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indicators for early surgery in patients with intra-abdominal fistulizing Crohn's disease.","authors":"Ghada N Enani, Sarah S Al Ghamdi, Reem L Mimish, Ali Farsi, Nadeem Shafique Butt, Nouf Akeel","doi":"10.5144/0256-4947.2025.182","DOIUrl":"10.5144/0256-4947.2025.182","url":null,"abstract":"<p><strong>Background: </strong>The management of intra-abdominal fistulizing Crohn's disease involves surgical resection and biologic therapy. The criteria for choosing one therapy over the other are debated.</p><p><strong>Objectives: </strong>Identify factors influencing the choice of early surgical intervention over biologic therapy.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Single center, tertiary training and research hospital.</p><p><strong>Patients and methods: </strong>We analyzed adult patients with Crohn's disease who had intra-abdominal fistulas and were followed for three years. Baseline data were collected from medical records, and imaging studies assessed the fistula type, number, affected segment length, and presence of strictures and abscesses. Multivariable logistic regression analysis was used to identify predictors for surgical intervention.</p><p><strong>Main outcome measures: </strong>Factors that led to early surgical intervention in patients with intra-abdominal fistulizing Crohn's disease.</p><p><strong>Sample size: </strong>73 patients.</p><p><strong>Results: </strong>Seventy-three patients met the inclusion criteria: 27 (37.0%) in the nonsurgical group and 46 (63.0%) in the surgical group. Early surgical intervention was done if patients had bloating or constipation (<i>P</i>=.018), extensive disease segments (<i>P</i><.001), and no prior biologic treatment (0.015). In the multivariate analysis, early surgical intervention was indicated for enterocutaneous fistulas (odds ratio [OR]: 8.20, 95% confidence interval [CI]: 1.25-53.80, <i>P</i>=.03), abscesses (OR: 5.18, 95% CI: 1.03-26.12, <i>P</i>=.046), and strictures (OR: 6.08, 95% CI: 1.26-29.25, <i>P</i>=.024). Nonsurgical fistula treatment resulted in complications in 55% of patients, 48% of them requiring surgical resections, whereas biologic treatment achieved a 40.7% fistula healing rate.</p><p><strong>Conclusions: </strong>Findings associated with Crohn's fistulas, including enterocutaneous fistulas, extensive disease segments, strictures, and abscesses, are associated with a higher likelihood of early surgical intervention and may suggest potential ineffectiveness of biologic therapies.</p><p><strong>Limitations: </strong>This was a retrospective analysis of a single center with a small sample size, which may involve a degree of recall bias when data are collected, thus reducing the reliability of the results.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"182-189"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chromosomal abnormalities in couples with recurrent pregnancy loss: a 16-year cross-sectional study of 4030 cases from Turkey.","authors":"Sabri Aynaci, Sinem Kocagil, Esfun Tosumoglu, Ezgi Susam, Betul Kilic, Ebru Erzurumluoglu Gokalp, Oguz Cilingir, Beyhan Durak Aras, Basar Tekin, Sevilhan Artan","doi":"10.5144/0256-4947.2025.154","DOIUrl":"10.5144/0256-4947.2025.154","url":null,"abstract":"<p><strong>Background: </strong>Chromosomal abnormalities are a significant cause of miscarriages. Carriers of balanced chromosome rearrangement are often at risk of recurrent pregnancy loss (RPL), as they are more likely to produce gametes with unbalanced chromosome rearrangements.</p><p><strong>Objective: </strong>This study evaluated the chromosomal abnormalities detected in couples with history of primary recurrent pregnancy loss.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>Single center, tertiary healthcare center in Turkey.</p><p><strong>Patients and methods: </strong>This study reviewed conventional cytogenetic/molecular cytogenetic analysis data of 4030 patients (2015 couples) who visited the clinic from 2008-2024.</p><p><strong>Main outcome measures: </strong>Chromosomal abnormalities in patients diagnosed with primary recurrent pregnancy loss and genetic testing results of spontaneously achieved pregnancies in 16 patients with a balanced chromosomal rearrangement.</p><p><strong>Sample size: </strong>4030 individuals (2015 couples).</p><p><strong>Results: </strong>Majority of couples had a history of two spontaneous miscarriages (59.4%), followed by couples with 3 miscarriages (28.1%), 4 miscarriages (7.5%), and 5 or more miscarriages (4.91%). Chromosomal abnormality was detected in 133 (3.3%) cases. Among the revealed abnormalities, 130 (97.7%) were structural chromosome anomalies, while only 3 (2.3%) numerical chromosome anomalies were observed, including sex chromosome aneuploidy in 2 cases and mosaic karyotype in one case. Among the detected 130 structural chromosome abnormalities, reciprocal translocations (86 cases, 66.2%) were most frequently observed, followed by Robertsonian translocations in 26 cases (20.0%), inversion in 11 cases (8.5%), marker chromosome in 5 cases (3.8%), and derivative chromosomes in 2 cases (1.5%). Products of conception (conceptus materials) were analyzed from 16 spontaneously conceived pregnancies in individuals identified as carriers of chromosomal rearrangements. Although reciprocal translocations involving acrocentric chromosomes are typically expected to result in 3:1 meiotic segregation, adjacent-1 segregation was observed in two female individuals carrying the translocation t(9;15)(p22;q23). This finding is likely due to the limited genetic content of the translocated segments. Additionally, a novel complex three-way translocation, t(5;7;13)(p12;p12;p11), was identified for the first time.</p><p><strong>Conclusion: </strong>Cytogenetic and molecular analyses are crucial components in the etiological investigations of couples with RPL.</p><p><strong>Limitations: </strong>Retrospective design.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"154-164"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in pain management of sickle cell disease patients presenting with acute vasoocclusive crises: a multi-center retrospective study in Saudi Arabia.","authors":"Saif Musaad Aljuaed, Maan Khalid Jamjoom, Alaa Mohammed Althubaiti, Mohammed Eidhah Alsukhayri","doi":"10.5144/0256-4947.2025.190","DOIUrl":"10.5144/0256-4947.2025.190","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a chronic condition characterized by acute vaso-occlusive crisis (AVOC), which is the primary cause of emergency department (ED) visits for SCD patients. Despite recommendations for opioid use to manage AVOC pain, regional variations and biases in pain management persist, particularly in Saudi Arabia, where the prevalence of SCD varies by region.</p><p><strong>Objective: </strong>To identify national trends in pain management for AVOC in EDs across Saudi Arabia and analyze the duration and frequency of ED visits.</p><p><strong>Design: </strong>A multicenter retrospective cohort study.</p><p><strong>Settings: </strong>Multiple acute care centers in Saudi Arabia under the Ministry of National Guard Health Affairs, including EDs and urgent care centers in Riyadh, Jeddah, Al-Ahsa, Dhahran, and Medina.</p><p><strong>Patients and methods: </strong>A total of 421 SCD patients presenting with AVOC between 2016 and 2021 were included. Patients with other complications such as infections or acute chest syndrome were excluded. Data on patient demographics, ED visit frequency, length of stay, and medications administered were collected.</p><p><strong>Main outcome measures: </strong>The primary outcomes were the duration and frequency of ED visits and the types and frequency of analgesics administered.</p><p><strong>Sample size: </strong>The study included 421 patients accounting for 20 508 ED visits.</p><p><strong>Results: </strong>The average length of stay per ED visit was 4.7 hours. Morphine was the most frequently used opioid, administered to 86% of patients, while paracetamol was the most commonly used analgesic overall (93%). Regional differences were observed, with less opioid use in the Eastern region, where the disease is less severe due to haplotype variations. Ketamine was used in 13% of cases, predominantly in the Western region.</p><p><strong>Conclusions: </strong>The study highlights a diverse approach to AVOC management across Saudi Arabia, with variations influenced by regional differences and physician practices. Paracetamol and morphine were the primary analgesics, though disparities in opioid use suggest the need for standardized pain management protocols.</p><p><strong>Limitations: </strong>This study was limited to centers under one organization and excluded patients with coexisting conditions, which may limit generalizability.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"190-197"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary staging with 18F-FDG PET/CT in early breast cancer: impact of tumor subtypes.","authors":"Abdullah Gunes, Nuray Colapkulu-Akgul, Caner Akgul, Ibrahim Unlu, Saffet Cinar","doi":"10.5144/0256-4947.2025.145","DOIUrl":"10.5144/0256-4947.2025.145","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is one of the most common cancers in women globally. Axillary lymph node metastasis remains one of the most independent prognostic factors in breast cancer.</p><p><strong>Objective: </strong>Evaluate the diagnostic accuracy of 18F-FDG-PET/CT in detecting axillary lymph node metastasis based on immunohistochemical subtypes and its correlation with sentinel lymph node biopsy (SLNB) results.</p><p><strong>Design: </strong>A retrospective cohort.</p><p><strong>Setting: </strong>Tertiary oncology center in Turkiye.</p><p><strong>Patients and methods: </strong>Patients diagnosed with early-stage invasive ductal breast cancer and who underwent preoperative F-18 fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT) evaluation were included in the study. Patients were divided into five immunohistochemical subtypes: Luminal A, Luminal B HER2 (-) (human epidermal growth factor receptor 2), Luminal B HER2 (+), HER2 (+), and triple negative. SLNB and SUVmax (Maximum Standard Unit Value) results were compared.</p><p><strong>Main outcome measures: </strong>Diagnostic accuracy of 18F-FDG PET/CT for detecting axillary metastasis was the primary outcome. Interrater reliability testing in determining the agreement between 18F-FDG PET/CT and SLNB was the secondary outcome.</p><p><strong>Sample size: </strong>248.</p><p><strong>Results: </strong>The sensitivity, specificity, PPV, NPV and accuracy of 18F-FDG-PET/CT for detecting axillary metastasis were 62%, 92%, 88%, 71% and 77%, respectively. Cohen's Kappa coefficient (0.54) showed moderate agreement with SLNB (<i>P</i><.001). Tumors with positive HER2 gene amplification [HER2 (+) and Luminal B HER2 (+) have higher sensitivity than other subtypes (Luminal A, Luminal B HER2 (-) and triple negative). HER2 gene amplification also increases the agreement between 18F-FDG-PET/CT and SLNB results.</p><p><strong>Conclusion: </strong>18F-FDG-PET/CT has a high specificity but low sensitivity for ipsilateral axillary metastasis in invasive ductal carcinoma. The presence of HER2 gene amplification can increase sensitivity and concordance with SLNB.</p><p><strong>Limitations: </strong>Retrospective design and limited number of patients for each subtype.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"145-153"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric aerodigestive foreign bodies in the Qassim region: a retrospective study of epidemiology, clinical characteristics, and outcomes.","authors":"Mazyad M Alenezi, Sami H Alrashidi, Faisal A Al-Harbi, Turki A Al-Mutairi, Ziyad A Alsweed, Emad K Al-Oadah, Abdulaziz F Alharbi","doi":"10.5144/0256-4947.2025.177","DOIUrl":"10.5144/0256-4947.2025.177","url":null,"abstract":"<p><strong>Background: </strong>Aerodigestive foreign bodies (ADFBs) are a common pediatric emergency, often caused by tiny objects like toys, coins, seeds, and other foreign materials getting lodged in the airway during swallowing or breathing. Inadequate handling and delayed treatment could lead to potentially life-threatening complications. Understanding the symptoms and dangers associated with ADFBs is crucial in implementing preventative measures to reduce their occurrences.</p><p><strong>Objectives: </strong>The study aimed to evaluate the epidemiology, clinical characteristics, management strategies, and outcomes of pediatric patients with ADFBs in the Qassim region.</p><p><strong>Design: </strong>Single-center, retrospective study.</p><p><strong>Setting: </strong>Maternal and Children's Hospital, Qassim, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Retrospective data of pediatric patients (0-14 years) with confirmed ADFBs recorded over the past 5 years at Maternal and Children Hospital (MCH) in Buraidah, Saudi Arabia. Data was first cleaned and then analyzed using SPSS version 26 to obtain crucial insights.</p><p><strong>Main outcome measures: </strong>Common characteristics and management strategies of ADFBs in pediatric patients, including demographic factors, such as age and gender, the type and location of the foreign bodies, and the clinical presentation and outcomes following intervention.</p><p><strong>Sample size: </strong>149 patients.</p><p><strong>Results: </strong>Most patients were symptomatic 89 (59.7%) with frequent symptoms such as vomiting 38 (42.7%) followed by drooling 14 (15.7%) and cough 13 (14.6%). Most of the objects 122 (81.9%) were radiopaque, impacted in the upper esophagus above clavicle 90 (60.4%). The common foreign body type identified were coin 96 (64.4%); seeds 8 (5.4%) and battery 8 (5.4%). Most objects (91.94%) were visualized, and 76.5% were removed via endoscopy. Only 10 (6.7%) of the patients had complications with nearly one-third 3 (30.0%) of them presenting with erosion.</p><p><strong>Conclusion: </strong>Common foreign body types reported are coins, seeds, and batteries. Most objects impacted are radiopaque; with endoscopy commonly used in visualization and foreign body extraction from patients. The study highlights the need for increased awareness among caregivers regarding pediatric safety and the potential risks and complications associated with ADFBs. It recommends prompt action, including medical intervention and preventive measures, to reduce the incidence and risks of ADFBs.</p><p><strong>Limitation: </strong>Single-center and retrospective design limited the generalizability of the investigation.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"177-181"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of co-occurring functional seizure in patients with epilepsy at a tertiary care center in Makkah.","authors":"Amal Mohammed Alkhotani, Hanadi Abualela","doi":"10.5144/0256-4947.2025.198","DOIUrl":"10.5144/0256-4947.2025.198","url":null,"abstract":"<p><strong>Background: </strong>A functional seizure (FS) is a paroxysmal event that resembles epileptic seizures (ES) but without associated changes in cortical activity.</p><p><strong>Objective: </strong>To assess the prevalence of FS among ES patients admitted to the epilepsy monitoring unit (EMU) in King Abdullah Medical City (KAMC).</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>EMU at KAMC.</p><p><strong>Patients and methods: </strong>EMU database from 2015 to 2023 were reviewed. Patients were included in the study if they had a diagnosis of epilepsy and recorded seizure during admission.</p><p><strong>Main outcome measures: </strong>The prevalence and the predictors of FS developments among patients with ES.</p><p><strong>Sample size: </strong>198 patients.</p><p><strong>Results: </strong>The prevalence of FS was 10.6%. Significant risk factors associated with FS were income (18.6% vs 8.4% <i>P</i>=.048), focal epilepsy (66.7% vs 33.3% for generalized <i>P</i>=.004), frontal localization (38.5 versus 14.3% of temporal localization <i>P</i>=.041), on 5 antiseizure medications (ASMs) (75% versus 3% of on one ASM <i>P</i>=.001), receiving phenytoin (PHY) (46.2% vs other ASMs, <i>P</i>=.001), on psychiatric medications before EMU (29.4% vs. 8.8%) and those on the same medication after the EMU (35.6 % vs. 3.3%) (<i>P</i>=.008 and .001, respectively). Around 33.3% of FS cases had a major depressive disorder (MDD), 19% had a generalized anxiety disorder (GAD) and 14.3% were diagnosed with both MDD and GAD compared to without FS 4%, 2.3%, and 4.5%, respectively (<i>P</i>=.001). Multiple stepwise logistic regression analysis identified additional risk factors including male gender (odds ratio [OR] 3.0, 95% CI: 2.4-47.3; <i>P</i>=.048), shorter epilepsy duration (OR 0.8, 95% CI: 0.6-1.0; <i>P</i>=.046), history of head trauma (OR 5.5, 95% CI: 1.4-25.7; <i>P</i>=.047) and intellectual disability (OR 17.5, 95% CI: 1.4-39.2; <i>P</i>=.044).</p><p><strong>Conclusion: </strong>Patients with combined disorders are more likely to be male, shorter epilepsy duration, had salary income, focal epilepsy, frontal localization, history of head trauma, intellectual disability and be on higher ASMs, phenytoin as ASMs, depression, anxiety and more likely to be on psychiatric treatment.</p><p><strong>Limitations: </strong>The study was a retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 3","pages":"198-206"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiogram screening for school children: a cross-sectional, population-based study.","authors":"Ali A Alakhfash, Abdulrahman Al Mesned, Waleed Al-Manea, Abdulla Al Qwaee, Zuhair Nasser Al-Hassnan","doi":"10.5144/0256-4947.2025.69","DOIUrl":"10.5144/0256-4947.2025.69","url":null,"abstract":"<p><strong>Background: </strong>Identification of life-threatening arrhythmogenic disorders, which may present during infancy, childhood, or later stages, enables the early initiation of effective preventive therapies. Electrocardiogram (ECG) screening may detect conditions that elevate risk of sudden cardiac death (SCD) at an early stage.</p><p><strong>Objectives: </strong>This study aims to assess the prevalence, clinical significance, and characteristics of ECG abnormalities in a large population of schoolchildren. It also aims to determine whether ECGs performed during childhood can aid in the early detection of conditions associated with the risk of SCD.</p><p><strong>Design: </strong>Population-based cross-sectional study.</p><p><strong>Setting: </strong>A multicenter study conducted at King Faisal Specialist Hospital & Research Centre (KFSHRC) in Riyadh and Prince Sultan Cardiac Center-Qassim (PSCC-Q), Qassim, Saudi Arabia.</p><p><strong>Methods: </strong>The study analyzed 12-lead ECGs performed on elementary school students 6-15 years old in Buraidah, Qassim region, Saudi Arabia. ECGs were recorded and interpreted following international standards. Children with abnormal ECG results were referred for full pediatric cardiology evaluation.</p><p><strong>Main outcome measures: </strong>Prevalence of normal and abnormal ECG findings, including long QT intervals.</p><p><strong>Sample size: </strong>14 403 students.</p><p><strong>Results: </strong>During the study period, ECGs were performed on 14 403 students (53.8% females). The mean age was 9.5±1.9 years, and the mean weight was 32.1±16.1 kg. Abnormal ECGs were identified in 468 students (3.3%), 271 of whom had complete clinical evaluation, including repeat ECG and echocardiography. The most common ECG abnormality was a prolonged QTc interval. The overall prevalence of abnormal ECG findings ranged from 0.7% to 2.04%, with long QTc intervals (460 msec or more) found in 0.4% to 1.6% of students.</p><p><strong>Conclusions: </strong>Long QTc intervals (460 msec or more) were the most common ECG abnormality in school children, with an estimated prevalence of 0.4% to 1.6%. This study may serve as a model for large-scale, community-based, 12-lead ECG screening programs for children.</p><p><strong>Limitations: </strong>Causality cannot be derived given the design, the potential for false positive and false-negative results, and the lack of genetic studies for children with prolonged QT intervals.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"69-78"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between human herpesviruses and head and neck squamous cell carcinoma: a molecular perspective.","authors":"Merve Gürler, Mustafa Kürsat Gōkcan, Seher Yüksel, Zeynep Ceren Karahan","doi":"10.5144/0256-4947.2025.104","DOIUrl":"10.5144/0256-4947.2025.104","url":null,"abstract":"<p><strong>Background: </strong>Head and neck cancer (HNC) is the seventh most common malignant tumor. Herpesviruses are a significant risk factor in the multifactorial pathogenesis of HNC.</p><p><strong>Objectives: </strong>This study aimed to investigate the association between herpesviruses and the development of head and neck squamous cell carcinoma (HN-SCC).</p><p><strong>Design: </strong>Experimental study.</p><p><strong>Setting: </strong>A university hospital in Turkey.</p><p><strong>Patients and methods: </strong>Pathological archive tissue samples of 500 patients were included in the study. These samples were categorized into two groups: those diagnosed with HN-SCC (n=300, malignant group [MG]) and those diagnosed with benign head and neck lesions (n=200, benign group [BG]). The presence of herpesvirus in samples was detected using polymerase chain reaction.</p><p><strong>Main outcome measures: </strong>Association of herpesviruses in the development of head and neck cancer.</p><p><strong>Sample size: </strong>500 patients.</p><p><strong>Results: </strong>HHV-1, -2, -7, and -8 were not detected in any samples. In the malignant group (MG), EBV-DNA was detected in 1 patient (0.3%) and HHV-6 DNA in 2 patients (0.6%), while in the benign group (BG), VZV-DNA was detected in 1 patient (0.5%), EBV-DNA in 3 patients (1.5%), CMV-DNA in 5 patients (2.5%), and HHV-6 DNA in 3 patients (1.5%). While no significant difference was found between the groups for VZV, EBV, and HHV-6, a statistically significant difference was found in favor of the benign group for CMV.</p><p><strong>Conclusion: </strong>Although herpesvirus seroprevalence is relatively high in the population, the lack of viral genome in tissue samples indicates that other factors might be prominent in developing HN-SCC.</p><p><strong>Limitation: </strong>The storage conditions of the sample used (paraffinized sample) may have negatively affected the detection frequency of HHVs.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"104-111"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}