Annals of Saudi medicine最新文献

{"title":"Effect of different patient positions on endotracheal tube cuff pressure in patients undergoing urological procedures: a prospective study.","authors":"Eda Tok, Nursen Karaca, Ozge Karakoc, Isik Alper","doi":"10.5144/0256-4947.2024.289","DOIUrl":"10.5144/0256-4947.2024.289","url":null,"abstract":"<p><strong>Background: </strong>The endotracheal tube (ETT) contains a cuff that is placed in the trachea to prevent gas leakage and aspiration of secretions and gastric contents. However, patient positioning after intubation may cause ETT displacement and changes in cuff pressure.</p><p><strong>Objectives: </strong>Evaluate the effect of different patient positions on ETT cuff pressure in patients undergoing urological procedures in supine, prone, lateral flank, and lithotomy positions.</p><p><strong>Design: </strong>Prospective and observational study.</p><p><strong>Setting: </strong>A university hospital in Turkey.</p><p><strong>Patients and methods: </strong>Patients who underwent surgeries under general anesthesia in different patient positions were involved. After intubation (T0), the cuff pressure was checked with a manometer and adjusted to 25 cmH₂O and continuously monitored. The cuff pressure was checked before (T1) and after achieving the final position (T2) and then at 5, (T3), 10, (T4), 15 minutes (T5) of the position, at the end of the procedure (T6) and before extubation (T7). At postoperative 2nd and 12th hours, the patients were interviewed for sore throat, hoarseness, and cough.</p><p><strong>Main outcome measures: </strong>The effect of different patient positions on the ETT cuff pressure.</p><p><strong>Sample si̇ze: </strong>200 patients.</p><p><strong>Results: </strong>The cuff pressure increased significantly at T2 in the lithotomy, lateral flank, and prone groups (<i>P</i><.001 each). The highest increase in cuff pressure occurred in the prone group (34.3 [7.5] cmH₂O). Over time, the cuff pressure decreased in all groups during surgery. Postoperative complications at the 2nd postoperative hour were similar in all groups; however, the mean cuff pressure was significantly higher in the patients with postoperative sore throat or cough (sore throat: <i>P</i>=.003; cough: <i>P</i>=.047).</p><p><strong>Conclusion: </strong>ETT cuff pressures are affected by different patient positioning; therefore, regular recording and adjustment of cuff pressure are necessary for patient safety.</p><p><strong>Limitation: </strong>We used ETT of a single manufacturer. Therefore, our findings may not be applicable to other types of ETT.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"289-295"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378689","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 of hyponatremia among medically hospitalized patients and associated outcomes: a retrospective cohort study.","authors":"Intisar Hamood Al Yaqoubi, Juhaina Salim Al-Maqbali, Afnan Ahmed Al Farsi, Rayan Khalfan Al Jabri, Saif Ahmed Khan, Abdullah M Al Alawi","doi":"10.5144/0256-4947.2024.339","DOIUrl":"10.5144/0256-4947.2024.339","url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia is a common electrolyte disturbance among hospitalized patients and is linked to increased mortality as well as poor outcomes.</p><p><strong>Objectives: </strong>Study the prevalence of hyponatremia among medically admitted patients and the outcomes associated with hyponatremia.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Medical ward at tertiary hospital setting.</p><p><strong>Patients and methods: </strong>The study included adult (≥18 years) hospitalized patients in general medical wards. Three readings of serum sodium level were taken (initial sodium level, nadir during admission, and before discharge).</p><p><strong>Sample size and basis: </strong>The sample size of 350 was determined based on a presumed 35% incidence of hyponatremia among hospitalized patients, with a 5% error margin.</p><p><strong>Main outcome measures: </strong>The prevalence of hyponatremia among medically hospitalized patients and association with health outcomes including length of hospital stay, inpatient mortality, 90-days readmission and 1-year mortality.</p><p><strong>Results: </strong>In this study, 736 patients met the inclusion criteria. Of these, 377 (51.2%) had hyponatremia on admission, increasing to 562 (76.35%) during hospitalization. Mild hyponatremia was observed in 49.6% (n=365), moderate in 13.6% (n=100), and severe in 13.2% (n=97). Severe hyponatremia patients were significantly older (<i>P</i><.01), predominantly female (<i>P</i>=.014), and had lower serum magnesium and albumin levels (<i>P</i><.01). Hypertension, ischemic heart disease, heart failure, and diabetes were more prevalent in severe hyponatremia cases (<i>P</i><.01, <i>P</i><.01, <i>P</i>=.045, <i>P</i><.01, respectively). Hospital stays were significantly shorter for patients with normal sodium levels (<i>P</i><.01). Patients with severe hyponatremia had a shorter time for first hospital readmission (HR=0.80, <i>P</i><.01 [95% CI; 0.69-0.94]).</p><p><strong>Conclusion: </strong>Hyponatremia was prevalent among medically hospitalized patients and more common among old patients, women, and patients with comorbidities. Hyponatremia was associated with increased length of stay in hospital and increased risk of 90-day re-admission.</p><p><strong>Limitations: </strong>Single-centre design and retrospective nature.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"339-348"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378694","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":"Evaluation of optic nerve sheath diameter in patients undergoing laparoscopic surgery in the Trendelenburg position: a prospective observational study.","authors":"Burak Ömür, Bahadır Çiftçi, Pelin Karaaslan","doi":"10.5144/0256-4947.2024.319","DOIUrl":"10.5144/0256-4947.2024.319","url":null,"abstract":"<p><strong>Background: </strong>The Trendelenburg position and pneumoperitoneum may cause cerebral edema and increased intracranial pressure. Non-invasive measurement of the diameter of the optic nerve sheath by ultrasonography can provide early recognition of intracranial pressure.</p><p><strong>Objective: </strong>Evaluate the optic nerve sheath diameter (ONSD) changes in patients who undergo laparoscopic surgery in the Trendelenburg position and make indirect conclusions about changes in intracranial pressure.</p><p><strong>Design: </strong>Prospective, observational.</p><p><strong>Setting: </strong>Laparoscopic surgeries.</p><p><strong>Patients and methods: </strong>Patients aged 18-75 years who underwent laparoscopic surgery in the Trendelenburg position under general anesthesia were included in our study. The ONSD was measured four times: Immediately after tracheal intubation, in the neutral position (baseline value) (T0), 10 minutes after pneumoperitoneum and Trendelenburg position (T1), 60 minutes after pneumoperitoneum and Trendelenburg position (T2), and 10 minutes after the pneumoperitoneum is terminated and placed in the neutral position (T3).</p><p><strong>Main outcome measures: </strong>Compare ONSD measured by ultrasonography at different times of surgery.</p><p><strong>Sample size: </strong>40.</p><p><strong>Results: </strong>Arterial carbon dioxide pressure increased with laparoscopy and Trendelenburg position in parallel with ONSD measurements and decreased again after returning to the neutral position. It was still higher than the baseline value at the T3. There was also a significant difference[a] between the measurement made at the T2 and the measurement made at T1. This difference showed that the prolongation of the Trendelenburg time was associated with an increase in ONSD. At the end of the operation it was observed that the decreased statistically significantly (T3) 10 minutes after the pneumoperitoneum was terminated and the position was corrected. However, the ONSD was still higher at the end of the operation (T3) compared to the baseline value measured at the beginning of the operation (T0).</p><p><strong>Conclusion: </strong>The ONSD increased in relation to Trendelenburg position and pneumoperitoneum. With these results, we think the ultrasonographic measurement of ONSD, a non-invasive method, can be used for clinical follow-up when performing laparoscopic surgery in the Trendelenburg position in cases requiring intracranial pressure monitoring.</p><p><strong>Limitations: </strong>There may be variations in the measurement of ONSD, even in the measurements of the same practitioner, as in all imaging with an ultrasonography device.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"319-328"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378691","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":"Estimating the prevalence of select non-communicable diseases in Saudi Arabia using a population-based sample: econometric analysis with natural language processing.","authors":"Suliman Alghnam, Mohammad Bosaeed, Abdulrahman Aljouie, Saeed Mastour Alshahrani, Omar Alshenqeety, Rifat Atun, Saleh Alqahtani","doi":"10.5144/0256-4947.2024.329","DOIUrl":"10.5144/0256-4947.2024.329","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases (NCDs) are a major public health challenge globally, including in Saudi Arabia. However, measuring the true extent of NCD prevalence has been hampered by a paucity of nationally representative epidemiological studies.</p><p><strong>Objectives: </strong>Assess the prevalence of selected NCDs, using population-based electronic health records and applying novel analytical methods to identify cases of NCDs.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>A large healthcare network in Saudi Arabia.</p><p><strong>Patients and methods: </strong>We included all beneficiaries aged 16 years or older (n=650 835[a]) and used the International Classification of Disease (ICD-10) codes, laboratory results, and associated medications to identify individuals with diabetes, obesity, hypertension, dyslipidemia, mental disorders, and injuries. For diabetes and hypertension, we used natural language processing (NLP) on clinical notes in the electronic health records. The prevalence of multimorbidity across age groups was also tabulated, and logistic regression was used to examine its association with glycemic control.</p><p><strong>Main outcome measures: </strong>The primary outcomes measured were the prevalence of diabetes, hypertension, and multimorbidity, and their association with glycemic control.</p><p><strong>Sample size: </strong>650 835 individuals aged 16 years or older.</p><p><strong>Results: </strong>The study population was relatively young, with 41.2% aged between 26 and 45 years, and around two-thirds were married. The prevalence of diabetes and hypertension was 18.5% (95% CI: 18.5-18.7) and 13.0% (95% CI: 12.9-13.1), respectively. Approximately 26.7% (95% CI: 26.7-26.8) of the population had multimorbidity, with levels increasing to 62.9% for those aged 65 or older. Multimorbidity was associated with a four-fold increase in the likelihood of poor glycemic control. NLP analysis suggested that the prevalence of diabetes or hypertension may be underestimated by no more than 1.5%.</p><p><strong>Conclusions: </strong>The study suggests a higher prevalence of NCDs than earlier national estimates. Electronic health records with regular analysis provide an opportunity to estimate changes in the prevalence of NCDs in Saudi Arabia. Health policies and interventions are needed to address the high levels of multimorbidity, which adversely impact glycemic control.</p><p><strong>Limitations: </strong>Retrospective design and reliance on electronic health records, which may not capture all cases of NCDs.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"329-338"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378690","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":"Predictors of medication regimen complexity and its impact on hemoglobin a1c in type 2 diabetes patients: a retrospective analysis in ambulatory care in Makkah City.","authors":"Sarah M Khayyat, Ruba S Azfr Ali, Hanadi H Alrammaal, Salwa M S Khayyat, Wafaa A Alqurashi, Reemaz Alsaedi, Wejdan Alotaibi, Aseel Alahmadi","doi":"10.5144/0256-4947.2024.296","DOIUrl":"10.5144/0256-4947.2024.296","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a widespread chronic disease that poses a significant management challenge due to the complexity of the associated medication regimens, which can have a considerable impact on patient outcomes.</p><p><strong>Objectives: </strong>Explore the complexity level of diabetes medications among patients with T2DM and to identify the predictors of medication regimen complexity (MRC) and its correlation with hemoglobin A1C (HbA1c) levels.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>An ambulatory care setting of a tertiary hospital in Makkah City, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Patients with T2DM referred to the diabetic clinic were identified and assessed for eligibility. The data were collected from patient electronic medical records between October 2022 and September 2023. The MRC Index was used to evaluate the complexity of the patients' medication regimens.</p><p><strong>Main outcomes measures: </strong>MRC index scores and HbA1c levels.</p><p><strong>Sample size: </strong>353 records of patients with T2DM.</p><p><strong>Results: </strong>The analysis revealed that 61.8% (n=218) of patients had high MRC, with the dosing frequency contributing significantly to their MRC (mean=3.9, SD=1.9). Having polypharmacy and longstanding T2DM were predictors of high MRC (odds ratios=4.9 and 2.6, respectively; <i>P</i>≤.01). Additionally, there was an inverse association between the patients' diabetes-specific MRC index scores and their glycemic control (odds ratios=0.2, <i>P</i><.001).</p><p><strong>Conclusion: </strong>The study findings highlight the importance of considering MRC in managing T2DM. Simplifying medication regimens and optimizing medication management strategies can improve patient outcomes. Further research is needed to explore interventions to reduce MRC and enhance diabetes management in this population.</p><p><strong>Limitations: </strong>Retrospective study design measuring the MRC at a diabetes-specific level.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 5","pages":"296-305"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11454975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378693","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":"Evaluating the effect of histopathological parameters of prostate adenocarcinoma on prognosis in radical prostatectomy specimens.","authors":"Ergün Tercan, O Uzcan Erbatu, Oktay Üçer, Sefa Metin, Nalan Ne E","doi":"10.5144/0256-4947.2024.234","DOIUrl":"10.5144/0256-4947.2024.234","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, significant updates have been made regarding the classification and grading of prostate adenocarcinoma in radical prostatectomy specimens, following decisions reached in international conferences and through impactful publications. These alterations are closely linked to patient prognosis.</p><p><strong>Objectives: </strong>Observe the incidence of these changes and their impact on patient prognosis. Additionally, investigate the relationship between histopathological and clinical parameters to assist in multidisciplinary treatment planning.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary university hospital.</p><p><strong>Methods: </strong>Hematoxylin and eosin, along with immunohistochemistry stained sections, were reevaluated, and clinical information, including patient demographics, preoperative PSA levels, and patient follow-up were collected from patients who underwent radical prostatectomy at our center.</p><p><strong>Sample size: </strong>182 patients.</p><p><strong>Main outcome measures: </strong>Biochemical recurrence.</p><p><strong>Results: </strong>The study highlighted the negative prognostic effects of factors such as Gleason grade group, lymphovascular invasion, intraductal carcinoma, positive surgical margins, extraprostatic extension, pathological T stage, and seminal vesicle invasion. These factors are important determinants of recurrence-free survival in prostate adenocarcinoma patients.</p><p><strong>Conclusion: </strong>This study identified comedonecrosis and intraductal carcinoma as independent negative prognostic factors. A 3-mm cutoff for positive surgical margins was supported, while the current cutoff for extraprostatic extension may require reevaluation. The impact of cribriform pattern and ductal carcinoma appears to be influenced by the grade group. No independent relationship was found between the Gleason score/pattern on positive surgical margins or extraprostatic extension and prognosis. Further, large-scale studies with long-term follow-up are needed.</p><p><strong>Limitations: </strong>The study is limited by the relatively small number of patients for certain parameters.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"234-248"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914840","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":"Assessing risk factors for complications in computer tomography-guided lung biopsy: quantitative analysis for predicting pneumothorax.","authors":"Jie Zhang, Jianli An, Xiuxiu Jing, Jingpeng Wu, Xioxia Zhang, Hongzhi Lu, Ye Tian","doi":"10.5144/0256-4947.2024.228","DOIUrl":"10.5144/0256-4947.2024.228","url":null,"abstract":"<p><strong>Background: </strong>Computer tomography (CT)-guided lung biopsy carries the risk of pneumothorax. A variety of other risk factors affect the occurrence of pneumothorax.</p><p><strong>Objective: </strong>Assess the incidence and risk factors associated with pneumothorax complications in CT-guided lung biopsy, and to conduct a quantitative analysis of the variables among the significant risk factors to identify more effective indicators for predicting pneumothorax complications.</p><p><strong>Design: </strong>Retrospective logistic.</p><p><strong>Setting: </strong>Single center in China.</p><p><strong>Patients and methods: </strong>From June 2017 to May 2021, consecutive patients who underwent CT-guided lung biopsy were identified from the medical record system. Binary logistic regression analysis was used to identify potential risk factors for pneumothorax. Receiver operating characteristic (ROC) curves were constructed for continuous variables to determine cutoff values that optimized sensitivity and specificity.</p><p><strong>Main outcome measures: </strong>The incidence and risk factors of pneumothorax in CT-guided lung biopsy.</p><p><strong>Sample size: </strong>132 patients.</p><p><strong>Results: </strong>The incidence of pneumothorax was 28.9% (38/132), with 6.8% (9/132) of patients requiring chest tube insertion. Results indicated that smaller lesion size (OR 0.724; 95% CI 0.619-0.848; <i>P</i>=.0001), longer needle tract length (OR 1.320; 95% CI 1.145-1.521; <i>P</i>=.001), multiple passes through the pleura (OR 4.618; 95% CI 1.378-15.467; <i>P</i>=.013), and needle tract length/lesion diameter (L/D) ratio (OR 0.028; 95% CI 0.002-0.732; <i>P</i>=.007) were independent risk factors for pneumothorax. ROC curve analysis determined a cut-off value of 0.81 for the L/D ratio (sensitivity=89.5%, specificity=71.3%). The area under the ROC curve (AUC) values of maximum diameter, needle tract length, and L/D ratio for pneumothorax were 0.749, 0.812, and 0.850, respectively.</p><p><strong>Conclusions: </strong>The L/D ratio, multiple passes through the pleura, longer needle tract length, and smaller lesions were independent risk factors for pneumothorax. A L/D ratio of less than 0.81 may indicate a pneumothorax. It may be necessary to use the proper sealing procedure for this patient group.</p><p><strong>Limitations: </strong>Due to its retrospective nature, there may be inherent selection bias.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"228-233"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914836","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":"Comparisons of the oncological results of transoral laser surgery and radiotherapy for early stage laryngeal squamous cell cancer: single-center long-term results.","authors":"Sumeyra Doluoglu, Omer Bayir, Bulent Ocal, Emel Cadalli Tatar, Mehmet Hakan Korkmaz, Guleser Saylam","doi":"10.5144/0256-4947.2024.213","DOIUrl":"10.5144/0256-4947.2024.213","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of early stage laryngeal cancers, surgery (transoral laryngeal surgery (TOLS), open partial laryngeal surgery (OPLS) and radiotherapy (RT) are used.</p><p><strong>Objectives: </strong>Compare the oncological results of patients with early stage laryngeal squamous cell carcinoma (LSCC) treated with TOLS or RT.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Tertiary training and research hospital.</p><p><strong>Patients and methods: </strong>The participants were divided into patients who underwent TOLS and RT treatment. The groups were compared with each other in terms of local recurrence, regional recurrence, distant metastasis, 3 and 5-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS) and laryngectomy-free survival rates (LFS).</p><p><strong>Main outcome measures: </strong>The effects of TOLS and RT treatment on local control, regional control, OS, DFS, DDS and LFS in early stage laryngeal cancers.</p><p><strong>Sample size: </strong>261.</p><p><strong>Results: </strong>The mean follow-up time was 48 (26) months. There were 186 patients who underwent TOLS and 75 patients who underwent RT treatment. Gender, cigarette/alcohol consumption, tumor localization, anterior commissure involvement, tumor grades, recurrence rates and recurrence localizations of the groups were similar. The 5-year overall, disease specific, disease free and laryngectomy-free survival rates were 85.9%, 88%, 79.4%, 96.3% in the TOLS group and 74.3%, 76.7%, 72.3%, 85.2% in the RT group (<i>P</i>=.034, .065, .269, .060, respectively).</p><p><strong>Conclusions: </strong>TOLS had equal and good oncological outcomes on OS and DFS compared to RT. Anterior commissure involvement was statistically significant independent prognostic risk factor for DFS in both groups. The 5-year OS rate was greater in the TOLS groups (<i>P</i>=.034).</p><p><strong>Limitations: </strong>Retrospective, but to the best our knowledge, this is the first study in Turkey with a high patient volume and a long follow-up time.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914837","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":"Efficacy and safety of autologous platelet-rich plasma in anal fistula: a systematic review and meta-analysis.","authors":"Yuanhui Xu, Lin Ma, Keliang Jia, Xiaoling Wu, Chang Ge","doi":"10.5144/0256-4947.2024.264","DOIUrl":"10.5144/0256-4947.2024.264","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the efficacy and safety of autologous PRP in anal fistula.</p><p><strong>Methods: </strong>The search was done in electronic databases such as; PubMed, Scopus, Google Scholar, Embase, and Cochrane Library. The outcomes investigated in this study were the rate of improvement, the rate of recurrence, and the rate of fecal incontinence.</p><p><strong>Results: </strong>Cure, incontinence, and recurrence rates were 68% (95% CI, .60-.76), 27% (95% CI, .12-.46), and 18% (95% CI, .12-.26), respectively. The pooled improvement ratio in patients treated with PRP compared to control group was 1.35 times, which was statistically significant (pooled OR=1.35, 95% CI, 1.14-1.60, <i>P</i><001). The pooled recurrence ratio in patients treated with PRP compared to control group was 1.17, which was not statistically significant (pooled OR=1.17, 95% CI, 0.44-3.11).</p><p><strong>Discussion: </strong>Platelet-rich plasma is an effective method of healing people with anal fistula.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"264-271"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914839","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":"The role of endocervical curettage in the diagnosis of cervical intraepithelial neoplasia in human papillomavirus positive patients.","authors":"Ibrahim Gulhan, Raziye Özdemir, Alper İleri, Hande İleri, Sena Özcan, Ayse Betül Öztürk, Mehmet Gökçü, Mehmet Özeren","doi":"10.5144/0256-4947.2024.220","DOIUrl":"10.5144/0256-4947.2024.220","url":null,"abstract":"<p><strong>Background: </strong>The role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia (CIN) is a controversial topic.</p><p><strong>Objectives: </strong>Investigate the role of ECC in the diagnosis of CIN in human papillomavirus (HPV) positive patients.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>A tertiary training and research hospital.</p><p><strong>Patients and methods: </strong>This study included patients who were referred for colposcopy between 2018-2022 because of abnormal screening results. ECC results, age, cytology, HPV status, and colposcopic impression of the patients were extracted from the medical records. Multinomial logistic regression analyses were performed to identify factors that could predict CIN on ECC.</p><p><strong>Main outcome and measures: </strong>The likelihood of high-grade squamous intraepithelial lesions (HSIL) in ECC in patients with cervical biopsy results of normal and low-grade squamous intraepithelial lesion (LSIL).</p><p><strong>Sample size: </strong>2895 women.</p><p><strong>Results: </strong>In patients with normal and LSIL cervical biopsy results, HSILs were detected in 6.7% of ECC results. There was no difference in the detection rates of CIN in ECC among groups with smear results negative for intraepithelial lesions or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US), and LSIL. The likelihood of HSIL being observed in ECC was 2.2 times higher in patients with HPV16. The probability of LSIL disanois was 2.3 times higher in women aged 50-59 years and 2.8 times higher in women ≥ 60 years compared to the reference group of <30 years. The probability of LSIL was 2.3 and HSIL by ECC was 2.2 times higher in both age categories (<i>P</i><.012 and <i>P</i>=.032, respectively) than the reference group of <30 years.</p><p><strong>Conclusion: </strong>Regardless of colposcopic findings, ECC should be performed in patients with smear results of NILM who are positive for HPV16, in patients with smear results of ASC-US and LSIL who are positive for any oncogenic type of HPV and in patients 50 and above with any result of smear or any oncogenic HPV type.</p><p><strong>Limitations: </strong>We did not have the components of the HPV types in mixed groups.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 4","pages":"220-227"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914842","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}