Annals of Saudi medicine最新文献

{"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":"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":"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":"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}

{"title":"Comorbidity of attention deficit hyperactivity disorder in young adults who had major depressive disorder.","authors":"Merve Yazıcı, Meltem Puşuroğlu","doi":"10.5144/0256-4947.2025.95","DOIUrl":"10.5144/0256-4947.2025.95","url":null,"abstract":"<p><strong>Background: </strong>The comorbidity of Major Depressive Disorder (MDD) and Attention Deficit Hyperactivity Disorder (ADHD) in adults is well recognized. The role of ADHD in the etiology of MDD, as well as the overlap of genetic and environmental factors between these two disorders, is an area of research. ADHD symptoms are considered risk factors for MDD.</p><p><strong>Objectives: </strong>The study aimed to examine the relationship between MDD in young adults with history of ADHD.</p><p><strong>Design: </strong>Retrospective and observational study.</p><p><strong>Settings: </strong>Outpatient clinic of a tertiary hospital.</p><p><strong>Patients and methods: </strong>Data of young adults diagnosed with MDD, aged 18-25 years and seen between January 2017 and May 2023, were included. Individuals with comorbidities other than ADHD in adulthood were excluded from the study. The sociodemographic and clinical data of a total of 489 cases, as well as data on childhood psychiatric referrals, diagnoses, and treatment histories, were retrospectively examined.</p><p><strong>Main outcome measures: </strong>ADHD diagnosis history and clinical impact in adults diagnosed with MDD.</p><p><strong>Sample size: </strong>489.</p><p><strong>Results: </strong>A total of 489 cases (68.9% female) with a mean age of 21.14 years were included in the study. It was determined that 8% of the cases had ADHD in adulthood, 13.3% in childhood, and 31.9% had at least one mental health diagnosis during childhood. The rate of ADHD diagnosis was significantly higher in males than females in both adulthood and childhood. Additionally, the age of diagnosis of MDD was lower in individuals with ADHD diagnosis and/or those who have discontinued ADHD treatment.</p><p><strong>Conclusions: </strong>In young adults diagnosed with MDD, the comorbidity of ADHD should also be considered. It is important to acknowledge that ADHD is not just a childhood disorder but a lifelong disorder due to its negative consequences, and to develop appropriate strategies in this regard.</p><p><strong>Limitati̇ons: </strong>Retrospective observational design and the single-center setting, which may affect the generalizability of the findings.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"95-103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797156","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":"Gastrointestinal safety of semaglutide and tirzepatide vs. placebo in obese individuals without diabetes: a systematic review and meta analysis.","authors":"Moaz Safwan, Mariam Safwan Bourgleh, Shahad Abdullah Alotaibi, Eman Alotaibi, Abdulsalam Al-Ruqi, Fathiya El Raeya","doi":"10.5144/0256-4947.2025.129","DOIUrl":"10.5144/0256-4947.2025.129","url":null,"abstract":"<p><strong>Introduction: </strong>Semaglutide and tirzepatide are newly approved glucagon-like peptide-1 receptor agonists for weight management in adults without diabetes. However, safety concerns regarding gastrointestinal (GI) adverse outcomes have been raised. This review comprehensively evaluates their GI safety profile in randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>Thirteen RCTs involving 26 894 obese participants without diabetes were analyzed. Pooled analysis assessed the risks for GI, biliary, hepatic, and pancreatic adverse events.</p><p><strong>Results: </strong>Overall GI adverse events were 1.86 times higher with *both* agents (95% CI=1.56, 2.21), with tirzepatide showing a greater risk (RR 2.94, 95% CI=2.61, 3.32) than semaglutide (RR 1.68, 95% CI=1.46, 1.94). Semaglutide increased gallbladder-related disorders, particularly cholelithiasis, by over 2.6 times (95% CI=1.40, 4.82), while tirzepatide showed no significant biliary risk. Neither agent significantly increased hepatic or pancreatic adverse events.</p><p><strong>Conclusion: </strong>Compared to placebo, both Semaglutide and tirzepatide are associated with increased GI adverse outcomes, with most cases being mild. Clinicians should carefully monitor patients for potential adverse outcomes.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"129-143"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based outcomes of obesity in critically ill patients: a retrospective cohort study.","authors":"Mohammed Alqahtani, Farhan Alenezi, Musharaf Sadat, Hani Tamim, Felwa Bin Humaid, Nahla Awadh Albaalharith, Yaseen Arabi","doi":"10.5144/0256-4947.2025.79","DOIUrl":"10.5144/0256-4947.2025.79","url":null,"abstract":"<p><strong>Background: </strong>Obesity is increasingly prevalent among critically ill patients, generally more common among females than males. Whether the patient's sex influences the outcome in these patients is unclear.</p><p><strong>Objective: </strong>Evaluate the outcomes of critically ill-patients with obesity admitted to the intensive care unit (ICU).</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>ICU of King Abdulaziz Medical City, Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>All obese patients aged more than 18 years admitted to ICU between 2002 to 2017 were included.</p><p><strong>Main outcome measures: </strong>The primary outcome was hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital lengths of stay, mechanical ventilation duration, renal replacement therapy, vasopressor use, and tracheostomy. A multivariable analysis was conducted to evaluate the association of sex differences with hospital mortality.</p><p><strong>Sample size: </strong>7277 patients.</p><p><strong>Results: </strong>Of the included patients with obesity, 3965 were females, and 3312 were males. The females were older, more likely to be admitted for medical reasons and less likely for trauma than males. The crude hospital mortality rate was significantly higher in females than males (1056 [26.7%] vs. 744 [22.5%], <i>P</i><.0001). Multivariable analysis demonstrated no association between sex and hospital mortality (OR: 1.05, 95% CI: 0.94, 1.19, <i>P</i>=.52). However, age (OR: 1.04; 95% CI: 1.01-1.02; <i>P</i><.0001), chronic liver disease (OR: 5.04; 95% CI: 4.19-6.06; <i>P</i><.0001), and chronic renal disease (OR: 2.19; 95% CI: 1.86-2.57;<i>P</i><.0001) were found to be associated with higher mortality while admission due to trauma showed lower mortality (OR: 0.69; 95% CI: 0.53-0.90; <i>P</i>=.007).</p><p><strong>Conclusion: </strong>Obese females admitted to ICU have a higher hospital crude mortality rate than obese males. This difference does not appear to be related to sex, but rather to older age, higher comorbid conditions, and more frequent admissions related to non-trauma reasons among females.</p><p><strong>Limitations: </strong>A single-center retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797179","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":"Errata.","authors":"","doi":"10.5144/0256-4947.2025.144","DOIUrl":"10.5144/0256-4947.2025.144","url":null,"abstract":"","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 2","pages":"144"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797165","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}