Annals of Saudi medicine最新文献

{"title":"Nontraumatic headaches in the emergency department: identifying clinical associations and predictive warning signs of intracranial pathologies.","authors":"Abdulaziz M Alghamdi, Abdulkarim M Alghamdi, Yousof Fahad Allarakia, Arwa S Alghamdi, Abdulaziz S Alrashid, Abdulwhab M Alotaibi, Reem Addas, Ahmed I Lary","doi":"10.5144/0256-4947.2025.50","DOIUrl":"10.5144/0256-4947.2025.50","url":null,"abstract":"<p><strong>Background: </strong>Although headaches are common, only 3-21% are estimated to be secondary, with their causes ranging from non-alarming to life-threatening conditions.</p><p><strong>Objectives: </strong>Evaluate the associated factors and predictive warning signs of intracranial pathologies in patients presenting with nontraumatic headaches to the emergency document (ED).</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Settings: </strong>Medical center in Jeddah.</p><p><strong>Patients and methods: </strong>Data were collected from all patients who presented to the ED with nontraumatic headaches and underwent brain computed tomography (CT) scans from September 2021 to September 2022.</p><p><strong>Main outcome measures: </strong>The associated factors and predictive warning signs of intracranial pathologies.</p><p><strong>Sample size: </strong>387.</p><p><strong>Results: </strong>Sixty-seven (17.31%) patients had intracranial pathologies. The median (IQR) age of all patients was 49 (23) years and females constituted 61.8%. Patients with intracranial pathologies were significantly more likely to have severe headaches (59.7% vs. 33.7%, <i>P</i><.001), to have compressing or sharp headaches (16.4% vs. 6.2%, P=.003), to have constant headaches (16.4% vs. 7.8%, <i>P</i>=.003), to be on chemo-therapy or radiotherapy (10.5% vs. 2.8%, <i>P</i>=.004), and to be smokers (13.4% vs. 6.2%, <i>P</i>=.042) than the other group. Multiple logistic regression of headache warning signs revealed that significant changes or progression in pattern, frequency, or severity of headache (OR: 3.2, CI: 1.5-6.6, <i>P</i>=.001), motor deficits, including abnormal reflexes (OR: 2.9, CI: 1.2-6.9, <i>P</i>=.011), personality changes, confusion, memory impairment, drowsiness, slurred speech or loss of consciousness (OR: 2.6, CI: 1.4-5.0, <i>P</i>=.002), and sudden onset of headache (OR: 1.9, CI: 1.0-3.6, <i>P</i>=.046) were predictive of intracranial pathologies.</p><p><strong>Conclusions: </strong>Our findings suggest that these four headache warning signs can help physicians predict intracranial pathologies and subsequently decide which patients should undergo brain imaging in non-traumatic headache cases.</p><p><strong>Limitations: </strong>Single-center study and retrospective design.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"50-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392708","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 therapeutic effect of leucogen in treating alcoholic liver cirrhosis with thrombocytopenia or leukopenia.","authors":"Min Su, Mengwen He, Wu-Cai Yang, Jianjun Wang, Chang Guo, Yi-Ming Fu, Chun-Wang, Shuyao Li, Dong Ji, Hong-Yan Chen","doi":"10.5144/0256-4947.2025.9","DOIUrl":"10.5144/0256-4947.2025.9","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia and leukopenia are common complications of alcoholic liver cirrhosis (ALC) and are associated with an increased risk of bleeding, infection and mortality.</p><p><strong>Objectives: </strong>Evaluate the effectiveness and safety of leucogen, a cysteine derivative that increases platelet (PLT) and white blood cell (WBC) counts in ALC patients.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Setting: </strong>Department of hepatology, general hospital.</p><p><strong>Patients and methods: </strong>Patients with ALC who had thrombocytopenia and/or leukopenia were enrolled between 2022 and 2023 and were divided into two groups based on their treatment: the leucogen group (20 mg, three times per day) and the non-leucogen group.</p><p><strong>Main outcome measures: </strong>The primary endpoint was an increase in PLT or WBC of ≥5% from baseline.</p><p><strong>Sample size: </strong>413 patients (320 patients in the final analysis).</p><p><strong>Results: </strong>In this retrospective study, 320 patients were analyzed post-propensity score matching: 160 patients each in the leucogen and non-leucogen groups. Following 3 months of treatment, the leucogen group experienced a median increase in PLT levels of 1.0×10⁹/L versus a decrease of 3.0×10⁹/L in the non-leucogen group (<i>P</i>=.003), and a median increase in WBC counts of 0.1×10⁹/L compared to a decrease of 0.1×10⁹/L (<i>P</i>=.006). The changes in ALT, AST, and TBIL levels were not significantly different between groups. A higher proportion of patients in the leucogen group experienced increases in both PLT (46.9% vs. 32.5%, <i>P</i>=.012) and WBC counts (50.0% vs. 36.2%, <i>P</i>=.018), and 28.1% of patients in the leucogen group had increases in both parameters, compared to 15.6% in the non-leucogen group (<i>P</i>=.01). The leucogen group also demonstrated greater increases in PLT (OR 1.833; <i>P</i>=.009) and WBC counts (OR 1.759; <i>P</i>=.013) compared to the non-leucogen group. The safety profile of leucogen was favorable, with no significant adverse events reported. Leucogen was particularly beneficial for patients younger than 60 years and those with lower baseline ALT and AST levels, showing significant improvements in both PLT and WBC counts in these subgroups.</p><p><strong>Conclusions: </strong>Leucogen effectively increased PLT and WBC counts in patients with ALC, showing a favorable safety profile.</p><p><strong>Limitations: </strong>Retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392710","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 intra-abdominal injuries in patients referred to the emergency department as a result of traffic accidents.","authors":"Ahmet Münir Yılmaz, Enes Kalıntaş, Hatice Eylem Kömürcüler Yılmaz","doi":"10.5144/0256-4947.2025.1","DOIUrl":"10.5144/0256-4947.2025.1","url":null,"abstract":"<p><strong>Background: </strong>Traffic accidents are one of the most important reasons that increase the workload of emergency services all over the world. Especially in developing countries, this problem is difficult to solve due to rapid population growth.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the causes of mortality and morbidity, the organs affected by the injury, and the prognosis of the patients who are referred to the emergency department as a result of traffic accidents and underwent abdominal imaging.</p><p><strong>Design: </strong>Retrospective, cross-sectional study.</p><p><strong>Setting: </strong>A state hospital in Turkey.</p><p><strong>Patients and methods: </strong>1014 patients admitted to Gaziantep Abdulkadir Yüksel State Hospital between 15 July 2022 to 15 July 2023 due to traffic accidents and examined for abdominal trauma were retrospectively evaluated.</p><p><strong>Main outcome measures: </strong>Evaluation of patients admitted due to traffic accidents and examined for abdominal trauma.</p><p><strong>Sample size: </strong>1014 patients.</p><p><strong>Results: </strong>The mean age of the patients was 25.88 years, 79.6% were male, 67.3% were admitted to the hospital by ambulance, 47.4% were admitted as a result of a vehicular traffic accident, 34.3% were admitted as a result of a non-vehicular traffic accident, 18.2% were admitted as a result of a motorcycle accident and 36.4% were drivers, 35.3% were pedestrians and 28.3% were passengers. Intra-abdominal organ injuries were detected in 3.2% of all patients, including urinary system in 1%, hepatobiliary system in 0.9% and spleen in 0.8%. It was determined that 13% of the patients had life-threatening injuries and 40.2% had injuries that could not be treated with simple medical intervention.</p><p><strong>Conclusion: </strong>It was determined that 21% of the patients admitted to the emergency department as a result of traffic accidents required hospitalization or resulted in death. Prevention of traffic accidents, which especially threaten the young population, is of great importance both in reducing the workload in the emergency department and in minimizing labor and financial losses.</p><p><strong>Limitations: </strong>Since the study was based on retrospective file review, files with missing information were not included in the study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392679","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":"Timing of discharge of pediatric patients post cardiac catheterization.","authors":"Ali A Alakhfash, Abdulrahman A Al Mesned, Abdulla M Al Qwaiee, Naser Kolko, Zainab Alnakhli","doi":"10.5144/0256-4947.2025.40","DOIUrl":"10.5144/0256-4947.2025.40","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Same-day discharge after cardiac catheterization may be safe for some patients. This study aimed to review our experience with same-day discharge after pediatric cardiac catheterization following the implementation of a fast-track protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Evaluate the feasibility of same-day discharge after pediatric cardiac catheterization and identify risk factors for prolonged hospital stay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Pediatric cardiology department.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;Data from patients who underwent cardiac catheterization were recorded over 17 months, from January 2022 to May 2023, focusing on pediatric cardiac catheterization procedures, including demographics, clinical, echocardiographic, catheterization data, and outcomes. Criteria were set to determine the possibility of same-day discharge post-cardiac catheterization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was the length of hospital stay post-cardiac catheterization. Secondary outcomes included identifying risk factors for prolonged hospital stay (more than 12 hours) and any associated complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Sample size: &lt;/strong&gt;300 patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 300 patients, 201 (67%) were discharged on the same day (with less than 12 hours' hospital stay), and 57 patients (19%) stayed overnight. The median length of stay (LOS) after pediatric cardiac catheterization was 8.7 hours (25th percentile: 7.5 hours, 75th percentile: 23.8 hours). No complications were reported in patients discharged on the same day. The majority of procedures were interventional cardiac catheterizations (242 cases, 80.7%), with most patients (166 cases, 55.3%) discharged on the same day of the procedure. The most common age group was between 3 to 6 months (114 patients, 38%). Regression analysis revealed that cardiac catheterization in neonates and infants less than 3 months old, more complex interventions such as patent ductus arteriosus stenting and right ventricular outflow tract stenting, interventions in the aortic valve, and the occurrence of complications were associated with prolonged hospital stay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Same-day discharge following catheterization is feasible for the majority of pediatric patients and can contribute to reduced healthcare costs and improved patient satisfaction. We developed a fast-track protocol for assessing the timing of discharge after pediatric cardiac catheterization, outlining potential indications and contraindications for same-day discharge. Factors associated with prolonged hospital stays include interventions in the neonatal period and procedure-related complications. Careful patient selection and monitoring impleare essential to ensure optimal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The retrospective nature of the study and the single-center experience","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"40-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392711","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":"Application of digital slide scanning in external quality assessment program on intestinal parasites.","authors":"Vien Tien Nguyen, Phuc Thi Diem Huynh, Phuong Thi Be Nguyen, Dang Ngoc Tran, Vien Truong Nguyen, Dat Quoc Ngo, Chuon Van Le","doi":"10.5144/0256-4947.2024.369","DOIUrl":"10.5144/0256-4947.2024.369","url":null,"abstract":"<p><strong>Background: </strong>Intestinal parasitic infections remain prevalent in Viet Nam. Therefore, ensuring quality assurance in intestinal parasite testing is crucial for screening laboratories. The challenges associated with liquid or glass slide samples necessitate the exploration of digital slide applications, which can offer numerous benefits to program suppliers and participants.</p><p><strong>Objectives: </strong>Compare the true and concordance rates of digital and glass slides for diagnosis.</p><p><strong>Design: </strong>Experimental research design.</p><p><strong>Materials and methods: </strong>In total, 30 medical professionals from 30 hospitals participated in the trial. The sets of slides encompassed a range of densities, including negative and coinfected slides. Seven types of glass slides were selected for scanning and digital slide production.</p><p><strong>Main outcome measures: </strong>The primary outcomes were true and concordance variables. Secondary outcomes included time sample sending and time completion. The digital slides were uploaded to a secure website for participant access while glass slides were sent individually by mail. Data collection involved participants analyzing specimens and reporting their results using a scoring method based on parasite detection and identification accuracy.</p><p><strong>Sample size: </strong>210 glass and digital slide-reading results each.</p><p><strong>Results: </strong>The mean true rate between original and glass slides diagnosis was 97.6% (range 90.0%-100%), and it slightly increased to 98.1% (range 90.0%-100%) when using digital slides. The average concordance diagnosis rate between glass and digital slides was 99.5%. Importantly, there were no differences in the diagnostic results between glass and digital slides. The findings revealed that the use of digital slides reduced the total time required by approximately 1.1 days compared with that of glass slides.</p><p><strong>Conclusion: </strong>Altogether, the application of digital slides in the external quality assessment program for intestinal parasites offers convenience for users through online platforms and saves operational time process.</p><p><strong>Limitations: </strong>The small sample size in this experimental study limited the statistical significance of the comparisons.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"369-376"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803943","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":"Advanced trauma life support training outcomes in Saudi Arabia: a four-year multicenter analysis of influential characteristics and factors (2019-2023).","authors":"Fayez G Aldarsouni, Hani Alkhulaiwi, Hosam Alruwaite, Shara Alsubaie, Faye Abdulkareem, Norah Alsuabie","doi":"10.5144/0256-4947.2024.394","DOIUrl":"10.5144/0256-4947.2024.394","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of trauma necessitates effective training for healthcare providers in Saudi Arabia. The Advanced Trauma Life Support (ATLS) program is pivotal, yet localized success rate data are lacking.</p><p><strong>Objectives: </strong>Determine the failure rate and identify factors influencing ATLS course success rates among physicianss in Saudi Arabia.</p><p><strong>Design: </strong>A retrospective cohort.</p><p><strong>Setting: </strong>Two major accredited ATLS training centers in Riyadh.</p><p><strong>Patients and methods: </strong>Participants who completed ATLS training at the Trauma Courses Office at the Ministry of National Guard Health Affairs from January 2019 to December 2020, and at the Clinical Skills and Simulation Center at King Saud University Medical City from December 2020 through January 2023. Particpitants were grouped as interns and all physicians other than interns, for the purpose of analysis.</p><p><strong>Main outcome measures: </strong>Success and failure rates were the primary outcomes, with failure identified as a score of less than 75% or below standard performance in the practical session.</p><p><strong>Sample size: </strong>603.</p><p><strong>Results: </strong>The overall failure rate for the ATLS courses was 36.6%. Analysis revealed age, pre-test scores, and attendance at a refresher course as significant predictors of success. Specifically, general practitioners and OMFS specialists had a higher odds of failing, while general surgeons and trauma-related specialties consultants were more likely to succeed.</p><p><strong>Conclusion: </strong>ATLS course failure is notably high, with specific specialties and levels demonstrating increased risk. Results indicate a need for tailored pre-course preparation and an extension of the course duration for less experienced participants to improve proficiency, especially for at-risk groups.</p><p><strong>Limitations: </strong>Retrospective design and other variables, such as emotional status, level of instructors, and level of motivation.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"394-407"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803861","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":"Prospective evaluation of serum and peritoneal fluid markers as indicators of postoperative complications in patients with enteric anastomosis.","authors":"Mladen Kasalović, Božidar Odalović, Lazar Mihajlović, Stefan Jakovljević, Zlatan Elek, Gojko Igrutinović, Milena Anđelković, Mirjana Pajčin","doi":"10.5144/0256-4947.2024.422","DOIUrl":"10.5144/0256-4947.2024.422","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications of colorectal cancer surgery contribute to increased morbidity and mortality in patients.</p><p><strong>Objectives: </strong>Investigate the role of biochemical markers in serum and peritoneal fluid in the development of postoperative complications in patients with enteral anastomosis.</p><p><strong>Design: </strong>Prospective.</p><p><strong>Setting: </strong>University hospitals.</p><p><strong>Patients and methods: </strong>The studied population consisted of patients who underwent surgical treatment with created anastomosis or Hartmann's resection from April 2022 to April 2024, conducted at the Clinical-Hospital Center Kosovska Mitrovica and the University Clinical Center Kragujevac. Spearman's correlation coefficient (r_s) was used to test associations between categorical variables.</p><p><strong>Main outcome measures: </strong>Lactate, albumin, lactate dehydrogenase, and IgA antibodies were monitored as predictors of anastomotic dehiscence and general postoperative complications.</p><p><strong>Sample size: </strong>52.</p><p><strong>Results: </strong>The concentration of lactate in the drain fluid on the third postoperative day was statistically significantly higher in patients who did not develop anastomotic dehiscence (<i>P</i>=.006). The concentration of IgA antibodies in the drain fluid on the third and fifth days post-surgery showed a moderate negative correlation with lactate concentration (r_s=-.670, <i>P</i>=.012; r_s=-.577, <i>P</i>=.039), repectively. There was a significantly higher concentration of albumin in the drain fluid on the third day post-surgery in patients who developed dehiscence (<i>P</i>=.040), and on the seventh day post-surgery in those who did not develop dehiscence (<i>P</i>=.001). The concentration of LDH on the third day in the drain fluid after surgery was statistically significantly higher in patients who did not develop dehiscence (<i>P</i>=.020). There was a statistically significant difference in lactate concentration in the drain fluid on the third (<i>P</i><.001) and fifth days (<i>P</i>=.041) post-surgery, as well as in albumin concentration on the third day post-surgery (<i>P</i>=.024) with respect to the development of general postoperative complications.</p><p><strong>Conclusion: </strong>This study revealed significant differences in the concentrations of lactate, albumin, and LDH in the drain fluid on the third and fifth days post-surgery with respect to the development of complications. These results suggest that monitoring these markers may help in the early identification of patients at risk of complications such as dehiscence.</p><p><strong>Limitations: </strong>Limited literature on specific aspects of this study, including the absence of a control group, small sample size, and two-center study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"422-434"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803993","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":"Hepatitis A virus infection and seroprevalence, Istanbul, Turkey, 2020-2023.","authors":"Mehmet Karabey, Sema Alacam, Nuran Karabulut, Hayriye Uysal, Alper Gunduz, Ozlem Altuntas Aydina","doi":"10.5144/0256-4947.2024.386","DOIUrl":"10.5144/0256-4947.2024.386","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatitis A infections continue to be a major global public health problem. The epidemiology and seroprevalence of hepatitis A virus (HAV) have important public health implications. This study aimed to retrospectively examine the hepatitis A cases and hepatitis A seroprevalence in our region in our hospital with the highest number of inpatient and outpatient cases in Istanbul.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Determination of hepatitis A cases and seroprevalence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Tertiary care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;A total of 39 385 individuals who were tested for Anti-HAV IgM and Anti-HAV Total (IgM+IgG) antibodies between May 2020 and September 2023 and were included in this study. Hepatitis A specific IgM and Total (IgM+IgG) antibodies were determined using the enzyme-linked immunosorbent assay method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measure: &lt;/strong&gt;Hepatitis A seroprevalence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Sample size: &lt;/strong&gt;46 721.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included a total of 46 721 samples from 39 385 individuals who were tested for hepatitis A serology. The median age of the 39385 individuals included in the study was 28 (interquartile range [IQR]; 22-46), with 58.74% being female and 4.07% (n=1163) being foreign nationals. Reactivity was detected in 91 of the 25 442 patients tested for HAV-IgM. Among these patients, 33 (0.13%) had acute hepatitis A infection, while 58 (0.23%) were considered false positives. Of the acute hepatitis A patients, 13 (0.09%) were women, and 22 (0.80%) were children. Acute hepatitis A was most commonly observed in the 6-9 and 15-18 age groups, with 7 cases each. The seroprevalence rate of hepatitis A was 67.23% among 33 683 individuals. Of those tested for HAV-Total, 13 132 (64.92%) were women, and 2533 (64.88%) were children. The lowest seroprevalence rate among age groups (35.91%) was in the 15-18 age year range, while the highest seroprevalence (98.34%) was detected in individuals aged 60 years and above.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;With a seroprevalence rate of 67.23%, our region is still considered a medium-endemic area for hepatitis A, and it is crucial to continue administering the HAV vaccine as currently included in the childhood vaccination schedule in our country. Additionally, the significantly low hepatitis A seropositivity, particularly in the 15-18 and 19-24 age groups, indicates the need to promote catch-up vaccination for young adults. Since our study covers a large population, it can serve as a guide regarding the serological status of hepatitis A in Istanbul.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Since vaccination information for the study population was not available, it was not possible to distinguish between seropositivity due to vaccination or natural immunity. Despite being conducted in Istanbul, a cosmopolitan city, and in the largest city hospital, the results ma","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"386-393"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803986","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":"Feasibility, safety, and outcome of fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia at a low case-load center: one center's experience.","authors":"Saud Alshanafey, Wesam I Kurdi, Maha Tulbah, Rubina Ma Khan, Nada Al Sahan, Maisoon Al Mugbel, Fahad Al-Hazzani, Gawaher Almutairi, Ala Jebreel, Maha Al-Nemer","doi":"10.5144/0256-4947.2024.408","DOIUrl":"10.5144/0256-4947.2024.408","url":null,"abstract":"<p><strong>Background: </strong>Antenatal fetoscopic endoluminal tracheal occlusion (FETO) has been introduced as an effective intervention to improve the outcome of severe congenital diaphragmatic hernia (CDH).</p><p><strong>Objective: </strong>We report our early experience with FETO.</p><p><strong>Design: </strong>A retrospective chart review of case series.</p><p><strong>Setting: </strong>Tertiary health care center.</p><p><strong>Patients and methods: </strong>18-45 years old, with single fetuses diagnosed with left severe CDH (lung-head ratio <1 measured between 27-29 weeks of gestational age (GA) and liver up or observed/expected lung-to-head ratio <25%, normal echocardiogram and karyotype were included. FETO was performed between 28-30 weeks of gestation and removed after 4-6 weeks or at birth during an ex utero intrapartum treatment (EXIT) procedure.</p><p><strong>Main outcome measures: </strong>FETO represents a viable option for severe type of CDH fetuses with reasonable outcomes. FETO performance in low volume centers may be feasible with reasonable outcomes. Good outcome of postnatal care with no potential antenatal complications may affect FETO adoption in some societies.</p><p><strong>Sample size: </strong>5.</p><p><strong>Results: </strong>14 pregnant women were referred for assessment and only 7 met the inclusion criteria. Two were excluded initially (late referral and spouse refusal) and a 3rd excluded later due to failure of FETO due to faulty balloons. The median age of the mothers was 28 years and the gestational age was 29 weeks. Median observed/expected lung-to-head ratio was 23%. Among patients who had successful FETO, one had the balloon removed fetoscopically 4 weeks after insertion and one was removed 8 weeks after insertion during an elective EXIT procedure and both have survived. The other two had premature labor after 1 and 5 weeks after FETO and balloon removed during an emergency EXIT procedures, and both died within 24 hours of birth.</p><p><strong>Conclusion: </strong>FETO represents a viable option for severe type of CDH fetuses with reasonable outcome. FETO performance in a low volume centers may be feasible with reasonable outcomes. Good outcome of postnatal care with no potential antenatal complications may affect FETO adoption in some societies.</p><p><strong>Limitations: </strong>Retrospective nature of the study may imply inaccuracy, but we believe data from electronic medical records is highly accurate.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"408-413"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803980","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 semaglutide: real-world tertiary care experience from Saudi Arabia.","authors":"Muhammad Imran Butt, Khalid Mania Alkhalifah, Muhammad Riazuddin, Saud Mohammed Almuammar, Salman Mohammed Almuammar, Ghayda Abdulkader Alhifthi, Fahad Wali Ahmed, Samia Mohamed Al Hashim, Najeeb Waheed","doi":"10.5144/0256-4947.2024.361","DOIUrl":"10.5144/0256-4947.2024.361","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide, a glucagon-like peptide-1, is an effective antidiabetic drug promoting weight loss and providing cardiovascular protection. The original trials did not include participants from Saudi Arabia; hence, the study's findings are expected to be useful.</p><p><strong>Objectives: </strong>Explore the efficacy, safety, and favorable effects of once-weekly subcutaneous semaglutide (1 mg) in patients with type 2 diabetes and those who received it as an off-license prescription without having diabetes.</p><p><strong>Design: </strong>Retrospective review of medical records.</p><p><strong>Setting: </strong>Department of medicine at our institution.</p><p><strong>Patients and methods: </strong>This retrospective observational study evaluated patients receiving the glucagon-like peptide-1 analog semaglutide, with the trade name Ozempic. The weight, height, body mass index, blood pressure, and laboratory data, including serum creatinine and hemoglobin A1c (HbA1c) levels and urine albumin/creatinine ratio, were recorded. Moreover, any history of medical comorbidities, such as cardiovascular diseases, cerebrovascular diseases, and heart failure, was documented before and after drug administration.</p><p><strong>Main outcome measures: </strong>Glycemic and weight loss efficacy.</p><p><strong>Sample size: </strong>1007 patients.</p><p><strong>Results: </strong>The median age of the patients was 57.0 years, comprising 60.28% females. Among them, 955 and 442 patients received the medication for at least 3 and 6 months, respectively. Our results show a 4.4% weight loss and 0.4% improvement in HBA1c in patients with diabetes. Similar results were observed in the patients without diabetes in terms of weight along with a significant decrease in diastolic blood pressure. Our results also show stability in the serum creatinine and urine albumin creatinine ratio. The drug was equally effective in males and females.</p><p><strong>Conclusion: </strong>Treatment with once-weekly subcutaneous semaglutide (1 mg) led to clinically significant weight loss and improved HbA1c level and cardiometabolic risk factors such as blood pressure.</p><p><strong>Limitations: </strong>Retrospective design.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"44 6","pages":"361-368"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803903","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}