Annals of Saudi medicine最新文献

{"title":"Clinical features and disease severity across immune status in pediatric patients with COVID-19.","authors":"Nawaf Mohammed Al-Dajani, Mona Ahmed Bahasan, Maha Abdullah Alzubed, Rawan Ahmen AlSahafi, Ela Lutfallah Alturkistani, Nada Saleh AlZahrani","doi":"10.5144/0256-4947.2026.84","DOIUrl":"10.5144/0256-4947.2026.84","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic has caused a major global health disruption. Pediatric presentations vary widely, particularly among children with differing immune status.</p><p><strong>Objectives: </strong>To compare the clinical presentation, disease course, and outcomes of immunocompetent versus immunocompromised pediatric patients with COVID-19 in a tertiary referral hospital in Jeddah, Saudi Arabia.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Settings: </strong>A tertiary center treating immunocompromised children including those with HIV, solid and hematologic malignancies, and solid organ or hematopoietic stem cell transplantation.</p><p><strong>Patients and methods: </strong>Records of 123 pediatric patients (<15 years) with confirmed COVID-19 from March 2020 to March 2021 were reviewed. Demographic, clinical, laboratory, radiologic, and treatment variables were extracted and compared between immunocompetent and immunocompromised patients. Chi-square testing was used with significance set at <i>P</i><.05. Immunocompromised status was defined as the presence of an underlying medical condition or treatment associated with clinically significant immune suppression.</p><p><strong>Main outcome measures: </strong>Differences in symptoms, severity, clinical progression, and outcomes between immunocompetent and immunocompromised children.</p><p><strong>Sample size: </strong>123 children.</p><p><strong>Results: </strong>Most patients were immunocompetent (93, 75.6%). Immunocompromised children primarily included post-transplant or oncology patients on chemotherapy. Fever was the most common presenting symptom (69, 56.1%), significantly more common in immunocompetent children (<i>P</i>=.029). Immunocompromised children were more frequently admitted, mainly for non-COVID-related concerns (e.g., abnormal chest radiograph, febrile neutropenia, or hydration). Nearly all patients recovered without complications, and no significant difference in recovery rate was observed between groups (<i>P</i>=.568).</p><p><strong>Conclusion: </strong>COVID-19 severity and recovery appeared similar between immunocompetent and immunocompromised pediatric patients in this cohort. However, the higher hospitalization rate observed among immunocompromised children likely reflects precautionary admission practices rather than increased disease severity. Findings should be interpreted cautiously given the small immunocompromised subgroup and heterogeneity of underlying conditions. Interpretation of these findings is limited by the retrospective design and relatively small sample size. Larger multicenter studies are required to confirm these observations.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 2","pages":"84-93"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719233","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":"Complications of silicone airway stents in malignant and benign central airway stenosis: timing of complications and survival outcomes.","authors":"Ezgi Gürel Akan, Zafer Aktaş, Ayperi Merzi Öztürk, Aydın Yılmaz","doi":"10.5144/0256-4947.2026.104","DOIUrl":"10.5144/0256-4947.2026.104","url":null,"abstract":"<p><strong>Background: </strong>Silicone airway stents restore airway patency in central airway stenosis but may be complicated by migration, mucostasis, granulation tissue, and tumor overgrowth.</p><p><strong>Objective: </strong>To compare complication profiles, timing of complications, and survival outcomes after silicone airway stent placement in malignant versus benign central airway stenosis.</p><p><strong>Design: </strong>Retrospective comparative cohort study.</p><p><strong>Setting: </strong>Single center, tertiary referral interventional bronchoscopy unit in Ankara, Türkiye.</p><p><strong>Patients and methods: </strong>Consecutive adults who underwent silicone airway stent placement by rigid bronchoscopy between September 2012 and July 2017 were reviewed and analyzed.</p><p><strong>Main outcome measures: </strong>Complication distribution by etiology, time to first complication, complication-free survival, and stent survival.</p><p><strong>Sample size: </strong>80 patients (59 malignant, 21 benign).</p><p><strong>Results: </strong>Complications occurred in 48% of benign and 30% of malignant cases, with significant differences in complication profiles between groups (<i>P</i>=.003). Migration was the most frequent complication in benign stenosis, whereas stent-edge granulation predominated in malignant stenosis. In benign stenosis, median time to migration, mucostasis, and granulation was 17 days (interquartile range, 6-50), 135.5 days (63-140.5), and 206 days (103.8-354.5), respectively. In malignant stenosis, the corresponding times were 25.5 (21.3-29.8), 22 (21.3-22.0), and 89 days (57.5-181.5), while stent-margin tumor overgrowth was 105 days (78.5-174.5). Median complication-free survival was 500 days (95% CI, 353-857), with no significant difference between benign (701 days) and malignant (410 days) groups (<i>P</i>=.5138). Median stent survival was 578 days (95% CI, 351-956), also comparable between groups (351 vs 578 days; <i>P</i>=.9688).</p><p><strong>Conclusions: </strong>Silicone airway stenting is associated with distinct complication patterns and timing in benign and malignant central airway stenosis. These findings support structured post-stent bronchoscopic surveillance.</p><p><strong>Limitations: </strong>Retrospective single-center design, small benign subgroup, symptom-driven follow-up, and potential confounding and immortal-time bias in survival analyses.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 2","pages":"104-110"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719253","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":"Genetic analysis and clinical phenotype of pulmonary arterial hypertension in an Algerian population.","authors":"Amel Wafa Berkane, Rachida Yahiaoui, Nadéra Methia, Nassima Djami-Temim, Florence Coulet, Fabrice Antigny, David Montani, Zohra Hamouli-Said","doi":"10.5144/0256-4947.2026.111","DOIUrl":"10.5144/0256-4947.2026.111","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) involves progressive obstruction of small pulmonary vessels due to vascular remodeling. Although the genetic architecture of PAH is increasingly understood, it remains poorly characterized in Algeria due to limited studies and the absence of molecular diagnostic infrastructure.</p><p><strong>Objectives: </strong>To identify pathogenic variants in <i>BMPR2</i> and other PAH-related genes in Algerian patients, enabling targeted screening of high-risk individuals, refined classification of variants of uncertain significance (VUS), and early, personalized clinical management.</p><p><strong>Design: </strong>Cross-sectional study using targeted next-generation sequencing (NGS) of 15 PAH-associated genes.</p><p><strong>Setting: </strong>Multicenter (3 university hospitals in Algiers).</p><p><strong>Patients and methods: </strong>Thirty adults with confirmed pre-capillary PAH (Group 1) of unknown etiology, diagnosed according to clinical guidelines, and 30 age- and sex-matched healthy controls were enrolled. Peripheral blood was collected for genetic analysis, and pathogenic variants were identified using targeted NGS. IL-6 plasma levels were quantified by immunoassay.</p><p><strong>Main outcome measures: </strong>Contribution to the genetic characterization of PAH and potential implications for personalized clinical management.</p><p><strong>Sample size: </strong>30 patients and 30 controls.</p><p><strong>Results: </strong>Pathogenic variants were identified in 6 out of 30 patients (20%) involving <i>BMPR2, SOX17, TBX4, ATP13A3</i>, and <i>EIF2AK4</i>. Homozygosity for the <i>EIF2AK4</i> variant led to a revised diagnosis of Pulmonary Veno-Occlusive Disease/Pulmonary Capillary Hemangiomatosis (PVOD/PCH). Carriers of pathogenic variants were younger at diagnosis (30 vs. 49 years, <i>P</i>=.0115) and exhibited more severe hemodynamic profiles. Most patients (80%) were in New York Heart Association (NYHA) functional class III or IV. Mean pulmonary arterial pressure (mPAP) was 59 (45-64) vs. 46 (39.7-59) mmHg in patients without variants. IL-6 levels were significantly higher in patients than in controls (<i>P</i><.0001).</p><p><strong>Conclusion: </strong>This first genetic study in Algerian PAH patients highlights the relevance of genetic testing for diagnosis and management. The findings support the development of national genetic infrastructure and confirm the role of inflammation in PAH.</p><p><strong>Limitations: </strong>Modest sample size and the lack of family segregation data limited the assessment of Variant of Unknown Significance (VUS) and heritability.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 2","pages":"111-120"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719264","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":"Epidemiological patterns of acute respiratory illnesses in a tertiary center in Riyadh, Saudi Arabia.","authors":"Mohammed A Althomali, Nabiha Bouafia, Ibrahim Ali Balhareth, Suzan Salman AlHarbi, Khalaf H Alshammari, Reham Alwetishi, Majed S Al Alanazi, Souad M Alateah, Abdurahman Al Odayani, Naoufel Kaabia","doi":"10.5144/0256-4947.2026.94","DOIUrl":"10.5144/0256-4947.2026.94","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory illnesses (ARIs) are a major public health concern and are ranked by the World Health Organization among the leading causes of death worldwide.</p><p><strong>Objectives: </strong>To determine the positivity proportion, clinical presentation, and risk factors associated with major respiratory viruses, including Influenza A, Influenza B, respiratory syncytial virus <i>(</i>RSV<i>)</i>, and SARS-CoV-2.</p><p><strong>Design: </strong>Retrospective study conducted between October 2022 and March 2023.</p><p><strong>Settings: </strong>Single center tertiary hospital in Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Nasopharyngeal swabs (NPS) were collected from patients with ARI and tested for Influenza A<i>/B</i>, RSV, and SARS-CoV-2 using a multiplex polymerase chain reaction (PCR) panel, a molecular technique used to amplify DNA for detection and analysis. Patients were categorized into three groups based on the type of viral infection, and comparisons between groups were performed using chi-square or Fisher's exact tests for categorical variables to assess associations among viral infections.</p><p><strong>Main outcome measures: </strong>Epidemiological and clinical characteristics of patients with positive PCR results.</p><p><strong>Sample size: </strong>4526 patients with ARI underwent NPS for viral PCR screening.</p><p><strong>Results: </strong>Among study population, 537 (11.9%) patients tested positive for at least one of the targeted respiratory viruses. RSV was the predominant pathogen among pediatric patients (n=195, 62.2%), particularly in infants younger than six months. In adults, SARS-CoV-2 was most common (n=98, 44.1%), followed by Influenza A and B. RSV infection was significantly associated with lower respiratory tract involvement (<i>P</i><.0001), whereas SARS-CoV-2 and Influenza were more frequently linked to upper respiratory tract symptoms. The overall recovery rate was 98.8% (n=531), with a mortality rate of 1.2% (n=6).</p><p><strong>Conclusion: </strong>RSV, Influenza, and SARS-CoV-2 remain significant causes of ARIs in Riyadh, Saudi Arabia, showing distinct age and seasonal patterns. The results underscore the importance of targeted vaccination and strengthened surveillance to protect high-risk groups.</p><p><strong>Limitations: </strong>The study was limited by its single-center design and short six-month duration.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 2","pages":"94-103"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719221","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":"Beyond the ports: outcomes in uni-port vs. multi-port video assisted thoracoscopic surgery (VATS) lung resections.","authors":"Suha Kaaki, Lama Alzelfawi, Ebtesam Almajed, Saleh Husam Aldeligan, Bandar Alzaaidi, Ahmad Addas, Abdulaziz Nasser, Ashraf A Maghrabi","doi":"10.5144/0256-4947.2026.32","DOIUrl":"10.5144/0256-4947.2026.32","url":null,"abstract":"<p><strong>Background: </strong>Video-assisted thoracoscopic surgery (VATS) has become the preferred minimally invasive approach for thoracic surgical procedures, with potential advantages over traditional thoracotomy. Perioperative and long-term outcomes between uni-port (U-VATS) versus multi-port (M-VATS) techniques remains under investigation.</p><p><strong>Objectives: </strong>To compare U-VATS and M-VATS in terms of operative outcomes, complications, and oncological parameters.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single tertiary referral center, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>Adult patients aged 18-75 years who underwent VATS lung resection between January 2015 and September 2024 were included. Pediatric patients and those undergoing open techniques were excluded. Collected data included sociodemographic, preoperative, intraoperative, and postoperative variables. Statistical analysis used t-test, Mann-Whitney U, Chi-square, and multivariate logistic regression.</p><p><strong>Main outcome measures: </strong>Operative time, blood loss, lymph node dissection, postoperative complications, hospital stay, mortality, and recurrence.</p><p><strong>Sample size: </strong>194 patients (103 U-VATS, 91 M-VATS).</p><p><strong>Results: </strong>Baseline characteristics were similar between groups. U-VATS was associated with longer operative time, [mean (SD) 210.0 (110.4) vs. 154.2 (69.9) min, <i>P</i><.001] and greater blood loss [416.7 (392.2) vs. 150.0 (76.4) ml, <i>P</i>=.034]. Malignant lymph node involvement was higher in U-VATS (39.8% vs. 19.8%, <i>P</i>=.021), with more lymph node stations sampled. Anatomical resections were more common in U-VATS (31.1% vs. 13.2%, <i>P</i>=.005). Complication rates were low, with pneumonia (4.4%) as the most frequent in M-VATS and prolonged air leak (2.9%) in U-VATS. Thirty-day mortality was comparable (17.5% vs. 15.4%). Multivariate analysis showed M-VATS was associated with dissecting more lymph nodes (odds ratio, OR: 1.223; 95% confidence interval, CI: 1.019-1.468; <i>P</i>=.030), while anatomical resections were more likely with U-VATS (OR: 0.40; 95% CI: 0.180-0.740; <i>P</i>=.006).</p><p><strong>Conclusions: </strong>Both U-VATS and M-VATS are safe for lung resections. U-VATS is more commonly used for anatomical resections and allows broader lymph node station sampling, supporting its expanding role in thoracic surgery.</p><p><strong>Limitations: </strong>Single-center retrospective design, relatively small sample, and incomplete lymph node documentation.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013624","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":"Effectiveness of intercostal tube drainage versus other invasive approaches in initial management of pneumothorax in adults: a systematic review and meta-analysis.","authors":"Sultan Alsaigh, Feras Abu Reida, Maram Marzouq Almimoni, Mohammed Faisal Alnajm, Raghad Abdulaziz Alhojailan, Miad Alhamrani, Abdulmajeed Alharbi, Maram Mohammed Hassam Alwadai, Abdulhadi Jameel Alotaibi","doi":"10.5144/0256-4947.2026.61","DOIUrl":"10.5144/0256-4947.2026.61","url":null,"abstract":"<p><strong>Background: </strong>The comparative effectiveness of intercostal tube drainage (ITD) and less invasive methods in initial pneumothorax management remains uncertain.</p><p><strong>Objectives: </strong>To compare ITD with other invasive approaches in adults.</p><p><strong>Design: </strong>A systematic review and meta-analysis based on PRISMA guidelines, covering twelve studies from nine countries (Iran, UK, Netherlands, USA, Belgium, Kuwait, Norway, Pakistan, Switzerland) published between 1994 and 2021.</p><p><strong>Materials and methods: </strong>A comprehensive search was conducted in PubMed, and Google Scholar. The study encompassed randomized controlled trials (RCTs), prospective and retrospective analyses with adults presenting pneumothorax. Quality assessment was conducted using the Cochrane risk-of-bias (RoB 2) tool for randomized trials and the MINORS tool for non-randomized studies.</p><p><strong>Main outcome measures: </strong>Immediate success rates, hospital stay durations, complication rates, and recurrence rates at 12 months.</p><p><strong>Sample size: </strong>A total of 1204 patients were included across 12 studies, ten RCTs (n=932), one prospective (n=60) and one retrospective study (n=212).</p><p><strong>Results: </strong>Meta-analysis showed no statistically significant differences between the ITD and the less invasive techniques in the immediate success rate (OR: 0.88, 95% CI: 0.47-1.65, <i>P</i>=.69). Also, no difference was noticed in the 1-week success rate (OR: 1.01, 95% CI: 0.6-1.5, <i>P</i>=.96) and recurrence (OR: 1.20, 95% CI: 0.80-1.80, <i>P</i>=.38).</p><p><strong>Risk of bias: </strong>The RoB was low in 82% of studies assessed by RoB 2 and the study evaluated by MINORS demonstrated a moderate RoB.</p><p><strong>Heterogeneity: </strong>A high statistical heterogeneity was observed (I²=77%).</p><p><strong>Conclusions: </strong>ITD and other invasive approaches demonstrated comparable effectiveness, with no significant differences in immediate success, 1-week success, or recurrence rates.</p><p><strong>Limitations: </strong>The studies varied widely in design, patient groups, and quality. There were also signs of publication bias and a limited number of high-quality RCTs.</p><p><strong>Prospero registration number: </strong>CRD42024517888.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"61-74"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013691","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":"ANCA-associated vasculitis in the United Arab Emirates: a 17-year case series with review from Gulf literature.","authors":"Hala Shahrour, Neama Luqman, Fatima AlKindi, Mumtaz Khan, Shamma Ahmad Al Nokhatha","doi":"10.5144/0256-4947.2026.20","DOIUrl":"10.5144/0256-4947.2026.20","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare and severe autoimmune disease characterized by pauci-immune necrotizing vasculitis.</p><p><strong>Objectives: </strong>The study aims to explore the frequency, clinical characteristics, and management of AAV patients in two tertiary centers in the United Arab Emirates (UAE) over 17 years.</p><p><strong>Design: </strong>A retrospective observational case series.</p><p><strong>Setting: </strong>Two tertiary centers in the UAE.</p><p><strong>Methods: </strong>Patients diagnosed with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic granulomatosis with polyangiitis (EGPA) from 2008 to 2024 were included. Demographic, clinical, laboratory, histopathological information, treatment, complications, relapses, and mortality were collected. ANCA testing for anti-proteinase 3 (PR3) and anti-myeloperoxidase (MPO) antibodies was performed using enzyme-linked immunosorbent assays. Descriptive statistical analysis was performed to summarize the data.</p><p><strong>Main outcome measures: </strong>Subtype distribution, organ involvement, ANCA positivity, relapse, and mortality rates.</p><p><strong>Sample size: </strong>Twenty-six patients.</p><p><strong>Results: </strong>We identified 26 AAV patients with a median age of 52.5 years. The majority were females (58%, n=15), and half were locals. The most common AAV subtype was microscopic polyangiitis (50%, n=13), followed by granulomatosis with polyangiitis (38%, n=10) and eosinophilic granulomatosis with polyangiitis (12%, n=3). ANCAs tested positive in nearly all of these cases. The most common clinical manifestations of AAV were constitutional symptoms with renal and pulmonary involvement. The induction therapy included corticosteroids, rituximab, cyclophosphamide, mycophenolate mofetil, and plasma exchange. The most prescribed maintenance medications were corticosteroids and azathioprine. The overall relapse rate was 31%, and the overall mortality rate was 19% (n=5).</p><p><strong>Conclusion: </strong>In our cohort, MPA was the most common subtype, being predominantly associated with P-ANCA/MPO-ANCA positivity. Notably, few studies from the Gulf region have addressed this topic. It's unclear whether this finding reflects low occurrence or potential underdiagnosis and, thus, points to unmet needs and a significant gap in the understanding of AAV. Multicenter studies are needed to validate these results and improve AAV management in Middle Eastern populations.</p><p><strong>Limitations: </strong>Retrospective design with small number of participants.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"20-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013675","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":"Liver measurements on computed tomography: a guide for day-to-day practice in the Saudi population.","authors":"Nouran W Molla, Abdulrhman A Aleisa, Fawaz S Alhuqayl, Dareen W Aljohani, Yahya A Alghamdi, Khalid A Alghamdi, Osamah A Almayouf, Abdulmalik A Alduraibi","doi":"10.5144/0256-4947.2026.48","DOIUrl":"10.5144/0256-4947.2026.48","url":null,"abstract":"<p><strong>Background: </strong>Liver size can indicate the presence of liver diseases such as cirrhosis, hepatitis, and malignancy. Accurate assessment of liver span is essential for the early identification of liver pathologies.</p><p><strong>Objectives: </strong>The objective of this study is to establish a reference value for the average liver size of the Saudi population using abdominal computed tomography (CT) scans. A secondary objective of the study is to explore the correlations of demographic factors and comorbidities with liver size.</p><p><strong>Design: </strong>A retrospective cross-sectional study.</p><p><strong>Setting: </strong>Tertiary healthcare center in Riyadh, Saudi Arabia.</p><p><strong>Patients and methods: </strong>A retrospective cross-sectional analysis of liver span, liver width, and spleen span was performed. The maximum oblique craniocaudal (MaxCC) length and transverse width of the liver and maximum length of the spleen were obtained in coronal view. The demographic characteristics and comorbidities of patients were collected.</p><p><strong>Main outcome measures: </strong>Liver span, width, and spleen span of the study population. In addition to demographic characteristics and comorbidities that were correlates of larger liver size.</p><p><strong>Sample size: </strong>2500 adult patients who underwent CT scans for conditions unrelated to liver disease.</p><p><strong>Results: </strong>The mean (SD) liver span of the study population was 17.6 cm (2.4), while mean liver width was 18.9 cm (2.8). Multivariate analysis showed that a larger liver span was significantly correlated with increased age, height, a diagnosis of diabetes, as well as fatty liver and a larger BMI score.</p><p><strong>Conclusions: </strong>Measurement of the liver span using the MaxCC length and liver width is a simple method for routine clinical screening. The values established are useful in screening for liver disease that causes hepatomegaly and should therefore be used more frequently in a clinical setting in CT imaging.</p><p><strong>Limitations: </strong>Retrospective single-center design and reliance on CT-based diagnosis of fatty liver, which may not detect subclinical steatohepatitis.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013653","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":"Medical malpractice in pediatric surgery: an analysis of Supreme Court decisions involving physicians.","authors":"Nergül Çördük, Abdülkadir İzci, Ayse Kurtulus Dereli, Kemalettin Acar","doi":"10.5144/0256-4947.2026.1","DOIUrl":"10.5144/0256-4947.2026.1","url":null,"abstract":"<p><strong>Background: </strong>In pediatric surgical practice, physicians may face malpractice claims leading to substantial compensations and even criminal liability.</p><p><strong>Objectives: </strong>To examine the legal processes and responsibilities of physicians by reviewing Supreme Court decisions related to malpractice claims involving pediatric surgeons.</p><p><strong>Design and settings: </strong>A retrospective study based on the online archive of Supreme Court decisions.</p><p><strong>Patients and methods: </strong>A search was conducted using keywords from the Supreme Court decision search engine. Decisions were reached regarding malpractice claims involving pediatric surgery.</p><p><strong>Main outcomes measures: </strong>The medical procedure that was the subject of the malpractice claim, the resulting damage, the expertise of the physicians, and the reasons for the Supreme Court's reversal and approval were evaluated.</p><p><strong>Sample size: </strong>82 Supreme Court decisions.</p><p><strong>Results: </strong>Among 82 decisions, circumcision (46%; n=38) was the most common. Appendicitis and testicular torsion followed. Total/subtotal penile amputation was present in 40% (n=15) of circumcisions. Half of the appendicitis cases resulted in death, and all testicular torsion cases resulted in organ loss. General surgeons were the most frequent physicians involved in litigation, accounting for 16% of cases (n=13), followed by pediatric surgeons and general practitioners, each accounting for 15% of cases (n=12). Supreme Courts found physicians at fault in 35% of criminal cases and 38% of civil cases. Deficiencies in expert reports were the reason for reversals in 42% of the decisions.</p><p><strong>Conclusion: </strong>Supreme Courts conduct comprehensive evaluations in malpractice cases, considering factors such as indication, authority, fault status, complication management, and causal link. Physicians' understanding of these issues will significantly contribute to minimizing malpractice claims.</p><p><strong>Limitations: </strong>Retrospective study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013660","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":"Diagnostic yield of pre- versus post-biopsy bronchial washing in endobronchial cancer: Impact of procedural sequence.","authors":"Galbinur Abdullayev, Ahmet Ilgazli, Busra Yaprak Bayrak","doi":"10.5144/0256-4947.2026.54","DOIUrl":"10.5144/0256-4947.2026.54","url":null,"abstract":"<p><strong>Background: </strong>Fiberoptic bronchoscopy is a crucial diagnostic tool in the evaluation of lung cancer, particularly in tumors with endobronchial involvement. While forceps biopsy, bronchial brushing, and bronchial washing are commonly used, the diagnostic value and optimal timing of bronchial washing remain debatable.</p><p><strong>Objectives: </strong>To evaluate the effect of pre- and post-biopsy bronchial washing on cytological diagnostic yield in patients with visible endobronchial lesions.</p><p><strong>Design: </strong>Prospective diagnostic study.</p><p><strong>Settings: </strong>Single tertiary university hospital.</p><p><strong>Materials and methods: </strong>Between April 2018 and April 2021, 55 patients with bronchoscopically visible endobronchial lesions underwent flexible bronchoscopy. Patients with invisible or submucosal tumors were excluded. Bronchial washings were obtained before and after 4-6 forceps biopsies. Cytological analyses were conducted blindly on all specimens. Statistical analysis included Chi-square and McNemar tests, with <i>P</i><.05 considered significant.</p><p><strong>Main outcome measures: </strong>Cytological diagnostic positivity rates in pre- and post-biopsy bronchial washings.</p><p><strong>Sample size: </strong>Fifty-five patients.</p><p><strong>Results: </strong>Forceps biopsy alone achieved a diagnostic yield of 95%, which increased to 96% when combined with bronchial washing. Post-biopsy washing demonstrated a significantly higher cytological positivity rate (47%) than pre-biopsy washing (22%) (<i>P</i>=.002). No complications were observed.</p><p><strong>Conclusions: </strong>Bronchial washing after forceps biopsy significantly improves cytological diagnostic yield in endobronchial lung lesions. Its simplicity, low cost, and additional diagnostic yield support its routine use in bronchoscopic evaluation.</p><p><strong>Limitations: </strong>Single-center design and relatively small sample size; other cytologic methods such as brushing orendobronchial ultrasound (EBUS) were not evaluated.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"46 1","pages":"54-60"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013652","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}