Annals of Saudi medicine最新文献

{"title":"Rebound pain after interscalene brachial plexus block for shoulder surgery: a randomized clinical trial of the effect of different multimodal analgesia regimens.","authors":"Tayfun Et, Betul Basaran, Aysegul Bilge, Rafet Yarımoğlu, Muhammet Korkusuz, İbrahim Tülüce","doi":"10.5144/0256-4947.2023.339","DOIUrl":"10.5144/0256-4947.2023.339","url":null,"abstract":"<p><strong>Background: </strong>Rebound pain is characterized by sudden, significant acute postoperative pain occurring after the resolution of inter-scalene block (ISB); it affects the quality of recovery postoperatively. Dexamethasone increases ISB resolution time and decreases opioid consumption and the incidence of rebound pain.</p><p><strong>Objective: </strong>Evaluate whether multimodal analgesia including intravenous dexamethasone administration with preoperative ISB reduces the incidence of rebound pain.</p><p><strong>Design: </strong>Prospective, randomized, controlled trial.</p><p><strong>Setting: </strong>Tertiary university hospital.</p><p><strong>Sample size: </strong>60 patients.</p><p><strong>Patients and methods: </strong>Patients who underwent shoulder surgery under general anesthesia were assigned randomly to two different multimodal analgesia protocols. Thirty patients received 5 mg IV dexamethasone with non-steroid, paracetamol, and ISB with 15 mL 0.5% bupivacaine, while the control patients received the same regimen and ISB with 15 mL 0.5% bupivacaine without dexamethasone. Postoperative opioids were given to any patient on demand.</p><p><strong>Main outcomes measures: </strong>Effect of IV dexamethasone on pain score and incidence of rebound pain after ISB resolution and postoperative opioid consumption at 0-48 hours, numerical pain rating scale (NPRS) scores, sleep scale scores, and quality of recovery-15 scores (QoR-15).</p><p><strong>Results: </strong>The incidence of rebound pain was lower in the dexamethasone group than in the control group (73.3% and 30%, respectively, <i>P</i>=.001). NPRS scores after ISB resolution were lower in the dexamethasone group (5 ([4-7]), 8 ([5.75-8]), <i>P</i><.001, respectively). Those who received IV dexamethasone had less sleep disturbances (<i>P</i><.001) and higher QoR-15 on day 1 (<i>P</i><.001) and day 7 (<i>P</i>=.020) postoperatively.</p><p><strong>Conclusions: </strong>IV dexamethasone added to the ISB block resulted in a lower incidence of rebound pain. In addition, better results were obtained in postoperative sleep quality and QoR-15.</p><p><strong>Limitations: </strong>Single-center study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 6","pages":"339-347"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11182429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801525","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":"Transanal minimally invasive surgery for benign and malignant rectal lesions: midterm outcomes from a tertiary center.","authors":"Mahmood Al-Dhaheri, Fajer Al-Ishaq, Ali Toffaha, Mohamed Abu Nada, Amjad Parvaiz, Mohamed Kurer","doi":"10.5144/0256-4947.2023.348","DOIUrl":"10.5144/0256-4947.2023.348","url":null,"abstract":"<p><strong>Background: </strong>Although transanal minimally invasive surgery (TAMIS) for rectal neoplasia has gained wide acceptance, the mid-term and long-term outcomes are not widely reported in the literature.</p><p><strong>Objective: </strong>Describe the mid-term outcomes of patients who underwent TAMIS for benign and malignant rectal lesions in a single center.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Tertiary referral center.</p><p><strong>Patients and methods: </strong>Demographic, clinical, and oncological outcomes of patients who underwent TAMIS between January 2015 and December 2022 were prospectively collected. The indication for TAMIS was based on the National Comprehensive Cancer Network guidelines. The follow up for the cancer patients included clinical examination, tumor markers every 6 months and MRI rectum at the end of one year. In addition, colonoscopy and CT scan at years one and three and a final CT scan and colonoscopy at year five.</p><p><strong>Main outcome measures: </strong>Mid-term oncological and clinical outcome.</p><p><strong>Results: </strong>Thirty elective TAMIS procedures included adenocarcinoma for 33.3% (n=10) of the patients, 20% (n=6) neuroendocrine tumor and the 40% (n=12) were adenomatous lesions. Negative resection margins were achieved in all malignant lesions. Perioperative complications occurred in 2 patients (6.6%), one patient had breaching into the peritoneal cavity, and postoperative hypotension occurred in another patient. The median follow-up time was 23 months (range: 5-72 months). Two patients with adenoma and positive margins developed recurrent adenoma (6.6%) and one patient with initial polypectomy biopsy of adenocarcinoma, had TAMIS with histopathology of adenoma and distant metastasis had developed.</p><p><strong>Conclusions: </strong>TAMIS for local excision of rectal neoplasia is a valid option with favorable mid-term outcomes provided there is adherence to careful selection criteria.</p><p><strong>Limitations: </strong>Retrospective nature and small number of the patients.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 6","pages":"348-351"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11182431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801657","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":"Selective anterior annuloplasty during inguinal herniotomy in boys: an approach to further reduce hernia recurrence.","authors":"Ayman Aljazaeri, Raghad AlKhashan, Razan Naif AlRabah, Sadem Al Zayed, Sara Al-Jazaeri","doi":"10.5144/0256-4947.2023.277","DOIUrl":"10.5144/0256-4947.2023.277","url":null,"abstract":"<p><strong>Background: </strong>Hernia recurrence is one of the most common complications after inguinal herniotomy (IH) in children. We describe a novel approach that involves adding anterior annuloplasty (AAP) during IH for selective high recurrence-risk children.</p><p><strong>Objectives: </strong>Evaluate the initial safety and effectiveness of selective AAP during IH in boys.</p><p><strong>Design: </strong>Retrospective SETTING: Tertiary care center.</p><p><strong>Patients and methods: </strong>The study included boys younger than 15 who were selected to undergo either IH with or without AAP between January 2011 and January 2022. The preoperative recurrence risks were compared for the two groups. Cases who underwent other forms of hernia repair were excluded.</p><p><strong>Main outcome measures: </strong>The frequency of recurrence and other postoperative complications and the distribution of high recurrence-risks.</p><p><strong>Sample size: </strong>315 boys; 143 underwent IH and AAP, while 172 had IH only.</p><p><strong>Results: </strong>Among all the cases, only one recurrence was reported (0.3%). Other complications were hydrocele in 29 (9.2%), scrotal hematoma/inflammation in 9 (2.9%), and wound infection in 8 (2.6%), which resolved spontaneously in all cases. Compared to IH only, those selected for an additional AAP were significantly younger (3 [16%] vs. 12 [46%] months, <i>P</i>=.038) and more likely to be premature (35 [24.5%] vs. 15 [8.7%], <i>P</i><.0001), frequently had extensive cremasteric adhesions (39.2% versus 3.5%, <i>P</i><.0001) and had a higher rate of incarcerated hernia at presentation (6.3% versus 1.2%, <i>P</i>=.026). The high-recurrence risk group was almost twice as likely to be selected for an additional AAP compared to the low-risk group (143 vs. 75, <i>P</i><.0001).</p><p><strong>Conclusion: </strong>Adding simple AAP to conventional hernia repair for high-recurrence risk boys can be a safe and effective step to reduce the overall risk of recurrence without increasing the incidence of other postoperative complications.</p><p><strong>Limitations: </strong>The study lacked a control group of patients to whom selective AAP would not be offered despite a high-recurrence risk. A prospective, controlled trial with a longer follow-up would lead to a stronger conclusion.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/c2/0256-4947.2023.277.PMC10560372.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41157700","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":"Experience with direct-acting antivirals in genotype 1-5 infected chronic hepatitis C patients in Turkey.","authors":"Ahmet Sahin,&nbsp;Ozlem Akay","doi":"10.5144/0256-4947.2023.308","DOIUrl":"10.5144/0256-4947.2023.308","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C virus (HCV) can cause chronic liver disease, hepatic cirrhosis, hepatocellular carcinoma, liver transplantation, and death. Early diagnosis and treatment are thus vital.</p><p><strong>Objectives: </strong>We aimed to investigate the sustained virological response (SVR) rates in chronic hepatitis C patients infected with different genotypes, receiving different direct-acting antiviral treatments (DAAs).</p><p><strong>Design: </strong>Retrospective, observational SETTING: Clinic for infectious diseases and clinical microbiology PATIENTS AND METHODS: Patients diagnosed with chronic hepatitis C who applied to our outpatient clinic between January 2016 and November 2022 and were treated with a DAA were included in the study. Treatment responses were evaluated after each patient was treated with either ledipasvir plus sofosbuvir (LDV/SOF), LDV/SOF + ribavirin (RBV), SOF+RBV, ombitasvir/paritaprevir/ritonavir plus dasabuvir (OBV/PTV/r±DSV) ±RBV, or glecaprevir plus pibrentasvir (GLE/PIB).</p><p><strong>Main outcome measures: </strong>Sustained virological response (SVR) rates at 12 weeks (SVR12) post-treatment.</p><p><strong>Sample size: </strong>360 patients.</p><p><strong>Results: </strong>Of 360 patients who met the inclusion criteria, 218 (60.6%) were male and 142 (39.4%) were female with no statistically significant differences in SVR between sexes (<i>P</i>=.252). Nearly all had a SVR (n=353, 98.1%). The median (IQR) age of the patients was 56 (30.3) years. There were 42 (11.7%), 199 (55.3%), 4 (1.1%), 106 (29.4%), 8 (2.2%) and 1 (0.3%) patient with genotypes 1a, 1b, 2, 3, 4 and 5, respectively, and SVR12 did not differ significantly between genotypes (<i>P</i>=.066). SVR12 response was higher in 246 (68.3%) non-injecting drug users compared to 114 (31.7%) injecting drug users (<i>P</i>=.005). The SVR12 response was achieved in 100% of patients with genotypes 1a, 2, 4, and 5. SVR12 response could not be obtained in 1 of 199 genotype 1b patients and 6 of 106 genotype 3 patients. The common feature of 6 reinfection patients with genotype 3 was that they were using intravenous drugs. These 6 patients were reinfected due to their continued intravenous drug use.</p><p><strong>Conclusion: </strong>In conclusion, DAAs provide high SVR12 rates in cirrhotic/non-cirrhotic, pegylated interferon-naive/experienced patient groups and in patients infected with all genotypes. DAAs have a high SVR12 rate in patients with chronic hepatitis C.</p><p><strong>Limitations: </strong>Retrospective, single-center.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"308-314"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/03/0256-4947.2023.308.PMC10560371.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41124030","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":"Overall and progression-free survival in endometrial carcinoma: A single-center retrospective study of patients treated between 2000-2018.","authors":"Khalid H Sait,&nbsp;Nisreen Anfinan,&nbsp;Hesham Sait,&nbsp;Hanan Shamrani,&nbsp;Maram Sait","doi":"10.5144/0256-4947.2023.315","DOIUrl":"10.5144/0256-4947.2023.315","url":null,"abstract":"<p><strong>Background: </strong>Investigating survival in endometrial cancer (EC) is crucial to determine the effectiveness of overall management as it will reflect on the level of care provided among this population.</p><p><strong>Objective: </strong>The study was conducted to analyze the overall survival (OS) and progression-free survival (PFS) in treated endometrial carcinoma and to determine the associated predictors.</p><p><strong>Design: </strong>Retrospective SETTING: Department of obstetrics and gynecology in university tertiary hospital PATIENTS AND METHODS: Baseline demographic and clinical data, tumor characteristics and perioperative and outcome data were collected from consecutive patients treated for EC between 2000 and 2018. Kaplan-Meier method and multivariate Cox regression were used to analyze factors and predictors of OS and PFS.</p><p><strong>Main outcome measures: </strong>OS, PFS and prognostic factors SAMPLE SIZE: 200 RESULT: Endometrioid type was the most common type accounting for 78.5% of the cases, followed by papillary serous carcinoma (18.5%). At diagnosis, 21.5% were stage III, and 12.0% were stage IV. Invasiveness features showed involvement of the myometrium (96.5%), lymph vessels (36.5%), cervix stroma (18.5%), lower segment (22.0%), and parametrium (7.0%). The majority of patients had open surgery (80.0%), while 11.5% and 7.0% had laparoscopy and robotic surgery, respectively. Staging and debulking were performed in 89.0% of patients, and 12.5% of patients had residual disease of more than 2 cm. The mean OS and PFS were 104.4 (95% CI=91.8-117.0) months and 96.8 (95% CI=83.9-109.7) months, respectively. The 5-year OS and PFS were 62.5% and 46.9%, respectively. The majority of the factors we assessed were significantly associated with OS or PFS. However, reduced OS was independently associated age ≥60 years (hazard ratio [HR]=1.99, <i>P</i>=.010), papillary serous carcinoma (HR=2.35, <i>P</i>=.021), and residual disease (HR=3.84, <i>P</i>=.007); whereas PFS was predicted by age ≥60 years (HR=1.87, <i>P</i>=.014) and residual disease (HR=3.22, <i>P</i>=.040).</p><p><strong>Conclusion: </strong>There is a need for a national strategy to tackle the growing burden of EC, by identifying the locally-specific incidence, delayed diagnosis and survival outcome.</p><p><strong>Limitations: </strong>This was a single-center study conducted at a tertiary center, which may question the generalizability of the findings, as the sample may be biased by overrepresentation with patients who were diagnosed at an advanced stage.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"315-328"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/cf/0256-4947.2023.315.PMC10560369.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165849","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":"Screening tools for metabolic syndrome based on anthropometric cut-off values among Thai working adults: a community-based study.","authors":"Thidarat Somdee,&nbsp;Theerasak Somdee,&nbsp;Suneerat Yangyuen,&nbsp;Aravan Mungvongsa,&nbsp;Santisith Khiewkhern,&nbsp;Thanyathorn Puapittayathorn,&nbsp;Sawan Thitisutthi,&nbsp;Piyaporn Srikongpan,&nbsp;Supattra Keawmuanga","doi":"10.5144/0256-4947.2023.291","DOIUrl":"10.5144/0256-4947.2023.291","url":null,"abstract":"<p><strong>Background: </strong>The metabolic syndrome (MetS) is a universal disease of increasing prevalence, but the prevalence varies depending on ethnicity. There is a crucial need to assess the validity of anthropometric indicators and determine appropriate cut-off values for MetS screening.</p><p><strong>Objective: </strong>Determine cut-off anthropometric indicators values for screening of MetS.</p><p><strong>Design: </strong>Cross-sectional SETTING: Rural and urban areas of provinces with a high prevalence of MetS in the central region of Thailand.</p><p><strong>Subjects and methods: </strong>The subjects were recruited based on the International Diabetes Federation definition of MetS, which includes four anthropometric indicators. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity for different cut-off values of all novel indicators.</p><p><strong>Main outcome measures: </strong>The cut-off values for screening of MetS, which included neck circumference (NC), body roundness index (BRI), conicity index (C-index), and body shape index (BSI).</p><p><strong>Sample size: </strong>2520 participants RESULTS: The BRI and NC were the indices with higher areas under the curve, followed by the C-index and BSI. The optimal cut-off values for BRI and NC were 4.1 and 36.5 cm for males and 4.0 and 34.5 cm for females.</p><p><strong>Conclusions: </strong>This study defined the specific cut-off values for Thai working adults.</p><p><strong>Limitations: </strong>The participants might not be representative of all Thai adults and we may have overestimated MetS for Thai working adults because our research focus was on the highest prevalence of MetS in the central region of Thailand.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"291-297"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/23/0256-4947.2023.291.PMC10560367.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144705","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":"Climate change and cutaneous leishmaniasis in the province of Ghardaïa in Algeria: A model-based approach to predict disease outbreaks.","authors":"Yasmine Saadene, Amina Salhi, Feriel Mliki, Zihad Bouslama","doi":"10.5144/0256-4947.2023.263","DOIUrl":"10.5144/0256-4947.2023.263","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis (CL) is a vector-borne disease prevalent in Algeria since 2000. The disease has significant impacts on affected communities, including morbidity and social stigma.</p><p><strong>Objective: </strong>Investigate the association between environmental factors and the incidence of CL in the province of Ghardaïa and assess the predictive capacity of these factors for disease occurrence.</p><p><strong>Design: </strong>Retrospective SETTING: The study area included both urban and rural communities.</p><p><strong>Methods: </strong>We analyzed a dataset on CL in the province of Ghardaïa, Algeria, spanning from 2000 to 2020. The dataset included climatic variables such as temperature, average humidity, wind speed, rainfall, and the normalized difference vegetation index (NDVI). Using generalized additive models, we examined the relationships and interactions between these variables to predict the emergence of CL in the study area.</p><p><strong>Main outcome measures: </strong>The identification of the most significant environmental factors associated with the incidence and the predicted incidence rates of CL in the province of Ghardaïa, Algeria.</p><p><strong>Sample size and characteristics: </strong>252 monthly observations of both climatic and epidemiological variables.</p><p><strong>Results: </strong>Relative humidity and wind speed were the primary climatic factors influencing the occurrence of CL epidemics in Ghardaïa, Algeria. Additionally, NDVI was a significant environmental factor associated with CL incidence. Surprisingly, temperature did not show a strong effect on CL occurrence, while rainfall was not statistically significant. The final fitted model predictions were highly correlated with real cases.</p><p><strong>Conclusion: </strong>This study provides a better understanding of the long-term trend in how environmental and climatic factors contribute to the emergence of CL. Our results can inform the development of effective early warning systems for preventing the transmission and emergence of vector-borne diseases.</p><p><strong>Limitations: </strong>Incorporating additional reservoir statistics such as rodent density and a human development index in the region could improve our understanding of disease transmission.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"263-276"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/41/0256-4947.2023.263.PMC10560365.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180691","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 relationship between asymptomatic atherosclerosis and hepcidin-25 in chronic kidney disease patients.","authors":"Osama Nady Mohamed,&nbsp;Ahmed Mohamed Mady,&nbsp;Mohamed Mamdouh Sedik,&nbsp;Ahmed S Issa,&nbsp;Omima M Mohamed,&nbsp;Nadia Ismail Abdelhameed","doi":"10.5144/0256-4947.2023.298","DOIUrl":"10.5144/0256-4947.2023.298","url":null,"abstract":"<p><strong>Background: </strong>The most common and lethal consequence of chronic kidney disease (CKD) is atherosclerotic cardiovascular disease. The persistent inflammation present in CKD increases hepcidin levels. Iron accumulates in the arterial wall in atherosclerosis. Hepcidin-25 was thought to accelerate the development of atherosclerotic plaques by blocking iron release from macrophages. Therefore, we sought to determine the relationship between hepcidin-25 and asymptomatic atherosclerosis in non-dialysis CKD patients.</p><p><strong>Objectives: </strong>Investigate the relationship between hepcidin-25 and subclinical atherosclerosis in non-dialysis CKD patients.</p><p><strong>Design: </strong>Cross-sectional SETTINGS: Outpatient clinic for urology and nephrology at a university hospital SUBJECTS AND METHODS: Participants above the age of 18 years included a group of healthy controls and a group of CKD patients who were not routinely maintained on hemodialysis. The latter group was further divided according to eGFR into CKD-3, CKD-4 and CKD-5 subgroups. We excluded patients with comorbidities, patients with chronic liver disease, and other conditions or habits. CBC, kidney function tests, and serum levels of hepcidin-25 (SH-25), TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), TC, TG, LDL-C and HDL-C were assessed. To measure carotid intima media thickness (CIMT) and determine presence of plaques, carotid ultrasonography was performed. The near or far walls of common carotid artery, bulb, and internal carotid artery were used to measure CIMT.</p><p><strong>Main outcome measures: </strong>SH-25 association and indicators of subclinical atherosclerosis.</p><p><strong>Sample size: </strong>128 participants, the control group (n=25) and the non-hemodialysis CKD patients (n=103) RESULTS: The CKD patients had significantly higher serum levels of markers of inflammation including IL-6, TNF-α, and hs-CRP (<i>P</i><.001 for each) compared to the controls. There was a significantly higher level of TC, TG and LDL-C (<i>P</i><.001 for each) and a lower level of HDL-C (<i>P</i><.001) in the CDK patients compared to controls. SH-25 was considerably higher in all CKD subgroups, especially with progression of CKD. CIMT was increased in CKD patients especially CKD-4 and CKD-5 subgroups when compared to healthy participants (<i>P</i><.001 for each). In the patient group, CIMT showed a positive correlation with SH-25, (r=.65 and <i>P</i><.001), IL-6 (r=.65, <i>P</i><.001), TNF-α (r=.71, <i>P</i><.001), and hs-CRP (r=.52, <i>P</i><.001). The ROC curve study showed that SH-25 (AUC=.86, <i>P</i><.001), IL-6 (AUC=.83, <i>P</i><.001), hs-CRP (AUC=.72, <i>P</i><.001), TNF-α (AUC=.82, <i>P</i><.001) were strong predictors of subclinical atherosclerosis in the CKD patients.</p><p><strong>Conclusions: </strong>SH-25 and CIMT had a positive relationship in CKD patients. The ROC curve showed that SH-25 is a reliable predictor of carotid atherosclerosis. Theref","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"298-308"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/77/0256-4947.2023.298.PMC10560366.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148736","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 the systemic immune inflammation index and the systemic inflammatory response index as new markers for the diagnosis of acute appendicitis in children.","authors":"Fatma Özcan Siki,&nbsp;Mehmet Sarıkaya,&nbsp;Metin Gunduz,&nbsp;Tamer Sekmenli,&nbsp;Muslu Kazim Korez,&nbsp;Ilhan Ciftci","doi":"10.5144/0256-4947.2023.329","DOIUrl":"10.5144/0256-4947.2023.329","url":null,"abstract":"<p><strong>Background: </strong>Abdominal pain is a common and non-specific symptom in children. It is important to be able to distinguish the source of abdominal pain before surgery.</p><p><strong>Objectives: </strong>Assess importance of the systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and other systemic inflammatory response blood cell indices in predicting the diagnosis and prognosis of acute appendicitis in children.</p><p><strong>Design: </strong>Retrospective cohort SETTING: Single center in Turkey PATIENTS AND METHODS: The files of patients with abdominal pain aged 0-18 years who underwent surgery for appendicitis in our clinic between January 2011 and January 2022 were reviewed. According to the pathology results, patients were divided into two groups, those with pathologic findings of appendicitis (positive for appendicitis) and those without appendicitis. Systemic inflammation markers were statistically compared between the groups.</p><p><strong>Main outcome measures: </strong>Systemic inflammation markers.</p><p><strong>Sample size: </strong>1265 patients RESULTS: Of the 1265 patients, 784 (62%) were male and 481 were female (38%). According to the pathologic examinations, 256 (20.2%) patients did not have appendicitis, and 1009 (79.8%) patients had acute appendicitis. The SIRI level was significantly higher in patients with acute appendicitis compared with patients without acute appendicitis (<i>P</i><.001). Levels of SII were significantly higher in patients with acute appendicitis (<i>P</i><.001).</p><p><strong>Conclusion: </strong>In children presenting with abdominal pain, high SIRI and SII values alone support the diagnosis of acute appendicitis at a rate of 95%. When physical examination findings, duration of pain, and imaging test results are added, the diagnosis becomes clear at a rate of 98%.</p><p><strong>Limitations: </strong>Single-center study and retrospective.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"329-338"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/3a/0256-4947.2023.329.PMC10560368.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148735","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 outcome of high-frequency oscillatory ventilation in pediatric patients with acute respiratory distress syndrome in an intensive care unit.","authors":"Tareq Al-Ayed,&nbsp;Iyad B Alsarhi,&nbsp;Abdullah Alturki,&nbsp;Fahad Aljofan,&nbsp;Tariq Alofisan,&nbsp;Moath Al Abdulsalam,&nbsp;Deema Gashgarey,&nbsp;Rwan Alrwili,&nbsp;Wala Aldihan,&nbsp;Saleh Badr Bin Mahfodh,&nbsp;Fawaz Alanzi,&nbsp;Ahmed M Otaibi,&nbsp;Raghad Tariq Alhuthil","doi":"10.5144/0256-4947.2023.283","DOIUrl":"10.5144/0256-4947.2023.283","url":null,"abstract":"<p><strong>Background: </strong>In adults with acute respiratory distress syndrome (ARDS), high-frequency oscillatory ventilation (HFOV) has been associated with higher mortality rates. Therefore, its use in children with ARDS is still controversial.</p><p><strong>Objectives: </strong>Evaluate the overall mortality of HFOV in children with ARDS and explore mortality-related risk factors; compare the outcome of using HFOV post-endotracheal intubation early (≤24 hours) versus late (≤24 hours).</p><p><strong>Design: </strong>Retrospective (medical record review) SETTING: Pediatric intensive care unit in a tertiary care center in Saudi Arabia.</p><p><strong>Patients and methods: </strong>Data were collected from medical records of all pediatric patients with ARDS aged one week to 14 years, who were admitted to the pediatric intensive care unit (PICU) from January 2016-June 2019 and who required HFOV.</p><p><strong>Main outcome measures: </strong>PICU mortality.</p><p><strong>Sample size and characteristics: </strong>135 ARDS patients including 74 females (54.8%), and 61 males (45.2%), with a median age (interquar-tile range) of 35 (72) months.</p><p><strong>Results: </strong>The overall mortality rate was 60.0% (81/135), and most died in the first 28 days in the PICU (91.3%, 74/8). Of non-survivors, 75.3% (61/81) were immunocompromised, and 24.7% (20/81) were immuno-competent patients, 52 (64.2%) received inotropic support, 40 (49.4%) had a bone-marrow transplant (BMT) before HFOV initiation. Although the prone position was used in 20.7% (28/135) to improve the survival rate post-HFOV ventilation, only 28.6% (8/28) survived. In addition, altered code status or chemotherapy reported a significant association with mortality (<i>P</i><.05). Interestingly, early HFOV initiation (≤24 hours) did not seem to have a high impact on survival compared to late initiation (>24 hours); (57.4% vs. 42.6%, <i>P</i>=.721).</p><p><strong>Conclusion: </strong>Immunocompromised and oncology patients, including post-BMT, reported poorer outcomes, and neither the prone position nor early use of HFOV improved outcomes. However, it is recommended to replicate the study in a larger cohort to generalize the results.</p><p><strong>Limitations: </strong>Retrospective single-center study.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"43 5","pages":"283-290"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/e0/0256-4947.2023.283.PMC10560370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174566","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}