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Sphingosine-1-Phosphate Regulation To Alleviate Sickle Cell Disease Severity: A Promising Therapeutic Approach, Shahanas Chathoth

Saudi Medical Journal

Sickle cell disease (SCD) is a genetic disorder that affects millions of individuals worldwide. Chronic anemia, hemolysis and vasculopathy are the most common symptoms that arise from hemoglobin (Hb) polymerization, which is the primary event of SCD. The above process can lead to erythrocyte sickling. Therapeutic options for SCD remain limited, and novel therapies are still being evaluated for their effectiveness in particular populations. Sphingosine-1-phosphate (S1P), a significant bioactive sphingolipid, acts as a potent signal mediator, modulating several cellular functions. The potential role of erythrocyte-S1P in enhancing SCD severity has been previously reported by multiple studies. Therefore, the present review …

Colorectal Cancer Screening In Saudi Arabia: Current Challenges And Future Directions, Abdulrahman A. Aljabri, Abdulrahman G. Alharbi

Saudi Medical Journal

Colorectal cancer has become a major public health concern in Saudi Arabia. It is the most prevalent cancer among men and the third most prevalent among women. Although screening for people aged 45-75 is recommended by national recommendations, screening uptake is still below 10%, and less than 1% of older persons have a colonoscopy. With regional differences that vary from age-standardized rates of 3.2 per 100,000 in Jouf to 21.8 per 100,000 in Riyadh among men, approximately 29% of cases are detected at late stages. Therefore, we assessed the epidemiological, social, and health-related systemic structures preventing effective colorectal cancer screening …

Prevalence Of Carbapenem-Resistant Enterobacteriaceae In Intensive Care Units In Saudi Arabia: A 10-Year Systematic Review, Shadi A. Zakai

Saudi Medical Journal

Objective: To synthesize research on the prevalence and distribution patterns of carbapenem-resistant Enterobacteriaceae (CRE) in Intensive Care Units (ICUs) across Saudi Arabia. It also seeks to evaluate molecular resistance profiles, identify associated risk factors, assess antimicrobial susceptibility, and examine infection control strategies within these critical care settings.

Methods: A systematic analysis was conducted, including cross-sectional, retrospective, and genomic studies from various tertiary hospitals in Saudi Arabia. The review focused on epidemiological trends, molecular characterization of CRE strains, clinical correlates, and the outcomes of implemented intervention strategies.

Results: The findings indicate a high and steadily increasing prevalence of CRE, often exceeding …

Influence Of Metabolic Dysfunction-Associated Steatotic Liver Disease On Pattern And Management Of Acute Coronary Syndrome, Elshazly Abdulkhalik, Nagat Ibrahim, Selim Sidhom, Hesham H Alqurashi, Khaled Alghashmari, Muhammad Alotaibi, Ahmed Alqurashi, Moath Alzahrani, Shahad Alqahtani, Abdulaziz Alshalan, Nouran Althumali, Mazen Aljohani, Saud Alzahrani, Haidi Karam-Allah Ramadan

Saudi Medical Journal

Objectives: To determine the influence of metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and hepatic fibrosis on the pattern and management of patients who had acute coronary syndrome (ACS). Methods: Retrospective records of patients with ACS included demographic, electrocardiographic, and laboratory data of platelets count, glycated hemoglobin, lipogram, liver and cardiac enzymes. Ultrasound was used to evaluate fatty liver. Coronary angiography data included the number, site and percentage of the coronary arteries occluded. The type and outcome of treatment of ACS were recorded. Laboratory markers were measured to evaluate fibrosis. Results: The study recruited 259 patients, and the majority were males. …

Juvenile Idiopathic Arthritis Registry At King Abdullah Specialized Children’S Hospital (Jiar-Kasch) In Riyadh, Saudi Arabia, Jubran T. Alqanatish, Abdullah I. Almojali, Wejdan M. Algbaiwi, Abdullah S. Alqahtani, Abdulrahman A. Alrasheed, Lubna A. Alnasser, Wafaa M. Alsuwairi

Saudi Medical Journal

Objectives: To establish and maintain a comprehensive, up-to-date registry of juvenile idiopathic arthritis (JIA) cases, and to outline the methodology used in creating it. Methods: Retrospective and prospective data collection commenced in August 2021, using the Hospital Information System to identify electronic medical records of JIA patients. All individuals diagnosed with JIA and receiving follow-up care at King Abdullah Specialized Children’s Hospital (KASCH) in Riyadh were included. A broad range of variables covering sociodemographic characteristics, clinical features, laboratory results, imaging findings, and therapeutic medications were recorded in the REDCap platform. Data collection update occurs every 6 months. Results: By December …

Research Productivity On Obesity In The Arab World: A Bibliometric Analysis (2004–2023), Jamil Adnan Samkari, Ahamd Azam Malik

Saudi Medical Journal

Objective: To examine obesity research trends in Arab countries to inform policies and interventions. Methods: A bibliometric analysis was conducted using the Web of Science database accessed via King Abdulaziz University’s electronic library. Publications on obesity research in Arab countries from 2004 to 2023 were analyzed using R-Bibliometrix. Key parameters included publication volume, leading authors and institutions, funding sources, keyword co-occurrence networks, and collaboration patterns. Results: Obesity-related research output in Arab countries demonstrated consistent growth from 2004 to 2023, with a threefold increase in publications since 2015. Regional and international collaborations have intensified, although disparities in research productivity persist across …

Prevalence Of Carbapenem-Resistant Enterobacteriaceae In Intensive Care Units In Saudi Arabia: A 10-Year Systematic Review, Shadi A. Zakai

Saudi Medical Journal

Objective: To synthesize research on the prevalence and distribution patterns of carbapenem-resistant Enterobacteriaceae (CRE) in Intensive Care Units (ICUs) across Saudi Arabia. It also seeks to evaluate molecular resistance profiles, identify associated risk factors, assess antimicrobial susceptibility, and examine infection control strategies within these critical care settings. Methods: A systematic analysis was conducted, including cross-sectional, retrospective, and genomic studies from various tertiary hospitals in Saudi Arabia. The review focused on epidemiological trends, molecular characterization of CRE strains, clinical correlates, and the outcomes of implemented intervention strategies. Results: The findings indicate a high and steadily increasing prevalence of CRE, often exceeding …

Prevalence Of Autoimmune Thyroid Disease Among Individuals With Celiac Disease In A Primary Care Setting In Riyadh, Saudi Arabia, Mansour I. Alrasheed, Hussam Jnaid, Faisal K. Alrasheed, Tarfah R. Alsharidi, Abdulelah I. Alrasheed, Sarah A. Alobaid, Norah A. Sulaiman

Saudi Medical Journal

Objectives: Celiac disease (CD) is a prevalent autoimmune disorder triggered by gluten consumption, leading to an immune response that damages the small intestine. Research shows a link between CD and autoimmune thyroid disorders (AITD). This study seeks to determine the prevalence of AITD among adult and pediatric patients with CD in the primary care setting in Riyadh, Saudi Arabia. Methods: A retrospective cross-sectional study reviewed electronic health records of individuals diagnosed with CD from January 2016 to December 2023 at King Faisal Specialist Hospital and Research Centre. Collected data encompassed patient demographics, diagnostic approaches, thyroid function assessments, thyroid autoantibody profiles, …

Colorectal Cancer Screening In Saudi Arabia: Current Challenges And Future Directions, Abdulrahman A. Aljabri, Abdulrahman G. Alharbi

Saudi Medical Journal

Abstract Colorectal cancer has become a major public health concern in Saudi Arabia. It is the most prevalent cancer among men and the third most prevalent among women. Although screening for people aged 45-75 is recommended by national recommendations, screening uptake is still below 10%, and less than 1% of older persons have a colonoscopy. With regional differences that vary from age-standardized rates of 3.2 per 100,000 in Jouf to 21.8 per 100,000 in Riyadh among men, approximately 29% of cases are detected at late stages. Therefore, we assessed the epidemiological, social, and health-related systemic structures preventing effective colorectal cancer …

Magnitude Of Abdominal Solid Organs Injuries Among Patients With Pelvic Fracture At King Abdullah Hospital, Bisha City, Saudi Arabia, Ali Ibrahim Alshehri, Mohammed Jalawi Karkaman, Nawaf Amer Alsoiry, Naif Abdulaziz Alqarni

Saudi Medical Journal

Objective: To access the magnitude of these injuries in patients with pelvic fractures at King Abdullah Hospital, Bisha, Saudi Arabia. Abdominal solid organ injuries are life-threatening and results in adverse health effects particularly to patients with pelvic fracture. Methods: An analytical cross-sectional retrospective hospital-based study that reviewed a total of 236 medical records of patients with abdominal organ injuries and pelvic fractures at King Abdullah Hospital, Bisha, Saudi Arabia. Cleaned data was coded and analyzed with the use of SPSS version 23 to drive key insights. Results: The study comprised of 236 patients in total. Approximately 38 (16.1%) patients had …

Targeted Neonatal Echocardiography And Neonatal Hemodynamics In The Kingdom Of Saudi Arabia: A One-Year Experience In Service Implementation, Abdulaziz Homedi, Kamal Ali Ali, Abdulrahman Almehaid, Mohanned Alrahili, Abdulrahman Mandurah, Mohammed Almahdi, Faisal Alamer, Eman Bazbouz, Shatha Algarni, Atheer Alshehri, Faisal Alsehli, Hanof Bakri

Saudi Medical Journal

Objective: To evaluate the impact of a newly established targeted neonatal echocardiography (TNE) and Neonatal Hemodynamics consultation service on the assessment and management of neonates. Methods: This is a descriptive retrospective cohort study that included all neonates who underwent TNE consultations in the Neonatal Intensive Care Unit from October 2023 and September 2024. Clinical indications, diagnostic findings, and subsequent management were analyzed. Result: A total of 237 TNE consultations were performed for 105 neonates. The mean gestational age was 29.9 weeks, and the mean birth weight was 1433 grams. On average, 19.8 echocardiographic scans were performed per month. The leading …

Clinical Characteristics And Outcomes Of Patients With Amphetamine Associated Emergency Department Visits At A Tertiary Care Hospital In Riyadh, Saudi Arabia, Mohammed K. Alsharef, Mahdi Almutairi, Nouf Ababtain, Mohammed Alajmi, Abdulrahman Alrajhi, Faisal Alhusain, Mohammad Al Deeb

Saudi Medical Journal

Objective: To investigate the demographic and clinical profiles of patients presenting with amphetamine-related emergencies at a tertiary hospital in Riyadh, Saudi Arabia. Amphetamine use is an escalating public health issue linked to a rise in emergency department (ED) visits. Methods: This retrospective study encompasses 14 years and focuses on individuals diagnosed with amphetamine-related toxicity. Results: Among the 659 cases studied, a predominant 96% were male, with over half (52%) aged between 19 and 30 years. Most patients (91%) were Saudi nationals. The leading cause of presentation was trauma, accounting for 24% of cases. This was followed by altered mental status …

Endovascular Thrombectomy For Acute Ischemic Stroke Among Stroke Patients In Jeddah, Saudi Arabia: A Retrospective Cohort Study (2024) Detailing Dual Center Experience, Abdullah M Alkutbi, Omar Abdulhamidayoub, Fawaz Mosaedalshareef, Mohammed M Alwadi, Rawan I Alqurashi, Rayan I Almaghrabi, Naif F Alharbi, Omar M Alhazmi, Ziad H Alzabidi, Nagham S Alsolaimani, Saher F Alqarni

Saudi Medical Journal

Background: Te evaluate the outcomes of Endovascular thrombectomy (EVT) -treated AIS patients in Jeddah, Saudi Arabia, and explores predictors of functional recovery. Endovascular thrombectomy (EVT) is the standard of care for acute ischemic stroke (AIS), though patient outcomes can vary based on regional and clinical factors. Method: A retrospective cohort study was conducted using medical records from King Abdulaziz University Hospital (KAUH) and King Fahad Hospital Jeddah (KFHJ), including AIS patients treated with EVT between January 2020 and July 2024. Neurological status was assessed using the NIH Stroke Scale (NIHSS), and clinical outcomes were evaluated with the modified Rankin Scale …

Gender Differences In Sociodemographic And Clinical Characteristics Of Methamphetamine Use In Saudi Arabia, Halima M. Adam, Mohamed Abouzed, Ahmed H. Aljadani, Benayan B. Alrasheedy, Muath A. Alarfaj, Salwa R. Alshammari, Mohamed S. Almuqahwi

Saudi Medical Journal

Objectives: To explore gender-related variations in sociodemographic factors, clinical presentations, and psychosocial characteristics among methamphetamine users in Saudi Arabia. Methods: A retrospective cross-sectional study was conducted using the electronic health records of 1,181 patients (91% male, 9% female) treated at multiple Erada Mental and Addiction Centers across Saudi Arabia (2020–2024). Data on sociodemographic characteristics, methamphetamine use patterns, psychiatric comorbidities, and psychosocial functioning were collected and analyzed using validated tools, including the Addiction Severity Index, Beck Depression and Anxiety Inventory, and Quality of Life Scale. Results: Female participants were younger than males (mean age 25.3 vs 28.5 years; p < 0.001) and initiated methamphetamine at a later age (21.4 vs 19.2 years; p < 0.001). Females had greater proportion of daily use (65.4% vs. 60%, p = 0.035) but consumed smaller amounts per day (1.5 vs. 1.8 g, p = 0.041). They also exhibited higher rates of psychiatric comorbidities, including depression (50% vs. 30.0%, p < 0.001) and anxiety (40% vs. 20%, p < 0.001), and reported more severe psychosocial impairments, including lower quality of life (54.8 vs. 62.4, p < 0.001), higher unemployment rates (59.8% vs. 30%, p < 0.001), and more family conflicts (65.4% vs. 50%, p < 0.001). In contrast, Legal issues were more common among males (40% vs. 29.9%, p = 0.002). Conclusions: Female methamphetamine users demonstrate greater vulnerability with earlier onset, more psychiatric comorbidities, and worse psychosocial outcomes. Targeted interventions are needed for female methamphetamine users in Saudi Arabia.

Invasive Methicillin-Susceptible And Methicillin-Resistant Staphylococcus Aureus Infections In The Pediatric Population: Prevalence And Management Outcomes, Khalifa M. Binkhamis, Ibrahim A. Alhezam, Hassan A. Alabdullatif, Othman M. Alabdullah, Omar Y. Alkadhi, Nawaf M. Alrefaei, Abdullah S. Almayah, Fatema A. Juma, Sarah S. Alangari

Saudi Medical Journal

Objectives: Infections by invasive methicillin-resistant Staphylococcus aureus (MRSA) are associated with higher morbidity and mortality compared to methicillin-susceptible Staphylococcus aureus (MSSA) infections, and have increased significantly in both healthy children and children with chronic illnesses. In our study we aimed to estimate the prevalence of invasive MSSA and MRSA among invasive Staphylococcus aureus (S. aureus ) infections in the pediatric population and measure the association between management outcomes and methicillin resistance in these infections. Methods: We conducted an observational, analytical, retrospective cross-sectional, chart-review study of pediatric patients (aged ≤16 years) admitted to King Khalid University Hospital in Riyadh, Saudi Arabia …

Medication Errors Reporting And Analysis: A Comparative Study For Advancing Medication Safety Practices In Ministry Of Health Hospitals In Saudi Arabia, Saleh A. Alghamdi

Saudi Medical Journal

Objectives: To analyze and compare these stages, types, frequency, causes, and corrective actions related to medication errors (MEs) reported in Ministry of Health (MOH) hospitals in Saudi Arabia, and thereby enhance medication safety through data driven decisions. Methods: A retrospective cross-sectional study was conducted using ME reports submitted to the Saudi MOH national reporting system from January 2023 to December 2024.Data were collected from nine hospitals, covering medication involved, reporting personnel, level of harm and corrective actions. A novel stratification framework (NSF) was used to visualize emerging risks and protective trends. Statistical analyses were conducted using relative risk (RR), risk …

Sphingosine-1-Phosphate Regulation To Alleviate Sickle Cell Disease Severity: A Promising Therapeutic Approach, Shahanas Chathoth

Saudi Medical Journal

Abstract Sickle cell disease (SCD) is a genetic disorder that affects millions of individuals worldwide. Chronic anemia, hemolysis and vasculopathy are the most common symptoms that arise from hemoglobin (Hb) polymerization, which is the primary event of SCD. The above process can lead to erythrocyte sickling. Therapeutic options for SCD remain limited, and novel therapies are still being evaluated for their effectiveness in particular populations. Sphingosine-1-phosphate (S1P), a significant bioactive sphingolipid, acts as a potent signal mediator, modulating several cellular functions. The potential role of erythrocyte-S1P in enhancing SCD severity has been previously reported by multiple studies. Therefore, the present …

From Text To Test: Pre-Lecture Reading Boosts Medical Students’ Comprehension And Retention, Hamad A. Alfahaad, Mohammed Y. Alasmary, Emad M. Masuadi, Henk G. Schmidt

Saudi Medical Journal

Objective: Medical students frequently attend lectures without prior review of the related literature when preparing for examinations. It raises the question of whether studying the material in advance could enhance their learning outcomes during lectures. Methods: A total of 102 medical students from a Saudi Arabian university took part in this research. Participants were assigned to one of 2 cohorts: one read a 4-page passage before a 15-minute lecture, while the other attended the lecture before reading the passage. Knowledge acquisition was measured using a test that assessed their ability to recall concepts administered 3 times—prior to the session, post …

National Heart Center/Saudi Heart Association 2025 Guidelines For Cardiovascular Diseases Prevention And Risk Assessment, Jamilah S Alrahimi, Laith Hussain-Alkhateeb, Ali M. Albarrati, Owayed M. Alshammeri, Talal S. Alghamdi, Ada M Al-Qunaibet, Nada A. Alnaji, Rasha A. Alfawaz, Waleed M. Alharbi, Waleed A. Alhabeeb, Fahad M. Alnouri, Adel A. Tash

Saudi Medical Journal

Objectives: To develop an evidence-based clinical guideline for the prevention and management of cardiovascular diseases (CVDs) in Saudi Arabia, tailored to local epidemiology and healthcare needs. Methods: A multidisciplinary task force comprising cardiologists, public health specialists, and epidemiologists from different healthcare sectors in Saudi Arabia developed the guideline. Evidence synthesis was based on a comprehensive literature review and adaptation of international guidelines, particularly the 2021 European Society of Cardiology recommendations, contextualized to the Saudi setting. Results: The guideline provides recommendations for both primary and secondary CVD prevention. Primary prevention emphasizes risk assessment incorporating genetic, lifestyle, and clinical factors, as well …

Obesity As A Health Priority: Insights From Research Productivity In The Arab World, Rania Hammami, Mirvat Alsnag

Saudi Medical Journal

No abstract provided.

Construction And Validation Of A Colorectal Cancer Diagnostic Model Based On Ferroptosis-Related Genes, Juan Wang, Qiuyue Zhang

Saudi Medical Journal

ABSTRACT Objectives: To establish a ferroptosis-related colorectal cancer (CRC) diagnostic model by integrating machine learning and gene expression analysis. Tumorigenesis is strongly linked to ferroptosis, an iron-mediated kind of cell death. The dismal prognosis of CRC, a severely malignant gastrointestinal cancer, accentuates the demand for effective diagnostic biomarkers. Methods: The study was performed between January 2024 and 2025. The GEO database provided 2 openly searchable gene expression profiles (GSE9348 and GSE21510) from CRC as well as non-tumor tissues. Genes that were expressed differently in tumor and healthy tissues were found using the GSE9348 dataset. Distinct genetic biological functions were identified …

Combating Antimicrobial Resistance In Asia: A Comprehensive Review Of Strategic Action Plans, Policies, And The Role Of The Who, Saud Almawash

Saudi Medical Journal

ABSTRACT Over the past 70 years, antimicrobial resistance (AMR) has emerged as a critical public health concern in Asia. Regional challenges such as dense population, scarce resources, and diverse healthcare systems further complicate the containment efforts. To address this, Asian countries have adopted several strategies and policies. A comprehensive review of published literature was conducted to identify key policies and interventions. Findings revealed diverse approaches to AMR containment, including surveillance and monitoring systems, antibiotic stewardship programs, infection control measures, vaccination strategies, and public health awareness campaigns. However, implementation of these strategies is hindered by resource, political, and regulatory barriers. The …

Unlocking Hidden Health Risks: Exploring Community-Based Screening For Kidney Disease, Rehab B. Albakr, Fadel Alrowie, Ibrahim A. Sandokji, Omar A. Alshammari, Hadeel A. Mitwalli, Hamood Alsudais, Abdulaziz B. Albacker, Mohamad-Hani Temsah, Ahmed H. Mitwalli, Khalid A. Alhasan

Saudi Medical Journal

ABSTRACT Objectives: To conduct a community-wide screening of the Saudi population for chronic kidney disease risk factors. Methods: This study utilized a non-selective, exploratory point-of-care screening approach involving 215 participants in Riyadh, Saudi Arabia, during a kidney disease awareness campaign for World Kidney Day in March 2022. Participants were randomly selected, and their estimated glomerular filtration rates (eGFRs) were measured to assess kidney function. Results: The findings revealed that 4% of participants had eGFRs less than 60 mL/min/1.73 m², 34% had eGFRs between 60 and 90 mL/min/1.73 m², and the rest had eGFRs over 90 mL/min/1.73 m². Key risk factors …

In This Issueclinical Practice Guidelinesreview Articleoriginal Articles

Saudi Medical Journal

No abstract provided.

Interventional Study Of The Iselfie Heart Health Tool For Assessment Of Vital Signs (Heart Rate, Blood Pressure, And Oxygen Saturation) In The Kingdom Of Saudi Arabia, Abdulaziz S. Alhomod, Demah Abdulaziz Almowanes, Robert Scooter Plowman, Azhar Quddus, Hassan Mohamed, Mahmut Karakaya, Ahmed Elgebaly, Jamilah Alrahimi, Raed Alkutshan, Adel Tash

Saudi Medical Journal

ABSTRACT Objectives: To validate the diagnostic performance of the iSelfie Heart Health tool compared to standard-of-care devices, focusing on accuracy, reliability, and classification capabilities. Methods: Vital sign measurements from 579 participants were analyzed using the iSelfie tool in calibrated and non-calibrated modes. Further analyses applied the Association for the Advancement of Medical Instrumentation (AAMI) standards and criteria for cuff-based blood pressure (BP) devices. Primary endpoints included mean absolute error (MAE) and cumulative error percentages for all vital parameters. Binary and multi-class classification analyses evaluated the device’s performance to categorize hypertension grades. Results: In calibrated mode, the iSelfie tool demonstrated high …

Discharge Against Medical Advice Among Pediatric Patients: A Retrospective Study From A Saudi Tertiary Emergency Department, Elaf A. Alshammari, Atheer M. Aljeraibah, Haya M. Aldabas, Saad M. Alqahtani, Raseel S. Alghamdi, Abdulrahman M. Alsharif, Yahya K. Alyahya, Abdullah I. Almojali

Saudi Medical Journal

ABSTRACT Objectives: To investigate the incidence, parental reasons, and predictors of emergency room (ER) revisits following discharge against medical advice (DAMA) in a pediatric center in Saudi Arabia. Methods: This retrospective cohort study was conducted between January 2020 and December 2024 at a tertiary care hospital. Pediatric patients aged 0-14 years who signed the DAMA during ER visits were included. Medical records of patients with DAMA were reviewed to collect demographic data, diagnoses, reasons for DAMA, and outcomes. Results: Among 446,251 ER visits, 2,336 (0.52%, 95% CI: 0.50%–0.55%) involved caregiver-signed DAMA. These rates ranged from 0.45% (2020) to 0.69% (2023). …

Correlation Of Clinical And Laboratory Findings Of Dehydration With Ultrasonographic Measurements, Yusuf Yilmazturk, Abdullah Sadik Girisgin, Mustafa Alpaslan, Necmi Baykan

Saudi Medical Journal

ABSTRACT Objectives: To assess bedside ultrasonographic readings in conjunction with laboratory and clinical results, as well as to look into the efficacy of these measurements while evaluating patients who are being monitored for dehydration and managing their therapy. Methods: We assessed 300 patients, 150 of whom were in the case group and 150 in the control group. Laboratory results throughout therapy, clinical dehydration, vital signs, and bedside ultrasonography results were all documented. A vena cava inferior collapsibility index of 50% or higher, dry oral mucosa, decreased skin turgor, and a fresh onset of altered consciousness were all considered clinical indicators …

Respiratory Distress Syndrome In Late Preterm Infants: Are We Doing Enough To Prevent It?, Adeeb Khawaji

Saudi Medical Journal

No abstract provided.

Launch Of Online Learning Course On Using The Iarc Atlas Of Breast Cancer Early Detection

Saudi Medical Journal

No abstract provided.

Navigating Challenges In Management Of Difficult-To-Treat Chronic Rhinosinusitis With Nasal Polyps In The Greater Gulf, Osama A. Marglani, Abdul Razzak Juratli, Athari Maatouq Alwael, Ghassan Hussain Alokby

Saudi Medical Journal

ABSTRACT Chronic rhinosinusitis with nasal polyps (CRSwNP) poses significant management challenges, particularly in treatment-resistant cases, greatly affecting patients’ quality of life. This paper provides consensus-based recommendations to guide clinicians in managing difficult-to-treat CRSwNP in the Gulf Cooperation Council (GCC) region. A modified Delphi method was used to gather expert opinions from GCC specialists through surveys and discussions, achieving consensus on 14 key statements for CRSwNP management. Key criteria identified for difficult-to-treat CRSwNP included early recurrence after surgery, comorbid atopic diseases, and frequent need for oral steroids. The importance of structured histopathology reporting and understanding inflammatory characteristics to differentiate patients with …