Medical Specialties Commons^™

Multiple Intracranial Aneurysms: An International Consensus Statement, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

Introduction: Multiple intracranial aneurysms (MIAs) pose diagnostic and therapeutic challenges, and widely used rupture-risk scores have not been validated for this subgroup. Research question: To develop expert-based recommendations for the diagnosis, rupture-risk assessment, treatment selection, and follow-up of patients with MIAs. Material and methods: A modified Delphi process was conducted. After topic generation from the literature, iterative questionnaires were administered anonymously online to invited experts. Consensus was prespecified as ≥70% agreement. Twenty-six of 35 invitees (74.3%) completed the survey. Results: Consensus identified the ruptured lesion in aneurysmal subarachnoid hemorrhage (aSAH) using computed tomographic angiography (CTA) and 3D rotational digital subtraction …

Imaging Of The Centromedian Thalamic Nucleus Using 3d Fast Gray Matter Acquisition T1 Inversion Recovery Sequence In 3t Mri In Epilepsy, Tunchanok Paprad, Thanyachat Yutthakasaemsan, Supada Prakkamakul

Chulalongkorn Medical Journal

Background:

The centromedian thalamic nucleus (CM) is an emerging deep brain stimulation (DBS) target for neurological disorders, including drug-resistant epilepsy. Traditional DBS localization relies on predefined stereotactic coordinates, which may be imprecise. Novel MRI sequences enhance gray-white matter contrast, potentially allowing direct CM visualization, improving accuracy in DBS planning and targeting.

Objective:

This study evaluates the 3D Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR) MRI sequence for the visualization of the CM in epilepsy patients.

Methods:

This prospective IRB-approved descriptive study included adult epilepsy patients who underwent 3D FGATIR MRI sequence at 3 Tesla. Two neuroradiologists independently assessed CM …

The Association Between Sarcopenia And Functional Outcomes After Bipolar Hemiarthroplasty In Elderly Patients With Displaced Femoral Neck Fracture. Structural Equation Modeling., Sanzhar Artykbay, Stephen J. Kerr, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Sarcopenia is an underrecognized condition that may impair recovery after hip fracture surgery in older adults.

Objectives: This study aimed to assess the impact of sarcopenia on functional outcomes and hip muscle strength in elderly individuals with femoral neck fractures while accounting for other potential confounding factors through a structural equation model (SEM).

Methods: Between January 2023 and October 2024, a prospective cohort study at a tertiary university hospital enrolled patients aged 60 and older undergoing bipolar hemiarthroplasty for displaced femoral neck fractures. Functional recovery was evaluated at 3-months follow-up using the Barthel Index (BI), Short Physical Performance Battery …

Clinical Outcomes Between Transradial And Transfemoral Primary Percutaneous Coronary Intervention In St-Segment Elevation Myocardial Infarction Patients In Chonburi Hospital: A Retrospective Study, Artit Torpongpun, Pornchai Ngamjanyaporn, Woravit Tantisiriwat, Chanadda Rutnuntamongkon, Gahn Nakornchai, Paramaporn Suttirut

Chulalongkorn Medical Journal

Background: According to recent global data, transradial primary PCI in ST-elevation myocardial infarction (STEMI) patients has demonstrated better procedural outcomes compared to transfemoral PCI.

Objective: To compare the clinical outcomes between transradial and transfemoral primary PCI in STEMI patients at Chonburi Hospital.

Methods: Patients diagnosed with STEMI who underwent PCI at Chonburi Hospital between October 1, 2016, and September 30, 2023, were enrolled. Clinical data were obtained through a retrospective review of medical records and the Chonburi Hospital STEMI registry database.

Results:A total of 913 patients were eligible for statistical analysis, with 532 and 381 patients undergoing PCI via …

Factors Influencing Outcomes In Neonatal Abdominal Surgery: Surgeons’ Perspectives, Nimmita Srisan, Kanyarat Olarachin, Pattamon Sutthatarn, Katawaetee Decharun, Prapapan Rajatapiti, Somboon Reukvibunsi, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Neonatal abdominal surgery was often indicated by congenital conditions, presenting significant risks of morbidity and mortality. However, comprehensive surgical data and identification of complication-related risk factors still receive little attention.

Purpose: Our objectives were to characterize neonatal patients undergoing abdominal surgery and to identify prognostic factors influencing complications and mortality in those patients.

Methods: A retrospective study was conducted on newborn patients aged between 0-30 days undergoing index surgery at a university hospital from 2013 to 2021. Categorical data were compared between the without-complication group and the with-complication group using the Chi-square tests and Fisher-Exact tests. Continuous data were analyzed …

Discharge Rates From Pediatric Emergency Departments Against Medical Advice Can Be Reduced By Improving Service Quality, Sounira Mehri, Josef Finsterer

Saudi Medical Journal

No abstract provided.

Integrating The Private Sector Into Surgical Residency Training: Insights From Dr. Sulaiman Al Habib Medical Group, Saudi Arabia, Nuha A. Alsaleh

Saudi Medical Journal

No abstract provided.

Covid-19–Associated Rhabdomyolysis In Hospitalized Patients: Retrospective Cohort Study, Paula Esquerdo-Serrano, Silvia Otero-Rodriguez, Hector Pinargote-Celorio, Sergio Reus, Esperanza Merino, José-Manuel Ramos-Rincón

Saudi Medical Journal

Objectives: To determine the frequency of rhabdomyolysis in patients hospitalized with COVID-19 and to characterize their clinical features and outcomes. Methods: All adults admitted to the hospital were included in this single-center retrospective cohort study with COVID-19 at a tertiary care institution in Alicante, Spain, between March 2020 and March 2024. A creatine kinase (CK) threshold of 1000 U/L or higher was used to define rhabdomyolysis. Demographic, clinical, laboratory, treatment, and outcome data were collected. Patients with and without rhabdomyolysis were compared, and factors associated with in-hospital mortality (IHM) were analyzed. Results: Among 7,590 hospitalized COVID-19 patients, 20 developed rhabdomyolyses …

Coronary Artery Ectasia: A 10-Year Experience At A Single Center In Saudi Arabia, Talal F. Aljabbary, Meshal S. Alhamed, Mohamed H. Ismaeel, Abdulrahman O. Alhaqbani, Abdullah S. Alhumimidi, Nouf A. Alanazi, Ayman M. Alsaleh, Khalid M. Aljohani, Waleed M. Alharbi, Mostafa Q. Alshamiri

Saudi Medical Journal

Objective: To assess the incidence of coronary artery ectasia (CAE) and its associated clinical characteristics and outcomes over a long follow-up period in Saudi Arabia. Methods: We retrospectively analyzed all coronary angiography procedures performed between January 2013 and June 2023. Patients with CAE were included in the final analysis. Results: During the 10-year period, 10,397 patients underwent coronary angiography. The CAE was diagnosed in 242 patients, yielding an incidence of 2.3%. The majority were male (92.6%). The average age was 57.15 ± 11.76 years. The right coronary artery (RCA) was the most involved vessel (65.2% of all patients). The most …

Tumor Markers And Pancreatic Enzymes Reflect Early Pancreatic Dysfunction In Type 2 Diabetes, Walaa Mohammedsaeed, Suliman Alharbi, Lama Alraddadi, Saja Aljohani, Talat Almehmadi, Sarah Alawfi

Saudi Medical Journal

Objective: To evaluate whether pancreatic enzymes and tumor markers reflect early pancreatic dysfunction in patients with type 2 diabetes mellitus (T2DM). Methods: In this cross-sectional study conducted between January 2023 and January 2024, 300 Saudi adults with T2DM were assessed for serum CA19-9, CA125, amylase, and lipase. Associations with glycemic control, insulin resistance (homeostatic model assessment for insulin resistance [HOMA-IR]), and metabolic parameters were examined using multivariable linear and logistic regression adjusted for age, sex, body mass index, diabetes duration, lipid profile, and medication use. Receiver-operating characteristic analyses evaluated biomarker performance for identifying poor glycemic control (HbA1c >8.5%). Exploratory analyses …

Male Pelvic Health In Saudi Arabia: Knowledge–Practice Gap In Pelvic Floor Muscle Exercises And Implications For Preventive Physiotherapy And Health Policy, Wael A. S. Alghamdi

Saudi Medical Journal

No abstract provided.

Demographic Profiles, Clinical Characteristics, And Meteorological Context Of Heat-Related Illnesses Among Hajj Pilgrims In 2023, Ghadah Alsaleh, Majed Alsalamah, Fahad Alamri, Fatemah Alsaleh, Anas Khan

Saudi Medical Journal

Objective: To describe the demographic profiles, clinical characteristics, and meteorological context of heat-related illnesses among Hajj pilgrims in 2023.

Methods: A retrospective cross-sectional study was conducted using data from 1,129 pilgrims diagnosed with HRIs across healthcare facilities in Mecca, Mina, and Arafat. Demographic and clinical data were extracted from the Hajj Health Information System, while temperature, humidity, wind speed, and rainfall records were obtained from the National Center for Meteorology.

Results: Heat exhaustion (48.2%) and heatstroke (37.4%) were the most common diagnoses, with 24.9% of the cases requiring hospitalization. Males represented 55.4% of cases and accounted for 51.2% of …

Obesity's Role In Stroke Incidence Among Smokers: An Assessment Of Confounding, Interaction, And Mediation Effects, Saeed Awad M. Alqahtani, Moutasem Salih Aboonq

Saudi Medical Journal

Objectives: To examine the association between body mass index (BMI) category and history of stroke among current smokers, while assessing potential confounding, effect modification by age, and mediation by cardiovascular comorbidities. Methods: Data were analyzed from 53,939 current adult smokers participating in the 2021 Behavioral Risk Factor Surveillance System (BRFSS). Survey-weighted logistic regression estimated the association between BMI categories (underweight, normal, overweight, obese) and self-reported stroke history. The study assessed multicollinearity and adjusted for sociodemographic and health variables. Interaction terms were tested to evaluate effect modification by age, and exploratory decomposition analysis was used to assess mediation by conditions such …

Prevalence And Antimicrobial Susceptibility Patterns Of Nosocomial Bacteria Across Different Units At King Faisal Complex Hospital, Taif, Kingdom Of Saudi Arabia, Nahed Hawsawi, Renad N. Al-Jaiud, Layal L. Khyyat, Kholoud Alsulimany, Manhal Shabat

Saudi Medical Journal

Objectives: Nosocomial infections significantly impact patient morbidity, mortality, and healthcare costs. To determine the prevalence, bacteriological profiles, antimicrobial susceptibility patterns, and resistance distribution of pathogens causing nosocomial infections at King Faisal Medical Complex, Taif, Kingdom of Saudi Arabia. Methods: This cross-sectional study was conducted between September 2023 and March 2024 at different hospital units following ethical approval. Samples (n = 667) were collected from patients (both genders; all ages) exhibiting infection symptoms ≥ 48 h post-admission and pre-antibiotic administration. Bacterial identification involved culture, Gram staining, and biochemical tests. Antimicrobial susceptibility was tested using the Phoenix100 system. Results: Of 667 patients, …

From Early Adversity To Adult Health: Quality-Of-Life Consequences In A Mental Illness In Saudi Arabia, Rawan Saad Alghamdi, Ahmad A. Mirza, Ibrahim Fae Asiri, Fatemah Samir Alghamdi, Nawaf Abdulaziz Alharthi, Shaymaa A. Abdalal, Iman K. Ramadan

Saudi Medical Journal

Objectives: Childhood trauma (CT) is prevalent among bipolar disorder (BD) patients and exacerbates clinical outcomes, which may impact the quality of life (QoL). This study explores the prevalence of CT and its association with QoL among BD patients in Saudi Arabia. Methods: Cross-sectional study conducted among adults with BD during the euthymic phase. Sample size was estimated using a single-proportion approach (target n=141), and participants recruited by convenience sampling of eligible outpatients. CT was assessed using the Childhood Trauma Questionnaire (CTQ), and QoL using the the Brief Quality of Life in Bipolar Disorder (Brief QoL.BD). Results: The CT prevalence was …

Re-Emergence Of Pertussis In The Pediatric Population: A Tertiary Care Center's Experience, Haya S. Alshaibani, Tahir K. Hameed, Khaled H. Alsager, Mohammed A. Alshaalan, Syed F. Jamil

Saudi Medical Journal

Objectives: To describe the 2024 surge in pertussis cases in the pediatric population in a large tertiary care center in Riyadh, Saudi Arabia. Methods: A retrospective observational study was conducted on children aged 0–14 years with PCR-confirmed Bordetella pertussis infection diagnosed at a tertiary hospital in Riyadh between January and December 2024. Patients older than 14 years, with negative or indeterminate PCR results, or diagnosed outside the study period were excluded, and demographic, immunization, clinical, and outcome data were analyzed. Results: A total of 36 children were diagnosed with pertussis, with 35 (97.2%) requiring hospital admission. The median age was …

A Retrospective Cohort Study Of Uterine Cancer Epidemiological Analysis And Age-Based Disparities In Saudi Arabian Population Across 32 Years, Sallwa M. Alshehre, Mohammad A. Althubiti

Saudi Medical Journal

Objectives: To investigate the burden of uterine tumour in Saudi Arabia during the past 32 years (1990–2021), with an emphasize on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Knowing these patterns strengthen the national aims of cancer control under Kingdom of Saudi Arabia (KSA) Vision 2030. Methods: A retrospective study was performed using data retrieved from the Global Burden of Disease (GBD) database. The work included population from Saudi Arabia between 1990 and 2021 and tested standardization age-specific metrics, involving uterine tumour incidence, prevalence, mortality, and DALYs. Results: Uterine tumour cases raised from 507 in 1990 to 6,366 …

Seroprevalence Of Hepatitis B And Hepatitis C In Patients Hospitalized In Palliative Care Service, Meryem Betos Koçak, Burcu Güler

Saudi Medical Journal

Objectives: Patients receiving palliative care often have complex comorbidities and frequent healthcare exposure, which may place them at risk for blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV). However, data on the seroprevalence and prognostic impact of these infections in palliative populations remain limited. This study aimed to determine the seroprevalence of HBV and HCV markers in patients hospitalized in a palliative care unit and to assess their association with mortality. Methods: This retrospective study conducted on 545 adult patients a tertiary palliative care unit between 2018 and 2024. Demographic characteristics, comorbidities, nutritional support, mobility, …

Artificial Intelligence In Dialysis Therapies: Applications In Hemodialysis And Peritoneal Dialysis For Managing Infectious Diseases And Complications, Waleed H. Mahallawi

Saudi Medical Journal

This narrative review synthesizes evidence from a systematic literature search (2019–2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing …

Post-Stroke Fatigue In Saudi Arabia: A Call To Action, Saad Z. Alqahtani

Saudi Medical Journal

Post-stroke fatigue (PSF) is a major consequence of stroke, with a prevalence of approximately 42–53% among stroke survivors. However, over the last 2 decades, only a few studies have explored PSF in Kingdom of Saudi Arabia (KSA). Findings from these studies show that PSF negatively impacts the quality of life of individuals with stroke. Furthermore, they emphasize the need for education for both health care providers and patients regarding PSF. This call-to-action mini narrative review identifies knowledge gaps and provides recommendations for both researchers and policymakers, including the need for standardized management and the exploration of hospital environment settings. Specifically, …

Contribution Of Interleukin-6 (Il-6) To Body Defense And Healing In Pulmonary Tuberculosis, Hasrah Junaidi, Annis C. Adi, Soedarsono Soedarsono, Soetjipto Soetjipto, Chatarina U. Wahyuni, Fariani Syahrul, Mahmudah Mahmudah, Zakiyuddin Zakiyuddin, Iskandar Arfan, Abdullah A. Mamun, Rubia Sari

Saudi Medical Journal

Objective: To examine the contribution of IL-6 to host defense and healing in pulmonary tuberculosis (TB). Pulmonary tuberculosis continues to pose a significant global health challenge, with disease outcomes determined by complex host–pathogen interactions. Interleukin-6 (IL-6), a multifunctional cytokine, has been implicated in immune regulation and tissue recovery during TB, but its specific role is not fully established. This review aimed to examine the contribution of IL-6 to host defense and healing in pulmonary TB. Methods: A comprehensive literature search was performed across PubMed, Scopus, Web of Science, ScienceDirect, and Medline following PRISMA guidelines, covering publications from 2015 to 2025. …

Impact Of Treatment On The Health-Related Quality Of Life Of Children With Cancer In Saudi Arabia, Fayzah Hussain Alhussain, Amany Anwar Saeed Alabdullah

Saudi Medical Journal

Objective: The impact of cancer on health-related quality of life (HRQOL) is considerable, particularly for children undergoing oncological treatment. While research has addressed HRQOL in childhood cancer survivors, less attention has been given to those actively undergoing treatment, including in Saudi Arabia. This systematic review aimed to address this gap by quantitatively evaluating studies reporting on the HRQOL of children in Saudi Arabia during their active cancer treatment phase. We also compare these findings with studies from around the world, emphasising demographic, medical and parental predictors of HRQOL. Methods: A comprehensive search of relevant databases (MEDLINE, CENTRAL, Embase, PsycINFO and …

Efficacy Of Continuous Pegcetacoplan Treatment For Subfoveal Geographic Atrophy In Age-Related Macular Degeneration: 36-Month Results From Oaks, Derby, And Gale Open-Label Extension, Dilsher S. Dhoot, Sunir J. Garg, David M. Brown, Ivan J. Suñer, Ehsan Rahimy, David S. Boyer, Kineta Naidu, Chao Li, Caroline R. Baumal, Robyn H. Guymer

Wills Eye Hospital Papers

PURPOSE: To report efficacy of intravitreal pegcetacoplan treatment over 36 months in eyes with subfoveal geographic atrophy (GA).

PATIENTS AND METHODS: The GALE (NCT04770545) open-label extension trial adds 12 months of results to the 24-month Phase 3 OAKS (NCT03525613) and DERBY (NCT03525600) trials, representing up to 36 months of continuous pegcetacoplan treatment. They included a heterogeneous population of eyes with subfoveal GA (63%). Pegcetacoplan-treated eyes enrolling in GALE continued at the same interval of pegcetacoplan monthly (PM) or every other month (PEOM). Patients' eyes in sham monthly or every-other-month arms crossed over to receive pegcetacoplan in GALE at the same …

Stimulant Medications And Bone Health, Christine M Swanson, Julie H Wolfe, Chadi A Calarge

Faculty, Staff and Students Publications

Purpose of review: This review summarizes the potential impact of stimulant medications on bone health, to raise awareness and optimize their safe use.

Recent findings: Stimulant medications can impair bone health through inadequate nutrient/calorie intake and stimulation of the sympathetic nervous system, which regulates bone metabolism. However, their use decreases fracture risk in younger populations ([Formula: see text]25 years old) with attention deficit/hyperactivity disorder (ADHD), likely through reductions in impulsivity and injury. Special care may be needed when fractures occur while using these medications, as recent data suggest psychostimulants are associated with impaired fracture healing. Prescription and non-prescription use of …

Cigarette And E-Cigarette Use In Greater Philadelphia: Proportion Of Use Compared To National Data And Local Predictors Of Smoking Status, Munjireen Sifat, Joshua Banks, Lilianna Phan, Kuang-Yi Wen, Julie A. Barta, Rebecca J. Melillo, Hee-Soon Juon

College of Population Health Faculty Papers

UNLABELLED: Objective tobacco use, cigarette, e-cigarette, cancer-related beliefs, perceived risk, lifestyle attribution, cancer disparities, health equity. We assessed cigarette smoking and e-cigarette use in the Greater Philadelphia region alongside national data. The objectives were to descriptively explore differences in tobacco use by sociodemographic characteristics. We also examined cancer belief associations with smoking and e-cigarette use in the local context.

METHODS: We descriptively compared cross-sectional survey data from 2744 adults in the Sidney Kimmel Comprehensive Cancer Center (SKCCC) catchment area (Greater Philadelphia region; May-July 2022) with 6252 Health Information National Trends Survey (HINTS 6) nationally representative respondents (United States; March-November 2022). …

Turf Toe And Sesamoid Fracture Case Study, Mason Cannon

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE This case presents the evaluation and management of a 15-year-old male multi-sport high school athlete. The athlete initially sustained a turf toe injury that progressed into a sesamoid fracture. This report showcases the clinical findings, treatment progression, and outcomes within a disablement model framework.

Prevalence Of Low Energy Availability (Lea) Risk In Division Iii Female Distance Athletes, Ciara Murphy

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The objective of this study was to explore the prevalence of LEA among division III female distance athletes.

The Effectiveness Of An Educational Program On Young Swimmers Water Consumption And Dry Land Exercises, Maria Thibodeaux, Shelby Bay, Maddie Hoyt, Elizabeth Starns, Elizabeth Nix

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/CONTEXT Although shown to improve performance, many young swimmers are reluctant to participate in dry land exercises.¹ They are also more likely to become dehydrated than their non-swimming counterparts, suggesting they are not adequately hydrating during activity and throughout their day.² Therefore, this study aimed to evaluate the impact of a four-week educational program on dry land exercises and water consumption.

From Focal Chondral Defect To Matrix-Induced Autologous Chondrocyte Implantation In An Active Adult: A Case Study, Zoey Scott

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Present a clinical case detailing the undetermined consequential factors associated with FCD progression  in athletic populations, and the subsequent challenges.

Post-Surgical Dislocations: A Latarjet Procedure, Brianagh Dean, Kimberly S. Peer

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

BACKGROUND The glenohumeral joint is the most frequently dislocated joint in the body, with an incidence rate of 40.4 per 100,000 in men and 15.5 per 100,000 women. Recurrence rates following a first-time anterior shoulder dislocation range from 33-40%, particularly among adolescent collision-sport athletes. Arthroscopic Bankart repair is performed to address anterior instability, however recurrent instability may occur in the presence of glenoid bone loss. The Latarjet surgery is indicated in cases of recurrent anterior instability with significant bony deficiency, functioning through a triple-blocking mechanism increasing glenoid surface area via coracoid transfer, creating a dynamic sling effect from the conjoined …