Saudi Medical Horizons Journal

Prevalence and Factors Associated with Tinea Pedis and Tinea Unguium among Diabetic Patients in Saudi Arabia

2026-03-15T20:47:06+01:00

Background: Chronic hyperglycemia in diabetes mellitus impairs cellular immunity, phagocytic activities, and polymorphonuclear leukocytes, resulting in frequent incidence of cutaneous fungal infections with more severe clinical manifestations. In this paper, the aim was to evaluate the prevalence and factors associated with tinea pedis and Tinea Unguium among diabetic patients.

Methodology: A descriptive cross-sectional study was conducted among Saudi adults aged 18 and above from all the regions of Saudi Arabia. Data were collected conveniently via structured questionnaires. Factors associated with the incidence of tinea unguium and tinea pedis were identified through Pearson’s chi-square test, univariate and multivariate logistic regression analysis with p-value < 0.05 considered statistically significant.

Results: We included 2,952 participants, with 52% being female, 56.4% diabetes type 1, and 41.3% aged 18-30 years. Around 61% are unaware of tinea pedis, 15.1% reported a previous diagnosis of tinea pedis. Younger individuals (18–30 years) and unmarried participants showed higher infection rates, while normal BMI individuals were more affected compared to obese participants. Pet ownership and participation in sports such as swimming and basketball were significant risk factors. Additionally, the use of immunosuppressive medications and the presence of peripheral vascular disease significantly elevated the risk. Regular foot inspection was associated with higher infection rates, while consistent use of nail clippers and socks offered protective benefits.

Conclusions: Fungal infections were more frequently observed in patients with type 1 diabetes and those with poor glycemic control, whereas lower rates were noted among participants who reported adhering to good foot care practices. Therefore, promoting improved foot care and achieving optimal diabetes management are crucial for reducing the burden of these infections and their associated complications.

Awareness and Knowledge Among residents in western region Regarding Lower Gastrointestinal Bleeding Etiologie

2026-03-15T20:46:19+01:00

Background: Lower gastrointestinal bleeding (LGIB) is an important condition that may indicate serious underlying diseases, including colorectal cancer. This study aimed to assess awareness and knowledge of LGIB etiology among adults in the Western Region of Saudi Arabia (SA) and to identify factors associated with good knowledge.

Methods: A descriptive cross-sectional study was conducted among adults aged ≥18 years. Data were collected using a validated online questionnaire distributed via social media. Knowledge scores were categorized as poor (<60%) or good (≥60%).

Results: A total of 439 participants were included. Only 26.9% demonstrated good knowledge. Awareness was highest for hemorrhoids and anal fissures, while knowledge of serious causes was limited.

Conclusion: Public awareness of LGIB remains limited. Targeted educational interventions are recommended.

The violence against emergency physicians influences medical students’ choice of speciality in Saudi Arabia: a cross-sectional study

2026-03-15T20:47:38+01:00

Background

Emergency medicine (EM) physicians and trainees are particularly affected by workplace violence (WPV) in emergency departments (EDs), posing a global concern for healthcare providers. In Saudi Arabia, limited data exist on how WPV influences medical students’ specialty preferences, and clinical performance.

Methodology

Between October 2024 and January 2025, 500 Saudi medical students and clinical year interns participated in a cross-sectional online survey. The English survey evaluated exposure to violence in ED, its effect on clinical performance, reporting practices, efficacy of training, and specialty selection. SPSS was used to analyse the data using Chi-square and Fisher's Exact tests for correlations.

Results

Overall, 44.0% of participants reported witnessing WPV, predominantly verbal abuse (43.2%). Perpetrators were mainly patients (35.4%) and their relatives (40.2%). Female students (47.3%) and those with longer ED rotations experienced higher exposure (p < 0.05). Violence discouraged 25.0% from choosing EM, while 23.6% reported a negative impact on specialty decisions. Only 30.2% had received training on managing WPV, which was significantly associated with reduced intent to leave EM (p < 0.001). Underreporting was common, driven by fear of stigma and lack of authority.

Conclusion

Medical students' clinical confidence and specialty choices are greatly impacted by violence in EDs, especially for female students and those with prolonged exposure to EDs. To lessen the effects of WPV and increase the appeal of EM careers in Saudi Arabia, improved training, reporting procedures, and institutional safety measures are crucial.

Awareness of Modifiable Cardiovascular Disease Risk Factors and Primary Preventive Practices Among the General Population in Makkah City: A Cross-Sectional Study

2026-03-25T19:18:24+01:00

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide and account for about 42% of deaths in Saudi Arabia. CVDs is strongly influenced by modifiable risk factors, including smoking, physical inactivity, and unhealthy diets. However, awareness of these risk factors among the Saudi population remains suboptimal.

Objectives:

This study aims to assess knowledge, awareness, prevalence of modifiable CVD risk factors, and primary prevention practices among the general population in Makkah.

Methods

A cross-sectional survey was conducted between April and May 2025 among the general population of Makkah city. Data was collected using an online validated questionnaire targeted residents >18 years via social media.

Results

The study included 623 participants, predominantly males (54.7%) aged 40–59 years (52.5%). Most participants (87.3%) demonstrated good knowledge of modifiable CVD risk factors, with high recognition of hypertension (95.7%) and hypercholesterolemia (94.1%), but lower awareness of diabetes (67.3%). While many reported healthy practices such as daily physical activity (62.1%) and adequate sleep (77.7%), over half did not regularly monitor blood glucose or blood pressure. Good knowledge was significantly associated with gender and income and correlated with healthier lifestyle behaviors.

Conclusion

Although participants showed overall good knowledge of modifiable CVD risk factors, important gaps remained, particularly regarding diabetes, inadequate sleep, and high salt intake. Most correctly identified major risk factors such as hypertension, hypercholesterolemia, obesity, smoking, and unhealthy diet. These findings underscore the need for targeted educational interventions to address knowledge gaps and strengthen CVD prevention and risk reduction.

Keywords: Cardiovascular Disease , Primary Prevention , Health Knowledge , General Population , Makkah City

Assessment of Vitamin D Levels in Children Attending Outpatient Clinics of Johns Hopkins Aramco Healthcare, Saudi Arabia

2026-04-10T13:44:38+02:00

Abstract

Background: Vitamin D deficiency is a common public health concern worldwide. Various guidelines exist for defining normal levels, testing and supplementation, with no consensus. This study aimed to assess vitamin D levels in children aged under 14 years attending our pediatric clinics in 2024, to review testing practices, and to compare these with existing guidelines.
Methods: Data on all 25-hydroxyvitamin D (25-OH Vit D) test results for children attending our primary care clinics during 2024 were collected electronically and analysed using SPSS.
Results: A total of 1448 25-OH Vit D tests were performed for 1346 patients; 55% were female. Ages ranged from 10 months to 14 years. Average levels of 25-OH Vit D. were 44.3 ng/mL (<2 years), 28 ng/mL (2–5 years), and 17.4 ng/mL (>5 years). Levels were higher in males than in females. Vitamin D deficiency (<20 ng/mL) was present in 57% of patients, including 108 (7%) with severe deficiency (<10 ng/mL). 40% had normal levels (20–50 ng/mL). 36 tests from 31 patients (3%) showed values >50 ng/mL. High levels were reported mostly in children younger than 2 years (65%). No patient had clinical features of vitamin D toxicity.
Discussion: Vitamin D deficiency is prevalent in Saudi Arabia, as reported in national and global studies. The current variation in practice underscores the need to develop guidelines tailored to Saudi Arabia's unique cultural context.
Conclusions: We recommend universal vitamin D supplementation for all children under 14 years, restricting testing to high-risk groups, and adopting a clear protocol for retesting.

Bidirectional Relationship between Obstructive Sleep Apnea and Head and Neck Cancer: A Systematic Review of Current Evidence

2026-03-15T20:49:13+01:00

A growing body of evidence suggests a complex, bidirectional relationship between obstructive sleep apnea (OSA) and head and neck cancer (HNC), though the literature remains fragmented. This systematic review consolidates current evidence to examine this dual association, exploring both the impact of OSA on HNC biology and outcomes, and the role of HNC and its treatment in the development or exacerbation of OSA. A systematic search of PubMed/MEDLINE, Embase, Cochrane Central, and Web of Science was conducted from January 2021 to December 2025 in accordance with PRISMA guidelines. Observational and interventional studies investigating OSA as an exposure for HNC outcomes, or HNC/treatment as an exposure for OSA outcomes, were included. Study quality was assessed using the Newcastle-Ottawa Scale. Five studies met the inclusion criteria. The evidence demonstrates an alarmingly high prevalence of OSA in HNC populations, both pre- (up to 90%) and post-treatment (up to 72%). For the direction of OSA influencing HNC, pre-treatment OSA severity (Apnea-Hypopnea Index) was significantly correlated with larger primary tumor size and associated with increased tumor recurrence and mortality in one study. OSA was also linked to worse patient-reported outcomes during radiotherapy. For the reverse direction, HNC treatment (particularly radiotherapy) was strongly implicated in causing or perpetuating OSA, with studies showing persistent high OSA rates post-treatment despite anatomical changes, indicating iatrogenic, treatment-induced pathophysiology. Current evidence supports a bidirectional relationship between OSA and HNC. HNC treatment is a significant risk factor for OSA, creating a major survivorship concern. Preliminary evidence suggests pre-existing OSA may be associated with more aggressive tumor behavior and worse treatment tolerance.

Impact of preoperative immunonutrition on postoperative outcomes in gastrointestinal cancer surgery: a systematic review and meta-analysis

2026-03-30T23:23:26+02:00

Background:
Patients with gastrointestinal cancer are at significant risk of malnutrition. Notably, the condition of most patients is often more deteriorated postoperative. Infections, poorer recovery and longer hospital stays are common complications of malnutrition. While preoperative immunenutrition emerged as an intervention tended to improve postoperative outcomes, the current evidence is limited. This review aims to investigate the effect of preoperative immunonutrition on postoperative complications and recovery in patients undergoing gastrointestinal cancer surgery.
Methods:
A comprehensive literature search was performed using MEDLINE, EMBASE (via Ovid), Google Scholar, ClinicalTrials.gov., and the Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials and observational studies were included. The ROB II tool and Minors’ checklist were used to assess the risk of bias of the included studies. While the treatment effect for dichotomous outcomes was expressed as a pooled odds' ratio (OR) with a 95% CI, continuous outcomes were pooled using the standardized mean difference (Hedges' *g*) with a 95% CI.
Results:
A total of 2,536 participants from the 19 included studies met the inclusion criteria. Preoperative immunonutrition revealed a protective effect against postoperative complications in patients undergoing gastrointestinal cancer surgery (Pooled OR = 0.57, 95% CI 0.39–0.82, p = 0.001). Similarly, infectious complications were significantly reduced after preoperative immunonutrition (OR = 0.48, 95% CI 0.34–0.68, p = 0.00). In contrast, no statistically significant overall effect was found on postoperative length of hospital stay (LOS) (Pooled Hedges' g = 0.37, 95% CI -0.59 to 1.34, p = 0.45).
Conclusion:
Preoperative immunonutrition is a promising intervention in patients undergoing gastrointestinal cancer surgery. This strategy decreases infectious complications and improves postoperative response. Future research should investigate their pathways and integrate the intervention into the multimodal perioperative care guidelines. Recent randomized controlled trials — especially on high-risk malnourished patients — are required to determine the appropriate timing, and formulations and patient selection.

The Role of JAK Inhibitors in Atopic Dermatitis, Alopecia Areata, and Vitiligo: A Review article

2026-03-15T20:50:02+01:00

Janus kinase (JAK) inhibitors have emerged as a groundbreaking option in dermatologic therapy, offering a more precise approach to manage inflammatory and autoimmune skin diseases. This narrative review explores the use of JAK inhibitors in three key conditions: atopic dermatitis, alopecia areata, and vitiligo. These disorders share a common underlying mechanism involving disruption of the JAK-STAT signaling pathway, which contributes to abnormal immune responses. A growing body of clinical research highlights the effectiveness of both topical and oral JAK inhibitors in managing symptoms across these conditions. For instance, ruxolitinib cream and oral agents such as abrocitinib, baricitinib, and upadacitinib have shown strong anti-inflammatory effects and relief of itching in atopic dermatitis. In the treatment of alopecia areata, medications like baricitinib, ritlecitinib, and the recently approved deuruxolitinib have brought renewed optimism for individuals with more severe forms of the disease. Meanwhile, topical ruxolitinib has shown promise in restoring pigment, particularly on facial areas affected by vitiligo. Although these therapies are generally well-tolerated, potential risks such as infections and cardiovascular concerns necessitate ongoing safety monitoring. Overall, this review brings together the latest evidence on the use of JAK inhibitors in dermatology, highlighting their clinical impact and underscoring the need for continued research to optimize long-term safety and patient selection.