Saudi Medical Horizons Journal

Public knowledge, Attitude and Practice Towards Esophageal Cancer in Makkah region, Saudi Arabia: cross sectional study

Rifal S. Alsharif — 2025-08-25

Introduction: Esophageal cancer is a highly aggressive malignancy affecting the esophagus. In Saudi Arabia, including the Makkah region, the incidence is rising, highlighting the need for a better public understanding of the disease. This study evaluated knowledge, attitudes, and practices regarding esophageal cancer in Makkah.

Methods: A cross-sectional study surveyed the public in Makkah region using an online questionnaire distributed via Google Forms. A minimum sample size of 385 participants was targeted and selected through convenience sampling. The questionnaire assessed sociodemographic data, awareness of esophageal cancer, its symptoms, risk factors, and screening practices.

Results: Among 494 participants, 256 (51.8%) were aged 20-30 years, and 336 (68.0%) were females. Most held a bachelor’s degree (n=325, 65.8%). Only 18 (3.6%) reported a family history of esophageal cancer and 10 (2.0%) had been diagnosed with the disease. Awareness of esophageal cancer was low, with 217 (43.9%) having heard about it. The most recognized symptom was difficulty swallowing (n=316, 64.0%) and the top risk factor was smoking (n=406, 82.2%). Only 174 (35.2%) were aware of the screening program. Knowledge levels varied by age, education, and information source, with the medical field being the most reliable source of good knowledge (n=85, 67.5%).

Conclusion: There was a notable gap in public awareness of esophageal cancer symptoms and screening practices. Enhancing educational efforts and screening accessibility is crucial to address this growing health concern effectively.

Screening and Impact of Non-Pharmacological Interventions for Gastroesophageal Reflux Disease in Eastern Province of Saudi Arabia

Abdulmohsen Al Mulhem — 2025-08-25

Background: Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal condition influenced by lifestyle factors such as obesity and diet. While proton pump inhibitors (PPIs) are widely used, concerns about long-term use have increased interest in non-pharmacological interventions.

Objective: To evaluate the prevalence of GERD and the effectiveness of non-pharmacological strategies, including lifestyle changes and natural remedies, among adults in the Eastern Province of Saudi Arabia.

Methods: A cross-sectional study was conducted from January to March 2025 using an online survey. Adults aged 18 years and older were screened with the GERD-Q questionnaire. Data on demographics, lifestyle practices, and symptom management approaches were collected. Statistical analyses included t-tests, ANOVA, and Pearson correlations.

Results: Of 567 respondents, 171 met inclusion criteria (GERD-Q ≥ 8). Most were females (60.8%), aged 30–50 years, and over 70% were overweight or obese. Common interventions included avoiding lying down after meals (73.2%) and elevating the bed head (64.3%). Fewer than 18% used natural remedies such as honey, melatonin, and pomegranate, with limited perceived benefit. No significant differences in symptom severity were found between users and non-users of individual interventions. While Participants using combined treatment (both pharmacological and non-pharmacological) reported higher symptom scores (p = 0.0003), likely reflecting more severe GERD. Correlations between symptom scores and age, BMI, and lifestyle factors were weak.

Conclusion: Given the limited effectiveness observed for individual non-pharmacological interventions in the Eastern Province, personalized treatment approaches and further research are critically needed to optimize GERD management in this population.

Generational perspectives on stigma and help-seeking for mental health disorders in Saudi Arabia: A cross-sectional study

Maryam Alnaim — 2025-08-25

Background: Mental health stigma hinders care-seeking in Saudi Arabia. Generational differences affect perceptions and behaviors, with younger people more exposed to awareness efforts.

Methodology: A cross-sectional survey of 700 Saudi adults (18+) was conducted from March to Mid-July 2025 using a 28-item Arabic questionnaire assessing attitudes, stigma, help-seeking, and generational views. Data were analyzed with SPSS.

Results: Participants were 45.6% aged 18–29 and 60.9% female. Most had a bachelor’s degree (59.9%) and no prior psychological treatment (88.9%). While 88.6% believed mental illness should be treated like physical illness, 89.6% feared judgment. Females sought help more (p < 0.001). Prior treatment improved attitudes (p = 0.009) but not help-seeking (p = 0.419). The 18–29 group was seen as most accepting (61.7%). Stigma (79.6%) was the main barrier; awareness and education were key enablers.

Conclusion: Stigma and gender gaps challenge mental health support. Despite younger generations’ openness, fear of judgment remains. Tailored awareness and culturally sensitive services are vital to improve mental health care in Saudi Arabia.

Assessing the knowledge of emergency respiratory diseases among clinical year medical students in Saudi universities of Western Region

Afnan Alhawsawi — 2025-08-25

Background: This study assessed the knowledge and preparedness of clinical-year medical students in the Western Region of Saudi Arabia regarding respiratory emergencies. The objective was to evaluate their understanding of critical respiratory conditions and identify gaps in education that may hinder effective patient management. By highlighting deficiencies in training, the study aimed to support the development of improved educational strategies to better equip future physicians for respiratory crises.

Methods: A cross-sectional design was used, involving fourth- to sixth-year medical students from various Saudi universities. A structured digital questionnaire evaluated their knowledge on the recognition, diagnosis, investigation, and management of respiratory emergencies, including acute exacerbations of COPD, asthma, pulmonary embolism, chest trauma, and respiratory failure. Pre-clinical students, those studying abroad, and non-medical students were excluded. Data were analyzed using descriptive and inferential statistics, with knowledge levels classified on a three-point scale.

Results: The findings revealed that while students generally recognized clinical signs and symptoms of conditions such as pulmonary embolism and acute respiratory failure, there were significant gaps in their understanding of appropriate diagnostic and initial management strategies. Certain demographic factors, including marital status, were associated with variations in knowledge levels.

Conclusion: The study highlighted a concerning lack of preparedness among clinical-year students in handling respiratory emergencies, despite a high level of theoretical awareness. These findings underline the urgent need to strengthen medical curricula with focused education and practical training on respiratory emergency management to ensure competent and effective future physicians.

Factors Influencing Patients' Selection of Healthcare Providers: A Cross-Sectional Study in Riyadh

Abdulelah Bin Shihah — 2025-08-25

Background: In the current healthcare system, patients increasingly play a significant role in selecting their healthcare providers (HCPs). This decision-making process has the potential to enhance service quality and reduce expenses. Access to quality information about HCPs is essential for patients to make informed choices. This study aims to identify the factors influencing HCP selection among residents of Al-Majmaah, Saudi Arabia, to suggest improvements in healthcare satisfaction and efficiency.

Methods: This cross-sectional, descriptive study was conducted in Al-Majmaah, Saudi Arabia (Feb-Apr 2024), targeting 414 adults aged ≥18 via an online questionnaire (Appendix A). Statistical analysis using R v 4.3 included linear regression, Sidak adjustment, and multinomial logistic regression to assess demographic associations with HCP preferences and trust in recommendation sources. Results were visualized with box/violin plots and tested at a 5% significance level.

Results: Analysis of 414 participants revealed reputation and experience as critical HCP selection factors. Family was the most trusted recommendation source (54.6%), followed by friends (20.1%) and social media (15.9%). The X platform was most trusted (61.4%), with TikTok (14.0%) and Snapchat (13.8%) nearly equal. A significant majority (85.5%) believed more information would improve decision-making. Age influenced social media preference: younger respondents (mean age 23.63 years) preferred TikTok, while older (mean age 38.50 years) favored Facebook.

Conclusion: This study emphasizes patient HCP preferences, highlighting family and social media influence, and provider reputation and experience. It suggests prioritizing transparency, reputation, and communication to enhance patient satisfaction.

Efficacy and Safety of Topical Difamilast in the Treatment of Atopic Dermatitis: A Systematic Review

Riyad Mustafa Abuhalimeh — 2025-08-25

Atopic dermatitis (AD) is a chronic inflammatory skin disorder with significant global prevalence. Topical difamilast (OPA-15406), a selective phosphodiesterase 4 (PDE4) inhibitor, has emerged as a potential alternative to conventional therapies like corticosteroids and calcineurin inhibitors, offering targeted anti-inflammatory effects with minimal systemic exposure. This systematic review evaluates the efficacy and safety of topical difamilast in AD management, synthesizing evidence from clinical trials and comparing its performance with other treatments. Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane Library. Six studies (Phase II and III trials) met inclusion criteria. Data on efficacy (Investigator’s Global Assessment [IGA] success, Eczema Area and Severity Index [EASI] improvement) and safety (adverse events) were extracted and assessed for bias using Cochrane RoB 2 and ROBINS-I tools. Difamilast demonstrated significant efficacy, with IGA success rates of 38.46–47.1% and EASI-75 responses of 55.4–73.5% across age groups. A matching-adjusted indirect comparison showed comparable efficacy to delgocitinib. Safety profiles were favorable, with predominantly mild adverse events (e.g., nasopharyngitis) and low discontinuation rates (3.5–8.4%). Long-term studies (52 weeks) confirmed sustained benefits without serious drug-related events. Topical difamilast is an effective and well-tolerated treatment for AD, particularly in pediatric and adult populations. Its rapid onset, durable efficacy, and minimal systemic absorption position it as a promising alternative to existing therapies. Further head-to-head trials and diverse population studies are warranted to validate its global applicability.

The Association between Type 1 Diabetes and Sleep Quality: A Systematic Review

Mohammed Ahmed Al-Anzi — 2025-08-25

The complex interplay between sleep quality and glycemic control in individuals with type 1 diabetes (T1D) warrants comprehensive investigation. This systematic review aims to evaluate their relationship, with a focus on outcomes such as HbA1c, glucose variability, and nocturnal hyperglycemia. A comprehensive search of four databases led to the discovery of 2116 relevant publications. After eliminating duplicates and assessing each article for relevance, 103 full-text articles were examined, and ultimately, 10 studies were selected based on the inclusion criteria. Ten studies were included, with a total of 803 patients with T1D and 411 (51.2%) were females. Findings across studies were mixed. While some showed significant associations between poor sleep and higher HbA1c or greater glucose variability, others found no direct correlation. Notably, poor sleep was consistently linked with increased nocturnal hyperglycemia, elevated time above range (TAR), and reduced self-reported diabetes management efficacy. Sleep disturbances are prevalent in individuals with T1D and may negatively influence glycemic stability and overall disease management. While the relationship with HbA1c remains inconsistent, the impact of sleep on glucose variability and behavioral outcomes is evident. Integrating sleep assessment into routine diabetes care may improve both metabolic and quality-of-life outcomes. This highlights sleep disturbances as a significant factor in T1D management, underscoring the importance of integrating routine sleep assessment into clinical care for optimized metabolic and quality-of-life outcomes.

Association between Migraine and Irritable Bowel Syndrome (IBS): Systematic Review

Mohammed Ahmed Al-Anzi — 2025-08-25

This study aims to assess the available evidence regarding the association between migraine and irritable bowel syndrome (IBS). A comprehensive search of four databases led to the discovery of 611 relevant publications. After eliminating duplicates and assessing each article for relevance, 301 full-text articles were examined, and ultimately, 7 studies were selected based on the inclusion criteria. Seven studies were included, with a total of 721,176 patients with migraine and 318,498 (44.2%) with comorbid gastrointestinal (GI) disorders (e.g., IBS, peptic ulcers). Across the included studies, IBS prevalence ranged from 2.7% to 87.7%, with higher rates found in studies using Rome IV criteria. Migraine was consistently associated with increased odds of having IBS. The association remained significant after adjusting for confounders. Mendelian randomization suggested a potential causal direction from IBS to migraine. There is strong evidence of a significant association between migraine and IBS. Clinicians should consider screening for both conditions in affected patients. Further research is needed to clarify causality and develop integrated treatment approaches.

Atopic Dermatitis Pathogenesis And Management: A Review Article

Mohammed Fakhry Alayoubi — 2025-08-25

Atopic dermatitis (AD) is a prevalent inflammatory skin condition that affects individuals of all ages, including children. It presents with persistent itching and rash that can significantly impair quality of life. The pathogenesis of AD is multifactorial, involving immune dysregulation, genetic defects in epidermal barrier proteins such as filaggrin, and environmental factors that exacerbate skin barrier dysfunction. Clinically, AD is characterized by recurrent eczematous lesions and increased susceptibility to infections. Traditional management includes topical corticosteroids and calcineurin inhibitors to control inflammation and pruritus. In more severe cases, phototherapy and systemic immunomodulatory agents are utilized. New therapies, such as Janus kinase inhibitors (e.g., abrocitinib, upadacitinib) and biologics (e.g., dupilumab), offer targeted options with improved safety profiles. The aim of this review is to provide a comprehensive summary of the underlying mechanisms of AD, highlight recent advances in understanding its pathophysiology, and discuss current and emerging treatment strategies that reflect the evolving landscape of AD management.

Interactions Between Gout and Chronic Kidney Disease: A Systematic Review

Mamdouh Mohammed Ramadan Alanazi — 2025-08-25

Despite the recognized clinical overlap between gout and chronic kidney disease (CKD), a comprehensive synthesis of the evidence regarding their intricate relationship, encompassing disease prevalence, risk of progression, and associated outcomes, remains crucial. This systematic review aims to synthesize existing evidence on the association between gout and CKD, focusing on these key aspects. A comprehensive search of four databases led to the discovery of 816 relevant publications. After eliminating duplicates and assessing each article for relevance, 51 full-text articles were examined, and ultimately, 9 studies were selected based on the inclusion criteria. Nine studies were included, with a total of 190,760 gout patients and 133,015 (69.7%) were males. The prevalence of CKD among gout patients ranged from 16.2% to 84.1%. Adjusted hazard ratios for incident or progressive CKD ranged from 1.28 to 3.05, confirming a significantly increased risk in gout patients. Elevated serum uric acid levels were associated with worse renal function, while achieving target urate levels (<6 mg/dL) was linked to a reduced risk of end-stage kidney disease. Patients with both gout and CKD had higher healthcare utilization and increased mortality. Gout appears to be a clinically relevant risk factor for the development and progression of CKD. Routine renal screening and effective urate-lowering therapy may play a critical role in mitigating renal outcomes and improving the overall prognosis of this high-risk patient population.

Efficacy and Complications of Open vs. Laparoscopic Splenectomy: A Systematic Review

Mohamed Suliman Ali Almahadi — 2025-08-25

Splenectomy is a critical surgical intervention for various hematologic disorders, trauma, and portal hypertension. While laparoscopic splenectomy has gained popularity due to its minimally invasive nature, debates persist regarding its comparative efficacy and safety versus open splenectomy, particularly in high-risk populations. This systematic review followed PRISMA guidelines, analyzing studies from PubMed, Web of Science, Scopus, and ScienceDirect. Six comparative studies (total number = 1,320 patients) were included, assessing operative outcomes, complications, and long-term efficacy. Risk of bias was evaluated using the Newcastle-Ottawa Scale. Laparoscopic splenectomy demonstrated significant advantages, including reduced intraoperative blood loss (180 mL vs. 380 mL, p < 0.001), shorter hospital stays (6 vs. 11 days, p < 0.001), and lower complication rates (24.2% vs. 56.1%, p < 0.001). Operative times were longer for laparoscopy (185 vs. 144 minutes, p = 0.048), but conversion rates were low (0–4.8%). Pediatric outcomes were comparable, though laparoscopy had higher blood loss in some cases. Portal hypertension patients benefited from reduced transfusion needs (15% vs. 38%, p = 0.02) and lower portal vein thrombosis rates (8% vs. 22%, p = 0.03). Laparoscopic splenectomy is associated with superior perioperative outcomes and fewer complications compared to open splenectomy, supporting its preference in elective settings. However, surgeon expertise and patient selection remain crucial. Further randomized trials are needed to evaluate long-term immunological effects and cost-effectiveness.

Association of Congenital Heart Defects with Growth and Developmental Disorders in Early Childhood: A Systematic Review

Amir Fayyaz Shaikh Sardar Muhammad — 2025-08-25

Congenital heart disease (CHD), affecting ~1% of live births, is linked to growth impairment and neurodevelopmental delays in children. This PRISMA-guided systematic review analyzed PubMed, Web of Science, SCOPUS, and Science Direct for studies on CHD patients (0–18 years) assessing growth (e.g., z-scores) and developmental outcomes (cognitive/motor/language delays). Risk of bias was evaluated using JBI tools. Among 10 included studies, children with CHD—especially cyanotic/complex types—showed significant growth deficits (e.g., 37% malnutrition) and neurodevelopmental delays (e.g., 28% motor delays). Contributing factors included reduced cerebral oxygen delivery and socioeconomic disparities (e.g., low maternal education). Early interventions (e.g., home-based exercise) improved motor outcomes (*p* < 0.001). Severe CHD strongly correlates with growth/developmental impairments. Early interventions may mitigate risks, but standardized assessments and multicenter studies are needed to optimize outcomes.