Saudi Medical Horizons Journal

Microvascular Complication: "Microalbuminuria"—Are Camel Dairy Products Really Helpful?

Sultan T. Alturki — 2025-01-04

Efficacy and Safety of Tofacitinib for Vitiligo: A Systematic Review

Riyad Mustafa Abuhalimeh — 2025-01-04

The main objective of this study was to evaluate and summarize the available clinical evidence on the efficacy and safety of tofacitinib for the treatment of vitiligo. A thorough search across four databases identified 416 relevant publications. After removing duplicates using Rayyan QCRI and assessing their relevance, 204 full-text articles were reviewed, and ultimately, five studies met the criteria for inclusion were included. A total of 121 vitiligo patients were included; less than half of them 52 (43%) were males. Findings indicate that while tofacitinib alone has limited effectiveness, its combination with narrowband-ultraviolet B (NBUVB) phototherapy significantly enhances repigmentation, particularly in refractory cases, including acral lesions. Micro-focused UVB phototherapy also demonstrates high efficacy, with further improvements observed when paired with tofacitinib. However, a 16-week treatment duration may be insufficient for patients with inadequate responses to prior therapies, suggesting the need for higher doses or extended treatment periods. This makes a combination of tofacitinib and phototherapy promising as a therapeutic strategy against vitiligo, with cases resistant to all the modalities of standard therapy. As promising as these results read with significant repigmentation, full optimization of treatment duration and dosage will be imperative. These findings need to be further confirmed in future large, randomized controlled trials and long-term outcomes evaluated to definitely establish a standardized protocol for vitiligo management. These efforts will be essential to fully realize the potential of Janus kinase (JAK) inhibitors as part of a comprehensive, targeted approach to the management of vitiligo.

The Bidirectional Relationship between Type 1 Diabetes and Depression according to Patient Health Questionnaire: A Systematic Review

Mohammed Ahmed Al-Anzi — 2025-01-04

The aim of this study is to examine the bidirectional type 1 diabetes (T1D) & depression relationship, using the Patient Health Questionnaire (PHQ) to measure depressive symptomatology. A total of 760 pertinent publications were found after a comprehensive search across four databases. 375 full-text publications were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; seven studies finally satisfied the requirements for inclusion. We included seven studies with a total of 2518 patients, and less than half of them 1112 (44.1%) were males. Emotional distress from managing T1D, along with chronic hyperglycemia, fatigue, and related complications, intensifies mental health challenges. Sociodemographic factors like age and disease duration, as well as biological mechanisms such as inflammation, further influence this interplay. These findings underline the importance of integrated care that simultaneously addresses both physical and psychological health in T1D patients. This review emphasizes the bidirectional relationship between T1D and depression, where depressive symptoms worsen diabetes outcomes, and managing T1D exacerbates mental health challenges. Using the PHQ as a reliable tool to measure depression, the findings highlight the need for an integrated treatment approach that includes routine depression screening, psychological therapies, and collaborative care among clinicians. Future research should prioritize longitudinal studies to explore causality and understand the biological mechanisms linking T1D and depression.

Relationship between Pre-Hospital Delays and Patient Outcomes in Acute Stroke Management: A Systematic Review

Ahmad Abdulelah Hakeem — 2025-01-04

This study aimed to investigate the associations between pre-hospital delays and outcomes for patients in acute stroke management. A total of 554 pertinent publications were found after a comprehensive search across four databases. Full-text publications (288) were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; six studies finally satisfied the requirements for inclusion. A total of 8906 patients were included, more than half of them 4953 (55.6%) were males. Research showed that early hospital admission leads to better survival, less disability, and better function, mainly from the early delivery of treatment such as thrombolysis. Nevertheless, delays are common for a variety of reasons including symptom appreciation, systemic, and/or logistical bottlenecks in emergency services. Reducing these delays by improved public awareness, improved emergency response, and better communication both between hospitals and emergency medical services (EMSs) will significantly enhance the stroke outcome and the disability burden itself. Minimizing pre-hospital delays is crucial for improving outcomes in acute stroke management. Timely and uninterrupted treatment increases access to life-saving interventions, reducing mortality and post-stroke disability. Pre-hospital delay has demonstrable effects on the outcome of acute stroke management, as early intervention is essential for survival and recovery. Strategies such as public awareness campaigns, enhanced EMS systems, and systemic reforms are essential for mitigating delays and improving stroke care efficiency. Future research should focus on evaluating interventions to reduce these delays, addressing healthcare disparities, and considering regional variations to optimize outcomes and reduce the global burden of stroke.

Link between Pediatric Inflammatory Bowel Disease and Growth Retardation: A Systematic Review

Amir Fayyaz Shaikh Sardar Muhammad — 2025-01-04

The main objective of this study was to underlie the growth impairment mechanisms in pediatric inflammatory bowel disease (IBD) patients. A total of 584 pertinent publications were found after a comprehensive search across four databases. Full-text publications (293) were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; seven studies finally satisfied the requirements for inclusion. A total of 1927 children diagnosed with IBD were included in this research; 1467 with Crohn's disease (CD) and 460 with ulcerative colitis (UC). Males were 1153 (59.5%). Growth abnormalities, especially in CD patients, are commonly observed in children with IBD, often appearing strongly before age fifteen. These growth issues, including height and weight retardation, are worsened by chronic inflammation and are particularly severe in children with low weight at diagnosis. Younger children, particularly those under ten, are more affected than older children, especially in cases of UC. Adolescents with IBD may also experience disruptions in the pubertal growth spurt, possibly due to hormonal imbalances, such as reduced insulin-like growth factor-1 (IGF-1) availability. Pediatric IBD is closely linked to growth issues, especially in children with CD and those diagnosed at a young age. Early diagnosis and proper management are essential to support normal growth and prevent long-term effects. Clinicians should monitor growth as a key indicator of disease impact and provide nutritional and medical support. Further researches are needed to identify the best strategies to address growth problems and help these children reach their full potential.

Pediatric Unplanned Admission in Specialized Tertiary Children Hospital; Case-control study.

Mohamed Daabiss — 2025-01-04

Background: Unplanned hospital admissions following surgical procedures are an important quality performance indicator, as they can reflect complications from anesthesia or surgery, in addition to communication issues within the healthcare team. Any patient who undergoes a surgical procedure under general anesthesia but has an unexpected hospital disposition, differing from the pre-operative plan, is considered to have an unplanned admission. These unanticipated admissions can have negative social, economic, and physical consequences for these patients. This study aimed to determine the proportion of unplanned post-operative admissions and to investigate the risk factors that contributed to these unplanned admissions.

Methods: The data on unplanned admissions was collected retrospectively by analyzing the medical records of children aged 14 and younger who underwent non-cardiac surgical procedures under general anesthesia at the King Abdullah Specialized Children's Hospital (KASCH) facility from January 2021 to October 2022.

Results: Out of 15,178 non-cardiac procedures performed, 119 patients (0.78%) experienced unplanned admission. The leading contributing factors were anesthesia-related in 49 patients (41.2%), surgical-related factors in 35 patients (29.4%), and communication failure between the anesthesia, surgical teams, and bed management in 19 cases (16%).

Conclusion: The unplanned admission rate of 0.78% in this facility was lower than the rates reported in the literature. However, these rates may not represent the national practice, and more multi-center studies are needed to gain a more comprehensive understanding of the extent of this problem within the country.

Awareness level of Headache Medication Side Effects within the General Population of Jeddah City, Saudi Arabia

Nora Alshareef — 2025-01-04

Background: Medication overuse headache (MOH) is a secondary headache caused by the frequent overuse of acute headache medications. In patients with primary headaches, it is characterized by a frequency of 15 or more days per month and is associated with the use of over-the-counter (OTC) analgesics for a period exceeding three months.

Objective: This study evaluated the prevalence of MOH and the level of awareness of adverse medication effects among the general population of Jeddah, Saudi Arabia.

Methods: A descriptive cross-sectional study was conducted between March 25 and May 25, 2023, using an online questionnaire administered to the general population. Data were collected from cooperative male and female residents of Jeddah City, Saudi Arabia.

Result: The questionnaire was completed by 449 individuals; of them, 388 (86.4%) were females,with 369 (82.2%) being Saudi nationals. According to the study, 39% of participants reported having headaches for one to two days within the previous month, indicating a significant prevalence of headaches. Over half of the participants (54.3%) were unaware of the side effects of headache medications. Paracetamol was the most commonly used drug (62.8%), followed by Solpadeine (10.2%) and NSAIDS (6.9%). Higher educational levels were linked to better awareness of medication side effects.

Conclusion: Our study found significant associations between socio-demographics and knowledge of headache medication's side effects, especially high educated females and frequent headache sufferers. We suggest that we need to increase awareness about the side effects of headache medication among the high school educational population in Jeddah City.

Awareness and Practice of Proper Insulin Self-Administration Among Patients With Diabetes Mellitus in Al-Ahsa, KSA

Wafa Alqahtani — 2025-01-04

Introduction: This study assessed the awareness and practices of subcutaneous insulin self-administration among diabetes mellitus (DM) patients in Saudi Arabia. The key objectives were to evaluate patients' knowledge, correlate it with glycemic control, and address gaps to enhance overall patient care for this highly prevalent condition in the region.

Methodology: This was a cross-sectional study conducted in Al-Ahsa, Saudi Arabia, using an online questionnaire to assess diabetes management in randomly selected adult DM patients aged 18-65. Ethical approval and informed consent were obtained prior to the study.

Results: The study involved 380 DM patients from Al-Ahsa, Saudi Arabia. Most were female (59.5%) and Saudi nationals (96.3%), with over half married (53.4%). While 42.1% had type 2 and 45.5% had type 1 diabetes, 12.7% were unsure of their type. 38.7% showed high insulin self-administration awareness, and 42.4% were diagnosed over 10 years ago. Patients heavily relied on healthcare professionals (75.5%) for insulin info, preferred insulin pens (91.3%), and adhered to instructions (65.3%). Factors like age, marital status, and medication use significantly impacted insulin practices. Many counted carbs (40.5%) and adjusted doses before meals (41.3%).

Conclusion: The current study highlights that 38.7% of DM patients show a comparatively high level of awareness. Carbohydrate counting and pre-meal insulin adjustments are practiced by an average of 40% of patients. There is considerable variability among patients regarding insulin practices.

Awareness, Prevalence, and Coping Measures of Premenstrual Dysphoric Disorder Among Female University Students in Riyadh

Badriya Abdulaziz Aldejain — 2025-01-04

Background: Premenstrual dysphoric disorder (PMDD) is a debilitating form of premenstrual syndrome that significantly disrupts daily life. Given its profound impact on quality of life, understanding its prevalence and awareness is essential. This study aimed to assess the awareness, prevalence, and coping strategies related to PMDD among female university students in Riyadh, Saudi Arabia.

Methods: A cross-sectional study was conducted on 896 participants aged 18-25 years, recruited from various universities through convenience sampling. Data were collected via an online survey consisting of 25 items that included socio-demographic information, menstrual history, physical activity, diet, and PMDD symptoms assessed by the Premenstrual Symptoms Screening Tool (PSST). The survey also evaluated participants' awareness of PMDD and their coping measures. Ethical approval was obtained from the Princess Nourah Bint Abdulrahman University Institutional Review Board.

Results: In total, 39.9% of participants met the criteria for PMDD, with 43.1% being health college students. Notably, 58.5% reported prior knowledge of PMDD. Coping strategies included normalization and awareness was 36.4% and frequently recognizing physical and emotional changes was 37.5%.

Conclusion: PMDD is prevalent among the female university students in Riyadh, Saudi Arabia. Also, there is a notable level of awareness regarding PMDD among the participants. This underscores the need for enhanced health education and clinical recognition of PMDD in this population.