Understanding the stroke burden in Saudi Arabia: Trends from 1990 to 2019 and forecasting through time series analysis.

Objectives: To describe age-standardized incidence and disability-adjusted life years (DALYs) of ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in the Kingdom of Saudi Arabia (KSA) from 1990 to 2019 and forecast these variables using the Global Burden of Diseases (GBD) data over the next years (2020-2030).

Methods: Poisson regression models were employed to identify significant changes in incidence rate ratios (IRRs) and DALY rates for different stroke types. For time series models, the autoregressive integrated moving average (ARIMA) and exponential smoothing state space (ETS) models were used for forecasting.

Pemphigus Vulgaris in a Sexagenarian Male: A Case Report and Review of Literature.

Pemphigus vulgaris (PV) is a rare autoimmune disorder characterized by mucocutaneous blistering due to autoantibodies targeting desmoglein proteins, leading to acantholysis. This case report presents a 60-year-old Hispanic male patient with a history of hypertension who developed PV, initially presenting with pruritic scalp lesions that progressively spread to the nares, mouth, chest, neck, and inguinal region. Despite initial management with topical treatments, the lesions persisted, prompting hospitalization.

A Case Report of Acute Pericarditis Presenting With Acute Aortic Dissection.

This case report presents a rare occurrence of acute pericarditis coinciding with acute aortic dissection (AAD), emphasizing the significance of recognizing and managing these dual conditions effectively. It highlights the necessity of a multidisciplinary approach and underscores the importance of maintaining a high index of suspicion regardless of symptomatology to ensure prompt patient management and complication prevention. This case describes a 91-year-old male patient, who initially presented with mild chest pain, and was later diagnosed with AAD alongside acute pericarditis.

Acute Rectal Bleeding in a COVID-19 Patient: Chasing a Diagnosis.

Guidelines for managing lower gastrointestinal bleeding (LGIB) can vary significantly, posing challenges in clinical settings. This case involves a previously healthy man who presented with severe acute rectal bleeding, along with COVID-19 positivity, Janeway lesions, and splinter hemorrhages. His condition rapidly deteriorated, with evidence suggesting a diverticular bleed.

The Incidental Finding of Trichilemmal Cyst in a Patient With Acute Kidney Injury.

This case highlights the importance of thorough clinical examinations from head to toe and the early diagnosis of trichilemmal cysts. We present a case of an incidentally discovered trichilemmal cyst in a 72-year-old patient who presented with acute kidney injury secondary to a urinary tract infection. In rare instances, these cysts can transform into malignant lesions.

Total Hip Arthroplasty Complications in Sickle Cell Disease: Systematic Review and Meta-Analysis.

: Microvascular occlusions caused by sickle-shaped erythrocytes in patients with sickle cell disease (SCD) can lead to increased intraoperative and postoperative complications during total hip arthroplasty (THA). This systematic review and meta-analysis aimed to estimate the overall rate of complications following THA in patients with SCD and to identify the predictors of these complications including the surgical approach. : The search was conducted across the grey literature, Google Scholar, and seven databases: Scopus, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, and Web of Science.

Posterior Inferior Cerebellar Artery Stroke Due to a Severe Right Vertebral Artery Stenosis With a Left Cervical Internal Carotid Artery Dissection: What's Next?

Guidelines for the treatment and management of ischemic strokes triggered by stenosis versus dissection are well established. However, the presence of both entities in the same patient, although rare, poses challenges for short- and long-term treatment. Here, we describe the case of a 55-year-old man who presented to the emergency department with a 72-hour history of headache, dizziness, unbalanced gait, nausea, and two episodes of vomiting.

Routine childhood immunization in Sub-Saharan Africa: addressing parental vaccine hesitancy.

Objectives: Parental vaccine hesitancy (VH) is a major barrier to childhood vaccination. We aimed to identify the determinants of parental VH towards routine childhood immunization in 12 Sub-Saharan African countries.

Study Design: A cross-sectional study was conducted from November 1 to December 15, 2022.

How can imported monkeypox break the borders? A rapid systematic review.

Background: Monkeypox was designated as an emerging illness in 2018 by the World Health Organization Research and Development Blueprint, necessitating expedited research, development, and public health action. In this review, we aim to shed the light on the imported cases of monkeypox in attempt to prevent the further spread of the disease. Methodology An electronic search in the relevant database (Web of Science, PubMed Medline, PubMed Central, Google scholar, and Embase) was conducted to identify eligible articles.

Unidentified Object in the Mediastinum: A Case Report of Severe Aortic Calcification in a Patient With Rheumatoid Arthritis.

We present a case of an 80-year-old female with a past medical history of rheumatoid arthritis (RA) who was incidentally found to have severe circumferential thoracic aortic calcification detected on chest X-ray and computed tomography (CT) scan of the chest. This case highlights the chronic inflammatory state and immunological vascular damage as key mechanisms for the accumulation of dystrophic calcification in the blood vessels and soft tissues of patients with autoimmune and inflammatory diseases. It also emphasizes the importance of coordinated multidisciplinary care and management between different specialties including primary care physician (PCP), cardiology, and rheumatology to address all the challenges related to disease control and optimize cardiovascular risk factors in this patient population.

Presentation and management of female breast cancer in Egypt.

Background: There have been system inefficiencies in the profiling and management of female breast cancer in Alexandria, Egypt.

Aims: To identify barriers to full implementation of international guidelines for the management of female breast cancer patients.

Methods: Female breast cancer data were extracted from records of 3 public oncology services in Alexandria, Egypt, from 2007 to 2016 and analysed.

Nonlinear features of the superconductor-ferromagnet-superconductor φ Josephson junction in the ferromagnetic resonance region.

We demonstrate the manifestations of nonlinear features in magnetic dynamics and - characteristics of a φ Josephson junction in the ferromagnetic resonance region. We show that at small values of the system parameters damping, spin-orbit interaction, and Josephson-to-magnetic energy ratio, the magnetic dynamics is reduced to the dynamics of a scalar Duffing oscillator driven by the Josephson oscillations. The role of the increasing superconducting current in the resonance region is clarified.

COVID-19 Vaccine Booster Dose Acceptance: Systematic Review and Meta-Analysis.

The World Health Organization (WHO) recommended coronavirus disease 2019 (COVID-19) booster dose vaccination after completing the primary vaccination series for individuals ≥18 years and most-at-risk populations. This study aimed to estimate the pooled proportion of COVID-19 vaccine booster dose uptake and intention to get the booster dose among general populations and healthcare workers (HCWs). We searched PsycINFO, Scopus, EBSCO, MEDLINE Central/PubMed, ProQuest, SciELO, SAGE, Web of Science, Google Scholar, and ScienceDirect according to PRISMA guidelines.

Descending Aortic Distensibility and Cardiovascular Outcomes: A Cardiac Magnetic Resonance Imaging Study.

Background: Aortic distensibility (AD) is an important determinant of cardiovascular (CV) morbidity and mortality. There is scant data on the association between AD measured within the descending thoracic aorta and CV outcomes.

Objective: We evaluated the association of AD at the descending thoracic aorta (AD ) with the primary outcome of all-cause mortality, myocardial infarction (MI), stroke or coronary revascularization in patients referred for a cardiovascular magnetic resonance (CMR) study.

Lithium-Induced Hyperparathyroidism: An Ill-defined Territory.

Lithium is the gold standard treatment for bipolar disorder. Studies have shown an association between lithium and hyperparathyroidism. However, there is limited data regarding the management of lithium-induced hyperparathyroidism.

OUTpatient intravenous LASix Trial in reducing hospitalization for acute decompensated heart failure (OUTLAST).

Background: Hospitalization for acute decompensated heart failure (ADHF) remains a major source of morbidity and mortality. The current study aimed to investigate the feasibility, safety, and efficacy of outpatient furosemide intravenous (IV) infusion following hospitalization for ADHF.

Methods: In a single center, prospective, randomized, double-blind study, 100 patients were randomized to receive standard of care (Group 1), IV placebo infusion (Group 2), or IV furosemide infusion (Group 3) over 3h, biweekly for a one-month period following ADHF hospitalization.

The Incidence and Natural Progression of New-Onset Postoperative Atrial Fibrillation.

Objectives: This study aimed to characterize the natural progression and recurrence of new-onset postoperative atrial fibrillation (POAF) during an intermediate-term follow-up post cardiac surgery by using continuous event monitoring.

Background: New-onset POAF is a common complication after cardiac surgery and is associated with an increased risk for stroke and all-cause mortality. Long-term data on new POAF recurrence and anticoagulation remain sparse.

Prognostic Value of Intraplaque Neovascularization Detected by Carotid Contrast-Enhanced Ultrasound in Patients Undergoing Stress Echocardiography.

Background: Stress echocardiography (SE) is used for diagnosis and risk stratification of patients with known or suspected coronary artery disease (CAD). Contrast-enhanced ultrasound (CEUS) detects carotid intraplaque neovascularization (IPN). The aim of this study was to test the hypothesis that combining SE with carotid CEUS in patients with known or suspected CAD might provide incremental prognostic value beyond clinical risk factors and either test alone for the occurrence of cardiovascular events.

Identification of the possible therapeutic targets in the insulin-like growth factor 1 receptor pathway in a cohort of Egyptian hepatocellular carcinoma complicating chronic hepatitis C type 4.

Background: Molecular targeted drugs are the first line of treatment of advanced hepatocellular carcinoma (HCC) due to its chemo- and radioresistant nature. HCC has several well-documented etiologic factors that drive hepatocarcinogenesis through different molecular pathways. Currently, hepatitis C virus (HCV) is a leading cause of HCC.

Author Correction: Combined spatiotemporal and frequency-dependent shear wave elastography enables detection of vulnerable carotid plaques as validated by MRI.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Designing an Effective Colorectal Cancer Screening Program in Egypt: A Qualitative Study of Perceptions of Egyptian Primary Care Physicians and Specialists.

Background: In Egypt more than one-third of colorectal cancer (CRC) cases occur in individuals aged 40 years and younger, and are diagnosed at advanced stages; currently, CRC screening is not done as a routine part of preventive care. To lay the foundation for the development of a CRC multilevel screening program in Egypt, this qualitative study aimed to explore the perspectives of Egyptian physicians.

Materials And Methods: The PRECEDE-PROCEED model, which focuses on predisposing (intrapersonal), reinforcing (interpersonal), and enabling (structural) factors inherent in health behaviors, served as our theoretical framework.

Combined spatiotemporal and frequency-dependent shear wave elastography enables detection of vulnerable carotid plaques as validated by MRI.

Fatal cerebrovascular events are often caused by rupture of atherosclerotic plaques. However, rupture-prone plaques are often distinguished by their internal composition rather than degree of luminal narrowing, and conventional imaging techniques might thus fail to detect such culprit lesions. In this feasibility study, we investigate the potential of ultrasound shear wave elastography (SWE) to detect vulnerable carotid plaques, evaluating group velocity and frequency-dependent phase velocities as novel biomarkers for plaque vulnerability.

Perioperative clinical utility of myocardial deformation imaging: a narrative review.

Preoperative cardiac function is an important predictor of postoperative outcomes. Patients with heart failure are at higher risk of perioperative morbidity and mortality. Left ventricular ejection fraction, derived by standard echocardiography, is most frequently used to assess cardiac function in the intraoperative and postoperative periods.

Echocardiographic Assessment for the Detection of Cardiotoxicity Due to Vascular Endothelial Growth Factor Inhibitor Therapy in Metastatic Renal Cell and Colorectal Cancers.

Background: Cardio-oncology is a recently established discipline that focuses on the management of patients with cancer who are at risk for developing cardiovascular complications as a result of their underlying oncologic treatment. In metastatic colorectal cancer (mCRC) and metastatic renal cell carcinoma (mRCC), vascular endothelial growth factor inhibitor (VEGF-i) therapy is commonly used to improve overall survival. Although these novel anticancer drugs may lead to the development of cardiotoxicity, whether early detection of cardiac dysfunction using serial echocardiography could potentially prevent the development of heart failure in this patient population requires further study.