Real-world retrospective study of effectiveness and safety of FINgOlimod in relapsing remitting multiple sclerosis in the Middle East and North Africa (FINOMENA).

Objectives: Evidence on the effectiveness and safety of fingolimod in real-world clinical practice in the Middle East and North African (MENA) region is limited. This study aimed to evaluate the effectiveness and safety of fingolimod in patients with relapsing-remitting multiple sclerosis (RRMS) in real-world setting in the MENA region.

Patients And Methods: RRMS patients who had been treated with fingolimod for at least 12 months were retrospectively identified from the databases of 34 centers across the MENA region.

Atypical Occipitocervical Dissociation Associated with Ossification of the Posterior Longitudinal Ligament and Diffuse Idiopathic Skeletal Hyperostosis in Low-Energy Trauma.

Introduction: Traumatic posterior occipitocervical dissociation (OCD) is a rare injury, and only a few cases have been reported in the literature. The diagnosis can be delayed or even missed because of its uncommon presentation. We present this rare case report and its management to highlight this unusual injury to increase the awareness of the existence of this pathology and prevent delayed diagnosis and treatment.

Open Partial Cystectomy of Intramural Bladder Leiomyoma With Unfavorable Position: A Rare Case Report.

Benign tumor of the bladder (Leiomyoma) is a rare condition representing less than 0.5% of all bladder tumors. A 50-year-old female presented with asymptomatic hematuria for three months.

Effects of chronic pain on sleep quality and depression: A cross-sectional study.

Objectives: To examined the impacts of chronic pain on depression and poor sleep quality dimensions as well as the mediating function of poor sleep quality in the pathway between chronic pain and depression.

Methods: Between March 2019 and February 2020, we conducted a cross-sectional study on 233 chronic pain patients in 2 tertiary hospitals in Riyadh, Saudi Arabia.

Results: Of the 233 patients, 36% had depression, while 66.

Hypotrichosis with Juvenile Macular Dystrophy in Saudi Arabia: A Case Report.

Hypotrichosis with juvenile macular dystrophy is an autosomal recessive disorder due to a mutation in the CDH3 gene. As its name indicates, the disease classically presented with hypotrichosis and early visual impairment. We describe herein a family member with alopecia since birth associated with severe visual impairment in their early life.

Late Complications After Previous Surgical Repair for Coarctation With Extra-Anatomic Bypass Graft: Report on Two Cases.

Surgical correction of aortic coarctation (CoA) has been the standard treatment in infants and adolescents to prevent late consequences related to obstruction and distal hypoperfusion. Several surgical techniques for CoA repair have traditionally been applied. However, late complications, including re-CoA and pseudoaneurysm formation, are not uncommon.

Safety and Efficacy of Convalescent Plasma for Severe COVID-19: Interim Report of a Multicenter Phase II Study from Saudi Arabia.

Objective: To present the interim findings from a national study investigating the safety and efficacy of convalescent plasma (CP) containing detectable IgG antibodies as a treatment strategy for severe coronavirus disease 2019 (COVID-19).

Trial Design And Participants: An open label, two-arm, phase-II clinical trial conducted across 22 hospitals from Saudi Arabia. The intervention group included 40 adults (aged ≥18 years) with confirmed severe COVID-19 and the control group included 124 patients matched using propensity score for age, gender, intubation status, and history of diabetes and/or hypertension.

Telemedicine Practice in Saudi Arabia During the COVID-19 Pandemic.

Objectives: The COVID-19 pandemic has led to an increased use of telemedicine. The primary objective of the study was to evaluate attitudes and behaviors of licensed physicians in the region to telemedicine.

Methodology: A cross-sectional design using an electronic survey as the primary tool was done.

Characteristics of Hospital Acquired Pressure Ulcer and Factors Affecting Its Development: A Retrospective Study.

Background Worldwide, pressure ulcers (PUs) have been implicated in costing billions annually, with 60,000 deaths out of 2.5 million hospitalized patients resulting from complications related to PU. The prevention of PU reduces the incidence of other illnesses, decreases the financial costs, and improves the quality of life for patients.

Attitudes Towards Introduction of Multiple Modalities of Simulation in Objective Structured Clinical Examination (OSCE) of Emergency Medicine (EM) Final Board Examination: A Cross-Sectional Study.

Purpose: Objective Structured Clinical Examination (OSCE) is the current modality of choice for evaluating practical skills for graduating emergency medicine residents of final Saudi board examination. This study aims to evaluate the attitudes of both residents and faculty towards the idea of utilizing multiple modalities of simulation in a high-stakes emergency medicine (EM) examination. The goal is to propose a method to improve the process of this examination.

The Prognostic Impact of Pulse Pressure in Acute Heart Failure: Insights from the HEARTS Registry.

Background: Low pulse pressure predicts long-term mortality in chronic heart failure, but its prognostic value in acute heart failure is less understood. The present study was designed to examine the prognostic value of pulse pressure in acute heart failure.

Methods: Pulse pressure was tested for its impact on short- and long-term mortality in all patients admitted with acute heart failure from October 2009 to December 2010 in eighteen tertiary centers in Saudi Arabia (n = 2609).

Effect of smoking on patient-reported postoperative complications following minor oral surgical procedures.

Objective: This study evaluated the effect of smoking on patient-reported postoperative complications after minor oral surgical procedures by comparing the post-extraction symptoms between smokers and nonsmokers.

Materials And Methods: Patients undergoing minor oral surgical procedures were recruited and followed up prospectively on the first, second, seventh, and twenty-first days after simple dental extractions.

Results: A total of 85 patients completed the study.

Next generation sequencing reveals novel homozygous frameshift in and splice acceptor variants in gene leading to intellectual disability, developmental delay, dysmorphic feature and microcephaly.

Intellectual developmental disorder with abnormal behavior, microcephaly and short stature (IDDABS), (OMIM# 618342) is an autosomal recessive condition described as developmental delay, poor or absent speech, intellectual disability, short stature, mild to progressive microcephaly, delayed psychomotor development, hyperactivity, seizure, along with mild to swear aggressive behavior. Homozygous frameshift mutation in Pseudouridine Synthase 7, Putative; (PUS7) OMIM# 616,261 NM_019042.3 and splice acceptor variants in Alpha-Aminoadipic Semialdehyde Synthase; (AASS) OMIM# 605,113 NM_005763.

Platelet-Rich Plasma in the Treatment of Alopecia Areata: A Review.

Platelet-rich plasma (PRP) is an autologous preparation of plasma with concentrated platelets containing various growth factors and cytokines that enhance the body's inherent capacity to repair and regenerate hair follicles. A few studies and case reports support the use of PRP for the treatment of alopecia areata (AA). Further large-scale studies are needed to evaluate the efficacy of PRP as monotherapy or in association with other therapeutic modalities for AA.

Clinical Characteristics of Hepatitis B Virus Patients After Switching to Tenofovir Alafenamide Fumarate: A Retrospective Observational Study.

Background Hepatitis B Virus (HBV) continues to be a significant global health problem despite vaccination programs and effective antiviral drugs. Aim Assess tenofovir alafenamide fumarate (TAF) as a new treatment modality in light of the clinical characteristics of HBV patients. Settings and design A real-world observational study Methods and material We collected data of 71 HBV patients and recorded the hepatitis B virus deoxyribonucleic acid (HBV-DNA) plasma levels and biochemistry test results for the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum creatinine levels at three time points, including baseline, time of switching to TAF, and six months after switching.

Enzyme-Linked Immunosorbent Assay for the Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) IgM/IgA and IgG Antibodies Among Healthcare Workers.

Background The outbreak of the novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been spreading rapidly across the world. A nucleic acid real-time quantitative polymerase chain reaction (RQ-PCR) test of nasopharyngeal samples is the standard method for the diagnosis of an active SARS-CoV-2 infection. However, many limitations of the RQ-PCR tests make them unsuitable for the simple and rapid diagnosis of COVID-19 patients.

Interferon Beta-1b and Lopinavir-Ritonavir for Middle East Respiratory Syndrome.

Background: Whether combined treatment with recombinant interferon beta-1b and lopinavir-ritonavir reduces mortality among patients hospitalized with Middle East respiratory syndrome (MERS) is unclear.

Methods: We conducted a randomized, adaptive, double-blind, placebo-controlled trial that enrolled patients at nine sites in Saudi Arabia. Hospitalized adults with laboratory-confirmed MERS were randomly assigned to receive recombinant interferon beta-1b plus lopinavir-ritonavir (intervention) or placebo for 14 days.

Anti-Neutrophilic Cytoplasmic Antibody (ANCA) Vasculitis Presented as Pulmonary Hemorrhage in a Positive COVID-19 Patient: A Case Report.

Granulomatosis with polyangiitis is a small vessel vasculitis with a wide spectrum of presentation, ranging from limited disease to life-threatening situation such as alveolar hemorrhage. Immunosuppression is the corner stone of the treatment and if left untreated, the death toll increases dramatically. We presented a case of granulomatosis with polyangiitis, presented with alveolar hemorrhage associated with COVID-19 infection.

Tumoral Calcinosis Presentation in Operated Developmental Dysplasia of the Hip: A Case Report and Review of Literature.

Tumoral calcinosis has long been a disputed clinical-pathological subject. It has been characterized by the deposition of calcium salt and hydroxyapatite in different periarticular soft tissue regions. It is most commonly seen in adults, and rarely seen in children.

Clinical, Radiological, and Histopathological Patterns of Allergic Fungal Sinusitis: A Single-Center Retrospective Study.

Objectives To explore the clinical, pathological, and imaging characteristics of allergic fungal sinusitis (AFS) and to analyze the correlation of disease duration with imaging and histopathology findings. Methods We reviewed all cases of AFS managed at the otorhinolaryngology department of King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Demographic and clinical features were collected, as well as imaging and histopathological findings, which were analyzed by time from onset.

Pelvic Aneurysmal Bone Cyst in an Adolescent: A Case Report and Literature Review.

An aneurysmal bone cyst (ABC) is a benign but locally aggressive lesion. The challenge in managing pelvic ABC arises from its relative inaccessibility and the presence of nearby neurovascular structures. In this report, we present the case of a 14-year-old female with pelvic ABC and describe the symptoms, signs, and radiographic appearance of the ABC, management, and good outcome of non-surgical management by selective trans-arterial embolization.

Middle East experience from the Asia And Latin America Fracture Observational Study (ALAFOS): Baseline characteristics of postmenopausal women with osteoporosis using teriparatide.

Objective: We aimed to describe the baseline clinical characteristics and fracture history of patients taking teriparatide in routine clinical practice in the Middle East (ME) subregional cohort of the Asia and Latin America Fracture Observational Study (ALAFOS).

Methods: Herein, we report baseline clinical characteristics of patients who were prescribed teriparatide (20 µg/day, subcutaneous injection) in four participant ME countries (Saudi Arabia, United Arab Emirates, Kuwait, and Lebanon).

Results: The ME cohort included 707 patients mean (SD) age 69.

Outcomes of microdebrider-assisted versus radiofrequency-assisted inferior turbinate reduction surgery: a systematic review and meta-analysis of interventional randomised studies.

Background: The microdebrider technique was introduced in clinical practice to provide a better outcome in nasal obstruction caused by inferior turbinate hypertrophy. We conducted this systematic review to evaluate the effectiveness of this technique, by comparison with the radiofrequency-assisted modality.

Methodology: PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched to retrieve relevant randomised studies published prior to November 2019.

Can the posterior:anterior urethral ratio on voiding cystourethrogram be used as a reliable predictor of successful posterior urethral valve ablation in male children?

Background: The role of the voiding cystourethrogram (VCUG) in the follow-up of children with posterior urethral valves (PUVs) post-ablation has been considered a standard practice. The urethral ratio and gradient of change have proven to be useful.

Objectives: We aimed to review the role of the 'ideal' ratio on predicting residual PUV post-ablation.

Patient-guided modifications of oral anticoagulant drug intake during Ramadan fasting: a multicenter cross-sectional study.

Fasting Ramadan is known to influence patients' medication adherence. Data on patients' behavior to oral anticoagulant (OAC) drug intake during Ramadan is missing. We aimed to determine patient-guided modifications of OAC medication regimen during Ramadan and to evaluate its consequences.