Building global collaborative research networks in paediatric critical care: a roadmap.

Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups.

Assessing the Impact of Irritable Bowel Syndrome on Quality of Life in Patients at Family Medicine and Primary Health Care Clinics of the National Guard Health Affairs, Riyadh.

Introduction Irritable bowel syndrome (IBS) is one of the most prevalent GI conditions, characterized by symptoms such as abdominal pain relieved by defecation, changes in bowel habits (e.g., diarrhea, constipation, or both), and bloating.

Gender-specific association of rs2371597 polymorphism in keratoconus patients of Saudi origin.

Objective: To investigate the association of specific genetic polymorphisms (rs2371597 in , rs11720822 in , rs387907358 in , and rs77542162 in ) in a Saudi cohort of keratoconus (KC) patients compared to controls.

Methods: A retrospective case-control genetic association study was conducted. The study included 99 KC patients and 193 healthy controls.

Age-related differences in gene expression and pathway activation following heatstroke.

This study investigates the molecular responses to heatstroke in young and old patients by comparing whole-genome transcriptomes between age groups. We analyzed transcriptomic profiles from patients categorized into two age-defined cohorts: young (mean age = 44.9 ± 6 yr) and old (mean age = 66.

A novel role for nonactin: interfering with G-quadruplex in RET-driven medullary thyroid cancer.

Background: Medullary Thyroid Carcinoma (MTC) is closely associated with mutations in the RET proto-oncogene, placing the activated RET protein at the center of MTC pathogenesis. Existing therapeutic solutions, primarily tyrosine kinase inhibitors such as selpercatinib, vandetanib, and cabozantinib, have shown moderate efficacy but are accompanied by increased risks of side effects and resistance. This study unveils a promising avenue using nonactin, a compound historically recognized for its antibacterial properties, targeting the G-quadruplex interactions within the RET proto-oncogene.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Vitiligo: Clinical and Laboratory Characteristics in 573 Saudi Patients.

Background: Vitiligo is a common disease. Limited studies in Saudi Arabia have explored the detailed clinical characteristics of vitiligo, as outlined in recent consensus reports by vitiligo experts.

Objective: To determine vitiligo prevalence and detailed clinical characteristics in a Saudi cohort.

Comparative Study Between Medical/Surgical Intensive Care Units vs. Mixed Intensive Care Units in Key Performance Indicators.

Background This comparative study evaluates the performance of medical/surgical and mixed intensive care units (ICUs) at a tertiary care university hospital in Riyadh, Saudi Arabia, using key performance indicators (KPIs). Since its establishment in 1982, the hospital has provided comprehensive medical services, including specialized, closed-model ICUs, including medical, surgical, and pediatric ICUs. In 2021, these ICUs transitioned to a mixed ICU model to enhance efficiency and patient care.

Exercise as a Therapeutic Intervention for Chronic Disease Management: A Comprehensive Review.

This comprehensive review examines exercise as a therapeutic intervention for managing chronic diseases. It explores the physiological mechanisms behind physical activity's beneficial effects and its impact on various conditions, including cardiovascular disease, diabetes mellitus, obesity, and mental health disorders. Drawing from current literature and research findings, this review highlights how regular exercise significantly reduces mortality rates, improves disease outcomes, and enhances the overall quality of life for those with chronic illnesses.

Risk of infection and conversion time from external to definitive fixation in open tibial fracture.

Background: An open fracture of the tibia is one of the most common and dangerous type of open fractures. In the management of these injuries, the primary focus is on reducing the infection rate, as this is crucial for achieving the best clinical outcomes. This study aims to explore how provisional external fixation duration influences the rates of infection and union in open tibial shaft fractures.

Meniscal tear analysis in anterior cruciate ligament rupture: A retrospective comparison of early versus delayed intervention.

Introduction: Combined anterior cruciate ligament (ACL) and meniscal tear patterns and their effect on knee stability have been widely researched, however, their evolution and repairability from time of injury have been scarcely addressed. When addressed with delay, meniscal lesions associated with ACL tears may increase in severity and irreparability. This study aims to investigate the incidence, rate and pattern of meniscus tears in the context of ACL deficient knees and to assess the meniscal condition in early versus late ACL reconstruction (ACLR).

Investigating medical students' perceptions of point-of-care ultrasound integration into preclinical education.

Introduction: Recent international consensus statements advocate for the integration of Point-of-Care Ultrasound (PoCUS) into the global undergraduate medical curriculum. Some medical schools outside Saudi Arabia have already incorporated PoCUS into their undergraduate curricula to enhance anatomy, physiology and pathology instruction. However, there are no data on the potential role of PoCUS in the preclinical training of medical students in Saudi Arabia.

Assessment of intimate partner violence victimization and its association with the psychological state of abused women and social support in Saudi Arabia: a cross-sectional study.

Background: Intimate partner violence (IPV) against women is a significant global concern, profoundly affecting physical, psychological, sexual, and financial well-being. Its prevalence is notably high in conservative societies including Saudi Arabia (SA). Given the limited research on the role of social support in IPV within SA.

Decorin alleviates non-alcoholic fatty liver disease in rats with polycystic ovary syndrome.

Endocrine multisystem defect polycystic ovary syndrome (PCOS) causes hyperandrogenism and infertility. Half of PCOS women have (non-alcoholic fatty liver disease) NAFLD, which increases metabolic disease risk. We tested decorin's effect on NAFLD and related processes in PCOS.

Unveiling the Influence of AI on Advancements in Respiratory Care: Narrative Review.

Background: Artificial intelligence is experiencing rapid growth, with continual innovation and advancements in the health care field.

Objective: This study aims to evaluate the application of artificial intelligence technologies across various domains of respiratory care.

Methods: We conducted a narrative review to examine the latest advancements in the use of artificial intelligence in the field of respiratory care.

Assessing flexible ureteroscopy outcomes for lower Pole versus non lower Pole stones using the flexible and navigable suction ureteric access sheath: a prospective multicenter study by EAU Endourology and PEARLS group.

Purpose: Use of suction in flexible ureteroscopy is increasing lately. The introduction of flexible and navigable suction access sheath (FANS) has shown improved stone free rate (SFR). However, its efficacy in lower pole stone (LPS) in terms of SFR and complications is yet to be studied.

Comparative analysis of the clinical aspects of colorectal cancer in young adult and older adult patients in Saudi Arabia.

Introduction: Recent studies have shown an increase in the prevalence of early-onset colorectal cancer (CRC) in people aged 20-49 compared to those aged 50-74, with a more rapid increase in the younger age groups. Poorly differentiated, left-sided, and rectal tumors were more common in young adults than in older adult CRC patients. We aimed to improve the understanding of early-onset CRC and to guide primary care physicians on strategies to mitigate its impact.

Diagnosis and management of sigmoid leiomyosarcoma presenting with intussusception: a case report.

Sigmoid leiomyosarcoma is a rare type of cancer that originates from smooth muscles of the sigmoid colon. This case report details a 50-year-old female found to have this condition, presenting to the emergency department with intussusception. A CT scan revealed two intraluminal masses, with the largest 10 cm from the anal verge.

An In-Depth Insight into Clinical, Cellular and Molecular Factors in COVID19-Associated Cardiovascular Ailments for Identifying Novel Disease Biomarkers, Drug Targets and Clinical Management Strategies.

COVID-19 was initially identified as a respiratory system disorder, but it has been reported to interact with and influence the cardiovascular system, in addition to many other body systems. Although COVID-19-associated cardiovascular (CV) complications are common, resulting in high acute phase mortality and a large number of morbidities in the chronic phase, thus severely impacting patients' quality of life and health outcomes, yet clinical, cellular, and molecular biological factors underlying the pathophysiology of cardiovascular complications associated with COVID-19 are poorly understood. This review investigates putative underlying clinical factors as well as cellular and molecular biological mechanisms by which COVID-19 leads to acute CV complications, including state-of-the-art genomic sequencing-based findings, and assessing the long-term CV consequences of COVID-19, aiming to shed light on developing strategies for differential diagnosis, risk prognostic stratification, prevention, and clinical management of CV sequels in COVID-19 patients.

Advanced Unresectable Differentiated Thyroid Cancer With Anaplastic Transformation: A Case Report and Review of the Literature.

Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid cancer (TC). Although surgery and radioactive iodine therapy (RAI) generally yield favorable outcomes, advanced cases with extensive local invasion and metastases pose significant challenges. We report the case of a 65-year-old male with advanced, inoperable PTC characterized by extensive local invasion and distant metastases.

Surgical Complications Following Appendectomy in Obese Patients: A Single Tertiary Care Center Study.

Background The escalating global prevalence of obesity raises concerns about its implications for health outcomes. While obesity is acknowledged as a major risk factor for various diseases, its impact on appendicitis and appendectomy outcomes remains less explored. Methods Data on overweight and obese adults aged 18 to 65 treated for appendicitis in King Abdulaziz Medical City in Riyadh, Saudi Arabia were collected retrospectively.

Insights into risk factors and outcomes of post-stroke seizures in Saudi Arabia: a multicenter analysis.

Post-stroke seizures present a global challenge, yet its frequency and factors associated with its incidence are poorly documented, particularly in the Middle East. Thus, this study aims to investigate post-stroke seizure frequency and stroke-associated factors among ischemic stroke patients in Saudi Arabia, addressing demographic, clinical, and comorbid aspects to improve prognosis, diagnosis, prevention, and management. A multicenter, cohort observational study included eligible ischemic stroke patients who were categorized into those who developed seizures after injury and those who did not.

Plastic Bronchitis-A Promising Intervention for a Challenging Condition.

This report describes the case of a 9-year-old boy with a single ventricular pathway land complex cardiac issue. After multiple cardiac procedures, including a non-fenestrated Fontan shunt at the age of 5 years, the patient presented 2 years later with a recurrent history of cough with whitish, thick and rubbery sputum and shortness of breath and was eventually diagnosed with PB. The patient was treated with medical therapy and failed; at this time, ligation of the thoracic duct was performed, which was a life-saving intervention for him.