Model-Based Dose Selection of a Sphingosine-1-Phosphate Modulator, Etrasimod, in Patients with Various Degrees of Hepatic Impairment.

Etrasimod is a newly FDA-approved Sphingosine-1-Phosphate modulator indicated for moderate and severe ulcerative colitis. It is extensively metabolized in the liver via the cytochrome P450 system and may accumulate markedly in patients with hepatic dysfunction, exposing them to toxicity. The aim of the current study is to utilize a physiologically-based pharmacokinetic modeling approach to evaluate the impact of hepatic impairment on the pharmacokinetic behavior of etrasimod and to appropriately select dosage regimens for patients with chronic liver disease; Methods: PK-Sim was used to develop the etrasimod PBPK model, which was verified using clinical data from healthy subjects and subsequently adapted to reflect the physiological changes associated with varying degrees of hepatic dysfunction; Results: Simulations indicated that hepatic clearance of etrasimod is clearly reduced in patients with Child-Pugh B and C liver impairment.

Patterns of Opioid and NSAID Use in Saudi Arabia from 2010 to 2020.

The use of analgesics has increased globally over the last three decades. Prescription drug abuse has increased significantly, and opioids have been identified as causing further harm to the world. This study explored the utilization and expenditure associated with opioids and non-steroidal anti-inflammatory drugs (NSAIDs) from 2010 to 2020 in Saudi Arabia.

Management of metastatic colorectal cancer: consensus in the Gulf Cooperation Council countries.

Colorectal cancer (CRC) represents a major public health challenge globally, particularly in the Gulf Cooperation Council (GCC) countries, where it is identified as the second most prevalent form of cancer. Despite advancements in management strategies, tailored guidelines specific to the Gulf region are lacking. This paper presents consensus recommendations developed by a panel of experts from the GCC countries to address this gap.

Real-world clinical outcome of unresectable locally advanced & de-novo metastatic pancreatic ductal adenocarcinoma: a multicentre retrospective study.

Background: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with limited treatment options yielding poor outcomes. This study aimed to evaluate the real-world clinical characteristics, treatment patterns, and outcomes of patients with locally advanced unresectable and de-novo metastatic PDAC in Saudi Arabia, providing regional data to compare with international benchmarks.

Methods: This is a retrospective, multicentre study involving 350 patients diagnosed with unresectable locally advanced or de-novo metastatic PDAC between January 2015 and November 2023.

Isotretinoin musculoskeletahl side effects: a systematic review.

This study aimed to investigate musculoskeletal complications secondary to isotretinoin use. A systematic review was conducted, and a total of 49 studies, including analytical studies, case reports, and case series, were included in the analysis. The studies examined musculoskeletal symptoms, diagnostic findings, and treatment approaches associated with isotretinoin use.

Neutrophilic urticarial dermatosis without systemic disease: case report.

Neutrophilic urticarial dermatosis (NUD) is an uncommon and not well understood disease. We report a 24-year-old female with persistent present with pruritic and painful urticarial plaques unresponsive to convential treatment. Histopathologically, it demonstrates a perivascular and interstitial neutrophilic infiltrate with leukocytoclasia without evidence of vasculitis or dermal edema consistent with neutrophilic urticarial dermatosis.

MicroRNAs and long non-coding RNAs In T-cell lymphoma: Mechanisms, pathway, therapeutic opportunities.

T-cell lymphomas represent non-Hodgkin lymphomas distinguished by the uncontrolled proliferation of malignant T lymphocytes. Classifying these neoplasms and the ongoing investigation of their underlying biological mechanisms remains challenging. Significant subtypes encompass peripheral T-cell lymphomas, anaplastic large-cell lymphomas, cutaneous T-cell lymphomas, and adult T-cell leukemia/lymphoma.

Hyperlipidemia in Saudi Arabian Patients With Systemic Lupus Erythematosus.

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with increased cardiovascular risk, partly due to dyslipidemia. This study aimed to evaluate the lipid profiles of Saudi Arabian patients with SLE and examine the impact of hydroxychloroquine (HCQ) and steroid use on these profiles, with a particular focus on patients with lupus nephritis. Methods A retrospective observational study was conducted at King Saud Medical City, Riyadh, Saudi Arabia, including SLE patients treated at the hospital's rheumatology clinic between July 2023 and December 2023.

Outcomes of Anti-VEGF Therapy in Eyes with Diabetic Macular Edema, Vein Occlusion-Related Macular Edema, and Neovascular Age-Related Macular Degeneration: A Systematic Review.

Background: Anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the management of various ocular conditions, including diabetic macular edema (DME), retinal vein occlusion (RVO)-related macular edema (ME), and neovascular age-related macular degeneration (nAMD). However, there remains a need to systematically assess its effectiveness across these distinct conditions.

Methodology: A systematic review was conducted to identify studies evaluating the efficacy of anti-VEGF therapy in improving ocular outcomes in patients with DME, RVO-related ME, and nAMD.

Prevalence and Risk Factors of Schistosomiasis in Sudan: A Systematic Review and Meta-Analysis.

Schistosomiasis is considered the most widespread parasitic infection. Both and are present, and as waterborne infections, their epidemiology is closely associated with proximity and exposure to freshwater sources. The objective of the current study is to estimate the pooled prevalence of schistosomiasis among the Sudanese population and examine any associated sociocultural risk factors.

Model-informed drug discovery and development approaches to inform clinical trial design and regulatory decisions: A primer for the MENA region.

Model-Informed Drug Discovery and Development (MID3) represents a transformative approach in pharmaceutical research, integrating quantitative models to inform and optimize decision-making throughout the drug development process. This review explores the current applications, challenges, and future prospects of MID3 within the Middle East and North Africa (MENA) region. By leveraging local data and advanced computational techniques, MID3 has the potential to significantly enhance the efficiency and success rates of drug development tailored to regional health priorities.

Budget impact analysis of baricitinib for treatment of alopecia areata: A Saudi hospital perspective.

Objectives: To perform a budget impact analysis (BIA) of the adoption of baricitinib for the management of alopecia areata (AA) by a Saudi public sector payer.

Methods: A BIA model was developed to calculate the expected financial impact under two scenarios: the baseline scenario, which reflects the current mix of treatments without baricitinib, and the projected scenario, in which baricitinib is adopted. The model assumed that patients with severe AA and those with mild-to-moderate AA who did not respond to other treatments were eligible for baricitinib treatment.

Estimated direct medical cost of orthopaedic trauma surgery in Saudi Arabia: a single-centre retrospective cost analysis.

Background: Physical trauma is a significant contributor to morbidity and mortality worldwide. In Saudi Arabia, RTAs are the leading cause of injuries, with fractures being a critical aspect of trauma care. To address this prevalent healthcare burden, a detailed analysis of the costs associated with surgical interventions to optimize resource allocation and improve healthcare planning is crucial.

Risk factors and comorbidities associated with cardiac arrests and medical emergencies in interventional radiology patients.

Purpose: To investigate the incidence, predictors, and outcomes of medical emergencies in patients undergoing IR procedures at a tertiary care center.

Materials And Methods: Seven-year retrospective review of all medical emergencies in patients undergoing IR procedures at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Medical emergencies included Cardiopulmonary arrest (CPA), or emergencies that required activation of the critical care response team (CCRT).

Observational study on the prescription practices of family and pulmonary physicians for airway clearance devices in chronic obstructive pulmonary disease management.

Background: Productive cough with sputum is a prominent sign generally associated with respiratory diseases, including chronic obstructive pulmonary disease (COPD). Airway clearance devices are an option for COPD management, but physicians' preferences for and clinical practice with them are not known.

Objective: This study aims to explore preferences for and clinical practice with airway clearance devices among physicians in Saudi Arabia.

Management of severe pyogenic spinal infections: the 2SICK study by the EANS spine section.

Background Context: Spondylodiscitis management presents significant clinical challenges, particularly in critically ill patients, where the risks and benefits of surgical intervention must be carefully balanced. The optimal timing of surgery in this context remains a subject of debate.

Purpose: This study aims to evaluate the effectiveness of early surgery versus delayed surgery or conservative management in critically ill patients with de novo pyogenic spondylodiscitis.

Prevalence of Back and Neck Pain Among Orthopedic Surgeons in Riyadh, Saudi Arabia.

Background And Objectives: Orthopedic surgeons' demanding work may negatively affect their health. This study examines the prevalence of musculoskeletal (MSK) issues, specifically back and neck pain, among orthopedic surgeons in Riyadh, Saudi Arabia, and explores contributing sociodemographic factors.

Materials And Methods: We conducted an observational study that assessed the prevalence of back and neck pain among certified orthopedic surgeons using an online survey, which included Logistic regression for risk factors, one-way ANOVA for disability-contributing factors, and Tukey's post-hoc test for subgroup analysis.

Mortality patterns in chronic granulomatous invasive fungal rhinosinusitis: insights from two fatal cases.

Chronic granulomatous invasive fungal rhinosinusitis (CGIFRS) is a type of invasive fungal rhinosinusitis that is characterized by the presence of pathologic findings of non-caseating granulomas in the paranasal sinuses. This article describes two cases of CGIFRS with fatal outcomes. The first case was for a 36-year-old man who presented with headache, dizziness, and vomiting for 1 month.

Highlights of Medial Tibial Stress Syndrome in Military Recruits: A Narrative Review.

Medial tibial stress syndrome (MTSS), commonly known as shin splints, is characterized by pain and inflammation in the shin caused by repetitive stress. While often associated with sports and physical activity, MTSS can significantly impact daily life, particularly in military recruits, making it a pertinent concern for this population. This narrative review synthesizes findings from a comprehensive search of databases to explore the prevalence, risk factors, and management of MTSS among military recruits.

Comparing tele-pharmacy and standard clinic follow-up for newly initiated warfarin anticoagulation therapy: A retrospective study.

Objectives: To compare the effectiveness of providing telepharmacy anticoagulation to on-site clinics in achieving optimal outcomes for patients newly starting warfarin.

Methods: This single-center retrospective cohort study included adult patients who started warfarin for the first time and were monitored by clinical pharmacists either on-site or via telepharmacy anticoagulation clinics between January 2017 and March 2024. The primary outcome is to compare the time in therapeutic range (TTR) between the 2 groups.

Isotretinoin-induced epistaxis among acne vulgaris patients: A cross sectional study from Saudi Arabia.

Objectives: To assess the prevalence and risk factors of isotretinoin-related epistaxis, among patients of acne vulgaris.

Methods: A retrospective cohort of 230 Saudi patients who received isotretinoin for treatment of acne vulgaris, was included in the study. An online questionnaire was used to collect data regarding demographics and treatment-related adverse events.

Navigating Compound Odontomas: A Case Study of Surgical Intervention and Full-Mouth Rehabilitation in a Pediatric Patient.

Odontomas are the most prevalent odontogenic tumors, often classified as hamartomas due to their slow growth and non-aggressive nature. Typically asymptomatic, they can obstruct the eruption of adjacent teeth. While the exact causes of odontomas remain unclear, potential factors include local trauma, infection, growth pressure, and hereditary influences.

How Reliable is the Assessment of Fusion Status Following ACDF Using Dynamic Flexion-Extension Radiographs?

Study Design: Reliability study.

Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.

Prognostic Significance of C-MYC and EGFR Overexpression in Gastrointestinal Stromal Tumors: An Immunohistochemical Study.

Introduction: In addition to mutations in KIT and PDGFRA, many other genetic alterations have been described in gastrointestinal stromal tumors (GISTs), including amplifications of C-MYC and EGFR, which are often associated with increased protein expression. The main of this study was to investigate the prognostic significance of C-MYC and EGFR expression in GISTs using immunohistochemistry (IHC).

Methods: We collected all GIST cases over a 16-year period.

Molecular dynamics-based computational investigations on the influence of tumor suppressor p53 binding protein against other proteins/peptides.

The tumor-suppressing p-53 binding protein is a crucial protein that is involved in the prevention of cancer via its regulatory effect on a number of cellular processes. Recent evidence indicates that it interacts with a number of other proteins involved in cancer in ways that are not fully understood. An understanding of such interactions could provide insights into novel ways p53 further exerts its tumour prevention role via its interactions with diverse proteins.