Association between Serum Vitamin B12 Concentration and Obesity Among Adults in The Ksa

Objective: To investigate the relationship between serum vitamin B12 levels and weight among the adult population in KSA. Methods: This research will employ a cross-sectional study design to investigate the association between serum vitamin B12 concentration and obesity among adults in the Kingdom of Saudi Arabia (KSA). Cross-sectional studies are suitable for examining relationships between variables within a specific population at a single point in time. The target population for this study includes all adult residents of the KSA aged 18 years and older. Results: The study included 869 participants. The most frequent weight among them was 51-65 kg (n= 255, 29.3%), followed by 66 -75 kg (n= 214, 24.6%). The most frequent height among study participants was 161-170 cm (n= 324, 37.3%) followed by 151-160 cm (n= 266, 30.6%). The most frequent body mass index (BMI) value among study participants was Normal 18.5-24.9 kg/m2 (n= 344, 39.6%), followed by overweight 25-29.9 kg/m2 (n= 281, 32.3%).  Vitamin B12 varied among study participants, with most of them having a normal range (n= 319, 36.7%) followed by a low range (n= 117, 13.5%) and the least common high range (n= 23, 2.6%). On the other hand, among 410 participants, 47.2% did not know their vitamin B12 value. Wech may indicate a lack of knowledge about the topic. Figure 4 shows the vitamin B12 levels among study participants. Conclusion: Study results showed that most of the study participants do not know their vitamin B12 level and need to increase awareness, followed by those who have a normal vitamin B12 level. The most common BMI was the normal level. There was a relationship between vitamin B12 levels and obesity.

Lumbosacral plexus delineation, dose distribution, and its correlation with radiation-induced lumbosacral plexopathy in cervical cancer patients

Mutahir Tunio,1 Mushabbab Al Asiri,1 Yasser Bayoumi,2 Ali Abdullah O Balbaid,1 Majed AlHameed,3 Stanciu Laura Gabriela,1 Ahmad Amir O Ali1 1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2National Cancer Institute, Cairo University, Cairo, Egypt; 3Neurology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia Background: To evaluate the dose distribution to the lumbosacral plexus (LSP) and its correlation with radiation-induced lumbosacral plexopathy (RILSP) in patients with cervical cancer treated with intensity-modulated radiotherapy (IMRT) and high-dose-rate brachytherapy.Materials and methods: After meeting eligibility criteria, 50 patients with cervical cancer were selected who were treated with IMRT and high-dose-rate brachytherapy, and the LSP was contoured. Mean volume; percentages of LSP volume absorbing 40, 50, 55, and 60 Gy (V30, V40, V50, V55, and V60) and point doses (P1, P2, P3, P4, P5, P6, P7, P8, P9, and P10); and RILSP incidence were calculated.Results: At 60 months of follow-up, four patients (8%) were found to have grade 2/3 RILSP. The mean maximal LSP dose in patients with RILSP was 59.6 Gy compared with 53.9 Gy in patients without RILSP (control; P=0.04). The mean values of V40, V50, V55, and V60 in patients with RILSP versus control were 61.8% versus 52.8%, 44.4% versus 27.7%, 8.0% versus 0.3% and 1.8% versus 0%, respectively (P=0.01, 0.001, 0.001, and 0.001, respectively).Conclusion: The delineation of the LSP during IMRT planning may reduce the risk for RILSP. The mean values of V40, V50, V55, and V60 for LSP should be less than 55%, 30%, 5%, and 0.5%, respectively; however, further studies are warranted.Keywords: cervical cancer, intensity-modulated radiation therapy, lumbosacral plexus delineation, radiation-induced lumbosacral plexopathy, dosimetric analysi

Comparison of Performance on the Clock Drawing Test Using Three Different Scales in Dialysis Patients

Background. The clock drawing test (CDT) is frequently used to detect changes in cognition. Multiple scales of varying length have been published to assess performance. The aim of this study is to compare the CDT performance measured by three scales among a sample of nondemented patients on renal dialysis and identify the variables that affect performance. Methodology. This is a cross-sectional study performed at the dialysis unit at King Saud University Medical City. Eighty-nine dialysis patients performed the CDT. The CDT was scored by the methods of Rouleau et al. (RCS 10-point), Babins et al. (BCS 18-point), and the MoCA (MCS 3-point). Regression models were used to determine influencing demographic and dialysis variables. Scores were then correlated, and a combined factor analysis of scale components was done. Results. Females represented 44.6%, the mean (SD) age was 49.99 (15.49) years, and education duration was 10.29 (5.5) years. Dialysis vintage was 55.81 (62.91) months. The scores for the MCS, RCS, and BCS were 2.18 (1.08), 6.67 (3.07), and 11.8 (5.5), respectively, with significant correlation (P<0.0001). In all scales, increasing age was associated with a lower score (each P<0.0001). The scores increased with increasing education (each P<0.0001). Diabetics had a lower score on both the BCS and MCS by 2.56 (SE 1.2) (P=0.035) and 0.71 (P=0.003) points, respectively. However, only age and years of education were significant in the multivariable analysis. In factor analysis, two shared factors appeared between the three scales: hand and number placement and the clock face. Conclusion. Age and education influence the performance on the CDT, and factors diverged into executive and visuospatial components. The MCS is likely to yield useful information but should be interpreted as part of the MoCA

Papillary Tumor of the Pineal Region Rare Pediatric CNS Tumor Case Series Treated in King Fahad Medical City (KFMC)

The clinical behaviors, prognosis, and appropriate treatments of papillary tumors of the pineal region (PTPR) are not fully defined due to the rarity of these tumors. At diagnosis, PTPR may present with clinical symptoms, including headache with obstructive hydrocephalus, diplopia, vomiting, and lethargy, as well as neurological signs, including Argyll Robertson pupils and Parinaud&rsquo;s syndrome due to compression of the dorsal midbrain, specifically the periaqueductal region with horizontal nystagmus. Radiological assessment of pineal region lesions is challenging, with a wide range of potential differential diagnoses. PTPR typically presents as a heterogeneous, well-circumscribed mass in the pineal region, which might contain cystic areas, calcifications, hemorrhages, or protein accumulations. Here, we report three female pediatric patients with PTPR treated in King Fahad Medical City (KFMC) in Saudi Arabia. Histological and immunohistochemical diagnosis was confirmed by analysis of genome-wide DNA methylation profiles. This case series expands on the available reports on the clinical presentations of PTPR and provides important information on the responses to different treatment modalities

Outcome analysis of breast cancer patients who declined evidence-based treatment

<p>Abstract</p> <p>Background</p> <p>To analyze the characteristics and outcomes of women with breast cancer in the Northern Alberta Health Region (NAHR) who declined recommended primary standard treatments.</p> <p>Methods</p> <p>A chart review was performed of breast cancer patients who refused recommended treatments during the period 1980 to 2006. A matched pair analysis was performed to compare the survival data between those who refused or received standard treatments.</p> <p>Results</p> <p>A total of 185 (1.2%) patients refused standard treatment. Eighty-seven (47%) were below the age of 75 at diagnosis. The majority of those who refused standard treatments were married (50.6%), 50 years or older (60.9%), and from the urban area (65.5%). The 5-year overall survival rates were 43.2% (95% CI: 32.0 to 54.4%) for those who refused standard treatments and 81.9% (95% CI: 76.9 to 86.9%) for those who received them. The corresponding values for the disease-specific survival were 46.2% (95% CI: 34.9 to 57.6%) vs. 84.7% (95% CI: 80.0 to 89.4%).</p> <p>Conclusions</p> <p>Women who declined primary standard treatment had significantly worse survival than those who received standard treatments. There is no evidence to support using Complementary and Alternative Medicine (CAM) as primary cancer treatment.</p