Hypertransaminasemia: Incidence and its Clinical Correlations in Patients with COVID-19 Infection

Background: coronavirus-19 disease recently emerged as a global pandemic affecting the respiratory system. However, during the course of the illness, the disease can directly or indirectly involve other body organs including the liver. Objectives: This study aimed to determine the incidence of hepatic involvement and its clinical significance in COVID-19 patients. Patients and Methods: This cross-sectional single-center study was conducted on 112 patients who have an infection with Covid 19 (proved by polymerase chain reaction). Depending on infection severity, patients were categorized into three groups (according to the guidelines of the Chinese National Health Committee): mild, moderate, and severe cases. Blood samples were collected from each patient and liver function tests were conducted. Abnormal hepatic enzyme was considered when any enzyme (alanine transaminase, aspartate transaminase, and alkaline phosphatase) was more than the upper normal laboratory value. Categorical variables were presented as numbers and percentages and analyzed with a Chi-square test. A P≤ 0.05 was considered statistically significant. Results: Sixty-six patients (58.93%) had normal liver enzymes, while the other 46 (41.07%) had abnormal liver enzymes. The mean age of patients with elevated liver enzymes was 45.17±11.93 years which was significantly higher than that of normal liver enzymes patients (38.92±13.47 years). In severe cases, 45.65% of patients had elevated liver enzyme compared with 43.48% in moderate group and 10.87 % in mild group. Conclusions: Acute liver injury as indicated by hypertransaminasemia is a frequent finding in COVID-19 patients. Elderly patients with moderate to severe COVID-19 are more prone to hepatic involvement. Received: May, 2022 Accepted: July, 2023 Published: Jan 2024

Does shared decision making increase prostate screening uptake in countries with a low prevalence of prostate cancer?

Background: Men over 50 should discuss the benefits and harms of prostate-specific antigen (PSA) testing with their doctors. Objectives: To investigate whether shared decision making (SDM) increases the uptake of prostate cancer screening practices among Saudi men. Methods: This community-based study recruited men aged 65 50 years between January and April 2019. Sociodemographic characteristics, history, and current medical condition information were collected. SDM information with regards to prostate cancer screening was discussed. Results: In total, 2034 Saudi men, aged between 50 and 88 years, agreed to participate in the current study. Prostate examination for early detection of cancer was recommended for 35.4% (720) of subjects. Of the subjects, 23.3% (473) reported that the physicians discussed the advantages and benefits of PSA testing, whereas only 5.6% (114) stated that the physicians explained the disadvantages and drawbacks of PSA testing. Conclusion: Our findings suggest that less than one fourth discussed the advantages and disadvantages of PSA testing with their physicians; of these, less than one third underwent PSA blood tests. Improvements are needed in SDM for and against PSA screening. SDM does not affect the intensity of PSA testing. Primary health care physicians should be actively involved in the SDM process

The SARS-CoV-2 Spike Protein Activates the Epidermal Growth Factor Receptor-Mediated Signaling

The coronavirus disease-19 (COVID-19) pandemic is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the molecular and cellular levels, the SARS-CoV-2 uses its envelope glycoprotein, the spike S protein, to infect the target cells in the lungs via binding with their transmembrane receptor, the angiotensin-converting enzyme 2 (ACE2). Here, we wanted to investigate if other molecular targets and pathways may be used by SARS-CoV-2. We investigated the possibility of the spike 1 S protein and its receptor-binding domain (RBD) to target the epidermal growth factor receptor (EGFR) and its downstream signaling pathway in vitro using the lung cancer cell line (A549 cells). Protein expression and phosphorylation were examined upon cell treatment with the recombinant full spike 1 S protein or RBD. We demonstrate for the first time the activation of EGFR by the Spike 1 protein associated with the phosphorylation of the canonical Extracellular signal-regulated kinase1/2 (ERK1/2) and AKT kinases and an increase in survivin expression controlling the survival pathway. Our study suggests the putative implication of EGFR and its related signaling pathways in SARS-CoV-2 infectivity and COVID-19 pathology. This may open new perspectives in the treatment of COVID-19 patients by targeting EGFR

Fertility Preservation among Cancer Patients in Saudi Arabia: Knowledge and Attitudes of Medical Students

Introduction: Cancer education and informing people about cancer treatment and its sequel and their fertility can significantly lessen their health risk. Objective: The aim of the current study was to assess medical students’ knowledge, attitudes, and understanding toward fertility preservation (FP) for cancer patients. Methods: This cross-sectional study was conducted among medical students at two universities in Riyadh. A questionnaire was developed based on different surveys and was adapted to our culture. It was composed of two parts: sociodemographic data and questions assessing students’ knowledge and attitudes regarding FP. The second section discussed factors that could influence the utilization of FP services. It was composed of 5 questions, 4-point Likert scale (greatly, usually, rarely, never) scored from 1 for never to 4 for greatly. Results: Students, particularly females, were more knowledgeable about different FP methods, such as Gonadotrophin releasing hormones, sperm cryopreservation, and oocyte cryopreservation. They stated that cost, lack of information, and access to FP services are the most common factors hindering the utilization of services. They expressed a good attitude toward FP; however, nearly half of them mentioned that cancer treatment should be started first before FP. Conclusion: This study demonstrated the respectable awareness and attitude of FP among Saudi medical students. However, some gaps are present, indicating the need to improve education about FP in the medical curriculum

Save the radial: go distally

Coronary artery disease is the leading cause of death worldwide.Percutaneous coronary intervention (PCI) is one of the most widely performed medical procedures used to save lives, currently over 3 million annually worldwide.The femoral artery has been the preferred vascular access site. However, radial access is gaining extensive popularity due to the benefits of earlier ambulation, fewer access site complications, and decreased rates of bleeding. Improvements in technology and understanding of the anatomic features of the vascular system have led to new insights into coronary angiography procedures.Distal radial access, which was first used in 2017, shows a higher success rate and fewer complications than previous sites; therefore, it might be the future for cardiovascular intervention.For this purpose, we conducted this prospective study at Beirut Cardiac Institute (BCI) comparing the two arms: radial vs. distal radial artery techniques through the anatomical snuffbox, in terms of patient’s length of stay, complication rate, and success rate of each procedure

Metastatic melanoma to the lung cured with lobectomy: A case report

We herein present the case of a 79-year-old female patient who presents with a single asymptomatic pulmonary nodule, melanocytic in nature, later identified as a remote secondary lesion of a primary cutaneous melanoma that was resected 22 years before presentation. Although quite atypical, the patient underwent resection of the affected pulmonary lobe; follow-up imaging did not reveal any local or distant recurrences

Saudi Oncology Society clinical management guidelines for renal cell carcinoma

In this report, guidelines for the evaluation, medical and surgical management of renal cell carcinoma is presented. It is categorized according to the stage of the disease using the tumor node metastasis staging system, 7th edition. The recommendations are presented with supporting evidence level