Traumatic spinal injuries in the Kingdom of Saudi Arabia: a study of associated injuries, management and mortality

Introduction: traumatic spinal fracture is a painful and disabling injury associated with poor long-term functional outcome. The objective of the present study was to assess the frequency of spinal fractures in road traffic accident (RTA) victims, their management, mortality rate and associated injuries. This study reveals and adds useful insights to the literature from Kingdom of Saudi Arabia (KSA) in terms of incidence of RTA-related spinal fractures, including their management and mortality rate. Methods: a cross-sectional study was conducted at King Khalid Hospital and Prince Sultan Center for Health Services (KKH & PSCHS) in AlKharj, KSA from September 2016 to June 2017. A total of 120 patients suffering from spinal/vertebral fractures due to RTAs were included in this study. The data was collected from patients' charts, including age, gender, region or distribution of the spinal fracture, associated fractures, number of fractures, degrees of shock, admission to intensive care unit (ICU), treatment modalities, along with the management of spinal fractures, days of hospital stay, referral and discharges or deaths. Results: the mean age of patients was 29.21. The most common anatomic region of the fracture was the cervical region (35%). Injuries associated with traumatic spinal fracture were predominated by clavicular fractures. More than half of the victims (58.30%) had a cervical brace applied before leaving the hospital. 29.20% patients required posterior stabilization with pedicle screws. Anterior corpectomy, grafting and plating was done to 4.30% patients. Conclusion: traumatic spinal fractures require prompt diagnosis and timely management in order to improve the outcome

Restless leg syndrome in multiple sclerosis: a case–control study

ObjectivesThis study assessed the prevalence of restless leg syndrome (RLS) among patients with multiple sclerosis (pwMS) and the association between RLS and MS disease duration, sleep disturbance, and daytime fatigue.MethodsIn this cross-sectional study, we interviewed 123 patients via phone calls using preset questionnaires containing the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS) diagnostic criteria validated in both Arabic and English. The prevalence of RLS in MS was compared to a group of healthy controls.ResultsThe prevalence of RLS in pwMS, defined by meeting all four requirements included in the IRLSSG diagnostic criteria, was 30.3% compared to 8.3% in the control group. About 27.3% had mild RLS, 36.4% presented with moderate, and the remaining had severe or very severe symptoms. Patients with MS who experience RLS had a 2.8 times higher risk of fatigue compared to pwMS without RLS. pwMS with RLS had worse sleep quality, with a mean difference of 0.64 in the global PSQI score. Sleep disturbance and latency had the most significant impact on sleep quality.ConclusionThe prevalence of RLS among MS patients was significantly higher compared to the control group. We recommend educating neurologists and general physicians to increase their awareness of the increasing prevalence of RLS and its association with fatigue and sleep disturbance in patients with MS

Investigating the awareness of corporate social responsibility (CSR) disclosure and practice in Saudi Arabia

This study investigates the awareness of corporate social responsibility (CSR) disclosure and practice in Saudi Arabia by investigating how Saudi stakeholders perceieve CSR and the extent of CSR reporting practices among Saudi listed companies, particularly investing how internal and external stakeholders understand CSR and its disclosure. Furthermore this study explores the integration of CSR within Saudi Listed Companies' corporate policies and strategies and the dimensions that affect it, including the local culture, religion, regulation and governance characteristics. Semi-structured interview were used to ascertain the perspectives of CSR among different stakeholders concerning the different dimensions, and content analysis technique was used to analyse annual reports concerning the extent of CSR disclosure. Listed Companies' corporate policies and strategies were explored by both semi-structured interview and content analysis. Overall, it was found the the CSR concept become understandable and there is a development of perspective of CSR in Saudi Arabia. This research also show the CSR disclosure by Saudi listed companies is driven by legitimacy theory. The findings also show the level of of CSR disclosure in Saudi Listed Companies has been increasing recently, particularly during the last six years, with increasing integration in companies' policy and strategy. Furthermore, 'culture' was rated as the greatest contributing factor to CSR in Saudi Arabia

Florid osseous dysplasia mimicking odontogenic infections: A report of two cases and literature review

Florid cemento-osseous dysplasia (FCOD) is an uncommon fibro-osseous lesion that can affect the jaws. It involves the deposition of dense, acellular amorphous bone on a foundation of fibrous connective tissue, replacing normal cancellous bone. This condition often affects middle-aged women, with a mean age of 42. The lesion's epicenter is at the teeth apices and typically appears posterior to the canines. We present two cases of female patients, aged 49 and 26, who were both initially misdiagnosed with periapical infection and underwent root canal treatments while the lesions remained. Both patients visited our clinic. After careful history taking and clinical and radiographic examination, FCOD was diagnosed, and both patients were treated conservatively

Association between academic stress during exam period, dietary behavior and bowel symptoms among medical students in Saudi Arabia

Background: The study evaluated the levels of academic stress in medical students and investigated its association with eating habits and bowel symptoms. Methods: Two hundred and ninety seven medical students participated in the study. Medical students from all five years of study were recruited using a stratified random sampling technique. A well-structured questionnaire containing three sections on stress levels, eating habits, and bowel symptoms was self-administered. Student t-test and ANOVA were used to quantify the association between variables. Results: The medical students showed high levels of stress accounting for low (2%), moderate (72%), and high-stress levels (26%) during exams. Men showed higher stress levels than women. The levels of stress were similar in distribution across all years of study. Poor dietary habits were noted among the medical students. Around 66% reported skipping breakfast, and 69% consumed frequent unhealthy snacks. Reduced consumption of fruits less than three times per week (61.5%) and drinking water less than 2 L per day (82.3%) was noted. Mean dietary scores worsened as the stress levels increased (p = 0.007). Similarly, higher PAC-SYM scores were associated with higher stress levels (p < 0.001). Women showed more severe constipation symptoms than men (8.83 ± 8.0 2; 5.68 ± 5.87; p < 0.001). Conclusions: Alarming levels of academic stress were noted during the exam period. There is an urgent need to frame multidisciplinary strategies involving behavior modification, nutrition education and a special focus on stress reduction programs for the medical students

Assessment of food labeling knowledge and associated reading barriers among patients with diabetes

Background: The most challenging part of diabetes management for a patient with diabetes is selecting a healthy diet. The purpose of this study is to evaluate participants' knowledge of food labels, to find out the relationship between the type of diabetes mellitus (DM) and knowledge score of food labels, and to explore the barriers that prevent patients from reading food labels. Methodology: This observational study was conducted on patients with type 1 or type 2 diabetes using a validated self-administered questionnaire. The study was conducted at diabetes clinics at King Khalid University Hospital and King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, from November 2019 to February 2020. Data were analyzed using SPSS. Results: A total of 310 participants were enrolled in this study, of which 50.3% had type 1 DM, and more than half of them were female (51.6%). Patients with type 1 DM had higher mean declarative and applied knowledge scores than those with type 2 DM, regardless of whether they were taking pre meals insulin or not. The highest proportion (39.9%) had difficulty in understanding the content of the nutrition labels, and some of them (37.2%) did not receive any educational session about it. Only 9.5% of the participants did not have any difficulties in reading food labels. Conclusion: Patients with both types of diabetes tended to have poor total knowledge about food labels and faced difficulties in reading them. Provided educational sessions by primary health care and specialized physician and DM educator about food labels are recommended to help them to choose food properly

Fabrication and Assessment of Orodispersible Tablets Loaded with Cubosomes for the Improved Anticancer Activity of Simvastatin against the MDA-MB-231 Breast Cancer Cell Line

Various factors limit the use of simvastatin as an anticancer drug. Therefore, this study aimed to analyse simvastatin (SIM)-loaded cubosome efficacy against breast cancer. SIM-loaded cubosomes were prepared using the emulsification method using different glyceryl monooleate, Pluronic F127 (PF-127), and polyvinyl alcohol (PVA) ratios. The best cubosomal formula was subjected to an in vitro cytotoxicity analysis using the human breast cancer cell line, MDA-MB-231 (MDA) (ATCC, HTB-26), and formulated as oral disintegrating tablets through direct compression. PF-127 and PVA positively affected drug loading, and the entrapment efficiency percentage of different SIM-cubosomal formulations ranged from 33.52% to 80.80%. Vesicle size ranged from 181.9 ± 0.50 to 316.6 ± 1.25 nm. PF-127 enhanced in vitro SIM release from cubosome formulations due to its solubilising action on SIM. The in vitro dissolution analysis indicated that SIM exhibited an initial dissolution of 10.4 ± 0.25% within the first 5 min, and 63.5 ± 0.29% of the loaded drug was released after 1 h. Moreover, cubosome formula F3 at 25 and 50 µg/mL doses significantly decreased MDA cell viability compared to the 12.5 µg/mL dose. The untreated SIM suspension and drug-free cubosomes at all doses had no significant influence on MDA cell viability compared to the control

Anticipating future global health crises: Strategies for addressing emerging infectious diseases and preparing for the next pandemic

Introduction: Despite initial optimism about controlling infectious diseases with antibiotics and vaccines, the emergence of the HIV pandemic and recent global health crises have highlighted the persistent threat of infectious diseases. The rise of antimicrobial resistance, novel viral agents like SARS-CoV-2, and bioterrorism underscore the need for ongoing vigilance. Emerging infectious diseases are those with increasing incidence or potential for increase, often stemming from zoonotic origins due to human-animal interactions and environmental changes. Aim: This article aims to review strategies for addressing emerging infectious diseases and preparing for future pandemics, emphasizing the roles of healthcare professionals and essential preparedness measures. Methods: A comprehensive review of historical and recent data on infectious disease emergence, including zoonotic pathogens and antimicrobial resistance, was conducted. The roles of physicians, pharmacists, and nurses in managing these diseases are analyzed, along with strategies for pandemic preparedness. Results: Effective strategies include strengthening global surveillance systems, investing in research and development of vaccines and treatments, improving preparedness planning, and fostering international collaboration. Key roles of healthcare professionals include diagnosis, treatment, medication management, infection control, and patient education.&nbsp

Exploring the future of surgical practices: Advances in minimally invasive techniques and the integration of robotic technology

Background: Robotic-Assisted Minimally Invasive Surgery (RAMIS) represents a significant advancement in surgical techniques, leveraging robotic systems to enhance precision, reduce invasiveness, and improve patient outcomes. The da Vinci surgical system has been a leading example, demonstrating the potential of robotic assistance in minimally invasive procedures. Aim: This paper explores the evolution of RAMIS, focusing on technological advancements, integration with Artificial Intelligence (AI), and future directions in surgical robotics. Methods: The study reviews the development and current state of RAMIS technologies, including the historical background, state-of-the-art systems, and emerging innovations. It analyzes data from a range of sources including literature reviews, market reports, and recent research developments. Results: RAMIS systems, particularly the da Vinci surgical system, have achieved widespread adoption due to their advanced features, such as enhanced vision, improved ergonomics, and training programs. Recent advancements include AI integration, new sensor technologies, and enhanced imaging modalities. Despite these improvements, challenges remain in achieving higher levels of autonomy and addressing cost and regulatory issues. Conclusion: RAMIS continues to evolve with significant advancements in AI, haptic feedback, and simulation technologies. Future developments are expected to further enhance surgical precision and outcomes.&nbsp

The first survey of the Saudi Acute Myocardial Infarction Registry Program: Main results and long-term outcomes (STARS-1 Program).

BACKGROUND:Prior acute coronary syndrome (ACS) registries in Saudi Arabia might not have accurately described the true demographics and cardiac care of patients with ACS. We aimed to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia. METHODS:We conducted a 1-month snap-shot, prospective, multi-center registry study in 50 hospitals from various health care sectors in Saudi Arabia. We followed patients for 1 month and 1 year after hospital discharge. Patients with AMI included those with or without ST-segment elevation (STEMI or NSTEMI, respectively). This program survey will be repeated every 5 years. RESULTS:Between May 2015 and January 2017, we enrolled 2233 patients with ACS (mean age was 56 [standard deviation = 13] years; 55.6% were Saudi citizens, 85.7% were men, and 65.9% had STEMI). Coronary artery disease risk factors were high; 52.7% had diabetes mellitus and 51.2% had hypertension. Emergency Medical Services (EMS) was utilized in only 5.2% of cases. Revascularization for patients with STEMI included thrombolytic therapy (29%), primary percutaneous coronary intervention (PCI); (42.5%), neither (29%), or a pharmaco-invasive approach (3%). Non-Saudis with STEMI were less likely to undergo primary PCI compared to Saudis (35.8% vs. 48.7%; respectively, p <0.001), and women were less likely than men to achieve a door-to-balloon time of <90 min (42% vs. 65%; respectively, p = 0.003). Around half of the patients with NSTEMI did not undergo a coronary angiogram. All-cause mortality rates were 4%, 5.8%, and 8.1%, in-hospital, at 1 month, and at 1 year, respectively. These rates were significantly higher in women than in men. CONCLUSIONS:There is an urgent need for primary prevention programs, improving the EMS infrastructure and utilization, and establishing organized ACS network programs. AMI care needs further improvement, particularly for women and non-Saudis