Pectus carinatum (PC) is a chest wall deformity characterized by the anterior projection of the sternum that typically manifests in adolescence and may result in notable psychosocial morbidity despite insubstantial physiological signs. Historically considered less common than pectus excavatum, recent trends suggest that PC may be underdiagnosed, with increasing recognition and referrals to specialized pectus clinics. The main objective of this review is to provide a comprehensive understanding of the role of bracing, particularly the dynamic compression system, in the non-surgical management of PC. Traditionally, a surgical condition, PC is currently being treated more often with dynamic compression bracing, especially in younger, more flexible chest wall patients. This evidence-based review aims to analyze the optimal time to start bracing, using current literature on anatomical correction, compliance, and psychosocial outcomes. It is known that early treatment, ideally at the pre-pubertal or early pubertal stage, can result in better-bracing success, shorter treatment time, and more favorable cosmetic and emotional outcomes. The key determinants of treatment effectiveness are age, severity of deformity at the start of treatment, pressure limits, brace type, and patient cooperation. Further, physiotherapy and psychosocial support have been found to have a positive impact on adherence and quality of life. However, there is no standard protocol for bracing. As outlined in this review, the proposed solution is a patient-centered, multidisciplinary approach that combines clinical timing and personalized care to develop feasible guidelines for effective and timely bracing in adolescents with pectus carinatum.
Objectives:To investigate the incidence, etiological factors, predictors, and clinical outcomes of acute kidney injury (AKI) in patients with acute intracerebral hemorrhage (ICH). Methods:This retrospective cohort study included patients with ICH who were admitted to the ICU of Rashid Hospital, Dubai, between 2019 and 2024. Patients were grouped into AKI and non-AKI groups depending on the occurrence of AKI according to KDIGO clinical practice guidelines. Demographic characteristics, comorbidities, potential risk factors, and clinical outcomes were compared between both groups. Results:A total of 418 patients were included (median age: 44 years; males: 79.2%). Of these, 138 patients developed AKI (33%). AKI was more common in patients with spontaneous ICH (P = 0.016), males with hypertensive crisis, lower Glasgow Coma Scale (GCS) scores, and higher APACHE II scores (for all, P < 0.001). Significant etiological factors included hypertensive crisis (P = 0.005), hypotension (P = 0.024), high intracranial pressure (P = 0.004), blood transfusion (P = 0.002), diabetes insipidus (P < 0.001), and rhabdomyolysis (P = 0.017). Lower GCS scores on admission was associated with AKI (rpb : -0.23; P < 0.001). Factors that were independently associated with the development of early AKI were history of chronic kidney disease (OR: 4.79, 95% CI: 2.29-10.04; P < 0.001), diabetes insipidus (OR: 3.97, 95% CI: 1.95-8.10; P < 0.001), and hypertensive crisis (OR: 2.09, 95% CI: 1.21-3.61; P < 0.008). AKI was associated with lower GCS score at ICU discharge (P < 0.001) and increased length of ICU stay (P = 0.017), requirement for and duration of mechanical ventilation, incidence of brain death, 28-day mortality (for all, P < 0.001), and >28-day mortality (P = 0.004). Conclusions:Acute kidney injury (AKI) develops in about one third of patients with acute intracerebral hemorrhage (ICH). Lower GCS score, chronic kidney disease history, diabetes insipidus and hypertensive crisis are independently associated with increased odds of AKI. AKI is associated with an increase in morbidity and mortality in ICH patients.
Background:Spine pain conditions, such as low back pain (LBP) and neck pain, are prevalent musculoskeletal disorders. The autonomic nervous system (ANS) has been implicated as a potential contributor to pain. However, research investigating the impact of physiotherapy interventions on ANS function in patients with spinal pain disorders remains limited. Objective:This review aims to examine the influence of physiotherapy interventions on the ANS in patients with spinal pain conditions. Methods:A comprehensive literature search was conducted in PubMed, CINAHL, Web of Science, Ovid, and the Cochrane Controlled Trials Register to identify eligible randomized clinical trials. For meta-analysis, a random-effects model was used to compare the effects of physiotherapy interventions on ANS outcomes to comparison interventions. Results:A total of 16 studies were included in the systematic review, of which 11 were eligible for meta-analysis. Nine studies focused on participants with LBP, while seven studies focused on neck pain. The included studies investigated a variety of physiotherapy interventions compared to various control interventions. The meta-analysis revealed no statistically significant difference in ANS-related parameters between physiotherapy and comparison groups for LBP (pooled standardized mean difference [SMD] = 0.12; 95% CI: -0.10, 0.32; I2 = 55%) or neck pain (SMD = 0.09; 95% CI: - 0.29, 0.46; I2 = 74%). Conclusions:This systematic review and meta-analysis found no evidence that physiotherapy interventions induce ANS modulation compared to other interventions. Funding:None. Registration:PROSPERO (registration no.: CRD42023460760).
Travel has been increasing globally since the COVID-19 pandemic ended, including travel from the Gulf Cooperation Council (GCC) countries to international destinations. This creates unique risks for travelers, who may return with various infectious diseases. Travel medicine is a well-established medical specialty worldwide; however, it has only recently been introduced within the GCC, with limited healthcare and public awareness of the importance of these services in preventing infectious diseases among international travelers. This document presents travel medicine recommendations for practicing clinicians in the GCC to help prevent these diseases through pre-travel consultation.
Osteoarthritis (OA) is the most prevalent degenerative joint disease and a leading cause of chronic pain and disability worldwide, particularly among aging populations. It is characterized by progressive degeneration of articular cartilage, synovial inflammation, subchondral bone remodeling, and metabolic alterations in the infrapatellar fat pad, reflecting pathology across the entire joint microenvironment. The onset and progression of OA are driven by complex interactions among mechanical stress, aging, obesity, and metabolic dysregulation, which collectively disrupt joint homeostasis. Mechanical injury and cartilage damage induce the release of damage-associated molecular patterns, activating innate immune receptors on chondrocytes and synovial cells. This promotes the production of pro-inflammatory mediators, including interleukin-1β, tumor necrosis factor-α (TNF-α), interleukin-6, and interleukin-17, which contribute to extracellular matrix degradation and cartilage deterioration. MicroRNAs (miRNAs), small non-coding RNAs that regulate gene expression post-transcriptionally, have emerged as key modulators in OA pathogenesis. They regulate chondrocyte proliferation, apoptosis, extracellular matrix turnover, inflammation, and osteochondral remodeling. Notably, certain miRNAs exhibit mechanosensitive properties, responding to altered biomechanical loading and translating mechanical stimuli into gene regulatory responses. This review synthesizes current evidence on the roles of miRNAs in OA, focusing on their regulatory functions across joint tissues, including cartilage, synovium, subchondral bone, and the infrapatellar fat pad. Key miRNAs such as miR-140, miR-146a, miR-27b, miR-34a, miR-155, and mechanosensitive miR-365 are discussed, along with their interactions with major inflammatory and degenerative signaling pathways. Their potential as diagnostic biomarkers and therapeutic targets is also highlighted.
Background:Dupilumab, an IL-4 and IL-13 inhibitor, has been approved for the treatment of eosinophilic esophagitis (EoE), a type two inflammatory disease. Few studies from Saudi Arabia have reported the prevalence and characteristics of EoE and treatment response, particularly dupilumab. Objective:To report dupilumab treatment outcomes in adult Saudi patients with EoE. Methods:This retrospective cohort study included all adult treatment-refractory EoE patients who received subcutaneous dupilumab 300 mg between January 2023 and November 2024 at a tertiary hospital in Riyadh, Saudi Arabia. Patient demographics, clinical characteristics, and procedural data were recorded. The primary outcome was to evaluate clinical response to dupilumab, and the secondary outcome was to compare Endoscopic Reference Score (EREFS) and histological outcome following dupilumab treatment with baseline assessments. Results:A total of 22 patients were included (mean age: 29.7 ± 11.2 years; male: 63.6%). At baseline, most had dysphagia to solids (95.5%) and type 2 inflammatory comorbidities (72.7%). In addition, all patients were on PPIs and had >15 eosinophils/hpf on histology. After dupilumab treatment, 91% (95% CI: 74.3%-97.9%) achieved symptomatic improvement. Post-dupilumab esophagogastroduodenoscopies were performed in 21 patients (median duration: 9.5 months), and most showed reduced inflammatory features. EREFS scores decline from a median of 3 units at baseline to 1 unit after dupilumab treatment (P <0.001). Histological remission (<15 eosinophils/hpf) was achieved in 87.5% of biopsied patients (63% of total cohort). Adverse events occurred in 27.3%, mainly injection-site reactions (66.7%). Conclusion:In this cohort study of Saudi adults with refractory eosinophilic esophagitis, dupilumab treatment was associated with significant clinical, endoscopic, and histological improvements, in addition to having an acceptable safety profile.
Background:Multiple sclerosis (MS) is a non-traumatic disability that affects the central nervous system and reduces quality of life (QoL). No study from Jordan has specifically assessed the QoL in patients with MS. Objectives:To evaluate QoL among Jordanian MS patients and examine its association with sociodemographic and medical characteristics. Methods:This cross-sectional analytical study included adult Jordanian MS patients (aged ≥18 years) who attended the MS Unit at Albasheer Governmental Teaching Hospital, Amman, between December 2023 and July 2025. Data was collected through face-to-face interviews using the validated 26-item WHOQOL-BREF questionnaire. Results:A total of 300 patients with MS were included (mean age: 35.3 ± 11.1 years; female: 68.7%). The overall mean QoL score was 57.2 ± 15.2, indicating generally low QoL. Physical and psychological domains had lower mean scores (49.7 ± 18 and 57.8 ± 18.4, respectively). In the univariate analysis, significant risk factors for poor QoL were parental consanguinity (OR: 1.88, 95% CI = 1.01-3.45) and smoking (OR: 1.74, 95% CI = 1.08-2.77). In the multivariable logistic regression analysis, factors independently associated with lower odds of higher QoL were smoking (OR = 0.454, 95% CI: 0.236-0.871; P = 0.018), having one comorbidity (OR = 0.278, 95% CI: 0.108-0.714; P = 0.008), and secondary progressive MS (OR = 0.260, 95% CI: 0.084-0.798; P = 0.019). Conclusions:The overall QoL of Jordanian multiple sclerosis patients is poor, particularly in the physical and psychological domains. Factors independently associated with lower odds of higher QoL were smoking, having one comorbidity, and secondary progressive multiple sclerosis, and thus interventions targeting these risk factors may improve the QoL.
Background:Patients with sickle cell disease (SCD) are at an increased risk of pulmonary complications, including acute chest syndrome, which can lead to significant morbidity and mortality. Objective:To determine the impact of SCD on pulmonary functions using spirometry and to identify an association between the level of hemoglobin S (Hgb S) and spirometry values. Methods:This retrospective study enrolled adult patients with SCD who had undergone spirometry testing at a university hospital in Saudi Arabia between February 2020 to January 2023. Spirometry parameters included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and their ratio. Abnormal spirometry was subcategorized into obstructive and restrictive patterns. Spirometry was performed according to the American Thoracic Society/European Respiratory Society guidelines. Results:The study included 68 patients with SCD (female: 67.7%). A total of 28 (41.2%) patients had abnormal spirometry, of whom 85.7% had restrictive patterns. No statistically significant correlation was found between Hgb S levels and FVC or FEV1. Baseline characteristics including age, sex, previous medical history of pneumonia or ACS, use of HU, white blood cells, hemoglobin levels and hemoglobin electrophoresis, were not statistically different between those with normal and abnormal spirometry. However, SCD patients with abnormal spirometry had higher platelet counts (P = 0.03). Conclusion:This study found that higher Hgb S levels were not associated with abnormal spirometry in patients with sickle cell disease. The predominant abnormal spirometry pattern was restrictive, and higher platelet counts is a potential predictor of an abnormal spirometry in patients with sickle cell disease.
Background:Breast reconstruction surgery (BRS) following mastectomy offers psychological and physical benefits; however, its acceptance remains limited among patients. Cultural perceptions, lack of awareness, and limited communication with healthcare providers may contribute to this gap. Objectives:To assess knowledge, misconceptions, attitudes, barriers, and motivators related to BRS among mastectomy patients in Eastern Saudi Arabia, and to explore associations with demographic and clinical factors. Methods:This cross-sectional survey was conducted from February to June 2025 at King Fahd Hospital of the University, Al Khobar, Saudi Arabia, and included all women who underwent mastectomy for breast cancer between 2016 and 2025. Data were elicited using a self-administered questionnaire assessing demographics, breast cancer history, knowledge and misconceptions about BRS, attitudes, and perceived barriers and motivators. Results:Of 144 eligible patients, 100 completed the questionnaire (response rate: 69.4%). Only 15% of patients had undergone BRS. Most patients had moderate misconceptions (85%), while 22% had excellent knowledge about BRS. Nonetheless, 65% had a positive attitude and 52% expressed willingness to undergo BRS. Key barriers included fear of additional surgery (42.4%) and lack of knowledge (38.8%), while key motivators were restoring body image (93.3%) and improving self-esteem (80%). In the univariate analysis, significant associations were observed between knowledge levels and factors such as age (P = 0.010), education (P < 0.001), income (P = 0.008), and current/past employment in healthcare (P = 0.008). However, in the multivariate logistic regression analysis, no variable was found to be an independent predictor of high knowledge of BRS. Conclusion:In breast cancer patients who underwent mastectomy in Eastern Saudi Arabia, there is positive attitude and willingness toward breast reconstruction surgery, yet the proportion of patients who underwent the surgery is low. The primary barriers identified are modifiable, and thus enhanced patient education and counseling may improve decision-making about breast reconstruction surgery.
Objective:To determine clinical and laboratory predictors of disease severity and mortality among patients with COVID-19 admitted to a tertiary care center in Saudi Arabia. Methods:This retrospective cohort study included patients with laboratory-confirmed SARS-CoV-2 infection admitted to King Fahd Hospital of the University, Al Khobar, Saudi Arabia, between May and August 2020. Disease severity was defined based on intensive care unit (ICU) admission. Demographic, clinical, and laboratory data were extracted from the patients' electronic medical records and the laboratory information system. Results:The study included 207 patients (mean age: 51 ± 16 years; male: 72%), of which 56 were severe cases. Compared to non-severe patients, severe patients had significantly higher white blood cell count (9.3 K/μl vs. 7.1 K/μl; P < 0.001), median absolute neutrophil count (6.2 vs. 4.4 K/μl; P = 0.003), absolute lymphocyte count (1.4 K/μl vs. 1.0 K/μl; P = 0.002); neutrophil-to-lymphocyte ratio (5.6 vs. 3.2; P < 0.001), median D-dimer (1.0 vs. 0.6 μg/ml; P < 0.001), median C-reactive protein (8.7 vs. 2.9 mg/dl; P < 0.001), and prothrombin time (14.1 vs. 13.6 seconds; P = 0.003). Similarly, compared to survivors, non-survivors had significantly higher median absolute neutrophil count (6.9 K/μl vs. 4.8 K/μl; P = 0.016), neutrophil-to-lymphocyte ratio (6.9 vs. 3.5; P < 0.001), median D-dimer (1.6 vs. 0.6 μg/ml; P = 0.005), and median C-reactive protein (11.7 vs. 3.1 mg/dl; P < 0.001). However, in the multivariable analysis, none of the laboratory parameters remained independently associated with disease severity or mortality. Conclusion:This study found that among hospitalized COVID-19 patients in Saudi Arabia, several clinical and laboratory markers were associated with disease severity and mortality in univariable analyses; however, no independent predictors were identified after adjustment. These findings highlight the complexity of COVID-19 progression and the need for cautious interpretation of laboratory markers in clinical decision-making.
Anthracotic mediastinal lymph nodes are an uncommon cause of intense fluorodeoxyglucose (FDG) uptake on positron-emission tomography-computed tomography (PET-CT), often mimicking malignancy and leading to diagnostic uncertainty. Here, we report the case of a 67-year-old Asian male with FDG-avid mediastinal lymphadenopathy that was highly suspicious for metastatic disease. Subsequent endobronchial ultrasound-guided lymph node sampling demonstrated anthracosis without evidence of malignancy or infection. Recognition of this rare benign entity prevented cancer upstaging and unnecessary treatment. This case highlights the importance of histopathological confirmation of PET-positive mediastinal lymph nodes, particularly in patients with suspected or known malignancy, to ensure accurate diagnosis and appropriate clinical management.
Non-alcoholic Wernicke-Korsakoff Syndrome (NA-WKS) is an under-recognised, thiamine-deficiency-mediated neurological disorder. While classically linked to chronic alcoholism, NA-WKS occurs in non-alcoholic patients. NA-WKS usually presents with episodes of anterograde amnesia accompanied by oculomotor signs, which occur more frequently than in alcoholic WKS. NA-WKS typically follows bariatric surgery, hyperemesis gravidarum, cancer cachexia, eating disorders, chronic kidney disease, or the use of certain oncologic or antidiabetic agents and chronic infectious diseases (e.g., immunodeficiency syndrome, tuberculosis, severe infections). Late diagnosis remains one of the leading factors for irreversible cognitive impairment. High-dose intravenous thiamine can reverse acute Wernicke encephalopathy when given early and prevent long-term damage. This review aims to provide clinicians with evidence based guidance regarding NA WKS to facilitate early recognition, timely treatment, and improved patient outcomes.
Background: Childhood developmental and behavioral disorders (CDABD), such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and learning disability (LD), have gained significant attention globally, including in Saudi Arabia. Early identification of these disorders is crucial for improving outcomes, and teachers play a pivotal role in recognizing symptoms, often before they are identified by healthcare professionals. Objectives: The aim of this study was to assess the level of knowledge and attitudes of Saudi preschool and elementary school teachers regarding CDABD and explore factors contributing to their knowledge gaps. Methods: A cross-sectional questionnaire-based study was conducted among 822 teachers from government, private, and international schools across Saudi Arabia. The questionnaire elicited the knowledge of teachers regarding normal child development, ASD, ADHD, LD, and available support services, as well as their attitudes. Results: The lowest median teacher knowledge score was for ASD (median = 33.3, IQR = 33.3-50), while the highest median teacher knowledge score was for LD (median = 66.7, IQR = 33.3-66.7). In terms of normal development, less than half the teachers correctly answered >50 of the items correctly, with the lowest knowledge being regarding the child empathy development (3.9%); the highest correct response rate was regarding the presentation of absence seizure (79.6%). Teachers' knowledge regarding availability of services and support systems for children with disabilities in Saudi Arabia was extremely poor, as all items had <10% correct responses. In terms of attitude, teachers strongly supported increasing resources and specialized education services (>95%). Conclusions: This study found that in Saudi Arabia, there are significant gaps in school teachers' knowledge, particularly regarding ASD and ADHD as well as about availability of resources. This study highlights the importance of improving teacher training, public awareness, and access to support services to improve outcomes for children with CDABD.
Objective:To study the prevalence and determinants of modifiable cardiovascular disease risk factors in Makkah, Saudi Arabia. Materials and Methods:This study included all adult patients who attended primary health care centers of Makkah Health Cluster between 2021 and 2024. Data collected included sociodemographic factors, anthropometric measurements, and list of all physician-confirmed diagnosis. Results:A total of 38,301 patients were included, of which 7% had hypertension, 9% had diabetes, and 64% were overweight/obese. Older and ever married patients had higher odds for hypertension (age: β = 1.06, 95% CI: 1.06-1.07, ever married; OR: 1.61, 95% CI: 1.31-1.99), diabetes (age: β = 1.06, 95% CI: 1.05-1.06, ever married; OR: 2.04, 95% CI: 1.67-2.50), and obesity (age; β = 0.08, 95% CI: 0.07-0.08, ever married; β = 2.04, 95% CI: 1.71-2.36). Private employees had higher odds of hypertension (OR: 1.24, 95% CI: 1.04-1.48) and diabetes (1.22, 95% CI: 1.03-1.44). Females had lower odds for diabetes (OR: 0.64, 95% CI: 0.58-0.70), but higher odds for hypertension (1.10, 95% CI: 1.00-1.22) and had greater body mass index (β = 0.77, 95% CI: 0.64-0.91). Retired individuals had greater odds of diabetes (OR: 1.30, 95% CI: 1.11-1.51), but lower measurements of body mass index (β = -1.28, 95% CI: -1.59--0.97). Higher education was a protective predictor for both hypertension (OR: 0.63, 95% CI: 0.46-0.88) and diabetes (0.82, 95% CI: 0.71-0.96). Saudis had greater odds for diabetes (1.19, 95% CI: 1.06-1.34) and lower body mass index (β = 0.20, 95% CI: 0.02-0.39). Conclusion:Among primary health care center attendees in Makkah, about two-thirds were found to be overweight or obese and 7% and 9% were hypertensive and diabetic, respectively. Predictors of hypertension and diabetes were older aged, married, and educationally disadvantaged groups.
Background: Poly ADP ribose polymerase (PARP) inhibitor resistance has emerged as a new challenge in the treatment of ovarian cancer. Intervening in cellular senescence to increase the sensitivity of ovarian cancer to olaparib has emerged as a key area of research. Objective: To determine the molecular mechanism underlying the antitumor effects of PPAR-γ agonists in promoting sensitivity to olaparib in ovarian cancer cells that induce senescence. Materials and Methods: The tumor-inhibitory effects of different PPAR-γ agonists alone or in combination with olaparib were analyzed in a subcutaneous transplanted ovarian tumor model in nude mice. β-Galactosidase (SA-β-Gal) staining and real-time PCR were used to detect changes in the cellular expression of senescence and senescence-associated secretory phenotype factors. Network pharmacological analysis revealed that the molecular mechanism underlying PPAR-γ agonist-mediated enhancement of olaparib’s anti-tumor efficacy is mechanistically linked to the SIRT1 signaling pathway. Subsequent functional validation through Western blotting and immunohistochemical analyses elucidated the critical modulatory role of SIRT1 signaling in determining olaparib sensitivity. Results: In vivo experiments showed that different PPAR-γ agonists (rosiglitazone and pioglitazone) combined with olaparib significantly reduced the volume of subcutaneously transplanted tumors in the mice. Further studies found that the PPAR-γ agonists inhibited the expression of SIRT1, attenuated olaparib-induced cellular senescence in ovarian cancer cells, and consequently inhibited tumor cell proliferation. Importantly, the SIRT1 overexpression reversed these phenotypic changes. Conclusions: PPAR-γ agonists enhance olaparib sensitivity through suppression of the SIRT1 signaling pathway and attenuation of olaparib-induced cellular senescence.
Background: Enhanced Recovery After Surgery (ERAS) protocols have gained global recognition for improving surgical outcomes, including in cesarean section (CS) deliveries. However, evidence regarding their implementation and impact within the Saudi Arabian context remains limited. Objectives: This study aimed to evaluate the safety profile and effectiveness of ERAS protocols compared to traditional care in CS deliveries at a tertiary care center in Saudi Arabia. Methodology: A matched retrospective cohort study was conducted at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Women who underwent CS and received ERAS-based perioperative management between January 2020 and October 2021 were compared with those who received traditional care between October 2018 and January 2019. The primary outcome was postoperative complications; other outcomes included 30-day readmission rates, total hospital length of stay (LOS), and postoperative LOS. Results: A total of 516 women were included (258 in each group). The ERAS group demonstrated significantly shorter median total hospital LOS (2 vs. 5 days; P < 0.001) and postoperative LOS (40.5 vs. 83.5 hours; P < 0.001). Postoperative complications occurred in 8% of the total cohort, with significantly fewer complications in the ERAS group (3.1% vs. 12.8%; P < 0.001). The 30-day readmission rate was also significantly lower in the ERAS group (0.8% vs. 9.3%; P < 0.001). Conclusion: ERAS protocols for CS deliveries were found to be safe, effective, and feasible in a tertiary Saudi setting. Their implementation resulted in shorter hospital stays, reduced complications, and lower readmission rates, supporting broader adoption across similar healthcare contexts.
Background:Positive body image, particularly body appreciation, is essential for mental well-being. The Body Appreciation Scale-2 (BAS-2) is a widely used tool, but a standalone psychometric validation for the Saudi population is lacking. Objectives:To validate the Arabic version of the BAS-2 by examining its reliability, factor structure, and measurement invariance among young adults from Saudi Arabia. Methods:This study employed a cross-sectional survey involving a convenience sample of 900 university students (62% female; mean age: 24.8 years). The dataset was randomly split for exploratory factor analysis (EFA; n = 630) and confirmatory factor analysis (CFA; n = 270). Fit was evaluated using RMSEA, SRMR, CFI, and TLI. Internal consistency was assessed using Cronbach's alpha and McDonald's omega. Measurement invariance was assessed with multi-group CFA using R software (lavaan package, Version 4.4.1). Results:Data suitability was supported (KMO = 0.95; Bartlett's test P < 0.001). Parallel analysis indicated an optimal unidimensional structure, explaining 71% of the variance, with all item loadings exceeding 0.68. CFA confirmed adequate fit (CFI = 0.95, TLI = 0.93, SRMR = 0.03, GFI = 0.90, and AGFI = 0.83), though RMSEA (0.12; 90% CI: 0.10-0.14) was beyond the threshold of 0.01. All items loaded strongly onto a single factor (loadings ≥0.678). Internal consistency was excellent (α = 0.96, ω = 0.96). Full metric and scalar invariance were supported across sex and age groups. Conclusions:The Arabic version of BAS-2 is both reliable and valid for Saudi young adults, supporting its use in research and interventions to promote body appreciation amid cultural and obesity-related challenges.
Background: Noncommunicable diseases (NCDs) impact a substantial proportion of adults in Saudi Arabia, highlighting the need for innovative preventive care models. Integrating physical therapy (PT) into primary care is a potentially promising strategy to enhance early intervention, reduce disability, and improve healthcare efficiency. Objectives: This scoping review aimed to examine global evidence on the integration of PT into primary care for NCD management, identify barriers and facilitators for implementation, and evaluate its applicability in Saudi Arabia. Methods: Using the Joanna Briggs Institute and Arksey and O’Malley frameworks, and following PRISMA-ScR guidelines, we conducted comprehensive literature searches in PubMed, CINAHL, Cochrane Library, Embase, and Web of Science for articles published between January 2010 and August 2024. Two reviewers independently screened and extracted data from studies involving adults with NCDs receiving PT in primary care. Results: A total of 24 studies (N = 22,830) met inclusion criteria: 17 randomized controlled trials, 5 prospective cohorts, 1 non-randomized trial, and 1 meta-analysis. Most studies showed improvements in pain, function, and quality of life, with early PT and direct-access models proving cost-effective. However, 96% of the studies were from Western, high-income settings, highlighting a critical evidence gap for Saudi Arabia. Conclusion: Despite strong international evidence, specific data for Saudi Arabia are lacking. Therefore, there is a need for local studies to determine the usefulness of integrating physical therapy into noncommunicable disease prevention and management, in alignment with Vision 2030.
Objective: To assess the quality of life of systemic lupus erythematosus (SLE) patients in the Eastern Province of Saudi Arabia, considering demographic and clinical factors that may influence their well-being. Materials and Methods: A descriptive cross-sectional study was conducted at King Fahd Hospital of the University, Al Khobar, with patients who had scheduled appointments at the rheumatology clinic from August 2023 to March 2024. The study included SLE-diagnosed patients with complete medical records who consented to participate. Data were collected using the Arabic version of the Systemic Lupus Erythematosus-Specific Quality of Life (SLEQOL) questionnaire, a structured online questionnaire that assesses health-related quality of life (HRQoL) across six domains. Results: A total of 110 SLE patients, with a mean age of 38.6 (±10.9) years, participated. The majority were female (89.1%) and Saudi nationals (97.3%). The overall mean SLEQOL score was 89.5. Physical functioning reflected the best QoL (11.4/42; 27.1%), while mood was most impaired (10.4/28; 37.1%). Treatment-related QoL (31.1%), activities (34.9%), self-image (36.6%), and symptom-related QoL (36.6%) showed intermediate impairment. Male patients had better physical functioning than females, Saudis reported better mood and activities-related QoL than non-Saudis, and patients without comorbidities had higher overall QoL. Conclusion: This study highlights the multidimensional impact of SLE in the Eastern Province of Saudi Arabia. Physical functioning was least affected, whereas mood was most impaired, with nationality, gender, and comorbidities influencing several domains. These findings emphasize the need for comprehensive care that addresses physical, emotional, and psychological aspects to enhance patient well-being.
Background:Mortality data are used to assess the development and implementation of health policies, set public health priorities, and evaluate population health. The proportions of ill-defined causes of death (IDCODs) and garbage codes (GCs) impact the accuracy of mortality data. Objectives:This study aimed to analyze the temporal evolution of the proportional mortality ratio (PMR) of IDCODs in Bahrain between 2000 and 2020 and to examine variations by age, sex, and nationality. Methods:We analyzed mortality statistics from 2000 to 2020 from official Bahrain data platforms. The PMR of the IDCODs was computed and examined for correlations with various causes of death (CODs). IDCODs were then redistributed to well-defined CODs using Ledermann's method. Results:IDCODs were among the top three CODs in Bahrain until 2014, with the highest PMR (28.8%) in 2009. In 2015, their PMR decreased significantly, and by 2017, it had fallen to 1.9%. Over several years, the ranking of GCs was affected by the inclusion of non-ICD codes (deaths listed as "undetermined" or "others"). Males and those aged ≥65 years were more likely to have IDCODs. There was a strong negative correlation between IDCODs and mortality from circulatory disorders (r = -0.958) and neoplasms (r = -0.893). The redistribution of IDCODs primarily led to an increase in circulatory diseases. Conclusion:Although Bahrain has made significant strides in reducing IDCODs, the use of non-ICD codes remains a concern. Mandatory training should be implemented to improve physicians' and medical students' proficiency in completing death certificates and to ensure regular audits of the coding process.
