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Aims: This study seeks to provide insights into the practical application and effects of oral semaglutide in Saudi T2DM patients under routine medical supervision. Methods: The primary outcome measure was the laboratory HbA1c. Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after six months and 12 months of initiation. Results: The analysis of this study included 245 uncontrolled (HbA1c > 7 %) T2DM patients. The mean baseline HbA1c was 10.1 % (1.2). HbA1c was reduced by an average of 3.1 % (0.8) and 3.2 % (0.8) at 6 and 12 months, respectively. The frequency of hypoglycemia events in the last three months before semaglutide was initiated was 4.4 (1.1). The frequency of hypoglycemia events in the last three months was 2.2 (0.8) and 0.7 (0.4) at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.0 % (1.4) and 19.7 % (3.4) at six months and 12 months, respectively. Lipid profile and blood pressure were improved at six months and 12 months. Conclusions: Oral semaglutide provided substantial glycemic and weight-loss benefits in adult individuals with T2DM.

Background Adjunctive treatment with sodium-glucose co-transporters 2 inhibitors (SGLT2- I) has been successfully used in patients with type 1 diabetes mellitus (T1DM) in recent years to improve glycemic control and reduce body weight without increasing the risk of hypoglycemia; however, there is a scarcity of evidence for real-world experience in their use in T1DM Saudi patients. The purpose of this study was to evaluate the efficacy and safety of empagliflozin as off-label adjunctive therapy in Saudi patients with T1DM. Methods This study was a retrospective study for T1DM patients, who were prescribed empagliflozin as an adjunctive therapy. Baseline characteristics including age, changes in HbA1c, body weight, total daily insulin dose, lipid profile, and well as side effects such as urinary tract infections (UTIs) and diabetes ketoacidosis (DKA) were evaluated before and after initiation empagliflozin in 37 T1DM patients. Results The mean age was 25.8 ± 8.0 years, mean weight was 75.3 ± 14.8 kg, mean body mass index (BMI) was 28.1 ± 6.7 kg/m2, mean duration of diabetes was 10.1 ± 6.5 years, and mean HbA1c was 9.4 ± 1.4%. After a mean follow-up duration of 15.8 ± 6.0 months, the mean reduction in the HbA1c% from baseline was 0.82% (p = 0.001) and mean weight reduction from baseline was 1.7 kg (p = 0.097). The total daily insulin dose was decreased by 2.9 units. UTIs and DKA episodes were reported among 2.7% and 10.8% of the participants, respectively. Conclusion Empagliflozin in combination with insulin in overweight Saudi T1DM subjects resulted in a significant improvement in glycemic control, mild non-significant reduction in body weight, and a small but statistically significant reduction in the total daily insulin dose with a slight increase in the risk of DKA and UTIs. Further larger prospective studies are needed for better evaluation of the efficacy and safety of these agents in Saudi T1DM patients.

Background: Glucose variability (GV) is a common and challenging clinical entity in the management of people with type 1 diabetes (T1DM). The magnitude of GV in Saudi people with T1DM was not addressed before. Therefore, we aimed to study GV in a consecutive cohort of Saudis with T1DM. Methods: We prospectively assessed interstitial glucose using FreeStyle ® Libre flash glucose monitoring in people with TIDM who attended follow-up in the diabetes clinics at King Fahad Medical City between March and June 2017. Glycemia profile, standard deviation (SD), coefficient of variation (CV), mean of daily differences (MODD), and mean amplitude of glucose excursion (MAGE) were measured using the standard equations over a period of 2 weeks. Results: Fifty T1DM subjects (20 males) with mean age 20.2 ± 6.1 years and mean fortnight glucose 192 ± 42.3 mg/dl were included. The mean SD of 2-week glucose readings was 100.4 ± 36.3 mg/dl and CV was 52.1% ± 13%. Higher levels of glucose excursions were also observed. MODD and MAGE were recorded as 104.5 ± 51.7 and 189 ± 54.9 mg/dl, respectively which is 2 to 4 times higher than the international standards. Higher MODD and MAGE were observed on weekends compared to weekdays (111.3 ± 62.1 vs 98.6 ± 56.2 mg/dl and 196.4 ± 64.6 vs 181.7 ± 52.4 mg/dl, respectively; P ⩽ .001). Conclusion: Higher degree of glycemic variability was observed in this cohort of TIDM Saudis. Weekends were associated with higher glucose swings than weekdays. More studies are needed to explore these findings further.

ContextFollowing total thyroidectomy and radioactive iodine (RAI) ablation, serum thyroglobulin levels should be undetectable to assure that patients are excellent responders and at very low risk of recurrence.ObjectiveTo assess the utility of stimulated (sTg) and non-stimulated (nsTg) thyroglobulin levels in prediction of patients outcomes with differentiated thyroid cancer (DTC) following total thyroidectomy and RAI ablation.MethodA prospective observational study conducted at a University Hospital in Saudi Arabia. Patients diagnosed with differentiated thyroid cancer and were post total thyroidectomy and RAI ablation. Thyroglobulin levels (nsTg and sTg) were estimated 3–6 months post-RAI. Patients with nsTg 1 occurred in 26 (35%) of patients with nsTg 0.1–2.0 ng/ml, 11 (15%) had structural incomplete response. None of the patients with sTg levels

Background: Management of giant prolactinomas presents a different challenge than the management of traditional prolactinomas. Objective: The aim of this study was to report the largest long-term single-center study of giant prolactinomas to analyze their clinical features; define epidemiological characteristics, comorbidities, complications, treatment outcomes; and to demonstrate our experience with long-term cabergoline (CAB) treatment of these giant tumors. Methods: A retrospective case study and clinical review of patients presenting with giant prolactinomas in the pituitary clinic at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, in the period between 2006 and 2018 were included in the study. Of the charts reviewed, 33 patients (24 men; 9 women) with age of diagnosis between 18 and 63 years (mean = 37.21 years) met the selection criteria for giant prolactinomas. Result: The most common presenting features include headache (87.8%), visual defects (69.7%), and hypogonadism (51.5%). The baseline means serum prolactin (PRL) level was extremely high for both sexes (95 615.03 nmol/L), which eventually decreased by as much as 95.4% after CAB treatment. Serum PRL concentrations completely normalized in 11 patients and significantly reduced in 22 patients. The mean tumor volume at baseline was 42.87 cm 3 , whereas the mean posttreatment tumor volume was 3.42 cm 3 (no residual tumor in 2 patients, while in others, it ranged from 0.11 to 16.7 cm 3 ) at the last follow-up visit. The mean change in tumor volume was 88.84%. Tumor volume decreased by an average of 92% for men and 80.4% for women. One patient had no tumor size change with CAB (3.5 mg thrice a week) or radiotherapy and required surgery. The response rate (remission after medical therapy alone) in this series was 84.84%. Conclusions: Findings reinforce results from our previous study that CAB provides dramatic clinical improvements with an excellent safety profile. The CAB should, therefore, be considered as the primary therapy for giant prolactinomas.

The superconducting properties of a series of Zr1+xNi2-xGa and Zr1-xNi2+xGa compounds have been investigated by x-ray diffraction, electrical resistivity, dc magnetization, and ac susceptibility measurements. While the parent compound, ZrNi2Ga, exhibited the cubic L21 Heusler structure, multiple non-cubic structures formed in the Zr and Ni rich doped materials. For x ≤ 0.3, all Zr1-xNi2+xGa compounds demonstrated superconducting behavior, but no superconductivity was observed in the Zr1+xNi2-xGa alloys for x > 0.2. The magnetization data revealed that all materials in both Zr1+xNi2-xGa and Zr1-xNi2+xGa series exhibited type-II superconductivity. With increasing doping concentration x, the paramagnetic ordering were enhanced in both systems while the superconducting properties were found to weaken. The observations are discussed considering the structural disorders in the systems.

Managing contrast allergies in patients undergoing diagnostic or interventional radiology procedures requires a multidisciplinary approach to prevent adverse reactions and improve patient safety. Nurses, pharmacists, and radiology teams play complementary roles in identifying high-risk patients, implementing premedication protocols, and ensuring effective communication throughout the care process. This review explores the collaborative roles of nurses, pharmacists, and radiologists in managing contrast allergies. It highlights the impact of such teamwork on patient outcomes, adherence to protocols, and the prevention of contrast-related adverse events. [ABSTRACT FROM AUTHOR]

In cases of cardiac arrest, efficient cardiopulmonary resuscitation (CPR) is essential to improve prognoses. The purpose of this study is to evaluate the level of CPR competency among paramedics in Saudi Arabia, with an emphasis on compression depth and ventilation procedures. In this investigation, 69 paramedics participated, and CPR scenarios were simulated on an Ambu manikin. With an emphasis on the accuracy and effectiveness of breathing procedures as well as the constancy of compression depth, this configuration made it possible to thoroughly evaluate each participant's approach. According to the study, paramedics performed chest compressions with impressive skill, averaging 58.48 mm, which is within the recommended range of 50 to 60 mm. The compression depths did, however, differ substantially, ranging from 47 mm to 72 mm. Furthermore, there were notable discrepancies in the ventilation methods, with 87.4% of ventilations being carried out below the suggested volume limit. More participants' deviations from the recommended compression-to-ventilation ratio highlight the need for stricter adherence to the standards. Although paramedics have a solid foundation in CPR, there are noticeable variances and anomalies that highlight the need for ongoing, targeted training. To remedy these gaps, this report recommends creating and implementing focused training initiatives. To enhance overall CPR performance and subsequently improve patient outcomes in emergencies, such programs should prioritize adherence to established CPR recommendations and highlight the integration of realistic simulation experiences. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is a symptom that is defined as a subjective perception of noise in an absence of external sound. It is an indicator of auditory system abnormalities. It can also be present in individuals without any hearing abnormalities. Difficulty to consternate, insomnia, and decreased speech discrimination are the most common symptoms related to tinnitus.Aim: To assess the magnitude and pattern with determinants of tinnitus among health science students at King Khalid University. Methodology. A descriptive cross-sectional survey was conducted targeting all accessible students in health science colleges in King Khalid University which is the main university in the Aseer region, south of Saudi Arabia. Students were included consecutively from different faculties and different grades. Data were collected through a self-administered prestructured questionnaire, which was distributed and recollected the next day. Tinnitus was screened using an adapted form of the National Health and Nutrition Examination Survey (NHANES).Results: A total sample of 400 students have been included with their ages ranging from 18 to 30 years with a mean age of 22 ± 1.8 years), and 28.5% of the students recorded positive findings. Tinnitus was bilateral among 51.8% of students, and 44.7% of tinnitus students hear buzzing sound while 21.1% have hissing sound and 10.5% had pulsating sound. Among 46.5% of students with tinnitus, the heard sound was of moderate loudness and intermittent among 64.9% of them. Conclusions and Recommendations. In conclusion, the study revealed that just more than a quarter of students complained of tinnitus which was bilateral among half of them. Tinnitus frequency was mainly moderate in intensity and intermittent. Having ear problems, loud sounds, and allergy were the most important predictors of having Tinnitus. [ABSTRACT FROM AUTHOR]

Background and Aim: Many primary care physicians (PCPs) believed that managing overweight and obesity is essential to their jobs, however, many believe that they were doing it ineffectively, unsatisfying, and had negative attitudes. We conducted this study to explore the knowledge, attitudes and adherence to obesity management guidelines, identify potential barriers that may prevent adherence of PCPs to obesity treatment guidelines. Methods: We conducted this cross-sectional study and conducted a questionnaire sent via email to all PCPs in the Ministry of Interior centers in Riyadh, Al-Kharj, AlQassim, Wadi Ad Dawasir, Hail and Tabuk in Saudi Arabia. Results: A total of 119 PCPs participated in the survey, 61 (51.3%) males and 58 (48.7%) females. All respondents (n = 119, 100%) answered correctly that obesity is a disease. Of PCPs surveyed, genetics accounted for 75.6% of the responses as the cause of obesity. 79.8% believed that the best way for patients with obesity to lose weight was to engage in regular physical activity. The majority of PCPs (87.4%) thought that treating obesity should be a top priority, and 88.2% would typically recommend obesity therapy to their patients. Around 68.9% of PCPs thought that it’s their patients’ responsibility to lose weight. The majority will recommend obesity treatment and 75.6% would talk to their patients about weight concerns, while 60.5% would refer their patients to obesity surgery. There was a positive significant association between higher knowledge and better attitude and better adherence to treatment guidelines. More experienced PCPs were more confident. The most common perceived barrier was the patients’ lack of desire to follow obesity treatment. Conclusion: Primary care clinics and PCPs play a crucial role in diagnosing and treating patients with obesity, according to Ministry of Health guidelines on the prevention and management of obesity. PCPs must not only acknowledge obesity as a chronic illness and the possible long-term consequences it may cause, but also provide comprehensive, multi-component interventions that include lifestyle changes, medication, and appropriate referrals for bariatric surgery when needed. Healthcare professionals must form a cooperative relationship with obese patients to ensure that the patients follow treatment protocols.

Background: Low back pain (LBP) is one of the most common complaints, especially among healthcare workers, with great impact on daily lifestyle and job performance regarding disability and absence. Therefore, in this study, we aimed to assess the prevalence and associated risk factors of LBP among surgeons of different specialties in Taif city, Saudi Arabia. Methods: A cross-sectional study among surgeons in Taif city randomly selected from the three major hospitals in the city, using a self-administered questionnaire of 41 items divided into three parts including demographic data, individual and occupational characteristics, and prevalence data. Results: The prevalence data of LBP were point prevalence of 28 (20.3%), last month prevalence of 67 (48.6%), last year prevalence of 91 (65.9%), and lifetime prevalence of 101 (73.2%). Some of the investigated individual and occupational characteristics associated with the prevalence of LBP with a statistically significant (P < 0.05) such as smoking, specialty, overall standing time, perceived level of stress, and using preventive strategies. Others might be associated but with no statistically significant (P > 0.05) such as age, gender, body mass index, and job satisfaction. Rest and painkillers are the best option for most of the affected surgeons to relieve the pain. Conclusion: LBP has a high prevalence in the healthcare field, and the results of this study show high prevalence among surgeons, with many avoidable risk factors. Recommendations: More studies must be conducted and planning educational programs and campaigns to reduce the magnitude of this problem.

Background. Tinnitus is a symptom that is defined as a subjective perception of noise in an absence of external sound. It is an indicator of auditory system abnormalities. It can also be present in individuals without any hearing abnormalities. Difficulty to consternate, insomnia, and decreased speech discrimination are the most common symptoms related to tinnitus. Aim. To assess the magnitude and pattern with determinants of tinnitus among health science students at King Khalid University. Methodology. A descriptive cross-sectional survey was conducted targeting all accessible students in health science colleges in King Khalid University which is the main university in the Aseer region, south of Saudi Arabia. Students were included consecutively from different faculties and different grades. Data were collected through a self-administered prestructured questionnaire, which was distributed and recollected the next day. Tinnitus was screened using an adapted form of the National Health and Nutrition Examination Survey (NHANES). Results. A total sample of 400 students have been included with their ages ranging from 18 to 30 years with a mean age of 22 ± 1.8 years), and 28.5% of the students recorded positive findings. Tinnitus was bilateral among 51.8% of students, and 44.7% of tinnitus students hear buzzing sound while 21.1% have hissing sound and 10.5% had pulsating sound. Among 46.5% of students with tinnitus, the heard sound was of moderate loudness and intermittent among 64.9% of them. Conclusions and Recommendations. In conclusion, the study revealed that just more than a quarter of students complained of tinnitus which was bilateral among half of them. Tinnitus frequency was mainly moderate in intensity and intermittent. Having ear problems, loud sounds, and allergy were the most important predictors of having Tinnitus.

Background:stroke is a neurological defect that could result in death thus adequate knowledgeof stroke is a must for correct treatment andprevention of stroke consequences and disability. Objectives:assessing theknowledge, attitude and practice(KAP) of Saudi population toward stroke risk factors and warning symptomsin Kingdom of Saudi Arabia (KSA). Methods:2021 adult Saudi subjects were enrolled in the study who were chosen from different parts of KSA. This cross sectional study was conducted using a structuredquestionnaire designed to examine KAP of participants about stroke risk factors. Results: most of subjects were 41-50 years old, females, employed and had a college degree.About 9% of the participated subjects were suffering from stroke while, 28% had relatives who suffered from stroke. The majority of subjects had insufficient knowledge regarding the risk factors and warning symptoms of stroke thus, resulting in inadequate KAP in 63.8% of the respondents while only 36.2% had good KAP. The good KAP was significantly associated with younger age participants and highly educated. Conclusion: The level of KAP toward stroke risk factors and warning symptoms wasinadequate among the majority of participants. Good KAP was associated with high educational degree and young age. [ABSTRACT FROM AUTHOR]