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Journal: Saudi medical journal


Rapid-onset obesity, hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) is a rare disease, but could be fatal if not diagnosed early. It mimics many other diseases and it may take few years after the onset of rapid obesity to have the other clinical features. Therefore, any patient with rapid-onset obesity after the age of 2 years should have high index of suspicion and long term follow up. We report a case of ROHHAD in Saudi Arabia and we highlight the clinical features and the importance of early diagnosis and management.

Concepts: Epidemiology, Cancer, Death, Medical terms, Saudi Arabia, Arabian Peninsula, Riyadh, ROHHAD


To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items; total score, 42). Results: The mean procedural score was 40.9 ± 1.3 of a possible 42. The maximum score of 42 was achieved by 39.7% of the medical interns, while another 33.3% achieved a score of 41. Of the participants, 85% succeeded in inserting the tube via an appropriate technique, achieving a score of 40 or more. Conclusion: Our results indicated that this model could be useful for effective training of medical interns for chest tube insertion, which is an important skill in emergency medicine. This biomaterial-covered model is inexpensive and its use can potentially be widened to improve training methods without significant financial demand.

Concepts: Medicine, Physician, Skill, Training, Anatomy, Pediatrics, Intern, Internship


To identify factors that increase the risk of developing febrile neutropenia (FN) during the first cycle of chemotherapy in breast cancer patients.

Concepts: Cancer, Breast cancer, Metastasis, Oncology, Chemotherapy, Pleural effusion, Chemotherapy regimens


To assess the epidemiological characteristics of prematurity and survival rate in preterm infants diagnosed at a university hospital in the Eastern province of Saudi Arabia.  

Concepts: Saudi Arabia, Arabian Peninsula, Riyadh, United Arab Emirates, Eastern Province, Saudi Arabia, Al-Hasa, Dammam, Ras Tanura


To examine the associations between sleep duration and a variety of demographic and clinical variables in a sample of Saudi adults.  Methods: A cross-sectional study among 2,095 participants was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between May and October 2014. A questionnaire was administered to collect data related to clinical health outcomes and demographic characteristics. Participants were asked to report their average sleep duration per night in hours.  Results: One-third (33.8%) reported short sleep duration of less than 7 hours/night. Short sleep duration was more prevalent in females (37.3% versus 31.4%, p=0.004). The most common medical problems reported were obesity with body mass index of greater than 30 Kg/m2 (39.1%), hypertension (33.9%), diabetes mellitus (20.8%), depression (4.3%), asthma (17.3%), COPD (6.6%), and hyperlipidemia (2.7%). Diabetes mellitus was associated with long sleep of more than 9 hours/night (25.4%, p=0.011) and hypertension (54.2%, p=0.001). The linear regression model tend to reduce their sleep duration by roughly 22 minutes in female gender, 66 minutes in participants with hyperlipidemia, and 70 minutes in participants with poor sleep quality.  Conclusions: Short sleep duration per night was prevalent, it affects one in every 3 Saudi adults. Long sleep duration of more than 9 hours was associated with increased comorbid conditions.

Concepts: Regression analysis, Linear regression, Diabetes mellitus, Obesity, Econometrics, Saudi Arabia, Arabian Peninsula, Mecca


The global prevalence of depression is increasing, along with rates of depression-associated disability and mortality, rendering depressive disorders a major public health issue. Chronotherapy involves a variety of strategies that control exposure to environmental stimuli that influence the biological clock, such as sleep deprivation (SD) or wake therapy (WT), sleep phase advance (SPA), and light and dark therapy (LT, DT). The purpose of this Evidence-Based Practice (EBP) paper is to answer PICOT questions by a review the effectiveness of chronotherapeutics interventions on depressive symptoms with depression and the depressive episode in the course of bipolar disorder. Early studies suggested the effectiveness of LT, SD, and SPA, more recent research has revealed differences in the efficacy of single and combined interventions involving both chronotherapeutic and pharmacological components. This therapy reduced dura-tion of hospitalization, improvement recovery, and reduced for changes in drug prescriptions.

Concepts: Sleep, Sleep deprivation, Schizophrenia, Bipolar disorder, Major depressive disorder, Dysthymia, Depression, Suicide


To  compare the efficacy of various standard bariatric surgical procedures using the Bariatric Analysis and Reporting Outcome System (BAROS). Methods: This is a prospective, descriptive analytical study conducted in 2 medical institutions in Saudi Arabia. A total of 270 patients who had different bariatric surgery during the period between March 2010 and December 2012 were included. The data was analyzed and scored against 3 outcomes, excess weight loss, cure or improvement of comorbidities, and quality of life changes. Results: All patients who had different bariatric procedures were included in our study. Seventy-nine (29.3%) underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP), 159 (58.9%) had laparoscopic sleeve gastrectomy (LSG), and 32 (11.9%) had laparoscopic adjustable gastric banding (LAGB). Complete remission of at least one comorbidity was reported in 36% of LRYGBP, 51% in LSG, and 42% in LAGB. While all other patients have improved comorbidities. The BAROS score was good or higher in 78.5% of LRYGBP, 83.6% for the LSG, and 84.4% of LAGB patients. The average excess weight loss was 67.9% in LRYGBP, 75.8% in LSG, and 81.7% LAGB patients. Conclusion: Bariatric surgery provides a substantial reduction in excess weight, improvement and cure of comorbidities, and improvement in quality of life. Standard bariatric procedures have different degrees of outcomes that can be beneficial in selecting appropriate procedure for appropriate indications and patients.

Concepts: Obesity, Surgery, Saudi Arabia, Bariatric surgery, Gastric bypass surgery, Bariatrics, Duodenum, Adjustable gastric band


To determine the prevalence of habitual snoring and risk of obstructive sleep apnea (OSA) among dental patients and investigate factors associated with high-risk OSA.

Concepts: Sleep apnea, Polysomnography, Obstructive sleep apnea, Abnormal respiration


Efficient process of litigation of medical errors is a key to ensure fair, speedy, and accessible justice system. The conditions of establishing medical negligence are similar in both legal systems. These conditions include the duty of care, breach of that duty of care, the damages, and establishing causation. A culture of litigation and compensation is growing in the United Kingdom and Kingdom of Saudi Arabia; however the cost of medical claims and awarded compensations are much more in the United Kingdom compared to Kingdom of Saudi Arabia. In Kingdom of Saudi Arabia, there is a need for more transparency in the documentation and publication of litigated medical errors. In addition, there is a need to introduce interventions to shorten the duration of litigation in both legal systems. Financial caps on awarded compensation and caps on expert and legal fees are potential strategies to control the cost of medical errors which seems to work well in the Saudi model.


To estimate the incidence and prevalence of prostate cancer in Saudi Arabia.