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Academic Journal

P Wave Duration and P Wave Dispersion in Electrocardiography of Stroke Patients.

  • Source: Journal of Harran University Medical Faculty / Harran Üniversitesi Tıp Fakültesi Dergisi. 2025, Vol. 22 Issue 3, p445-449. 5p.

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Academic Journal

How useful are the biochemical tests in guiding the diagnostic workup of infantile cholestasis? Background: The objective of our study was to determine whether biochemical tests, frequently requested at first presentation of infants with cholestasis, have a role in focusing investigations toward certain disease entities. Methods: All infants with cholestasis (2008 to 2020) were identified and reviewed for final diagnosis and serum levels of alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), lactate, cholesterol, ferritin, alpha-fetoprotein (AFP), total bile acids (TBAs), and hypoglycemia at first presentation. Results: ALT levels were normal in all infants with Dubin–Johnson syndrome. A normal TBA (0–10 μmol/L) in an infant with normal-GGT cholestasis was consistent with bile acids synthesis disorders (BASDs). There was a dichotomy pattern of "high-GGT cholestasis" [associated with biliary obstruction, Alagille syndrome, ciliopathies, mitochondrial hepatopathies] and "low GGT cholestasis", [associated with mutations in ATP8B1 , ABCB11 , TJP2 , USP53 , LSR , MYO5B , VIP AS39 , NR1H4 , BASD, galactosemia, gestational alloimmune liver disease (GALD), and endocrine causes]. Plasma lactate level was significantly elevated in infants with mitochondrial hepatopathies and hemophagocytic lymphohistiocytosis (HLH) [median 5.8 mmol/L and 7.7 mmo/L, respectively; P < 0.001]. The highest ferritin concentrations were in infants with HLH and GALD [medians 4883 μg/L and 2098 μg/L, respectively; P < 0.001]. The most marked elevation of AFP was consistent in all infants with mitochondrial hepatopathies, tyrosinemia, and GALD (median: 99637 ng/mL, 40000 ng/mL; 22566 ng/mL) as compared to causes of biliary obstruction (median: 3662 ng/mL). Hypoglycemia with preserved liver synthetic function was associated with metabolic or endocrine disorders. Conclusion: Although none of these biochemical tests is diagnostic in itself, they can be actionable

  • Source: Saudi Journal of Gastroenterology. Nov/Dec2025, Vol. 31 Issue 6, p373-382. 10p.

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Academic Journal

Eating behaviors in childhood eosinophilic esophagitis: A retrospective case-controlled study Background: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease in the esophagus. It is associated with feeding difficulties. We aimed to assess eating behaviors in patients with EoE and compare them with controls. Methods: This case-controled study enrolled children aged 0–16 years where their eating/behavior scores were measured. Child Behavior Frequency Scores (CBFS) >61, Parents Feeling/strategies Frequency Score (PFSFS) >20 and the Total Behavioral Pediatric Feeding Assessment Scores (BPFAS) >84 were considered as abnormal results. Results: The study involved 80 children with 40 in the EoE group and 40 in the control group. The mean age of EoE diagnosis was 6.4 ± 4.0 years, while the mean age of the control group was 8.4 ± 4.0 years. Fifty four of the 80 patients (67.5%) were male. There was a significant difference between the EoE patients and the controls regarding child feeding difficulties. The mean scores were as follows: problems chewing food, 2.4 ± 1.6 in EoE vs. 1.3 ± 0.7 in controls, P < 0.001; drinking more than eating, 2.6 ± 1.7 in EoE vs. 1.6 ± 1.2 in controls, P = 0.002; taking longer than 20 min to finish a meal, 3.3 ± 2.0 in EoE vs. 2.2 ± 1.5 in controls, P = 0.008; and parents get frustrated or anxious when feeding the child, 2.8 ± 1.7 in EoE vs. 1.3 ± 0.8 in controls, P < 0.001. Our results confirmed that the mean frequency score for parent feelings and strategies was significantly higher in the EoE group compared to controls (24.2 ± 7.4 vs. 18.9 ± 7.6); 95% confidence interval (CI), 2.0–8.7, P = 0.002. Additionally, the mean frequency score for Child behavior was 60.3 ± 16.9 in EoE vs. 43.5 ± 12.7 in controls; 95% CI, 10.2–23.4, P < 0.001. Furthermore, the total BPFA frequency mean score was 84.5 ± 22.7 in EoE vs. 62.3 ± 19.3

  • Source: Saudi Journal of Gastroenterology. Nov/Dec2025, Vol. 31 Issue 6, p367-372. 6p.

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Academic Journal

Large duct primary sclerosing cholangitis with or without inflammatory bowel disease in Saudi patients Background: Primary sclerosing cholangitis (PSC) is often associated with inflammatory bowel disease (IBD). We aimed to compare the clinical presentations and outcomes of PSC in patients with and without IBD in Saudi population. Methods: The medical records of patients with PSC, diagnosed between 2009 and 2020, in a single referral center in Saudi Arabia were reviewed. Primary outcomes included liver-related clinical decompensations, while secondary outcomes encompassed hepatobiliary malignancies, liver-related mortality, and liver transplantation. Results: Among 87 patients, 52 (59.8%) had PSC-IBD and 35 (40.2%) had PSC without IBD. PSC-IBD patients were significantly younger at diagnosis (35.4 ± 13.3 vs. 43.6 ± 12.8 years, P = 0.005). Non-IBD patients exhibited higher rates of diabetes (P = 0.045), hyperlipidemia (P = 0.022), and autoimmune hepatitis (P = 0.008). While clinical presentations were similar, non-IBD patients demonstrated more frequent cytopenia from splenomegaly (31.4% vs. 5.8%, P = 0.001) and hepatic decompensation (37.1% vs. 7.7%, P = 0.001). Bilirubin (P = 0.002) and aspartate aminotransferase (P = 0.042) levels were increased in non-IBD patients, while PSC-IBD patients had higher white blood cell (P = 0.021) and platelet counts (P < 0.001). Liver biopsies were more frequently performed in non-IBD patients (45.7% vs. 19.2%, P = 0.008). Overall mortality was 12.8%, with no difference in median survival time between groups (P = 0.782). Multivariate analysis identified age (hazard ratio [HR]: 1.048, P = 0.044) and MELD-Na (HR: 1.155, P = 0.016) as independent predictors of mortality. Conclusion: In this Saudi cohort, non-IBD PSC patients were diagnosed later and presented with more comorbidities and hepatic decompensation. However, IBD status did not impact overall survival. Older age and higher MELD-Na scores at presentation were signific

  • Source: Saudi Journal of Gastroenterology. Nov/Dec2025, Vol. 31 Issue 6, p356-366. 11p.

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Academic Journal

Endoscopic retrograde cholangiopancreatography of geriatric patients with cholangitis: A single-center experience in central Saudi Arabia Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential tool for managing biliary diseases, particularly in geriatric patients. However, limited data exists on its safety and efficacy in geriatric population in Saudi Arabia. Methods: This prospective study evaluated ERCP outcomes in patients aged ≥70 at Prince Sultan Military Medical City, Riyadh, between November 2023 and May 2025. Patients were categorized into two groups: 70–80 years and ≥81 years. Data collected included demographics, comorbidities, Charlson Comorbidity Index (CCI), American Society of Anesthesiologists status (ASA) physical status, Duke Activity Status Index (DASI), indications, procedural success, and 30-day complications (per Cotton's criteria). Results: Of 403 ERCPs, 363 (90.7%) were performed in patients ≥70 years old. Of those, 199 were aged 70–80 years (mean 77.67 ± 5.4 years) and 164 were aged 81–103 years (mean 87.36 ± 5.26 years). The ≥81 years age group had more males (120 of 164, 73.2% vs. 123 of 199, 61.8%; P = 0.022), lower DASI (14.8 vs. 25.12; P < 0.001), and higher comorbidity rate (156 of 164, 95.12% vs. 150 of 199, 75.38%; P < 0.001). Common indications and technique success rates were similar between groups. Overall complication rates did not differ significantly; post ERCP pancreatitis (PEP) was more frequent in younger than in the older group (8 of 199, 4.02% vs 2 of 164, 1.21%; P = 0.096). No 30-day ERCP-related mortality was reported in either group. Conclusions: ERCP was safe and effective in Saudi geriatric patients, including those ≥81 years, with complication rates indicating that age alone should not preclude its use when clinically indicated.

  • Source: Saudi Journal of Gastroenterology. Nov/Dec2025, Vol. 31 Issue 6, p338-346. 9p.

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