Exploring the incidence and characteristics of urolithiasis in the central region of Saudi Arabia: Insights from a prominent medical center.

Introduction: Urolithiasis is a common and recurrent condition with a rising global incidence. Stones typically develop in the upper urinary tract, primarily the kidneys. Various factors such as age, gender, diet, fluid intake, climate, occupation, genetics, and metabolic diseases influence stone formation. Stones can vary in size and location, causing obstruction, urine stasis, and complications such as infection. The prevalence of urolithiasis in Saudi Arabia has significantly increased in recent decades, and the study aims to determine the current prevalence and composition trends of urolithiasis, guide treatment and prevention strategies, as well as understand predictors of occurrence and recurrence. Materials and Methods: It is a retrospective cohort study where the data was collected in the time frame of 2015-2021. The study was conducted in the Department of Surgery and the Division of Urology at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia. Results: The study reveals significant trends in the sociodemographic profile and clinical aspects of urolithiasis patients. With a higher incidence among males (68.5%). Stone compositions predominantly consist of calcium oxalate (67.8%) and uric acid (19.7%), while site distribution shows the left kidney as the most common location (36.5%). Notably, hypertensive patients exhibit a significant association with stone site (P = 0.014). Encouragingly, the majority of patients do not experience reoccurrence (91.6%), and the study demonstrates an increasing recurrence rate with subsequent visits. The relatively shorter hospital stays (55.9% with 1-day stays) indicate efficient management, and this knowledge can aid in optimizing patient care. Conclusion: This study sheds light on the multifaceted nature of urolithiasis by examining various facets. Low recurrence rate of kidney stones offers positive prospects for effective initial management. The shorter hospital stays, suggest advancements in medical practices, enhancing patient convenience and healthcare resource optimization. Investigating the underlying causes behind the observed stone compositions yield insights into potential preventive strategies. Furthermore, extended studies examining the impact of lifestyle modifications and medical interventions on stone recurrence could contribute to refined treatment protocols. These findings can guide healthcare professionals in optimizing patient care, preventive strategies, and future research endeavors.

Nephrectomies in Saudi Arabia: A Comprehensive Analysis of Outcomes from a High-Volume Minimally Invasive Surgery Center.

Literature reporting on the outcomes of the different procedures of nephrectomies (open vs laparoscopic vs robotic) in Saudi Arabia remains limited. Compare surgical and oncological outcomes between open and minimally invasive nephrectomies. A retrospective cohort study. The present study included all adult patients who underwent nephrectomies between January 1, 2015 and January 31, 2023. We collected demographic, preoperative, intraoperative, and postoperative data on 408 adult cancer patients who underwent nephrectomies at our center between January 2015 and January 2023. Statistical differences were calculated between procedure types. Overall survival was calculated using Kaplan-Meier curves with log-rank tests. P<0.05 was considered statistically significant. Measures of operative success (intraoperative blood loss, intraoperative and postoperative complications, and hospital stay) and oncological outcomes (local recurrence, metastatic progression, and chemotherapy use) between different procedure and nephrectomy types for cancer patients. A total of 408 cancer patients underwent nephrectomies. In cancer patients, open nephrectomy was associated with significantly higher intraoperative blood loss (p<0.001), incidence of blood transfusions (p<0.001), hospital stay (p<0.001), intraoperative complications (p=0.027 and p=0.001, respectively), local recurrence (p<0.001), metastatic progression (p=0.001), and chemotherapy (p=0.001) than minimally invasive surgery, but survival differences across procedure types were not statistically significant (log-rank p-value = 0.054). Regarding nephrectomy type, significant differences were observed in tumor size (p < 0.001), initial procedure type (p<0.001), operation time (p<0.001), blood transfusion (p=0.033), length of hospital stay (p=0.004), intraoperative complications (p=0.020), postoperative complications (p=0.025), Clavien classification (p=0.003), mortality (p=0.022), metastatic progression (p<0.001), and chemotherapy use (p=0.001) between simple/total nephrectomy, radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy. Survival differences between the four nephrectomy types were statistically significant (log-rank p value = 0.001). Minimally invasive nephrectomies reduce inpatient morbidity while conferring equivalent oncological and surgical outcomes.

Atopy and allergic diseases among college students at a Saudi Public University.

Background: Despite its significant prevalence worldwide, atopy and allergic diseases continue to need more studies, with a need for published articles describing the prevalence of atopy and allergic diseases in Saudi society. The study aimed to determine the prevalence of atopic dermatitis diseases among college students at Imam Mohammad Ibn Saud Islamic University. Methods: The Cross-sectional study was conducted in Saudi Arabia among college students at Imam Mohammed bin Saud Islamic University in Riyadh based on self-report Asthma and Allergies questionnaires (ISSAC questionnaire, atopic dermatitis part). Results: Seven hundred ninety-seven (797) students from 11 colleges participated in the study. About half (47.6%) aged between 21 and 24, and 73.7% were females. More than one-third (34.8%) had atopic dermatitis during the last six months, while 30.7% of the participants reported having itchy rash in the past 12 months, and 33.8% were diagnosed with eczema in any life interval. Age is not one of the significant factors affecting the prevalence of atopic dermatitis. However, the prevalence of atopic dermatitis slightly increases with age (P = 0.062). Atopic dermatitis was significantly higher among female students (39.7%) than 21.0% among male students (P = 0.000). College level nor GPA had no significant impact on the prevalence of atopic dermatitis (P = 0.238 and 0.884, respectively). Conclusion: Imam Mohammad Ibn Saud Islamic University students have a high prevalence of atopic dermatitis, which may indicate a higher prevalence of allergens. Females and older participants were more liable to reported atopic dermatitis.

Exploring Renal Malignancies in Saudi Arabia: Insights from a Tertiary Care Center Study.

This retrospective study aims to describe the characteristics of renal cell carcinoma (RCC) in Saudi Arabia, in terms of epidemiology, clinical presentation, tumor subtype, Fuhrman grade, tumor size and stage, and overall survival. A total of 431 adult patients with a histopathological diagnosis of RCC between 2015 and 2023 were included in the analysis. Most patients (72.4%) had clear cell tumors, followed by chromophobe (15.1%) and papillary (12.5%) subtypes. In males, papillary RCC (85.2%) was more common compared to clear cell (59.8%) and chromophobe (67.7%) subtypes. Significant differences were observed in median body mass index (BMI) across tumor subtypes, and papillary tumor patients exhibited the highest incidence of hematuria (33.3%) compared to other subtypes. The Fuhrman grade also varied significantly among RCC types. Survival times were found to be lower for patients with papillary tumors. No significant difference was observed based on patients' nationality. This study can inform clinical decision-making on patient prognosis and management as well as public health efforts aimed at reducing the alarming rise of RCC incidence.

Preserving Renal Function without Compromising Oncological Outcomes: A Comparative Study of Partial and Total Nephrectomies in T3 Stage Renal Cell Carcinoma.

The utility of partial nephrectomy (PN) in locally advanced, stage T3 renal cell carcinoma (RCC) is controversial. This retrospective study aimed to review the oncological and functional outcomes of patients with T3a RCC who underwent PN. We included all patients with pT3a stage RCC undergoing either open, laparoscopic, or robotic PN at our center between January 2015 and 2023. A Wilcoxon rank sum test was utilized to compare nephrectomy types (radical nephrectomy [RN] vs PN). Survival analysis was conducted using Kaplan-Meier plots and a log-rank test. P-value < 0.05 indicated statistical significance. There were no significant differences in demographic characteristics between the RN and PN groups, except age (53.0 vs 6.5, respectively; P = 0.012) and body mass index (28.7 vs 34.3, respectively; P = 0.020). Furthermore, there were also no significant differences in the rates of local recurrence (P = 0.597), metastatic progression (P = 0.129), and chemotherapy use (P = 0.367) between nephrectomy types. Patient survival did not differ significantly based on the type of nephrectomy (log-rank P-value = 0.852). Together, our findings indicated that PN and RN yield near-equivalent oncological outcomes in terms of local recurrence, metastasis, and overall survival rates among pT3a RCC patients during a nearly 3-year follow-up period.

Mini gastric bypass for the management of gastrobronchial fistula: A case report.

INTRODUCTION: With the high rates of obesity worldwide, laparoscopic sleeve gastrectomy (LSG) has become a very popular procedure. Due to its simple technique, rare complications might be overseen. Gastric leaks and fistula are fairly uncommon complications. In comparison to other types of fistulas, gastrobronchial fistulas are rarer with serious complications. Definitive management is yet to be determined. We intend to explore the literature on the management approach of such patients. PRESENTATION OF CASE: A 46-year-old male, presented with on/off abdominal pain, productive cough, and vomiting. The patient had left sided rhonchi on examination. In addition to a history of laparoscopic sleeve gastrectomy (LSG) 4 years ago. Imaging confirmed the presence of a gastrobronchial fistula. Conservative and endoscopic treatment failed. Consecutively, surgery was indicated. A laparoscopic mini gastric bypass with refashioning of gastric fistula edges and closure with graham patch was done. CONCLUSION: Given the increasing number of such surgeries performed the recognition of acute and chronic complications, and their optimal management is of great importance. Although performing a Roux-en-Y fistulojejunostomy was recommended in the literature, conservative and endoscopic treatment should be considered before.