Predictive Factors for Critical Weight Loss in Saudi Head and Neck Cancer Patients Undergoing (Chemo)Radiotherapy

Weight loss is a significant health problem among patients with head and neck cancer (HNC) that is attributable primarily to the tumor or tumor therapy. Critical weight loss (CWL) is defined as the unintentional loss of ≥5% of weight. Therefore, this study's goal was to investigate and determine the possible factors influencing CWL among patients with HNC who have received radiotherapy or concurrent chemoradiotherapy (CCRT). We conducted a retrospective analysis of 175 patients who received radiotherapy or CCRT as either their primary, adjuvant, or combined treatment at the Oncology Center in King Abdullah Medical City. All patients were ≥18 years of age and diagnosed with HNC with no metastasis. The study results showed that 107 patients (61%) had CWL, while 68 (39%) did not. The following factors were significantly predictive of CWL with a multivariate regression analysis: pretreatment BMI (AOR = 1.1, 95% CI = 1.02-1.17), oral cavity cancer (AOR = 10.36, 95% CI = 1.13-94.55), and male sex (AOR = 3.15, 95% CI = 1.39-7.11). In conclusion, weight loss is highly prevalent among HNC patients during treatment. Accordingly, pretreatment BMI, cancer in the oral cavity, and being male can be considered predictive factors for CWL.

Epidemiological Profile of Urinary and Intestinal Schistosomiasis in the Kingdom of Saudi Arabia: A Seven-Year Retrospective Study

BACKGROUND

Despite the marked decline of schistosomiasis in Saudi Arabia in recent years, it is still reported in several regions. This study investigates the epidemiology of schistosomiasis in Saudi Arabia over seven years (2014-2020).

METHODOLOGY

A retrospective study was retrieved from the annual reports of the Ministry of Health. A Geographic Information System GIS, Chi-square, and logistic regression were used to analyze the data.

RESULTS

Out of the 4,371,481 tested, 680 cases were positive for schistosomiasis, with a cumulative incidence rate of 2.155/100,000 population. This number showed significant variation over the study period (p value < 0.001). The highest number of cases detected in 2015 was almost 2-fold (OR = 1.93; 95%CI: 1.36-2.74) higher than in 2020. Both clinical forms (urinary and intestinal schistosomiasis) exist in Saudi Arabia (79.6% and 20.4% of all schistosomiasis cases, respectively). Schistosomiasis was reported in seven out of thirteen regions. Among them, Mecca has a relatively high number of cases (OR = 5.57; 95%CI: 2.49-12.47). Conversely, the Eastern Province has a low number of cases (OR = 0.09; 95%CI: 0.02-0.39) when compared to the Najran region (p value > 0.001). Regarding the distribution of schistosomiasis cases by gender and nationality, we noticed that most of the positive cases were found among males (70.6%) and expatriates (83.6%).

CONCLUSIONS

The persistence of schistosomiasis and the disparity in the demographic factors underscores the imperative for intensified and integrative One Health interventions to combat this disease in Saudi Arabia.

Vitamin B12 status among asymptomatic young adult females and its association with some anthropometric and biochemical parameters: A cross-sectional study from Makkah (cobalamin deficiency in young adult females)

This study was designed to measure the prevalence of vitamin B12 deficiency among young adult females in Makkah City and study its correlation with some anthropometric and biochemical indicators. A cross-sectional study and a detailed questionnaire were used to collect information from 402 young women aged 19 to 22 years, who were university students. Moreover, dietary assessments using a validated food frequency questionnaire and anthropometric measurements were performed. The mean values of serum vitamin B12, serum folate, hemoglobin, and body mass index (BMI) were 343.29 ± 148.16 pg/mL, 12.72 ± 2.62 ng/mL, 12.69 ± 1.41 g/dL, and 22.64 ± 4.24 kg/m2, respectively. About three-quarters of the study sample had normal vitamin B12 levels, while the rest had vitamin B12 deficiency. Meanwhile, a significant negative association (r = -0.201, P = .048) was found between abdominal fat and serum vitamin B12 levels. This study concluded that the young adult females' population from Makkah City is among the risk groups for vitamin B12 deficiency, which is highly correlated with inappropriate values of weight, body fat, and some blood indices. Appropriate dietary interventions and awareness are needed for this population.

Factors associated with the prevalence of malnutrition among adult hemodialytic patients: A two-center study in the Jeddah region, Saudi Arabia

Chronic kidney disease, one of the most common diseases in the world, is characterized by irreversible impairment of the kidney's metabolic, excretory, and endocrine functions. During end-stage renal disease, patients require renal replacement therapy, such as hemodialysis (HD). Protein-energy wasting is a common health problem among HD patients. This study aims to assess the nutritional status of HD patients at two HD centers in Jeddah, Saudi Arabia, and to determine its associated factors. A cross-sectional study was conducted at two different dialysis centers in Jeddah, Saudi Arabia; 211 female and male HD patients. Malnutrition was recognized using the modified-subjective global assessment (M-SGA) comprising two parts: medical history and physical examination. Sociodemographic and health status for all patients were also determined. Patients were classified based on their M-SGA score into two groups: normal and malnourished. Overall, 54.5% of the participants showed malnutrition. Unemployment, low muscle strength and mass, high level of medication use, and high dialysis vintage were positively (P < .05) associated with malnutrition. In conclusion, the M-SGA score indicates a high prevalence of malnutrition among HD patients. These results show the importance of regular assessment and follow-ups for HD patients ensuring better health and nutritional status.

Consumption of Food Components of the Mediterranean Diet Decreases the Risk of Breast Cancer in the Makkah Region, Saudi Arabia: A Case-Control Study

Background

Breast cancer is one of the leading causes of death worldwide, it affects both men and women. In Saudi Arabia, breast cancer has been the most prevalent type of cancer in women, for the past few years. Dietary habits and cultural beliefs vary according to region, and further studies are required to demonstrate the relationship between these dietary habits and cultural beliefs and the risk of developing breast cancer. This study is aimed to discover the relationship between preventive dietary factors of the Mediterranean diet and rates of breast cancer among postmenopausal women in the Makkah region of Saudi Arabia.

Methods

A case-control study was conducted in King Abdulla Medical City Hospital, Makkah, Saudi Arabia and included 432 Saudi female participants: 218 in the control group and 214 breast cancer patients. All participants were postmenopausal, around the same age, and all were ethnically Arab Saudis. Data were obtained using a self-administered validated questionnaire.

Results

Study results showed that a diet that includes 1-2 servings of legumes weekly, 1-5 servings of fish weekly, 1-5 servings of dairy products daily, 3-5 servings of fruits and vegetables daily, and more than one cup of black tea and coffee per day significantly (p < 0.05) reduces the risk of breast cancer.

Conclusion

This study demonstrates that consuming a Mediterranean diet, which includes legumes, fish, fruits and vegetables, black tea, coffee, and low intake of dairy products, works as a preventive factor against breast cancer in postmenopausal females from the Makkah region.

Therapeutic Interventions of Cardamom in Cancer and Other Human Diseases

Cardamom, a dietary phytoproduct, is the most popular spice in the world, and its beneficial health properties are gaining more and more attention. Small cardamom [Elettaria cardamomum (L.) Maton. (Family: Zingiberaceae) ] has been used for traditional therapeutic applications, including the management of asthma, teeth and gum infections, cataracts, nausea, diarrhea and heart, digestive and kidney disorders. Numerous studies have demonstrated the biological activity of cardamom and its polyphenols, including antioxidant, anti-tumor, anti-inflammatory, and metabolic control.1,8-cineole, and its esters, Limonene, α-terpinyl acetates are the most abundant bioactive constituents in cardamom. They are known to be multifunctional compounds that can be efficient in the prevention or treatment of various types of cancers, cardiovascular diseases, chronic inflammatory conditions, digestive disorders, as well as infectious bacterial and fungal diseases. In this review, we summarized the up-to-date research and underlying molecular mechanisms of cardamom and its active components.

The Combined Effect of Vitamin D Deficiency and Hyperparathyroidism on Postural Stability among Healthy Adult Males

BACKGROUND AND OBJECTIVE

Vitamin D has been shown to improve muscle strength and bone health; consequently, be important for maintaining good balance. Possible risk factors related to postural stability in young adults still underdetermined. However, this study was designed to determine the effect of vitamin D status on postural stability.

MATERIALS AND METHODS

A cross-sectional study of 704 healthy young adult males were enrolled in this study. Dynamic balance was measured as overall stability index (OSI) using biodex balance system (BBS). Vitamin D deficiency was defined when its serum level <20 ng mL-1. The effect size was measured for vitamin D, parathyroid hormone (PTH) and the interaction between vitamin D and PTH (VTD*PTH) with respect to the OSI values. Correlations between variables were examined according to the beta standardised coefficient (β) and the effect size was measured using the partial eta-squared (η2) test.

RESULTS

About 95, 3.8 and 1.2% of individuals had deficient, insufficient and normal vitamin D levels, respectively. Vitamin D had no significant effect to OSI, but PTH exhibited a significant correlation with OSI (adjusted β = 0.095, p = 0.038). A significant effect size was observed between OSI and PTH (adjusted partial η2 = 0.012, p = 0.038) and between OSI and VTD*PTH (adjusted partial η2 = 0.034, p<0.001).

CONCLUSION

A significant interaction of vitamin D deficiency and high PTH on postural stability is detected among healthy adult males.

Some Socioeconomic Factors and Lifestyle Habits Influencing the Prevalence of Obesity among Adolescent Male Students in the Hail Region of Saudi Arabia

A cross-sectional study was conducted to investigate the effect of some socioeconomic factors and lifestyle habits on the prevalence of obesity among adolescent male students in the Hail region, Saudi Arabia. A questionnaire was filled by 1495 male adolescents distributed among 12 schools in the Hail region. Body weight and height were taken, and the Z-score of students was measured using Anthroplus software with a cutoff 1–2 and +2 standard deviations to determine overweight and obesity, respectively. The study revealed that 21.3% of students were overweight and 27% were obese, respectively. There was a negative association between family size of >8 and obesity (OR: 0.68, CI: 0.48–0.92, p = 0.05). Family income of <5000 SR was negatively associated with obesity (OR: 0.59, CI: 0.36–0.97, p = 0.03). Whether a subject’s mother worked (odds ratio (OR): 1.43, confidence interval CI: 1.03–1.99, p = 0.03) as well as the subject’s mother’s education—whether she can read and write, has a middle school degree, or has done postsecondary studies—were positively associated with obesity. Exercise, regardless of the duration, was negatively associated with obesity. In addition, sleeping <6 h/day had a positive association with obesity. Conclusion: a >8 family size and a low family income were negatively associated with obesity, while having an educated and working mother was positively associated with obesity.

Factors Associated with Not Breastfeeding and Delaying the Early Initiation of Breastfeeding in Mecca Region, Saudi Arabia

The objective of the study was to find the determinants related to not breastfeeding (BF) and others related to the delay in the early initiation of BF in the Mecca region, Saudi Arabia. A cross-sectional study in the Maternity and Children Hospital and primary healthcare centers was performed. A questionnaire was filled by dietitians to 814 asymptomatic Saudi mothers. Determinants related to not BF and the delay in the early initiation of BF were determined by binary logistic regression, and the odds ratio (OR) and 95% confidence interval (CI) were determined. Significant factors associated with not BF were not rooming-in infants in the mother’s room (OR: 2.37; 95% CI: 1.66–3.41) and using a pacifier (OR: 1.62; 95% CI: 1.13–2.33). The most significant determinant of the early initiation of BF was the initiation of bottle feeding (OR: 18.16; 95% CI: 10.51–31.4), followed by not rooming-in infants in the mother’s room (OR: 2.2; 95% CI: 1.52–3.18), initiation of partial feeding (OR: 1.89; 95% CI: 1.3–2.74), uninformed mothers regarding the importance of BF (OR: 1.56; 95% CI: 1.04–2.35), and cesarean sections (OR:1.42; 95% CI: 1.02–1.98). Risk factors affecting BF and the early initiation of BF in Mecca City should be highlighted in national campaigns to increase mothers’ awareness and promote BF practice.

Healthy dietary patterns decrease the risk of colorectal cancer in the Mecca Region, Saudi Arabia: a case-control study

Background

Colorectal cancer (CRC) is the first most common cancer in males and the third most common cancer in females in Saudi Arabia. Dietary habits are strongly associated with the inhibition or proliferation of malignancy. Therefore, this study is aiming to investigate the risks and protective benefits of dietary factors affecting CRC in the Mecca region of Saudi Arabia.

Methods

A case-control study was conducted from June 2014 to March 2015. One hundred thirty-seven patients with colon and/or rectal cancer were recruited in the case group, while 164 healthy participants were recruited in the control group. A questionnaire was completed with the help of trained dietitians to study the effects of several dietary patterns on the risk of CRC.

Results

Dairy product intake of 1–5 servings/day, legume intake of 3–5 servings/week, leafy vegetables intake of 1–5 servings/week, olive oil intake of 1–5 servings/week, black tea intake of three or more cups/day, and coffee intake of one or more cups/day was found to decrease the risk of CRC in participants.

Conclusion

This study highlights the importance of changing dietary habits to decrease CRC incidence in the Mecca region.

Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants

INTRODUCTION

Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated.

OBJECTIVE

To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia.

METHODS

A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants (< 1000 g birth weight). Data were collected at birth and at discharged. Infants' weights were recorded and growth velocity was calculated. Some biochemical tests and mineral levels were measured.

RESULTS

Body mass index values of VLBW and ELBW groups were lower (p < 0.05) than LBW group. The growth velocity of infants in all groups ranged between 8.7 to 10.2 g/kg/d with no differences (p > 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05) than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05) in ELBW group.

CONCLUSION

Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups.

Enhancement of alpha- and beta-galactosidase activity in Lactobacillus reuteri by different metal ions

The hydrolysis of oligosaccharides and lactose is of great importance to the food industry. Normally, oligosaccharides like raffinose, stachyose, and verbascose which are rich in different plants like soy bean are considered indigestible by the human gut. Moreover, many humans suffer from lactose intolerance due to the absence of effective enzyme that can digest lactose. alpha-Galactosidase can digest oligosaccharides like raffinose, while beta-galactosidases can hydrolyze lactose. Therefore, selection of microorganisms safe for human use and capable of producing high levels of enzymes becomes an attractive task. The objective of this study was to investigate the enhancement of alpha- and beta-galactosidase activity in Lactobacillus reuteri by different metal ions. Ten millimolar of Na(+), K(+), Fe(2+), and Mg(2+) and 1 mM of Mn(2+) were added separately to the growth culture of six strains of L. reuteri (CF2-7F, DSM20016, MF14-C, MM2-3, MM7, and SD2112). Results showed that L. reuteri CF2-7F had the highest alpha- and beta-galactosidase activity when grown in the medium with added Mn(2+) ions (22.7 and 19.3 Gal U/ml, respectively). 0.0274% of Mn(2+) ions lead to 27, 18% enhancement of alpha- and beta-galactosidase activity over the control group, and therefore, it could be added to the growth culture of CF2-7F to produce enhanced levels of alpha- and beta-galactosidase activity. The addition of Fe(2+) led to a significant (P < 0.01) decrease in the activity of both enzymes for most strains. This study shows that modified culture medium with that 0.0274% Mn(2+) can be used to promote the production for alpha- and beta-galactosidase in L. reuteri CF2-7F, which may lead to enhancement of alpha- and beta-galactosidase activity and have a good potential to be used in the food industry.

Impact of feeding saltbush twigs on feed intake, weight gain, and some mineral levels of fattening awassi lambs

This experiment was conducted to investigate the effect of the inclusion of saltbush (Atriplex sp.) on the productive performance and blood mineral profile of fattening lambs. Eighteen Awassi lambs, 70 +/- 3 days of age and 23 +/- 1.8 kg body weights, were randomly selected and divided into three equal groups. Lambs in group one (control) were offered 0.2 kg/day shredded straw of barley (tibin) as the sole source of roughage, while lambs in treatment groups 2 and 3 were provided either 0.2 kg/day Atriplex nummularia or Atriplex halimus as their sole roughage content for 10 weeks. All lambs were also provided 1.1 kg/day of concentrate ration. Although lambs fed A. halimus had significantly (P < 0.05) lower dry matter intake than the control group, the daily weight gain of the two groups of lambs were not significantly different (P > 0.05). Lambs fed either A. nummularia or A. halimus had significantly lower (P < 0.05) calcium and copper levels but significantly higher (P < 0.05) cobalt levels in their blood serum than the control group. Zinc blood serum level was not affected (P > 0.05) by the treatment diets. These results suggested that A. nummularia and A. halimus can substitute for barley straw in the ration of fattening Awassi lambs without compromising lambs weight gain; however, special attention should be given to the mineral status in lambs if saltbush is a major feed component for prolonged periods of time.