Rakan K. Alhabib

Patients with prior acute myocardial infarction (AMI) generally show low rates of achieving secondary prevention targets. Here we evaluated adherence to guideline-recommended secondary prevention strategies after AMI in Saudi Arabia. This ambispective multicenter cohort study included consecutive patients seen for follow-up visits 6–24 months after hospitalization for AMI. A standardized questionnaire was used to evaluate control of blood pressure (2), physical activity targets, smoking habits, guideline-directed medical therapy (GDMT), and referral to cardiac rehabilitation. Among 108 AMI patients (mean age 58.4 ± 10.9 years; 80.6% male; 76.9% Saudi nationals), 53.7% had uncontrolled blood pressure, ~40% uncontrolled glucose, and 67% above-target LDL-C levels. Most participants were overweight (40.7%) or obese (37%), and 28.7% achieved the physical activity targets. One-third of patients were not receiving all GDMT, 15.7% were current smokers, and 25% had been referred to cardiac rehabilitation. No patient met all guideline-recommended secondary prevention targets. This pilot study highlights gaps in secondary prevention among AMI survivors. Upcoming study phases will aim for national representation and help identify key clinical and demographic drivers to improve secondary prevention efforts across Saudi Arabia.

BACKGROUND: Ewing sarcoma (ES) is a rare malignancy primarily affecting children and adolescents, with cranial involvement representing less than 1% of cases. The sphenoid bone is an exceptionally uncommon site, presenting diagnostic and therapeutic challenges due to its proximity to neurovascular structures. OBSERVATIONS: We present the case of a 19-year-old male diagnosed at the age of 13 with ES in the sphenoid bone, extending into the anterior cranial fossa and orbit. The patient initially received chemotherapy and radiotherapy, resulting in partial regression; however, the patient experienced disease progression and underwent resection. Postoperative recovery was complicated by osteomyelitis, which was resolved with antibiotics and wound debridement. One year postoperatively, the patient was neurologically intact with stable imaging findings. A systematic review of the literature was conducted to identify similar cases of sphenoid ES and highlight their outcomes. LESSONS: ES of the sphenoid bone is a rare pathology that demands a high index of suspicion and a multidisciplinary treatment approach. Despite anatomical challenges, outcomes can be optimized through an aggressive multimodal therapy approach. Continued research is needed to establish standardized treatment protocols and improve long-term survival. https://thejns.org/doi/10.3171/CASE25427

Little is known about the obstacles medical students face when conducting research in Saudi Arabia. Moreover, the proportion of medical students in research has been unknown in our region compared to other regions. We sought to identify the barriers and motivators that influence undergraduate medical students in pursuing research. This was a cross-sectional study design, utilizing an online survey distributed through social media platforms from the 17^th of December 2021 to the 8^th of April 2022. The survey was distributed to four universities in Saudi Arabia. Participants’ characteristics, details regarding involvement in research, and attitude towards research were collected. Frequency measures were used to characterize the demographics and chi-squared tests to determine associations. A total of 435 students were included in the final analysis. The highest proportion of students that responded were second year, followed by first year medical students. Less than half (47.6%) of medical students were involved in research. A significant correlation was revealed between the involvement in research and higher participants’ Grade Point Average (GPA). The top three incentives for pursuing undergraduate research were “admission into residency programs” (44.8%), “interest in research” (28.7%), and “financial return” (10.8%). However, the top three limitations were “lack of time” (29.2%), “lack of mentoring” (16.8%), and “lack of interest in research” (14.7%). System-related barriers and motivators were the main reasons behind the involvement of medical students in research. Our study is a call for action to raise awareness among medical students about the importance of research and to provide solutions to overcome these barriers.